bluuebunny/crossref_metadata_2025 huggingface dataset:
A method for estimating embryo doses resulting from computed tomographic examinations
Authors: Panzer W. , Zankl M.
Published: July 2009

In 50% of all cases of pregnant patients undergoing computed tomographic (CT) examinations of the pelvic region, an embryo dose value of 20mGy will be exceeded. This was revealed in a field study on dose values and related data conducted during 1986 and 1987 in the Federal Republic of Germany, which covered 122 facilities, about one-fifth of all the installations operated at that time in the country (Panzer et al, 1989). In the Federal Republic of Germany, an embryo dose value of 20 mGy is considered as an investigation level (Leppin, 1979) in order to ensure that significantly higher values, which might indicate an interruption of pregnancy, do not fail to be noticed. Thus there exists an occasional need to estimate individual embryo doses, and in some cases to go further and make more detailed determination of the dose. Values reported in the literature are of little help in this context because it is unlikely that they were obtained under similar exposure conditions as the examination under question. In CT examinations there is a large variability in length and site of the scanned body region, the X-ray output and special techniques such as repeats of interesting sections with higher resolution or contrast media. Apart from anatomical differences between patients, the variety of the exposure conditions makes it impossible to determine and report embryo dose values that might hold true for all possible situations. Therefore, for the determination of embryo dose it remains necessary to simulate the examination under question and to study the impact of inevitable uncertainties by irradiating a patient-like phantom and measuring doses at the assumed position of the uterus. However, because of the time needed and a lack of suitable equipment, this procedure is restricted to very few institutes.
Ten-year results of a post-operative prospective trial: NSD and LQ correspondence
Authors: Bates Thelma D. , Scott O. C. A.
Published: July 2009

Our reply to Dr Ellis is essentially the same as our reply to Dr Tomlinson (Bates & Scott, 1989). The NSD concept correctly predicts the direction of the differences in the late reactions observed, but not the extent of these differences.
Book reviews
Authors: Butler P.
Published: July 2009

Head and neck radiology implies the radiology of those regions above the shoulders which are not the prime concern of the neurosurgeon and are thus deemed within the remit of the general radiologist, rather than the neuroradiologist. There are inevitably “grey areas” and this volume, despite being in the Modern Neuroradiology series, will be of interest to all radiologists working with computed tomography (CT).
Book reviews
Authors: Gleeson J. A.
Published: July 2009

This textbook, written by three authors with unrivalled experience in the clinical and radiological manifestations of AIDS, is an excellent reference book for those seeing the occasional case and those with a larger clinical practice. It is not an easy read, it is packed full of fact and extensively referenced, including recent (1987) publications from both America and Europe.
Book reviews
Authors: Sherwood Thomas
Published: July 2009

The publishers are inserting an erratum slip in this work; the cover and title page should have read “Edited by”.

The introduction says that, this book “is not intended to be all embracing, but rather an overview of the uses and problems associated with contrast media”. There are 19 chapters by 26 authors, making up a collection of interesting, varied essays on parenteral contrast media. Barium and other enteral agents are not considered.
Book reviews
Authors: Bomford C. K.
Published: July 2009

It is not possible to do justice to a review of the proceedings of a meeting of delegates from 34 countries covering 48 papers and 37 posters, but most readers will find something to interest them in these two volumes. The meeting was the IAEA Symposium on Dosimetry in Radiotherapy in 1987 and covers the whole gamut from the establishment of international standards of dose to the output of the treatment machine, from the dose profiles in the TBI patient to the dose per pulse in the very high-energy accelerator. The meeting was divided into eight sessions.
Ultrasound-guided, histological, fine-needle biopsy from suspect parathyroid tumours: success-rate and reliability of histological diagnosis
Authors: Karstrup S. , Glenthøj A. , Hainau B. , Hegedüs L. , Torp-Pedersen S. , Holm H. H.
Published: July 2009

Ultrasound-guided, fine-needle tissue biopsies were performed in 60 suspected parathyroid tumours in 55 consecutive patients with biochemically proven hyperparathyroidism. The specimens were randomly arranged and re-read “blind” by two pathologists. The interobserver agreement, corrected for chance agreement, was 0.92 (= kappa coefficient). Twenty-three of the 60 suspect parathyroid tumours were verified histologically following surgery. No diagnostic errors were seen but the percentage of insufficient biopsies from suspect parathyroid tumours or surgically verified parathyroid tumours was high (45 and 47%, respectively). We conclude that a reliable tissue diagnosis can be made by ultrasound-guided, fine-needle tissue biopsy. However, when the material is insufficient for histological diagnosis, we recommend the additional use of ultrasound-guided, fine-needle aspiration for cytology or parathyroid hormone determination.
A quality assessment of the effects of a hydrogenous filter on a p(66)Be(40) neutron beam
Authors: Slabbert J. P. , Binns P. J. , Jones H. L. , Hough J. H.
Published: July 2009

Recent measurements in a p(62)Be(36) neutron therapy beam have shown that the quality of the in-phantom beam changes with depth. This variation can be ascribed to the presence of a relatively large low-energy neutron component emanating from the neutron source. As part of the pre-clinical calibration programme at a newly commissioned neutron therapy facility, radiobiological and microdosimetric observations were made to determine the magnitude of this effect on a p(66)Be(40) beam and to evaluate the hardening effect of a hydrogenous filter. The reported data identify a correlation between the two assays and quantify a linear relationship between y* and filter thicknesses ≤ 6 cm. Using the data obtained in the study, a filter thickness was selected to comply with clinical requirements. By employing lineal energy spectra, it is demonstrated that subtle changes in beam quality may be quantified in a reproducible manner without resorting to time-consuming radiobiological studies.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

The authors have aimed this book at those who are involved in the practical aspects of NMR within the clinical environment. The contributors are a well balanced team drawn from university departments of medical physics, industry and radiology.
Book reviews
Authors: Buckler J. M. H.
Published: July 2009

As indicated by the title, the primary purpose of this book is to provide an improved method of assessing skeletal maturity based on radiographs of the hand and wrist. Additionally, the first two chapters describe the histological changes in bone maturation and a discussion of the many approaches to its assessment throughout this century and their relative values; there is an extensive bibliography. A rather cursory consideration of the need for skeletal age assessment is included but is of insufficient depth to be of value to the clinician.

The data were based on serial radiographs of the left wrist and hand of 355 boys and 322 girls born between 1928 and 1974, enrolled in the Fels Longitudinal Study of Growth and Development in Southwestern Ohio, USA. About 7000 radiographs were taken for each sex and the number for each child ranged from one to 38. As with scoring methods, each of several bones of the wrist and hand are evaluated individually and the skeletal age based on the total evaluation.
Book reviews
Authors: Barrington N. A.
Published: July 2009

The introduction of 99Tcm-labelled diphosphonates, together with the increasing sophistication of the gamma camera has revolutionized the diagnosis of bone disease over the past decade. Owing to the rapid development of this imaging technique, the requests for routine bone scans still continue to increase in most nuclear medicine departments and form the greatest part of the workload.

This atlas provides a comprehensive collection of 99Tcm-labelled diphosphonate bone scans drawn from the authors' wealth of experience in two busy hospitals, one either side of the Atlantic. Other imaging techniques are only mentioned when relevant to the cases presented.
Book reviews
Authors: Olliff Julie
Published: July 2009

This book succeeds very well in its aims to provide up-to-date technical information and to demonstrate the clinical applications of abdominal MRI. The illustrations are of high standard although the same illustration may appear more than once to explain a different point. They are accompanied by informative legends that are easy to understand and when necessary, diagrams and simple graphs are used.
Book reviews
Authors: Hunter G. J.
Published: July 2009

This is a pocket-sized book of 151 pages written in the style of an atlas of chest radiographs with clinical correlation. There are 10 chapters covering radiographic technique, normal anatomy, pulmonary shadows, chronic obstructive lung disease, pleura chest wall and diaphragm, the hila, the mediastinum, the heart and special techniques.

The stated aim of this book is to provide a concise atlas with clinical correlation suitable for the senior medical student and junior doctor. In addition the preface suggests that MRCP and FRCR candidates would find the book helpful.

The quality of the illustrations, both the radiographs and line drawings, is of a high standard. The points made in the text and legends are all clearly identifiable on the relevant plate, and free use of arrows helps the novice to be sure of the lesion being discussed. The text is clearly and well written. All the more common pulmonary and mediastinal pathologies are covered, albeit in a superficial fashion.
Pelvic actinomycosis: beware the intrauterine contraceptive device
Authors: Williams C. E. , Lamb G. H. R. , Lewis-Jones H. G.
Published: July 2009

Actinomycosis of the abdomen and pelvis is known as “the great imitator” because of its varied clinical presentations. This, together with its rarity, makes its diagnosis difficult. We present two cases of pelvic actinomycosis in females with intrauterine contraceptive devices (IUCD) in situ, and stress the need to consider this diagnosis when pelvic neoplasia or inflammatory disease are suspected.

A 46-year-old female was admitted with a 4 day history of colicky lower abdominal pain, diarrhoea, anorexia, “anal lumps” that were rapidly enlarging and recent weight loss. There was no noteworthy past medical history. An IUCD (Saf- T) had been in place for 15 years. Abdominal examination revealed a firm, fixed, tender lower abdominal mass that was palpable on vaginal and rectal examinations. The cervix appeared normal. A provisional diagnosis of pelvic malignancy was made.

Ultrasound examination was performed and the IUCD was noted within the uterus (Fig. 1). The adnexae and outlines of the uterus were obscured and hypoechoic areas around the uterus were thought to represent fixed bowel loops. A discrete mass could not be demonstrated. Examination under anaesthesia revealed a fixed pelvis. Sigmoidoscopy was performed, but the scope could not be passed beyond 10cm. The rectal mucosa appeared normal. The IUCD was removed and dilatation and curettage performed. A computed tomographic (CT) scan (Fig. 2) showed generalized soft-tissue thickening throughout most of the pelvis with obliteration of the tissue planes around the rectum, uterus and posterior aspect of the bladder.
Book reviews
Authors: Bingham John B.
Published: July 2009

A frequent question that arises during radiological tutorials for membership candidates concerns the choice of a suitable text for the MRCP exam. Until now there has been a limited selection, but this has been extended by the publication of this paperback book. The preface modestly indicates that it is appropriate for membership candidates, but the authors themselves suggest that the book is suitable for preparation for MRCP and FRCS, as well as for older clinicians wishing to update their radiological knowledge. I am sure that it is also a suitable textbook for students preparing for finals and even for first-year FRCR candidates.
Book reviews
Authors: Selby P.
Published: July 2009

There are now a number of short books on cancer chemotherapy and each sets out with a slightly different purpose. They all have a difficult task in trying to encompass this large, complex and rapidly changing subject in a short space and therefore, as expected, all have their strengths and weaknesses. The third edition of Priestman's book Cancer Chemotherapy: An Introduction is a welcome addition to this group of books. It sets out with a very clearly stated purpose: to provide an introductory text rather than a manual. It achieves this purpose very well indeed.
Book reviews
Authors: Sherriff S. B.
Published: July 2009

The last decade has seen an upsurge of interest in Doppler ultrasound. It is now in widespread clinical use with many new areas of application being demonstrated. There has, for some considerable time, been a need for a comprehensive text on the physical principles underlying the multiplicity of Doppler techniques. Numerous texts are available on the physics of ultrasound and on the clinical applications of Doppler ultrasound, but in both cases the physics of Doppler ultrasound usually receives only cursory coverage.

The stated objective of the book is to provide an up-to-date introduction to the technical aspects of Doppler ultrasound and the authors have successfully achieved this goal. The text has been divided into “essential” and “advanced” reading, the latter being marked by vertical lines in the left-hand margin.
The case of the surplus clues
Authors: Puri Sunil , Sharma Sanjiv , Baijal Vishwa Nath
Published: July 2009

A 16-year-old girl was admitted with a history of backache, fever and 4 month history of generalized weakness. Examination revealed pallor, sternal tendernessand hepatomegaly. Urine examination and the blood biochemistry were essentially normal. The haematological examination showed: haemoglobin, 5.5 gm%; packed cell volume, 16%; reticulocyte count, 2%; platelet count, 4000 cm3; total leucocytic count, 9800 cm3; and differential leucocytic count: 40% segmental neutrophils, 30% bands, 16% lymphocytes, 10% monocytes and 4% lymphoblasts with deeply basophilic cytoplasm containing prominent vacuoles. Subsequently, radiographs of the chest (Fig. 1), dorsolumbar spine (Fig. 2), skull (Fig. 3) and pelvis (Fig. 4) were obtained.
Book reviews
Authors: Williams C. E.
Published: July 2009

This book is intended to be used as an aid for the interpretation of radiographs and other diagnostic images and is aimed directly at medical students.

It starts by introducing the reader to the basic concepts of X-ray production and then moves on the subject of radiographic interpretation.
Book reviews
Authors: Steiner G. M.
Published: July 2009

Although this book is part 6 of a series entitled “Self- Assessment in Radiology and Imaging” there is no indication who this “self” is meant to be and accordingly no standard by which to judge it. One hundred and fifty-one assorted paediatric imaging problems are depicted with accompanying potted history and questions on one page; the films are discussed and answers given on the reverse page.
Sedation for CT examinations in children
Authors: Cremin B. J.
Published: July 2009

A few years ago I made extensive enquiries as to the most effective sedation for computed tomographic (CT) examinations in children under 4 years of age. The answers were diverse. In the USA intra-muscular Nembutal was commonly used, in Europe various cardiac cocktails were popular, whilst others preferred a light general anaesthetic. On a trip to Australia last year, I noted that at least three major paediatric centres used a general anaesthetic. This delayed the procedures and reduced the numbers of possible CT examinations to a maximum of half-a-dozen a day.
Recent advances and future projections in clinical radionuclide imaging
Authors: Peters A. M.
Published: July 2009

Since the almost simultaneous development of technetium-99m and invention of the gamma camera in the 1960s, nuclear medicine has made great strides. It is largely a physiological imaging modality, so a thorough grounding in physiology is essential for aspiring nuclear physicians. In contrast, computed tomography (CT), ultrasound, magnetic resonance imaging (MRI) and special radiographic techniques, like angiography, currently provide largely anatomical information.

Advances in nuclear medicine can be subdivided into seven areas: new synthetic radiopharmaceuticals, new radiolabelled biological agents, cell labelling, new singlephoton- emitting radionuclides, new approaches using radiopharmaceuticals that are already well established, positron emission tomography (PET), and physics and instrumentation.

The important developments in radiopharmaceuticals have had the common aim of replacing well-established agents labelled with radionuclides other than technetium-99m with agents that can be labelled with technetium-99m and which have similar pharmacokinetics. They include technetium-99m hexamethylpropyleneamine oxime (HMPAO), which will replace iodine-123 labelled amphetamines (themselves relatively new) for imaging brain perfusion, and also partly replace the indium-111 complexes for imaging inflammation. Others are mercaptoacetyltriglycine (MAG-3) which should replace radioiodinated hippuran for renography, the isonitriles which may replace thallium-201 for myocardial perfusion imaging, and the “pseudo-gases”, such as technegas, which may replace krypton-81m for routine ventilation imaging. The need for these technetium-99m radiopharmaceuticals is due not so much to their superior pharmacokinetics (where, in fact, they are generally somewhat inferior to their non-technetium counterparts) but to considerations of convenience, camera design and image resolution, dosimetry, and ultimately cost; although, at present, they are expensive.
Book reviews
Authors: Adams J. E.
Published: July 2009

This concise and comprehensive text covers important aspects of the normal anatomy of the pituitary gland and parasellar regions and the diagnosis of pituitary tumours by highresolution computed tomography (CT). The author is Dutch and I note that the text has also been published as a thesis in Utrecht.

The book opens with a review of the limitations of conventional radiography in the evaluation of pituitary adenomas. This is followed by a detailed derscription of highresolution CT scanning of the pituitary gland and parasellar region, including transverse axial and direct coronal scan planes with reformations, and the use of direct midline sagittal plane scanning. A chapter is devoted to the normal anatomy of the region and this is illustrated by excellent cadaver sections which are paired with annotated line diagrams and corresponding CT scans. There is a useful section on the normal size and shape of the pituitary gland and normal variations. The section on pituitary adenomas is based on the findings in 126 patients studied by the author and a review of the published literature. The abnormal features of microadenomas, macroadenomas and parasellar tumours and other conditions are described in detail.
Just another case of varicose veins?
Authors: Travis R. C. , Rowan D. M. , Miller J.
Published: July 2009

A 49-year-old Maori woman was referred to the Surgical Outpatients Department because of increasing discomfort and disability in the left leg. She had varicose vein surgery as a child, and the veins later recurred. Views from her left lower limb venogram and bilateral aorto-femoral angiogram are shown.
Book reviews
Authors: Byrne J. V.
Published: July 2009

This book outlines the imaging of the central nervous system in a single small volume. The work is structured around different imaging modalities with sections on plain radiography, computed tomography (CT) and magnetic resonance imaging (MRI) scanning, angiography, myelography and nuclear medicine. Each section includes notes on technique and brief descriptions of normal anatomy and common pathologies.
Book reviews
Authors: Guy Jean
Published: July 2009

This delightful little book is a facsimile reproduction of one published in June, 1896. It consists of extensive quotations from American electrical journals of the day linked as a continuous text under the chapter headings: “The intensity coil and the crookes tube”, “Experiments with X-rays” and “The fluorscope and other apparatus”. Radiology managers who are suffering from cuts in their departmental budgets will be pleased to know that with the aid of detailed instructions given in Chapter One they will be able to construct an induction coil from inexpensive materials.
Ultrasonic morphology of the uterus and ovaries after treatment of invasive mole and gestational choriocarcinoma
Authors: Long M. G. , Boultbee J. E. , Begent R. H. J. , Bagshawe K. D.
Published: July 2009

Ultrasound imaging of the uterus and ovaries was performed on 41 patients after completion of apparently successful cytotoxic chemotherapy for invasive mole and choriocarcinoma. Uterine volume was calculated and the echopattern of the uterus and ovaries assessed. Forty-nine per cent of subjects had an abnormal uterine appearance and 20% had ovarian theca-lutein cysts. Two patients relapsed on follow-up but no predictive ultrasonic features could be established on uterine or ovarian morphology after chemotherapy.
The influence of a seventy-two hour gap on the acute response of mouse skin and oesophagus
Authors: Marino C. , Hirn-Stadler B. , Rojas A.
Published: July 2009

The sparing effect of a 72 h gap, inserted after the third, sixth or ninth fraction of a 12 fraction X-ray schedule, was investigated in two early responding normal tissues: mouse skin and oesophagus. Acute skin reactions and body weight loss were used as assays to quantify changes in the radiation tolerance of these tissues. In skin, no evidence of compensatory proliferation was seen if a gap was inserted, whatever its position in the schedule. In oesophagus, a small but significant increase in radioresistance was observed if the gap was positioned ¼ of the way through treatment compared with the schedule delivered without an interruption (12F/12 days). Although an increase in normal tissue tolerance is not observed by increasing the overall time from 12 to 15 days, provided tumour clonogen proliferation does not occur during the weekend split, the insertion of a gap makes continuous accelerated clinical regimes, currently given without an interruption at weekends, easier to introduce into wider clinical practice.
High surface temperature of endovaginal probes
Authors: Davison M. , Clark P.
Published: July 2009

We have been concerned to hear reports of high surface temperatures on certain diagnostic ultrasound probes (Duck et al, 1989). It was not clear whether these temperatures resulted from faulty equipment or faulty design. Because of the sensitivity of vaginal tissue, we therefore undertook an evaluation of seven currently available systems to clarify these issues.
Book reviews
Authors: Gleeson J. A.
Published: July 2009

In these days of the increasing use of endoscopy, the role of barium examinations for the diagnosis of oesophageal disease may seem open to question. Other than the one gulp and two spot films for the exclusion of a stricture or pouch, the technique would seem consigned to the archives of radiological practice. Levine and Laufer give the lie to this. This book is a superb example of how a good test, well practised and interpreted, need not be overtaken by more modern or glamorous alternatives.
Book reviews
Authors: Dearnaley D. P.
Published: July 2009

What is new in the treatment of the urological cancer? Chemotherapy for bladder cancer, biological response modifiers for renal cell cancer, complete androgen blockade in prostate cancer, new approaches in reconstructive surgery and radiotherapy. These are all promising avenues of clinical research, but their place in the routine treatment of patients and their integration with standard management policies remains to be defined.
Book reviews
Authors: Karani J.
Published: July 2009

The increasing importance of intra-operative ultrasound is now recognized by surgeons and radiologists alike. The considerable superiority of this technique in detecting small tumours in the liver and pancreas, over the combination of pre-operative ultrasound and operative palpation, is now fact. This book, by European authors, is written as a practical guide for those becoming acquainted with this. It is said to be directed at those both well versed in ultrasound and also surgeons wishing to learn.
Book reviews
Authors: Reidy J. F.
Published: July 2009

Although PTA is now a well established treatment, its applications are still expanding and its techniques improving. Just when radiologists were beginning to look at angioplasty more critically, especially with regard to indications, results and complications, a whole new array of trans-catheter techniques for treating occlusive vascular disease has emerged. Amidst the welter of enthusiasm that new devices invariably attract, the same mistakes are being made as in the evaluation of PTA in the early days.

The title of this book offers hope and the prospect of critical evaluation but I am afraid it is misleading. First, PTA does not feature, but this book instead focuses exclusively on the new “auxiliary methods”.
Complications in percutaneous transluminal angioplasty: relationships with patient age
Authors: Morse M. H. , Jeans W. D. , Cole S. E. A. , Grier D. , Ndlovu D.
Published: July 2009

Five hundred consecutive attempted lower limb angioplasties for ischaemic disease (370 patients, mean age 65.6 years, range 33–91 years) were reviewed. Significant complications occurred in 44 cases (8.8%). Nine patients (1.8%) underwent emergency surgery related to a complication. A further 12 patients (2.4%) underwent elective surgery related to a complication. In addition, four patients died within 30 days of the procedure; one following surgery performed because of a complication of angioplasty, one following a myocardial infarction, one following severe bleeding associated with subsequent thrombolytic therapy and one during emergency surgery related to a complication of angioplasty. A correlation was found between complication rate and age. This relationship was independent of the approach to, the position of, and the severity of the treated lesion. Elderly patients are at increased risk of complication in lower limb angioplasty.
Book reviews
Authors: Roddie Mary E.
Published: July 2009

The editors of this book state that it has been written primarily for the physician who deals with adrenal disease in clinical practice. The have aimed to provide an up-to-date review of adrenal disorders with an emphasis on clinical management, from appropriate biochemical investigation to medical and surgical treatment.
Evaluation of the use of a niobium filter for patient dose reduction in chest radiography
Authors: Thierens H. , Kunnen M. , Van der Plaetsen A. , Segaert O.
Published: July 2009

The performance characteristics of a 50 μm. niobium filter and a copper filter of equivalent thickness (0.15 mm) were compared for postero-anterior chest X-ray examination. Radiographs of 20 patients obtained using an automatic exposure control device showed no significant differences in image quality and exposure setting between the filters. Radiation dose distributions measured in a Rando phantom revealed a higher reduction in the patient dose with the niobium filter. The reduction in the effective dose equivalent, produced by the addition of the niobium and copper filters to the standard filter of 2.5 mm aluminium, of 17% and 10%, was relatively small compared with the reductions in the entrance surface dose of 31% and 26%. Our study confirms that drastic alterations in the patient dose by the addition of a dose reduction filter to the usual filtration cannot be expected.
Book reviews
Authors: Grundy A.
Published: July 2009

The purpose of this book is to provide a detailed step-by-step description of the various examinations in gastrointestinal radiology, with emphasis on barium studies that provide the most useful and accurate clinical information. Endoscopic procedures are also described in the hope that this will allow for a closer interaction between radiology and endoscopy. It is aimed at radiology residents as well as being a reference for practising radiologists.
Doppler ultrasound studies in renal arteries of normal newborn babies
Authors: Lamont A. C. , Hall H. S. , Thompson J. R. , Evans D. H.
Published: July 2009

The renal arteries of 89 healthy full-term infants were examined using duplex Doppler ultrasonography to establish a normal range for renal blood flowvelocity in the first 3 days of life. In the first 24 h a wide range of renal blood flow velocities was noted with a statistically significant decrease in Pourcelot's index over the next 2 days.
Monoenergetic approximation of a polyenergetic beam: a theoretical approach
Authors: Robinson Donald M. , Scrimger John W.
Published: July 2009

There exist numerous occasions in which it is desirable to approximate the polyenergetic beams employed in radiation therapy by a beam of photons of a single energy. In some instances, commonly used rules of thumb for the selection of an appropriate energy may be valid. A more accurate approximate energy, however, may be determined by an analysis which takes into account both the spectral qualities of the beam and the material through which it passes. The theoretical basis of this method of analysis is presented in this paper. Experimental agreement with theory for a range of materials and beam qualities is also presented and demonstrates the validity of the theoretical approach taken.
Diffuse retroperitoneal amyloidosis: further radiological observations
Authors: Posner Ralph , Saks Avigdor M. , Leiman Gladwyn
Published: July 2009

Amyloidosis is characterized by deposition of insoluble extracellular protein material, which may be primary (idiopathic), or secondary (due to chronic disease, especially chronic infection and neoplasms). It occurs in 6–15% of patients with multiple myeloma. In retroperitoneal amyloidosis the protein deposits usually show two distinct patterns: nodal (Takebayashi et al, 1984) or diffuse (Glynn et al, 1989). The computerized tomographic (CT) appearance of diffuse retroperitoneal amyloidosis has previously been reported (Glynn et al, 1989) as a diffuse, non-enhancing thickening of the entire retroperitoneum. The perinephric fat was not involved.

We report a further case of diffuse retroperitoneal amyloidosis and document illustrative sonographic features correlated with CT.
Percutaneous nephrostomy to relieve renal tract obstruction in pregnancy
Authors: Trewhella M. , Reid B. , Gillespie A. , Jones D.
Published: July 2009

Dilatation of the renal tract in pregnancy is a common event (Peake et al, 1983). Whilst frequently asymptomatic, the distension can be associated with considerable pain, the acute presentation of which may be attributed to other surgical or obstetric emergencies such as appendicitis or placental separation (Anteby et al, 1975). Renal tract obstruction may also occur in pregnancy, and failure to recognize it may lead to rupture of the urinary tract and loss of the kidney (Meyers et al, 1985).

We present a case in which such a renal tract obstruction was relieved percutaneously. Whilst percutaneous nephrostomy is a commonly practised technique, its use in pregnancy has not been reported previously.
Quantitative magnetic resonance imaging in cervical carcinoma: a report on 30 cases
Authors: Santoni R. , Bucciolini M. , Chiostrini C. , Cionini L. , Renzi R.
Published: July 2009

T1 and T2 relaxation times were calculated, before radiation therapy, in 30 patients with cervical carcinoma. Eight healthy young women were submitted to magnetic resonance imaging (MRI) to determine T1 and T2 times of the normal cervix. Magnetic resonance imaging was repeated, in 22 patients, during radiation therapy and at follow-up. During treatment and follow-up, patients with complete tumour response showed a significant T1 reduction compared with the pre-treatment values. With persistence of palpable or visible tumour, T1 times showed a small decrease during therapy, and a marked increase at subsequent examinations. The results suggest that the modifications of T1 relaxation times, during radiation therapy and follow-up, could be considered as a useful discriminant between patients with differing tumour response.
The effect on pulmonary function of tangential field technique in radiotherapy for carcinoma of the breast
Authors: Lund May Brit , Myhre Kurt Inge , Melsom Haakon , Johansen Bjørn
Published: July 2009

Twenty-five patients treated by lumpectomy and radiotherapy for Stage I breast cancer were enrolled in a prospective study to measure the effects of tangential field irradiation on pulmonary function. Fractional doses of 2 Gy to a total of 50 Gy were administered with the tangential technique. An additional 10 Gy (2 Gy × 5) was given as direct booster. Dynamic and static lung volumes, distribution of ventilation and gas transfer were measured before irradiation and at varying intervals up to 1 year after the completion of therapy. There was a small, but statistically significant decrease in the forced vital capacity (mean 63 ml) and the forced expiratory volume in 1 second (mean 79 ml) measured 3 months after irradiation (p < 0.05). These changes were reversed within 1 year. The reduction in total lung capacity (mean 240 ml) after 3 months was nearly significant (p = 0.06). The remaining variables did not change to a significant degree. We conclude that a slight restrictive ventilatory impairment may occur when a combined tangential and direct booster technique is applied. The changes are, however, small and reversible, and imply no clinical importance.
The guidance notes revisited: advice to patients leaving hospital after diagnostic nuclear medicine
Authors: Shields R. A.
Published: July 2009

Recently the Radiation Protection Committee of the British Institute of Radiology conducted an informal survey of the practices adopted concerned with the method and level of information given to patients leaving hospital after administration of a radiopharmaceutical for diagnostic purposes only. There is wide variation in practice, which does not always follow the advice of the “Guidance Notes for the Protection of Persons against Ionising Radiation Arising from Medical and Dental Use” (National Radiological Protection Board, 1988). It seems appropriate to examine the logic of the relevant regulations and the derived guidance with regard to the non-conformity of standards practised.
A new phantom for mammography
Authors: Law J.
Published: July 2009

In reply to Dr Moores, the account he gives of my paper in paragraphs 1–6 of his letter in broadly correct, but I do not think it affects the conclusions reached. The Du Pont scores may be divided by three (or the relevant vertical axes of the graphs relabelled) to obtain a mean single-film result if desired. For the Du Pont phantom films, scores for contrast details and for resolution have been separated in Tables and Figures exactly as Dr Moores advocates in his seventh paragraph but appears to criticize in paragraph six.
Scoring of image quality phantom films in mammography
Authors: Law J.
Published: July 2009

I would like to comment briefly on the interesting letter from Mr A. Robinson and Dr A. C. Underwood.

The “0–3 scale of visiblity” referred to in the fourth paragraph of the letter from Robinson and Underwood was the basis of the “common scoring system” referred to in my reply to Dr Moores. Since learning of it from them, I have made some use of it with the Du Pont phantom and elsewhere, and found it helpful.
Primary lymphoma of the urinary bladder
Authors: Clarke N. W. , Maxwell A. J.
Published: July 2009

Primary lymphoma of the urinary bladder is rare, occurring most commonly in elderly women. This case report documents the clinical and radiological features of such a tumour presenting in a 22-year-old female patient. To our knowledge, this is the youngest reported case.

A 22-year-old woman presented with a 16-month history of episodic pain in the left loin and suprapubic region and a 6-week history of haematuria, dysuria and urinary frequency. She had lost 2 stones in weight in the preceding year. On physical examination the only finding of note was a palpable mobile mass anterior to and to the right of the cervix uteri.
Book reviews
Authors: Phelps P. D.
Published: July 2009

Three-dimensional reconstructive imaging may have a place for maxillo-facial and plastic surgery of the face, but it has little relevance for the study of the petrous temporal bone, for which a comprehensive knowledge of sectional imaging is essential.
Book reviews
Authors: Jones Simon N.
Published: July 2009

This book comprehensively covers “state of the art imaging” of the liver, pancreas, biliary tree and spleen. There is a refreshing spectrum of contributors from the length and breadth of the United Kingdom. It is well produced, easy to read and has a modern style. There are occasional algorithms which are especially useful. The illustrations are particularly excellent throughout with relevant labelling although some of the ultrasound images are rather out-dated.
Book reviews
Authors: Evans Sian E.
Published: July 2009

This book covers all of the radiological procedures likely to be requested in a modern hospital, with an emphasis on the practical aspects. Each procedure is described in terms of indications, contra-indications, patient preparation, technique, practical difficulties and complications.
Prenatal diagnosis of nuchal cystic hygroma
Authors: MacLeod A. M. , McHugo J. M.
Published: July 2009

Twenty-seven cases of nuchal cystic hygroma were diagnosed prenatally over a 5-year period at the Birmingham Maternity Hospital. Karyotypes were obtained in 20 cases, of which 14 (70%) were abnormal. Two-thirds of these represented various trisomy syndromes in contrast to other series where cases of Turner's syndrome have predominated. Twenty pregnancies were terminated. There was one intra-uterine death and two neonatal deaths. Hydrops was present in 15 cases, none of which survived to term. Associated structural abnormalities, mainly skeletal, renal and cardiac, were present in 18 cases. There were four long-term survivors with good quality of life, including both normal and abnormal karyotypes. In utero regression of the hygromawas documented in five cases, total in three and subtotal in two cases born with residual neck webbing.
A pain in the neck!
Authors: Rajah R. , Boothroyd A. , Lees W. R.
Published: July 2009

A 36-year-old female presented with a 24 h history of constant severe pain in the left side of her neck. On clinical examination there was marked tenderness and swelling within the left anterior triangle of the neck. She had documented polycystic ovarian disease and her two previous pregnancies were induced by Clomiphene and an LHRH pump, respectively. 2 months prior to this presentation she had received 10 000 u of human chorionic gonadotrophin (HCG) and her ovaries were monitored regularly. 3 weeks later she developed abdominal distension, nausea, weight gain, pleural effusion, low blood pressure and a tachycardia. A frontal chest radiograph was taken (Fig. 1). At this stage a clinical diagnosis was made and treatment commenced. 3 weeks later she presented with neck pain and an ultrasound examination was performed (Fig. 2a & b) using 5 MHz linear probe.
The use of a disposable nasoduodenal feeding tube for the small bowel enema examination
Authors: Ashleigh R. J. , Spinks B. C. , Bisset R.
Published: July 2009

The small bowel enema examination is a well accepted technique for the examination of the small bowel (Nolan & Cadman, 1987). Currently, the standard tubes used are the Nolan modification of the Bilbao-Dotter tube (Cook) and the Silk tube (Merck). We have been using a Levin-type nasoduodenal feeding tube manufactured by Vygon for jejunal intubation. This is a 125 cm long, 14F diameter tube designed for single use. It is easy and quick to pass and allows a fast barium flow rate. It is also cheap. We report a prospective randomized trial comparing the Vygon and Nolan tubes.
Dysphagia after fast neutron therapy to the head and neck
Authors: Catterall Mary
Published: July 2009

The letter from Duncan and Munro (1990) is very uncritical of the paper they refer to, “Dysphagia after fast neutron therapy to the head and neck”, and gives a further false impression of the role of neutrons in radiotherapy.
Tumour pH and response to chemotherapy: an in vivo 31P magnetic resonance spectroscopy study in non-Hodgkin's lymphoma
Authors: Smith S. R. , Martin P. A. , Edwards R. H. T.
Published: July 2009

Serial image-localized 31P magnetic resonance spectroscopy studies were performed in nine patients with newly diagnosed non-Hodgkin's lymphoma (NHL) during the early part of treatment with chemotherapy. The pre-treatment intracellular pH (pHi) of the tumours ranged from 6.97 to 7.61 for high-grade NHL (n = 3), and 7.16 to 7.39 for low-grade NHL (n = 5). A pH of 7.24 was recorded in a patient with intermediate-grade NHL. Slice-to-slice variation in tumour pHi in spectra obtained with a one-dimensional chemical shift imaging (1D-CSI) technique varied from zero to 0.5 pH units. The largest variation was seen in high-grade tumours. Slice-to-slice variation may reflect tumour heterogeneity. Alkaline shifts in tumour pHi of 0.14 to 0.45 pH units were seen in six patients following chemotherapy. Maximal change in tumour pH was related temporally to increases in the phosphodiesterβ-adenosine triphosphate ratio, and occurred before alterations in tumour size were documented. Cell death and necrosis may be associated with an alkaline shift in pHi due to cessation of H+-producing processes and release of basic components of proteins. An alkaline shift in tumour pHi may therefore be an early metabolic marker of response to chemotherapy.
The value of repeated chest radiographs in the follow-up of patients with germ cell testicular tumours
Authors: Dunn W. K. , McMillan P. J. , Sokal M. , Wastie M. L.
Published: July 2009

Patients with germ cell testicular tumours customarily have repeated follow-up chest radiographs after treatment. This study assesses the contribution of chest radiography to the detection of recurrent disease in 162 patients. Six patients developed an intrathoracic recurrence, but in only one case was the chest radiograph the only indication of recurrence. Five had other evidence to suggest recurrence, such as raised serum markers or palpable masses. The yield from follow-up chest radiographs in patients with germ cell testicular tumours is very low and their use must be balanced against both the harmful effects of radiation and the financial cost.
Lung function and radiation response
Authors: Hong A. , Dische S. , Saunders M. I. , Lockwood P. , Crocombe K.
Published: July 2009

This study investigated whether impaired respiratory function affected the response to radiotherapy. A prospective study was performed in which lung function, arterial oxygen and haemoglobin concentration were examined, before treatment with radical radiotherapy, in 141 patients with advanced non-small cell lung cancer and head and neck cancer. The findings were considered to reflect the physiological conditions present at the time of radiotherapy and these were related to acute normal tissue reactions and tumour control. Although 53% of the patients showed some impairment of lung function and 47% demonstrated a haemoglobin oxygen saturation below the normal range, oxygen partial pressure was below expected levels in fewer patients (27%) and total arterial oxygen content was below normal in only 12% of patients. No correlation was found between the tests performed and the severity of acute morbidity or with local tumour control. In the patients with carcinoma of the bronchus, there was a trend for incomplete tumour control to be associated with a lower haemoglobin level, but this did not reach statistical significance. In patients selected for curative radiotherapy, lung function would not appear to be an important factor influencing the response of normal tissues or tumour to irradiation.
Spontaneous fracture of the wire tip during breast localization
Authors: O'Doherty Ann J.
Published: July 2009

Needle localizations of radiologically suspicious but clinically impalpable breast lesions are being carried out with increasing frequency as a result of the National Breast Screening Programme. At our institution, the Nottingham Lesion Location Set (Mediplus Ltd, Bourne End, Bucks) has been used, without complication, for at least 50 such procedures (Fig. 1). It comprises an 18 gauge (G), or 21 G cannula, a fine needle localization wire which is fed through the cannula during initial positioning and a 20 G bluntended cannula which is introduced over the wire by the surgeon in theatre to facilitate identification of the wire tip. The following case report, undocumented to date, describes an unusual hazard of breast localization.
Afferent loop obstruction diagnosed by sonography and computed tomography
Authors: Hasuda Keitaro , Makino Yoshinari , Arata Toshihiko , Yamada Tsutomu
Published: July 2009

Although obstruction of the afferent loop following Billroth II gastrectomy is uncommon, it causes a rapid onset of severe abdominal pain, non-bilious vomiting and at times may become lethal if complicated by perforation and peritonitis. However, the diagnosis is sometimes difficult to establish by conventional biochemical and radiological means. We present one case in which both sonography and computed tomography (CT) were very helpful in establishing the early and accurate detection of this life threatening condition before surgery.

A 69-year-old female, who had previously undergone a partial gastrectomy and Billroth II reconstruction, was admitted with a 2 week history of right upper quadrant pain associated with nausea. There was a palpable mass in the right upper quadrant. Laboratory data on admission revealed normal values for haemoglobin, haematocrit, serum amylase, total birilubin, lactate dehydrogenase (LDH) and serum glutamate oxaloacetate transaminase (SGOT).
CT of a unicameral bone cyst in a rib
Authors: Ian Marsh J. , Munk Peter L. , Muller Nestor L.
Published: July 2009

Unicameral bone cysts are relatively common lesions in childhood but are distinctly unusual in the ribs; a single case having been reported previously (Shulman et al, 1977). They occur most frequently in the metaphysis of the proximal ends of the humerus or femur (Jaffe et al, 1942; Baker, 1970). There is an age dependency of the location of these lesions, the most common site after the age of 17 years being the pelvis and os calcis (Norman & Schiffman, 1977). The lesion shows a male predominance.

The computed tomographic (CT) appearance of unicameral bone cysts has been described infrequently. These lesions have a low attenuation value (0–20 Hounsfield Units (HU)) (Blumberg, 1981).