bluuebunny/crossref_metadata_2025 huggingface dataset:
Paediatric haemangiomas: the role of radiotherapy
Authors: Dutton S. C. , Plowman P. N.
Published: July 2009

Radiotherapy currently maintains an occasional place in the therapy of complicated haemangiomas of childhood. Eight such childhood benign lesions have been so treated at St Bartholomew's Hospital in the last 10 years. The case histories are presented before being discussed in the context of other therapies available (no treatment, steroids, embolism and surgery), radiation technique used and radiation dose prescription advised.
The prognostic significance of radiologically detected knee joint effusions in the absence of associated fracture
Authors: Maskell T. , Finlay D.
Published: July 2009

Our intention was simply to look at the clinical significance of a specific radiological sign, frequently seen in casualty X-ray film reporting.
Book reviews
Authors: Davis M.
Published: July 2009

First published in 1982, this book was aimed at a professional readership to give guidance on a number of aspects of non-ionizing radiation sources. The book was intended to provide practical information on the health aspects of exposure to non-ionizing radiation and the scientific, hazard, protection, instrumentation and dosimetry information required for the establishment of a non-ionizing radiation control programme.
Book reviews
Authors: Forster E.
Published: July 2009

This is an American book on the basic principles of radiographic exposure and is in reality a set of lecture notes for student radiographers, covering the subject in great detail.

Each chapter starts with a list of objectives and ends with a set of self-assessment questions (answers at the back) and some most useful practical exercises. The majority of the chapters are short and all achieve their objectives.
Imaging of neonatal pulmonary sequestration including Doppler ultrasound
Authors: Smart L. M. , Hendry G. M. A.
Published: July 2009

Seven cases of neonatal pulmonary sequestration are reviewed which illustrate the varied clinical presentations and radiological findings. In four patients, real time ultrasound scanning was used to image the chest and the features are described. In three cases, the systemic supplying artery was demonstrated by duplex Doppler scanning and further invasive investigations were avoided; after a chest radiograph, this should be the examination of choice in the investigation of a neonate with a possible pulmonary sequestration.
Patient dose and risk in mammography
Authors: Law J.
Published: July 2009

Patient dose in mammography is estimated by two different methods which are compared and which give good agreement. A mean tissue dose of about 1 mGy per film is found for a breast of 4.5 cm compressed thickness. Variables which affect dose are then considered quantitatively, including compressed breast thickness, tube potential, grids, magnification and beam collimation. The variables having the greatest effect are breast thickness and magnification. For example, an 8 cm breast receives about four times the mean tissue dose of a 3.5 cm breast. Similarly, using a magnification factor of about 2, dose is increased about four times in the primary beam, but the adverse consequences may be largely removed with conventional collimation to part of the breast only. Finally, the dose estimates are combined with existing data on breast cancer induction to predict the risk of carcinogenesis in a breast screening programme. For example, in a screening centre performing 15000 examinations per year, only one induced cancer is predicted in about 7 years of screening under average UK conditions of age and breast thickness.
Book reviews
Authors: Risdon R. A.
Published: July 2009

As its title suggests, this multi-author text, written by 28 pathologists, radiologists and urologists from the Emory University School of Medicine in Atlanta, Georgia, seeks a multidisciplinary approach to urological pathology.

The book is divided into seven chapters, with varying numbers of contributors to each, covering urological kidney disease, the urinary passages, renal transplantation, the prostate and seminal vesicles, the testis and paratesticular structures, the penis and scrotum, and the adrenals. Each chapter is preceded by a table of topics covered, and starts with sections on normal development and structure, radiological evaluation, specimen preparation and developmental anomalies.
Magnetic resonance imaging of spinal trauma
Authors: Kerslake R. W. , Jaspan T. , Worthington B. S.
Published: July 2009

A retrospective series of 118 magnetic resonance examinations of 110 patients who had sustained previous spinal trauma is reported. Examinations performed within 3 weeks of trauma showed extraspinal soft tissue (including ligamentous) injury in 48% and intraspinal lesions in 61% (mostly consisting of extradual haematoma and spinal cord contusion). In examinations performed more than 3 weeks after injury intraspinalabnormalities were shown in 51% and these represented spinal cord compression, atrophy, myelomalacia and syringohydromyelia. Magnetic resonance imaging has the unique capability of displaying non-invasively the late sequelae of spinal trauma permitting simultaneous evaluation of the extra-spinal soft tissues, vertebral column and spinal cord. It is therefore recommended as the technique of choice in the investigation of patients who have sustained previous spinal injury, particularly those with neurological deficit. In the acute phase potentially remediable causes of neurological impairment such as disc herniation or extradural haematoma can be identified. Signal changes in the cord may allow the prognosis for neurological recovery to be established. In the later stages sequelae such as cord atrophy, myelomalacia and syringohydromyelia are accurately identified and surgical therapy may be guided, where appropriate.
Implications of the uptake of 131I-radiolabelled metaiodobenzylguanidine (mIBG) for the targeted radiotherapy of neuroblastoma
Authors: O'Donoghue J. A. , Wheldon T. E. , Babich J. W. , Moyes J. S. E. , Barrett A. , Meller S. T.
Published: July 2009

Selective uptake of radiolabelled meta-iodobenzyJguanidine (mlBG)in neuroblastoma provides a possible approach to biologically targeted radiotherapy of this disease. A mathematical model was used to predict absorbed doses to tumours of varying size from therapeutic 13lI-mIBG, based on measurements of 125I-mIBG uptake in surgically excised tumours from six patients. Two size categories of tumour target were considered: bulk tumour and microscopic disease. The predicted absorbed doses were compared with doses calculated to achieve a 50% probability of tumour cure. The analysis shows that the probability of tumour cure depends strongly on mlBG uptake, effective half-life of mlBG in tumour and tumour diameter. Small microtumours may be relatively resistant to mlBG treatment owing to the limited absorption of 131I beta-energy. The product of patient mass and percentage uptake per unit mass of tumour may be a useful indicator of therapeutic outcome when targeted radiotherapy is used for the treatment of paediatric tumours.
Fast personal computer based retrieval system for a high-volume database of a radiology information system
Authors: Urhahn Reinhard , Günther Rolf W.
Published: July 2009

A personal computer system has been used to facilitate search and analysis of a radiology information system database (RADOS) for research purposes. The system enables flexible retrieval of examination data and radiographic findings with subsequent graphical manipulations. With modifications it could be implemented on other radiology information systems.
Estimation of doses to patients from “complex” conventional X-ray examinations
Authors: Calzado A. , Vañó E. , Morán P. , Castellote C. , Ruiz S. , González L.
Published: July 2009

A numerical method has been developed to estimate the organ doses and effective dose-equivalent for patients undergoing three “complex” examinations (barium meal, barium enema and intravenous urography). The separation of radiological procedures into a set of standard numerical views is based on the use of Monte Carlo conversion factors and measurements within a Remab phantom. The radiation doses measured in a phantom for such examinations have been compared with the predictions of the “numerical” method. Dosimetric measurements with thermoluminescent dosemeters attached to the patient's skin along with measurements of the dose-area product during the examination have enabled us to derive organ doses and to estimate the effective dose-equivalent. Mean frequency weighted values of dose-area product, energy imparted to the patient, doses to a set of organs and effective dose-equivalent in the area of Madrid are reported. Comparisons of the results with those from similar surveys in other countries have been made.
Demonstration of intramedullary tuberculomas by magnetic resonance imaging: a report of two cases
Authors: Jena A. , Banerji A. K. , Tripathi R. P. , Gulati P. K. , Jain R. K. , Khushu S. , Sapra M. L.
Published: July 2009

Intramedullary tuberculomas are rare (Arseni & Samitca, 1960; Dastur, 1972; Compton & Dorsch, 1984) but have been demonstrated either at surgery or at autopsy. The appearance of tuberculomas in the brain on magnetic resonance imaging (MRI) has been reported (Gupta et al, 1988). However, the image morphology of intrinsic cord tuberculomas has not been described. We present the MR findings in two patients with tuberculomas of the cervical cord diagnosed on the basis of positive therapeutic response to antituberculous therapy (ATT).

Two young patients with clinical and radiological evidence of intramedullary pathology, who were referred for MRI study with possibility of tuberculous myelitis, are described. Magnetic resonance imaging of the cervicodorsal spine was performed with a 1.5 T (MAGNETOM, Siemens) system using spin echo sequences (repetition time (TR), 2000 ms and echo time (TE), 69–90 ms for T2 images; TR, 700–800 ms and TE, 17–22 ms for T1 images) in axial and sagittal planes. Images were acquired on 256 × 256 matrix and 1.2 gradient zooming with 5 mm contiguous slices. Follow-up studies in both cases were taken after 4 months and after 1 year in Case 2. from C2 to C5/C6 (Figs la & b). The extradural space and vertebral bodies were found to be normal. The lesion appeared to be hypointense in its periphery with central hyperintensity on T2-weighted images and low to isointense on T1 images. The patient showed remarkable relief of her symptoms over a period of 4 months with ATT.
Haematopoiesis in the liver: the role of 99Tcm
Authors: Abboud M. , Morcos S. K.
Published: July 2009

We read with interest the case report of Bradley and Metreweli (1990), describing the ultrasound appearances of extramedullary haematopoiesis in the liver. However we are surprised that they omitted to include the role of isotope liver scanning using 99Tcm labelled millimicrospheres in suggesting the diagnosis of this condition.
Haematopoiesis in the liver: the role of 99Tcm
Authors: Bradley M. , Metreweli C.
Published: July 2009

We would like to thank Dr Abboud and Dr Morcos for pointing out the value of 99Tcm labelled millimicrospheres. However, the aim of this paper was to document some common ultrasonographic appearances of liver lesions with the unusual diagnosis of extradmedullary haematopoiesis, which is a rare liver condition with only one ultrasound documented case in the literature.
Book reviews
Authors: McNally N. J.
Published: July 2009

These two volumes represent the proceedings of the 5th International Symposium on Hyperthermic Oncology held in Kyoto in September 1988. There is an enormous amount of information here, with over 1700 pages and more than 400 presentations from the most basic, through clinical experience to the physics of hyperthermia.

Volume 1 contains a vast number of summary papers, up to three pages in length, on all aspects of hyperthermia. Only the really dedicated “hyperthermist” will find this volume of value.
Book reviews
Authors: Hunter G.
Published: July 2009

This is the 1989 incarnation of the popular annual series. The book follows the established pattern of its predecessors and consists of some 290 pages split into eight main subject areas. The quality of production is high and, in particular, the images are sufficiently well produced to allow all the points made within the text to be clearly illustrated. The first topic is that of thyroid scanning in the management of thyroid disease. It provides an up-to-date overview of the available methods of investigation within the nuclear medicine department of the thyroid and their applicability to clinical management.
Real-time digital contrast enhancement and magnification in the assessment of acute elbow injuries
Authors: Holland P. , Davies A. M. , Morris E. , Fowler J. , Wellings R. , Tyrrell P. N. M.
Published: July 2009

The elbow is a common site of injury and missed fractures may lead to disability and litigation. An assessment was made of a commercially available desk-top digital contrast enhancement and magnification unit (DETECT system) in a series of 320 patients with an acute elbow injury. Five radiologists of varying experience independently viewed elbow radiographs on a conventional light-box, and subsequently using the digitizer, indicating the presence or absence of a fracture. The overall results demonstrated no difference in performance when using the unit, though small improvements in the confidence with which a definite diagnosis was made were observed. Assessment of soft tissues with the digitizer was less reliable.
An innovative method for neuraxis radiotherapy using partial transmission block technique
Authors: Plowman P. N. , Doughty D.
Published: July 2009

Whole CNS (neuraxis) radiotherapy is an important part of therapy for certain CNS tumours which seed via the CSF. Many, if not the majority, of these predominantly young patients are cured but the neuropsychometric, neuroendocrine and growth morbidity of neuraxis radiotherapy on children by conventional methods may be considerable; patients receiving such therapy at an early age often are eventually in the educationally subnormal category. Recent radiobiological data support the concept that all aspects of CNS radiation tolerance are heavily dependent on daily fraction size. We describe a new radiotherapy technique that allows lower daily fraction sizes to be delivered to the neuraxis without prejudicing the total dose to the neuraxis or primary area and without prolonging the overall treatment time. Published radiobiological data support the concept that all the major morbidities attributed to conventional neuraxis radiotherapy will be reduced by the currently described technique without reducing tumour control rates.
Intracranial chondrosarcoma in a patient with Ollier's disease
Authors: Clifton A. G. , Kendall B. E. , Crockard H. A. , Hughes T.
Published: July 2009

Cartilaginous intracranial tumours are rare. A case of intracranial chondrosarcoma is described in a patient with Ollier's disease. The patient also had evidence on computed tomography of enchondromata involving the ethmoid sinuses.

A 36-year-old woman with Ollier's disease diagnosed at the age of 13 months, involving mainly her right side and affecting hand, rib cage, right femur, and right toes, presented with a 10-month history of intermittent diplopia on right gaze.
Scoring of image quality phantom films in mammography
Authors: Robinson A. , Underwood A. C.
Published: July 2009

We were very interested to read the paper by J. Law “A new phantom for mammography” (1991). We have been advocates of this particular phantom for some time and have used it regularly on a total of 29 mammography units (nine different makes/types in all) over the past 2 years.

One could of course use different methods of scoring the image quality perceived on test films and the degree of sensitivity to changes of kilovoltage, film processing etc. will clearly depend on the scoring system chosen.
Book reviews
Authors: Phelan M.
Published: July 2009

The authors correctly state that “the gamut approach to differential diagnosis is very useful in ultrasound” because of the lack of specificity of ultrasound. This short book costing £10 contains seven chapters on organ systems.
Book reviews
Authors: Wilson David
Published: July 2009

This book will tell you what joints look like on ultrasound but not which patients should be examined. In 160 pages the German authors describe the physical principles of ultrasound, methods of examination and the appearance of common pathology in each of the major joints. One chapter covers abnormalities of soft tissues. The numerous illustrations are in black and white and are mainly of good quality. The overall layout is clear but the text is at times difficult to read, perhaps as a result of the translation.
Book reviews
Authors: McCready Ralph
Published: July 2009

This book covers the broad panorama of clinical results in cancer and other pathologies such as acute inflammation, myocardial infarction and venous thrombosis. The book is edited by a leading expert in the field, with contributions from most of the main centres involved in developing immunoscintigraphic techniques.
Embolization with steel coils using a saline flush technique
Authors: Makita Kohzoh , Furui Shigeru , Irie Toshiyuki , Hirata Junnichi , Yamauchi Teiyuh , Tsuchiya Kazuhiro , Takenaka Eiichi , Ohtomo Kuni , Ibukuro Kenji
Published: July 2009

A method using saline flush to push Gianturco steel coils through catheters is described, and has been successfully used in 45 patients. The saline flush technique requires no precise matching of coils and catheters, solves problems associated with the conventional method and simplifies the coil embolization procedure.
Response of the mouse mediastinum to single and fractionated X-rays
Authors: Hirn-Stadler B. , Wbra F. , Fowler J. F. , Rojas A.
Published: July 2009

The acute oesophageal response, after localized mediastinal irradiation in unanaesthetized mice, was assessed with a sequential, non-invasive and clinically orientated assay. Changes in body weight, after single and fractionated X-ray doses (8 fractions in 8 or 15 days and 4 fractions in 4 or 13 days), were recorded and the nadir of weight loss for each regime was used as the end-point. In our studies, quantal and non-quantal analyses of the weight loss data gave good dose–response relationships. The shapes of the dose–effect curves for single doses, 4F/4 days and 8F/8 days showed a remarkable degree of radioresistance, which became less apparent when the overall time was increased to 13 and 15 days for 4 and 8 fractions, respectively. The α/β values (7–17 Gy) are within the range found for other acutely responding normal tissues. Histopathological changes were also assessed and the structural changes observed in the oesophageal epithelium, after a single dose of 34 Gy or after 46 Gy given as 3F/6 days, correlated with the gross changes observed in body weight.
The development of an infected false aneurysm following iliac angioplasty
Authors: Cooper J. C. , Woods D. A. , Spencer P. , Procter A. E.
Published: July 2009

Percutaneous transluminal angioplasty is now an established effective treatment for some patients with peripheral vascular disease. The effect of angioplasty is to stretch all layers of the vessel wall which results in splitting of the atheromatous plaque and intima and to some extent the media (Sandborn et al, 1983). Surprisingly, acute arterial rupture and false aneurysm formation at the site of angioplasty are rare complications and few cases have previously been reported (Simmonetti et al, 1983; Samson et al, 1984; Creasy & McMillan, 1987; Moran & Ruttley, 1987). We describe the development of an infected false aneurysm in a patient following iliac angioplasty. As far as we are aware this complication has not previously been recorded.
Book reviews
Authors: Shaw D. G.
Published: July 2009

For those, like me, whose numeracy is sub-optimal, the advent of nuclear magnetic resonance imaging and spectroscopy has been disquieting.
Book reviews
Authors: Blake Peter
Published: July 2009

This book concerns itself with damage to the gastro-intestinal tract and urinary tract from radiotherapy. There is an introductory part on general principles covering radiotherapy techniques, pathology of radiation injury and the radiological appearances of damaged bowel and urinary tract.
Duplex ultrasound of the common femoral vein in pregnancy and puerperium
Authors: Duddy M. J. , McHugo J. M.
Published: July 2009

The common femoral veins of 34 apparently normal women were examined by ultrasound during or just after pregnancy. The cross sectional areas of these veins were measured at rest in the supine position and during a Valsalva manoeuvre. The veins were also assessed by pulsed Doppler ultrasound. We believe that Doppler examination is superior to calibre response assessment during the Valsalva manoeuvre in excluding an isolated iliac occlusion in women in late pregnancy and in early puerperium.
The use of real-time ultrasound in the management of scrotal trauma
Authors: Lewis Carolyn A. , Michell Michael J.
Published: July 2009

27 patients were studied with real-time ultrasound following severe scrotal trauma. 22 (81.5%) had ultrasound features of scrotal trauma and, of these, five (18.5%) had signs of testicular rupture. Four of these five patients underwent surgery following ultrasound. This confirmed the diagnosis of rupture and the testes were repaired. Ultrasound should be offered to all patients presenting with scrotal trauma to select patients with testicular rupture for surgery.
Fascioliasis: findings in 15 patients
Authors: Pulpeiro J. R. , Armesto V. , Varela J. , Corredoira J.
Published: July 2009

The clinical and radiological features of 15 cases of fascioliasis are reported. Pleural effusion, associated with pulmonary infiltrates or ascites, was observed in two patients. Computed tomography (CT) was the most useful imaging method, showing small nodules and linear tracks within the liver parenchyma which were hypodense on non-enhanced scans, remaining hypodense or becoming isodense with normal liver after contrast medium administration. After successful treatment lesions decreased in number and size and finally disappeared or calcified. Lesions increased or remained unchanged when treatment failed to control the disease.
Dosimetric accuracy at low monitor unit settings
Authors: Das Indra J. , Kase Kenneth R. , Tello Victor M.
Published: July 2009

Dosimetric accuracies at low monitor units are evaluated for linear accelerators from various manufacturers. A large error is observed in the majority of the accelerators. The error can be positive or negative. Although the error can exceed 20% for the first few monitor units, it is usually less than 5% when more than 10 monitor units are delivered. When low doses are required proper precautions should be taken for dosimetric accuracy including the beam energy, beam flatness and dose per monitor unit.
Radiological assessment of dysphagia in Parkinson's disease
Authors: Stroudley Jessica , Walsh Margaret
Published: July 2009

Videofluoroscopy was used to examine swallowing in 24 patients with Parkinson's disease and dysphagia. Motility patterns for liquids, semi-solidsand solid foods were classified into oral, pharyngeal and oesophageal phases. Abnormalities in swallowing were demonstrated in 92% of patients in the oral phase, 54% in the pharyngeal phase and 8% in the oesophageal phase. Tracheal aspiration occurred in 46%. These abnormalities were more marked with liquids than with semi-solids or solids. Abnormalities of swallowing are common in Parkinsonian patients with dysphagia.Videofluoroscopy is the appropriate method of investigation.
Concomitant chemo/radiotherapy for advanced carcinoma of the head and neck
Authors: Macmillan C. H. , Carrick K. , Bradley P. J. , Morgan D. A. L.
Published: July 2009

Giving chemotherapy and radiotherapy simultaneously (concomitant therapy) is one approach to improving results in advanced head and neck cancer. To assess the feasibility of one such regimen, 25 patients with advanced squamous carcinoma of the head and neck were treated with a continuous intravenous infusion of 5-fluorouracil, 1 g/m2 per 24 h for Days 1–5 (105 h) and mitomycin-C 14 mg/m2intravenously on Day 3 during the first week of radiotherapy. Twenty had Stage IV disease; four Stage III; and one Stage II. Ages ranged from 21 to 73 years (median 60 years). The tumours involved were as follows: oral cavity (6); nasopharynx (8); oropharynx (5); secondary node from unknown primary (3); hypopharynx (2); paranasal sinus (1). Radiotherapy was delivered as 10 Gy per week (total dose 60–70 Gy). Chemotherapy was well tolerated and all received the intended dose. Mild nausea occurred in five patients and three experienced transient vomiting. A generalized “early” mucositis affected 16 out of 25 (64%), caused interruption of radiotherapy in three patients, and is thought to be chemotherapy related. Twenty-two patients received the dose of radiotherapy intended, and two stopped prematurely at 53 and 56 Gy. Three episodes of neutropaenic infection occurred. Two recovered uneventfully, but one toxic death occurred in a patient with alcoholic cirrhosis. A complete response was seen in 21 (84%). For 17 patients with non-nasopharyngeal carcinoma the 2-year survival is 40%, 24%disease free. The concomitant use of 5-fluorouracil, mitomycin and radiotherapy is well tolerated in this group of patients.
Arterial injury following shoulder trauma: a report of two cases
Authors: Nicholson D. A.
Published: July 2009

Anterior dislocation of the shoulder is a common injury with several well recognized complications including bony, neural and soft tissue injuries. Vascular damage is very rare and usually limited to a short segment of the axillary artery adjacent to the humeral head (Zuckerman et al, 1984). This report is of a patient with proximal subclavian artery occlusion following anterior shoulder dislocation and of another patient with extensive axillary and brachial artery thrombosis following a longstanding displaced fracture of the proximal humerus. Digital angiography demonstrated the unusual extent of these lesions accurately and is recommended in the pre-operative assessment of such cases.
Percutaneous nephrostomy to relieve renal tract obstruction in pregnancy
Authors: Trewhella M. , Jones D.
Published: July 2009

We are grateful for the comments on our case report. With regard to that from Drs Hinwood and Manhire, we read with interest of their experience of the technique.
Book reviews
Authors: Baddeley H.
Published: July 2009

The aim of this monograph is to provide an atlas of the magnetic resonance (MR) features of primary bone and soft tissue tumours. The 94 cases presented are derived from 275 new cases of bone and soft tissue lesions discovered in the province of Antwerp over a period of just 17 months. As the authors admit in their preface, the number of patients in each sub-group is too small to come to definite conclusions.
Chest radiograph scoring system for use in pre-term infants
Authors: Yuksel B. , Greenough A. , Karani J. , Page A.
Published: July 2009

A scoring system to characterize the pre-term infant's chest radiograph appearance has been evaluated. Chest radiographs taken at 1 month of age in 20 infants (median gestational age 27 weeks) were scored according to abnormalities of lung volume, presence of opacification, interstitial changes and cystic elements (maximum score 17). The median score was 4 (range 1–14); the highest scores were for the only infants with cystic elements and/or interstitial changes on their chest radiographs. The scoring system documented accurately the severity of neonatal respiratory distress; the highest scores occurred in those infants requiring the most prolonged respiratory support, i.e. ventilated beyond 1 week of age (p < 0.01) and oxygendependent beyond 1 month (p < 0.01). It was also a useful predictor of chronic respiratory problems, with an 88% sensitivity in the detection of infants with the most severe lung function abnormalities at 6 months of age.
Computed tomography attenuation measurements for the characterization of hepatic haemangiomas
Authors: Whitehouse R. W.
Published: July 2009

The attenuation values of 21 hepatic haemangiomas in 19 patients were measured on non-enhanced computed tomographic (CT) scans and compared with the attenuation of adjacent liver and the inferior vena cava (IVC). The attenuation of hepatic haemangiomas was lower than that of the surrounding liver, but there was no correlation between these two measurements. There was a highly significant correlation between the attenuation of haemangiomas and blood in the vena cava (r = 0.905, p < 0.001). All the haemangiomas had attenuations within 7 HU of caval blood. By comparison, in 34 hypodense hepatic lesions that did not show contrast-enhanced appearances characteristic of haemangioma, there was no significant correlation between the attenuation of the lesions and the IVC. Nineteen (56%) of these lesions had attenuations differing more than 7 HU from that of caval blood. The influence of this observation on the requirement for dynamic contrast-medium-enhanced and delayed post-contrast CT in the assessment of hepatic lesions is discussed.
Registration of MR and CT images for skull base surgery using point-like anatomical features
Authors: Hill D. L. G. , Hawkes D. J. , Crossman J. E. , Gleeson M. J. , Cox T. C. S. , Bracey E. E. C. M. L. , Strong A. J. , Graves P.
Published: July 2009

We have developed a registration technique for combining magnetic resonance imaging (MRI) and computed tomography (CT) images of the skull base for use in surgical planning. The technique is based on user identification of point-like landmarks visible in both modalities. The combination of images involves a small amount of expert interaction, is relatively quick and preliminary evaluation indicates that it is accurate to within 1.5 mm. Registered or fused images can be viewed either on an image processing workstation, or fused images can be printed onto conventional film for convenience in clinical use. We present one patient in order to demonstrate the technique's indications and advantages.
Book reviews
Authors: Henk J. M.
Published: July 2009

On first picking up this book I assumed it was the proceedings of a conference, as it contained 20 contributions by different authors on a diverse range of topics. In fact it is a collected series of essays obviously intended to be read by practising head and neck oncologists. The editor states in the introduction that it is hoped the volume will help to show the changing perspective and growth of wisdom with time.
Late enhancement of the left ventricular wall in hypertrophic cardiomyopathy by ultrafast computed tomography: a comparison with regional myocardial thickening
Authors: Saito Haruo , Naito Hiroaki , Takamiya Makoto , Hamada Seiki , Imakita Satoshi , Ohta Mitsushige
Published: July 2009

Eight patients with hypertrophic cardiomyopathy (HCM) were examined by ultrafast computed tomography (UFCT) to investigate the relationship between late enhancement (LE) of the left ventricular (LV) wall after injection of contrast medium and the variations between minimum and maximum wall thickness of the LV. Late enhancement was usually found as a patchy, stained area in the myocardium on delayed phase volume mode images of UFCT. Out of 48 LV segments of the patients with HCM, 21 had LE. Normalized percentage regional wall thickening in the segments that had LE was significantly less than that in the segments that did not have LE (63.6 ± 44.5% and 137.6 ± 54.6%, respectively; p < 0.001). This may reflect abnormal myocardial architecture.
Scintigraphic detection of abdominal hernias associated with continuous ambulatory peritoneal dialysis
Authors: Sissons G. R. J. , Jones S. M. Meecham , Evans C. , Richards A. R.
Published: July 2009

Continuous ambulatory peritoneal dialysis (CAPD) is an increasingly popular method of renal replacement therapy. There are many recognized abdominal complications including the leakage of dialysate fluid into abnormal sites (Steiner & Halasz, 1990). This may occur internally into the hernial sacs, the abdominal wall or the pleural cavity, or externally around the Tenckhoff cannula, or even via the female genital tract (Khanna et al, 1981).

Whenever possible, pre-existing hernias are repaired before commencing CAPD, as the raised intraperitoneal pressures involved can precipitate incarceration (Rubin et al, 1982). In addition, approximately 18% of patients will develop hernias during treatment (Johnson et al, 1987). Indirect inguinal, incisional, umbilical, ventral and diaphragmatic hernias are all described (Francis et al, 1984).

A common clinical problem is that of patients presenting with generalized swelling of the anterior abdominal wall, scrotum or labia. Localization of the abnormal communication is often not possible clinically. This report concerns nine patients presenting over a 3 year period in whom peritoneal scintigraphy was employed to detect the site of the leak.

Nine patients on CAPD were referred for scintigraphic evaluation after developing soft tissue swelling of the anterior abdominal wall, scrotum or labia. No patient was known to have a pre-existing hernia and no hernias were apparent on clinical examination. A total of 10 examinations were performed.

A dose of 70 MBq of 99Tcm-DTPA was injected into a 1 dm3 bag of dialysate. This was run into the peritoneal cavity over 10 15 min via the indwelling Tenckhoff cannula.
Tumour and tumour-like conditions of the soft tissue: magnetic resonance imaging features differentiating benign from malignant masses
Authors: Hermann George , Abdelwahab Ibrahim Fikry , Miller Theodore T. , Klein Michael J. , Lewis Michael M.
Published: July 2009

49 primary soft-tissue masses were studied by magnetic resonance imaging (MRI) in an effort to differentiate benign from malignant lesions. There were 24 benign and 25 malignant tumours. Images were evaluated for the presence of low-signal septation, changes in pattern of homogeneity, signal intensity, and margin definition and shape. 20 of the 25 malignant tumours (80%) demonstrated low-signal septation, and two of the 24 benign tumours (8%) also demonstrated this feature. Malignant tumours tended to change pattern from being homogeneous on T  1-weighted images to being heterogeneous on T  2-weighted images (72%). Benign tumours maintained their pattern on both sequences (67%). Only three of the 24 benign tumours (12.5%) changed from being homogeneous to heterogeneous. Our findings suggest that tumours which change pattern, from homogeneous on T  1-weighted images to heterogeneous on T  2-weighted images, and tumours which have low-signal septations are likely to be malignant. Moreover benign lesions tend to have well defined margins, and some benign masses have characteristic appearances that aid in their differentiation from malignant processes.
Malignant paraganglioma of the mediastinum: a further diagnostic and therapeutic use of radiolabelled mIBG
Authors: Cornford E. J. , Wastie M. L. , Morgan D. A. L.
Published: July 2009

The paraganglia are widely dispersed collections of specialized neural crest cells arising in association with the segmental or collateral autonomic ganglia (Enzinger & Weiss, 1988). The extra-adrenal paraganglia can be best classified by their anatomical site (Glenner & Grimley, 1974).

(1) Branchiomeric paraganglia arise in association with the arteries and cranial nerves of the head and neck. Carotid body and glomus jugulare tumours are neoplasms arising from these paraganglia.

(2) Intravagal paraganglia are located within the perineurium of the vagus nerve and a vagus body tumour is an example of this type.

(3) Aorticosympathetic paraganglia arise in association with the sympathetic nervous system. Aortic body tumours and retroperitoneal paragangliomas are examples of tumours from these paraganglia.
The effect on pulmonary function of tangential field technique in radiotherapy for carcinoma of the breast
Authors: Lund M. B. , Myhre K. I. , Melsom H. , Johansen B.
Published: July 2009

We thank A. E. Johnson for her interest in our paper. It is true that we only investigated patients without a history of respiratory disease or symptoms and with normal lung function. This was done not so much in fear of a critical reduction in lung function, but more out of concern that a reduced or variable lung function due to respiratory disease per se, would mask a radiation-induced effect.
Ultrasonic detection of parathyroid adenomas
Authors: Lloyd M. N. H.
Published: July 2009

Murchison et al (1991) are to be congratulated on the high accuracy they report for the pre-operative localization of large parathyroid tumours in a small series, and their figures confirm the supremacy of ultrasound for pre-operative localization in primary hyperparathyroidism.
Computed tomographic assessment of soft tissue abnormalities following calcaneal fractures
Authors: Bradley S. A. , Davies A. M.
Published: July 2009

Computed tomographic (CT) examinations of 50 acute calcaneal fractures were compared with a further series of 77 fractures in which the date of injury preceded the CT by 6 months or more. 42 (84%) of the fractures in the acute group and 55 (71%) in the chronic group were classified as intra-articular and they form the basis of this study. The alteration in the position of the peroneal tendons in the two groups was similar, with a 5% or less difference in each category. In the acute group the peroneal tendons were normally located in 40.4% of the cases, entrapped by bone in 11.9%, subluxed in 33.3% and dislocated in 14.2%. Structural abnormalities of the peroneal tendons and surrounding soft tissues were identified in 52.4% of the acute group and in 61.1% of the chronic group. The incidence of partial rupture of the peroneal tendons in the chronic group was approximately one third that in the acute group, but the low incidence of complete tendon rupture remained unchanged. The inference from these observations is that, in the majority of cases, partial peroneal tendon rupture is reversible, whereas complete rupture is not. Seven fractures were common to both series and from this limited group the identification of haemorrhage around the peroneal tendons in the acute phase was shown not to be related to the subsequent development of chronic stenosing tenosynovitis. Various abnormalities of the medial tendons of the hindfoot were identified in 17% of the acute group and in 18% of the chronic group. Following calcaneal fracture, CT in both the immediate post-fracture period and in the late phase can be used to detect and classify the soft tissue changes. The limitations of comparing the two groups in this study are discussed.
Measurement of tibial torsion—a new technique applicable to ultrasound and computed tomography
Authors: Butler-Manuel P. A. , Guy R. L. , Heatley F. W.
Published: July 2009

A new method for measuring tibial torsion is described which can be applied to both ultrasound (US) and computed tomography (CT). The method has been validated in dry tibiae by comparison with direct measurements and with Jend's established CT method. In clinical practice a good statistical level of agreement has been demonstrated between the values obtained from US and CT scans. Both compared well with values obtained using Jend's CT technique. The use of US avoids exposure to radiation and is therefore suited to studying young subjects and controls and making repeat measurements.
Percutaneous transluminal angioplasty: pain during balloon inflation
Authors: Korogi Yukunori , Takahashi Mutsumasa , Bussaka Hiromasa , Hatanaka Yoshimi
Published: July 2009

The pain during the balloon dilatation of angioplasty was evaluated prospectively to assess its clinical significance. In 54 angioplasties, no pain was observed in 54%, mild pain in 20%, moderate pain in 11% and severe pain in 15%. Moderate or severe pain was observed in 39% of 28 iliac angioplasties and in 7% of 14 femoral angioplasties. There was a significant difference between the two groups. We did not find any significant correlation between the severity of pain and stenotic ratio before angioplasty. Severe pain may be a warning of severe dissection; in our study, all severe dissections were accompanied by severe pain without arterial rupture.
Re-irradiation of soft-tissue sarcoma
Authors: Graham J. D. , Robinson M. H. , Harmer C. L.
Published: July 2009

Re-irradiation for local recurrence of malignancy after radical radiotherapy is of proven benefit at head and neck sites but has seldom been used elsewhere. This paper reports a series of 10 patients re-irradiated with external-beam techniques for local recurrence of soft-tissue sarcoma of the limb and limb girdle following initial limb conserving management with surgery and radiotherapy (dose range 33–60 Gy). Median survival was 14 months following re-treatment. Two cases received treatment with high-energy electrons and the rest with megavoltage photons. Five patients re-treated with radical intent (dose range 40–60 Gy) had a median survival of 36 months and median recurrence-free survival of 16 months. All five patients treated palliatively (dose range 12–50 Gy) have died, although two demonstrated local control until death. Acute reactions were not severe. Radionecrosis was seen in one patient who was re-irradiated twice (total dose 145 Gy) and subsequently required amputation. One other case required amputation for persistent local disease, but in the remaining eight, limb conservation was achieved. Re-irradiation of soft-tissue offers good local control and may avoid amputation.
Magnetic resonance imaging of peritoneal leiomyosarcomatosis
Authors: Kerslake Robert W. , Worthington Brian S.
Published: July 2009

Diffuse peritoneal and omental metastatic disease is a well recognized phenomenon and usually results from primary gastrointestinal tract or epithelial ovarian tumours. Leiomyosarcoma, an uncommon malignant neoplasm of smooth muscle origin that tends to arise in the genitourinary tract, retroperitoneum, alimentary tract or soft tissues, only infrequently gives rise to peritoneal or omental metastases. We report a patient with a primary high-grade leiomyosarcoma of the uterus, who subsequently developed diffuse peritoneal metastatic disease, demonstrated by magnetic resonance imaging (MRI) and confirmed surgically. These unusual MRI appearances do not appear to have been reported previously.

A previously well 43-year-old woman presented with polymenorrhagia and was found clinically to have a uterus enlarged to 12–14 weeks' gestational size. She underwent a routine hysterectomy, and at laparotomy an enlarged fibroid uterus (15 cm × 9 cm × 7 cm) was removed and a right haemosalpinx resected. The ovaries were normal and were conserved. Histological examination of the resected uterus showed a highgrade (mitotic count of more than 10/10 high-power field) leiomyosarcoma in a partially necrotic pedunculated fibroid of 5 cm diameter situated within the upper uterine cavity. There were several foci of myometrial invasion, the deepest extending to 0.3 cm from the serosal surface. Some regions of hyalinization and necrosis were present. Islands of tumour abutted but were not invading thin-walled blood vessels. The histology of the right fallopian tube showed chronic salpingitis only.
Computer-based teaching file
Authors: Cornali M. , Battaglia A. P.
Published: July 2009

Many radiologists take great pride in their collections of interesting cases, which are invaluable in teaching institutions. At times, either for statistical or research demands, it is necessary to have data at hand in a quick and easy way. The computer is ideally suited to accomplish these functions.
The use of MRI in the investigation of spinal cord compression
Authors: Podd T. J. , Walkden S. E.
Published: July 2009

Magnetic resonance imaging (MRI) already has an established place in the investigation of spinal cord compression (Chadwick et al, 1991), but is not widely available in district general hospitals in which, in contrast to academic centres, cost effectiveness is of paramount importance.
Book reviews
Authors: Blake P.
Published: July 2009

This book is produced by the Interstitial Collaborative Working Group in the United States, with contributions from 10 authors from the fields of radiotherapy and medical physics.
Book reviews
Authors: Reidy J. F.
Published: July 2009

At a time when most textbooks on cardiac imaging are concentrating on the newer techniques and, in particular, non-invasive methods, it is rather unusual for a new textbook on cardiac angiography to emerge. The University of Alabama is a world-renowned centre for congenital heart disease and the great experience of a cardiac radiologist and a surgeon has been combined in producing this impressive volume.
CT evaluation of lymph node status at presentation of prostatic carcinoma
Authors: Spencer John , Golding Stephen
Published: July 2009

Computed tomographic (CT) studies performed within a general oncology service in 104 consecutive patients with prostatic carcinoma were reviewed retrospectively to assess the incidence and distribution of lymphadenopathy. All patients were staged with CT at initial presentation, had normal skeletal scintigrams and were candidates for radical radiotherapy. The likelihood of lymphadenopathy was associated with increasing T-stage. 57 of the 92 (62%) patients without lymph node enlargement had local disease confined to the prostate (T2 or less) compared with only two of the 12 (17%) patients with enlarged nodes. Lymph node enlargement was more likely with a primary tumour of poorly differentiated histology. 12 patients (11.5%) had lymphadenopathy by established CT criteria; six with pelvic nodal enlargement alone and six with enlargement of pelvic and retroperitoneal nodes. In all patients pelvic nodal enlargement predominated and no patient had isolated retroperitoneal lymphadenopathy. Our findings indicate that CT staging studies of prostatic cancer do not need to include the retroperitoneum if there is no lymphadenopathy at or below the aortic bifurcation.
Echo pattern of lymph nodes in colorectal cancer: an in vitro study
Authors: Rafaelsen S. R. , Kronborg O. , Fenger C.
Published: July 2009

Surgical specimens from 75 patients with colorectal cancer were examined within 15 min of removal with a 7.5 MHz linear-array transducer. The echo pattern of 139 lymph nodes was analysed to evaluate previous criteria of malignancy and to establish other possible criteria, which could be tested in vivo. The pathologist examined each node without knowledge of the sonographic finding. Malignant nodes were larger than benign nodes. Of 21 nodes less than 5 mm in diameter, 20 were benign. Round nodes were malignant more often (45/78) than ovoid nodes (6/61). A homogeneous echo pattern was associated with malignancy in 39 of 82 nodes in contrast to 12 of 57 with a heterogeneous pattern. Thirty-one nodes were ovoid as well as heterogeneous and all of these were benign. A hyperechoic centre was found in 14 nodes of which two were malignant. The highest predictive value for malignancy (59%) was obtained by combining the discriminative properties of shape, homogeneity and echogenicity.Keywords: Colorectal carcinoma, Lymph nodes, Ultrasonography
Computed tomography in agenesis of the lung in infants
Authors: Argent A. C. , Cremin B. J.
Published: July 2009

This paper describes the clinical and radiological findings in three infants with agenesis of a single lung. In the two cases of right lung agenesis, severe gastro-oesophageal reflux was present. In these two cases, contrast-medium-enhanced computed tomography (CT) excluded vascular compression of major airways in one patient but demonstrated mild compression in the other. Conventional CT in the case of left lung agenesis demonstrated posterior herniation of the contralateral right lung.