bluuebunny/crossref_metadata_2025 huggingface dataset:
Book reviews
Authors: Reidy J. F.
Published: July 2009

Great developments have occurred in cardiac imaging with the advent of the new imaging techniques. In keeping with this, the editors state in the preface that their “major educational goal was the creation of a text that would serve as a bridge between the basic imaging scientists and clinicians”. The editor and his three associate editors are cardiologists who, it would appear, also have a major interest in nuclear medicine. This would account for the strong nuclear medicine bias seen throughout this book.
Are the results of the St Thomas' trial of post-mastectomy radiotherapy inconsistent with the predictions from the linear-quadratic model?
Authors: Bates Thelma D.
Published: July 2009

I welcome the constructive comments of Dr Bentzen and Dr Thames on the St Thomas' dose fractionation trial and agree with them that the linear-quadratic model predicts the less severe late subcutaneous fibrosis found in the 6-fraction arm of the trial. But this is not quite the same as predicting its degree.
Book review
Authors: Dennett Rosemary
Published: July 2009

The combination of clearly defined radiographic technique, together with explanations of variations in the anatomy and pathology found in the paediatric patient, will assist the radiographer or trainee radiologist in understanding the reasons why modifications in technique are sometimes required in paediatric practice.
Echocardiographic diagnosis of massive pulmonary embolism
Authors: Weston M. J. , Wilde P.
Published: July 2009

The radiological diagnosis of pulmonary embolus usually involves radionuclide ventilation–perfusion scans and pulmonary angiography (Windebank, 1987). The latter is an invasive technique with inherent risks to the patient, but is recognized as the investigation of choice for visualizing the embolus in the pulmonary artery (Alderson & Martin, 1987). We report on a case of an acute, haemodynamically significant pulmonary embolism, where echocardiography provided the diagnosis and demonstrated the embolus lying in the pulmonary artery.
Book reviews
Authors: Shaw D. G.
Published: July 2009

This delightful small book is a highly personal collection of articles. The first grouping consists of radiologists' views of their practice and themselves from such venerable practitioners as Mellins, Newell, Goin, Sherman, Ross and Riggler.
Biological equivalence between fractionated radiotherapy treatments using the linear-quadratic model
Authors: Yaes R. J. , Feola J. , Wierzbicki J. , Urano M. , Maruyama Y.
Published: July 2009

Deehan and O'Donoghue (1988) have shown that, in the context of the linear-quadratic (LQ) model, it is possible to define “generally equivalent” courses of treatment that will produce equal effects in all tissues and tumours. The LQ isoeffect relations used by Deehan and O'Donoghue have no dependence on the total treatment time and thus account for sublethal damage repair but not for cell proliferation. The authors have implied that a generalization of their result to a model that does describe cell proliferation with an explicit time dependence would be difficult. In fact, such a generalization is simple and appreciation of this could greatly aid radiation therapists in their clinical practice and could prove useful.

In the LQ model it is assumed that both normal-tissue damage and tumour control result from the depletion of specific target stem cell populations (Douglas & Fowler, 1976; Thames et al, 1982).
Soft-tissue sarcoma: neutrons versus photons for post-operative irradiation
Authors: Glaholm J. , Harmer C.
Published: July 2009

Our paper describes five patients of the Royal Marsden Hospital Sarcoma Unit who were referred to the Hammersmith Hospital for neutron irradiation.

Radiation field sizes were obtained from case notes and correspondence in the absence of planning details from the Hammersmith Hospital. We acknowledge the above discrepancies. It is to be noted that the field area used to treat Case 10 was smaller than that which we have quoted yet despite this the patient developed serious late tissue damage. Case 11 was excluded from analysis of late-effects because the patient died very soon after radiotherapy. Although this patient had macroscopic disease prior to radiotherapy and therefore technically breached the study protocol, we do not consider this to be a reason for exclusion from the report.
Book reviews
Authors: Tobias Jeffrey
Published: July 2009

This volume is the outcome of a symposium held in June 1986 designed to provide recommendations for therapy of lung metastases of malignant tumours, but biology, pathology and diagnosis are all well covered before the approached therapy is discussed. I particularly enjoyed the chapter by Schirrmacher (Heidelberg) on experimental approaches in nude mice and other tumour systems, with its useful summary of immunotherapy, and the two lengthy chapters, by one of the editors, on indications and surgical results.
Book reviews
Authors: Powell P. H.
Published: July 2009

This book covers in considerable detail some of the major topics in urological oncology. The text is aimed primarily at urologists practising in the field of clinical oncology. The contents comprise a series of papers given at a symposium on urological cancer held in Baltimore in 1987. The Editors aim to compile an in-depth study of recent advances in the diagnosis and management of genito-urinary tumours.
Book reviews
Authors: Shaw Donald
Published: July 2009

“Keat's Atlas” with its three previous editions has become established as a virtually essential bench book in all radiodiagnostic departments.
Book reviews
Authors: Kendall B.
Published: July 2009

In this book a detailed description of the anatomy and physiology of the arterial supply and venous drainage of the spinal cord, nerve roots and spinal meninges is presented. Pathological processes affecting the spinal circulation and, in particular, the pathophysiology of angiomas, arterio-venous anomalies, compressive lesions and vascular obstructions are discussed.
Book reviews
Authors: Parsons C. A.
Published: July 2009

The objective of the book is to set out the relative merits and limitations of the imaging methods currently available for breast cancer diagnosis. This is accomplished in a fair and accurate way. It is especially directed at those who “are seeking guidance on mammographic interpretation and in the selection of breast imaging equipment”.
A physical evaluation of the imaging performance of a high-resolution fluorography system
Authors: Cowen A. R.
Published: July 2009

A physical evaluation of the imaging performance of a unique high-resolution fluorography system is presented. Measurements have been made of contrast performance, unsharpness (modulation transfer function) and noise (Wiener spectrum and threshold contrast detectability), and the results have been compared with those measured from medium-fast calcium tungstate and rare-earth screen-film combinations and a standard fluorography system. The results have proved sufficiently encouraging that a full-scale trial is now underway to evaluate the system's performance in routine clinical application.
A painful knee
Authors: Davies A. M. , Evans N.
Published: July 2009

A 37-year-old Asian woman presented with a 10-month history of periodic pain in the lateral aspect of the right knee becoming more severe over the past 2 weeks. Plain radiography revealed an expansile, lytic lesion in the head of the fibula, which had a well defined margin with a small cortical infraction posteriorly (Fig. 1). A bone scan showed a solitary, uniform focus of increased activity corresponding to the abnormality on the radiographs. Computed tomography (CT) demonstrated the expansile nature of the lesion (Fig. 2). All routine laboratory investigations were normal.
A radiological feature to assist in the diagnosis of intestinal obstruction
Authors: Walker Jenny , Carty Helen
Published: July 2009

Management of intestinal obstruction in neonates and infants is improved if accurate diagnosis of the site and cause of obstruction can be made pre-operatively. Contrast studies can be helpful in this context, especially when performed by a radiologist experienced in paediatric surgical conditions. We present two cases where an unusual radiological feature helped to identify the site and cause of intestinal obstruction.
Book reviews
Authors: Peters A. M.
Published: July 2009

This is a short, easy-to-read book, generally well illustrated, in which the reader is shown radionuclide images and then questioned on them. In each case, the images are shown again on the following pages with a discussion of the findings and outcome.

The cases are a reasonably good reflection of current nuclear medicine referrals, except I thought some monoclonal antibody studies should have been introduced and there are only two cardiac studies in the 54 cases.
Magnetic resonance imaging of the normal prostate at 1.5 T
Authors: Gevenois P. A. , Salmon I. , Stallenberg B. , van Sinoy M. L. , van Regemorter G. , Struyven J.
Published: July 2009

Prostatic magnetic resonance images of 22 male volunteers less than 30 years old and with no known genito-urinary tract disease were obtained at 1.5 T. Normal anatomical features of the prostate were studied with spin–echo techniques. Different zones of the normal gland are shown by T  2weighted images: the anterior fibromuscular fascia, the central prostate, the peripheral prostate and the periurethral zone' can be differentiated. The normal prostate gland is shown on T  1-weighted images as a homogeneous appearance. It is important to recognize the normal zonal anatomy of the prostate since prostatic disorders arise in different anatomical zones.
Screening for breast cancer
Authors: MacDonald A. F.
Published: July 2009

It is a pity that in the otherwise excellent review of the UK Breast Screening situation by Professor Forrest he perpetuates two errors of his working party. The first is that a single view is adequate for the initial breast screen.
Book reviews
Authors: Gordon I.
Published: July 2009

This book is a comprehensive review of all aspects of nuclear medicine involving the lungs. The 19 chapters cover not only the full range of imaging but also the full spectrum of diseases affecting the lungs. Many of the chapters provide both a review of the literature and also a detailed study of a particular, and frequently not well known, aspect of the radionuclides in pulmonary function.
Book reviews
Authors: Savage John R. K.
Published: July 2009

This report reviews the methodologies used to evaluate the carcinogenic risk of radiation with particular reference to their applicability to chemical carcinogens. The mechanisms of action of chemicals are much more varied than ionizing radiation and concepts of “dose” and “dose-response” much less well defined. Add to this the problems posed by in vivo metabolism, organ specificity and the associated complexities introduced into mathematical modelling and it is obvious that risk and risk estimate exercises are much more-uncertain.

The responsible National Council on Radiation Protection and Measurements (NCRP) Task Group, under the able Chairmanship of Dr A. C.
Book reviews
Authors: Gifford Derek
Published: July 2009

This book is described as consisting of a collection of 74 worked problems in the general field of health protection from ionizing radiation. There could be little that is more revealing of the difference between the work of a health physicist in the nuclear industry and that of a medical physicist in a hospital, or of the difference between the American question and answer style of teaching and the system in the UK, where there are as yet few courses leading to formal qualifications in radiation protection and one is expected to go away and work by oneself, than this collection of 74 worked problems in the general field of protection from ionizing radiation.

As is inevitable in a book of this size which attempts to cover a wide range of subject matter—there are 17 topic headings, ranging from accelerators (two examples) to units—the coverage in each field is sometimes superficial.
Book reviews
Authors: Paine C. H.
Published: July 2009

This short book provides an excellent overview of several different but related problems that face not only cancer physicians, but other groups of doctors too in the whole field of modern medicine.

In his preface, Dr Stoll draws attention to the sensitive area of the limitation of active treatment in advanced disease. Serious ethical problems arise here and the cost of continuing active treatment is not only financial but also relates to the risk of lessening the quality of the remainder of the patient's life rather than improving it. High technology plays its part in this dilemma, as may inappropriate recourse to surgery or intensive cytotoxic chemotherapy. The increasing age of the population in developed countries makes these decisions even more difficult.
Book reviews
Authors: Bingham J. B.
Published: July 2009

This inexpensive, pocket-sized paperback is part of a series published by Raven Press on MR anatomy. The first section of the book covers the anatomy of the thorax with spin-echo images in transaxial section, a few sagittal and coronal sections and sagittal oblique images through the aortic arch. The majority of these were obtained at 0.35 Tesla, but there are a few transaxial images at 1.5 Tesla and eight gradient-echo images showing the enhancement of signal seen with flowing blood using this sequence.
The computed tomographic appearances and clinical significance of intussusception in adults with malignant neoplasms
Authors: Lorigan James G. , DuBrow Ronelle A.
Published: July 2009

The computed tomography (CT) appearances of intussusception in 14 patients and the clinical follow-up of this condition in 17 adults with known primary malignant neoplasms were retrospectively reviewed. The ages of the 11 men and six women ranged from 25 to 83 years. Nine patients had been treated for malignant melanoma and the others for various primary neoplasms. Intussusception on CT was characterized by thickening of the affected bowel segment in all 14 patients and by the presence of intraluminal fat density material in 13, a concentric ring or “target” lesion in four, and an intra-luminal soft-tissue mass in nine. Five patients had intussusception, without other evidence of disease, caused by metastases in three patients, lipoma in one and idiopathic in one. Eleven of the other 12 patients had extensive disease, and one had small bowel cytomegalovirus infection. Five of these patients had more than one site of bowel involvement. Ten of the 12 patients had progression of disease on follow-up CT examinations and six died between 26 days and 7 months after diagnosis of intussusception. Intussusception may occur as the first indication of tumour recurrence or metastasis, but is more commonly a manifestation of widespread disease. However, even in patients with malignant neoplasms, it may be idiopathic or a result of benign neoplasm.
Clinical study of relative biological effectiveness for cervical carcinoma treated by 252Cf neutrons and assessed by histological tumour eradication
Authors: Maruyama Yosh , Feola Jose M. , Wierzbicki Jacek , van Nagell John R. , Powell Deborah , Yoneda Justine
Published: July 2009

Clinical data of the University of Kentucky trial using californium (252Cf), or caesium (137Cs), are reviewed for dose–response based on the endpoint of tumour eradication estimated from hysterectomy specimens obtained 4–6 weeks after preoperative irradiation. These data are used to assess the relative biological effectiveness (RBE) for 252Cf neutrons compared with l37Cs γ radiation. Tumours treated were of common stage but were of bulky or barrel shape suitable for “radiosurgical” therapy. Dose–response curves were constructed, and additional data from the literature used to analyse the curve shape. The photon dose–response curve is complex on a logarthmic plot, whereas the 252Cf neutron curve is exponential. This indicates that the RBE can be different depending on the number of implants, schedule and size of dose delivered per session. The RBE values were approximately 8.0 at low doses or for multiple implants but they may rise to approximately 16 at larger doses or for single 252Cf implants.
Osteosarcoma: an unusual thoracic metastasis
Authors: Charig M. J. , Golding S. J. , Lindsell D. R. M.
Published: July 2009

Metastases from osteosarcoma often occur in the lungs, usually as multiple nodules but sometimes as a solitary mass. Lymph node involvement is unusual. We present a case of metastatic recurrence as a solitary, stellate, ossified, pulmonary mass extending across the pleura associated with ossified hilar lymphadenopathy.

A 15-year-old male, whose only previous medical history was resection of a right ventricular infundibular stenosis 18 months earlier, presented in November, 1987 with pain and swelling in the distal right femur. This proved on biopsy to be caused by an osteosarcoma, and after staging with chest radiograph, computed tomography (CT) and bone scintigraphy, no spread was evident. After three courses of cisplatinum and adriamycin, the distal femur containing the primary tumour was resected and a knee prosthesis inserted. Following three further courses of chemotherapy he. remained well for nearly a year, until March, 1989. A follow-up chest radiograph at this time revealed right paratracheal lymphadenopathy and an upper lobe mass (Fig. 1). A chest radiograph 2 months earlier had been normal. Computed tomography demonstrated an irregular, stellate mass with central ossification in the right upper lobe, extending supero-posteriorly, and ossifying lymphadenopathy around the upper lobe bronchus (Fig. 2). The latter was connected to the mass by strands of ossified material. Scintigraphy with 99Tcm-hydroxy methylene diphosphonate (99Tcm-HMDP) revealed intense uptake in the mass and nodes but no skeletal metastases (Fig. 3).
A diaphragmatic nick
Authors: Broderick N. J. , Whyte A. M.
Published: July 2009

A 27-year-old man was admitted with acute onset of severe, constant epigastric pain and vomiting associated with lifting at work. There were no other symptoms. Four years previously he had attended the Casualty Department with a knife wound to the left chest which had been sutured. Examination revealed only generalized abdominal tenderness. Haematological and biochemical investigations showed a mildly elevated white cell count (16.1 × 109/L). Abdominal radiographs were unremarkable. Forty-eight hours after admission he deteriorated rapidly with increasing abdominal pain, hypotension and tachycardia.
Final Report of the BIR fractionation study
Authors: Wiernik George , Alcock C. J. , Fowler J. F. , Haybittle J. L. , Hopewell J. W. , Rezvani M.
Published: July 2009

We were interested to see Dr Fletcher's comments on the Final Report of the BIR Fractionation Working Party's trial of 3F/wk versus 5F/wk in the treatment of carcinoma of the laryngo-pharynx. Any reader examining the report in detail will, we believe, find very little evidence to support Dr Fletcher's criticisms.
Can ultrasound replace the intravenous urogram?
Authors: Spencer J. A. , Lindsell D. R. M. , Mastorakou I.
Published: July 2009

We read with interest the study of Lewis-Jones et al (1989) comparing ultrasound (US) with intravenous urography (IVU) in the preliminary investigation of renal tract disease.

We have compared the two prospectively, with an almost identical protocol, in adults referred for IVU to investigate urinary tract infection (UTI) and haematuria (excluding patients with traumatic haematuria or acute loin pain).

We would concur with their comments about the need to reduce the hazards of exposure to radiation (and to contrast media) in young women, a significant proportion of patients referred for investigation of UTI.
Book reviews
Authors: Blake P.
Published: July 2009

This book is Volume 20 in the Monograph series of the European Organization for Research and Treatment of Cancer (EORTC). It contains contributions from a large number of authors concerned with carcinoma of the ovary, with 37 chapters covering tumour biology, diagnosis of and staging early ovarian carcinoma, surgery, advanced ovarian carcinoma and new therapeutic modalities.
Book reviews
Authors: Tait Diana
Published: July 2009

This is a useful book for anyone concerned with the care of children with cancer. Because of the impact of chemotherapy in this area of oncology, most textbooks deal only briefly with the role of radiotherapy. Here is a text that systematically covers the cancers of childhood, giving a full picture of the epidemiology, pathology, diagnosis and treatment, but, in addition, addresses the question of the use and effects of radiation.
Glutathione and cysteine levels in human tumour biopsies
Authors: Guichard M. , Lespinasse F. , Estelin R. , Gerbaulet A. , Haie C. , Lartigau E. , Malaise E. P. , Micheau C. , Prade M. , Richard J. M. , Weeger P.
Published: July 2009

There is evidence that some human tumours could be treated with a combination of buthionine sulfoximine and hypoxic cell sensitizers. However, clinical application of this technique requires a prior knowledge of the level of non-protein bound sulfhydryl (NPSH) compounds in these tumours. The present study provides data on the levels of glutathione (GSH) and cysteine (CYS) in human tumour biopsies from the cervix and from the head and neck. The NPSH compounds were measured by high performance liquid chromatography. The median GSH values were 20.5 nmol/mg protein (cervix) and 23 nmol/mg protein (head and neck) while the median CYS values were 4.4 (cervix) and 4.2 nmol/mg protein (head and neck). The values varied widely from one patient to another.
Intraluminal irradiation in oesophageal tumours using the high-dose-rate Microselectron
Authors: Hay J. H. , Flores A. D.
Published: July 2009

We were interested to read the technique for intraluminal irradiation of oesphageal tumours described by Burt and his colleagues (1989) and wish to comment on the conclusions that they have drawn from their limited experience with the highdose- rate Microselectron.

Since January 1985 we have used intraluminal radiotherapy as part of the treatment of more than 300 patients with either oesophageal or cardia tumours. These patients represent more than 90% of all the patients with oesphageal tumours referred to our centre.
Book reviews
Authors: Freeman Alan
Published: July 2009

With the steady advance of endoscopic techniques from both ends of the alimentary tract, radiologists are turning their attention to the relatively neglected portion in between; the small intestine. As a result, a number of books have appeared in recent years, and a new addition to these ranks is this elegant publication by Antes and Eggemann. The authors are champions of the double contrast technique and in particular favour the use of high density barium together with a methyl cellulose suspension in order to gain the double contrast effect.
Book reviews
Authors: Freeman A. H.
Published: July 2009

I experienced a certain sense of déjà vu when I was presented with this book. The reason is simple: the cover illustration is almost exactly the same as that found on Radiology of the Small Bowel, Modern Enterolysis Technique and Atlas by Sellink and Miller, published by Martinus Nijhoff in 1982. This was a superb book and regarded by many as the “Bible” of small bowel radiology. It was authoritative, comprehensive and beautifully illustrated.
Magnetic resonance of diseased skeletal muscle: combined T
1 measurement and chemical shift imaging
Authors: Lamminen Antti E. , Tanttu Jukka I. , Sepponen Raimo E. , Suramo Iikka J. I. , Pinko Helena
Published: July 2009

Magnetic resonance examinations of skeletal muscle with differential T  1 relaxation time measurements were performed in 19 patients with muscular dystrophies and congenital myopathies, and in eight control subjects. A field echo chemical shift imaging technique was used. Tx values of muscular tissue were measured from the primary composite images, and differential T  1 values were calculated separately from water and fat images. Longitudinal relaxation times of skeletal muscle were significantly increased in both dystrophies and myopathies. The results of differential relaxation time measurements suggest that intramuscular fat reduces the abnormal increase in T  1 of diseased muscle tissue. When characterizing diseases of skeletal muscle by T  1 relaxation time measurements, the contribution of secondary fatty infiltration must be considered.
Linear opacities as a feature of pneumocystis pneumonia
Authors: Page J. E. , Wilson A. G.
Published: July 2009

Linear opacities are generally regarded as uncommon in pneumocystis pneumonia. The authors' experience suggests this is not so, and that such opacities may have diagnostic value. Chest radiographs of 22 episodes of uncomplicated pneumocystis pneumonia were reviewed and linear opacities were present in nine episodes (41%). Similar opacities were present in 11 out of 121 cases of other pneumonias (9%). Characteristically the opacities are related to the acute illness, usually one to three in number, predominantly basal, 1–4 cm long and less than 2 mm thick. Other radiographic signs of pneumocystis pneumonia were present in all cases. The pathogenesis of these linear opacities is uncertain, but it is possible that they result from areas of sub-segmental atelectasis. The frequency of such linear opacities is much greater in pneumocystis pneumonia (four times) than in other pneumonias and they therefore have some diagnostic value.
A flat-top patient support for radiotherapy application computed tomographic scanning
Authors: Clark J. , Seaby A. W. , White M. V.
Published: July 2009

Computed tomographic (CT) scans for radiotherapy treatment planning must be taken with the patient lying in a position that can be reproduced exactly on the simulator and treatment unit couches. For this reason, a flat-top patient support must be placed over the dished CT cradle. The insertion of additional material in the beam may degrade the quality of the image obtained. Therefore, it is desirable that the flat-top should have a high X-ray transmission. Other desirable characteristics are that it should be:

strong—the flat-top must not be distorted by the weight of the patient;

stable;

light and easy to handle and position;

comfortable;

easy to clean and resistant to biological fluids; low cost.
Computed tomography demonstration of portal venous gas after hepatic artery embolization
Authors: McCarthy P. , Adam A. , Jackson J. , Benjamin I. S. , Allison D.
Published: July 2009

Hepatic portal venous gas is an entity frequently associated with a sinister outcome in infantile necrotizing enterocolitis, small bowel infarction and intra-abdominal sepsis (Sisley et al, 1987). A recent case report described its occurrence in a patient receiving monoclonal antibody therapy (Waymack et al, 1987). We describe a case in which portal venous gas appeared secondary to therapeutic embolization of the hepatic artery, a phenomenon which, to our knowledge, has not been reported previously. The diagnosis was made by computed tomography (CT) and the gas remained in the portal system for at least 8 days.

A 22-year-old male patient was referred from another hospital following a road traffic accident 2 weeks previously. Laparotomy immediately after the accident had revealed two deep lacerations in the right lobe of liver which were controlled by suturing and drainage. Post-operatively the patient had a persistent pyrexia followed 2 weeks later by melaena and haematemesis associated with hypotension and right hypochondrial pain.
Ultrasound as part of a 1-day gastroenterology clinic: advantages and problems
Authors: Ryan S. , Chua A. , Clabby C. , Keeling P. W. N. , Fitzgerald E. J.
Published: July 2009

Ultrasound was introduced into a 1-day gastroenterology clinic so that clinical assessment, endoscopy and ultrasound could be performed as appropriate in a single hospital visit. The findings in 602 patients are reported. A total of 256 (43%) patients underwent ultrasound, 35% of which showed positive findings including cholelithiasis in 12% and tumours in 7%. This system of referral for ultrasound is very convenient for patients and their general practitioner and is less costly than traditional referral methods. It is, however, time-consuming for the radiologist.
Comparison of iopromide and iopamidol in left ventricular angiography and in coronary angiography
Authors: Dyet J. F. , Carter E. C. , Hartley W. C.
Published: July 2009

A double blind randomized trial of two non-ionic contrast media—iopamidol and iopromide—was performed on 101 patients undergoing left ventriculography and coronary angiography. Both products performed well in the trial and there were no statistically significant differences in side effects, cardiovascular parameters, blood analysis or film quality between the two products.
Treatment outcome of spinal cord compression by nasopharyngeal carcinoma
Authors: Leung S. F. , Tsao S. Y. , Shiu Wesely
Published: July 2009

Spinal cord compression occurred in 1.6% of a cohort of 626 patients with nasopharyngeal carcinoma during a median follow-up period of 22 months. The degree of motor deficit before treatment was the most important predictor of subsequent motor recovery. One patient had complete reversal of motor deficit and returned to an ambulatory state by chemotherapy alone. The development of spinal cord compression was associated with a short life expectancy in nasopharyngeal carcinoma.
Book reviews
Authors: Starritt Hazel
Published: July 2009

Currently radiation dose limits are under review. This book is a compilation of 54 papers, discussing the biological basis of risk assessment, presented at a recent international conference supported by the L. H. Gray Trustees. The editors, from the MRC Radiobiology unit and the NRPB, state that the book is intended to fulfil two main objectives. The first is to provide information which can be used as the basis of recommendations for radiation protection, and the second is to contribute to an understanding of the underlying mechanisms of biological effects of radiation. Both these aims are addressed thoroughly.
Book reviews
Authors: Shaw P. J.
Published: July 2009

This book is primarily concerned with breast sonography and covers basic technical aspects, benign and malignant disease in some detail, effects of iatrogenic procedures and blood flow assessment. It describes the evolution and illustrates the present state of breast sonography well. The chapter on benign breast disease is particularly informative and well illustrated, covering a wide range of topics from ductectasia, benign and other unusual benign tumours and indicates the difficulty in distinguishing a carcinoma from fibrocystic disease. Useful line drawings help to illustrate the text.

The editorial standard of the book is good, and the book is easy to read. It is reasonably indexed and very well referenced. There are an appropriate number of illustrations which are mainly of automated immersion scans with some real time scans. Both are of a high standard making interpretation of the former easy for ultrasonographers not used to this type of breast sonogram. The quality of reproduction is very high and labelling usually accurate. Many of the lesions are arrowed but there are still several rather subtle lesions which are not. Colour illustrations for thermography are included.
The role of Indium-labelled leukocyte imaging in pyrexia of unknown origin
Authors: Davies S. G. , Garvie N. W.
Published: July 2009

Indium-111-labelled white blood cell scanning is often used in the investigation of pyrexia of unknown origin (PUO) to locate an otherwise occult source of sepsis. From a series of 166 white blood cell studies performed for sepsis, 28 cases of true PUO were identified and reviewed. The sensitivity was 60% and specificity 70%, with a positive predictive value of 38% and negative predictive value of 90%. Only 11% of studies revealed a pyogenic cause for PUO. These results are discussed and the potential role of gallium scanning in PUO is raised.
Book reviews
Authors: Hunter G. J.
Published: July 2009

This is a book of 311 pages in the usual format of multi-author chapters under the editorial control of Drs Wasserman and Ross.

The preface sets out the aims of the book and, in summary, these aims are fulfilled by 12 chapters covering all aspects of cardiovascular digital subtraction angiography (DSA).

In the introduction, one quibble is the use of “digitalization” when clearly the authors meant “digitization”, one referring to examination by the use of a finger, the other being the computerization of data! Otherwise the introduction covers briefly the history and present and future potential of subtraction angiography.
Book reviews
Authors: Baddeley H.
Published: July 2009

Magnetic resonance imaging (MRI) and computed tomography (CT) have an increasing role in the diagnosis of head and neck tumours, and this monograph presents 35 cases in which CT and MRI have played a role in diagnosis and staging. Although two orbital cases are included, the emphasis is on tumours of the paranasal sinuses, temporal bone, salivary glands, pharynx and larynx. Glomus tumours are included but acoustic neuromas and haemangiomas are not.
The antenatal diagnosis of congenital cystic adenomatoid malformation of the lung
Authors: Deacon C. S. , Smart P. J. , Rimmer S.
Published: July 2009

Congenital cystic adenamatoid malformation (CCAM) is a rare pulmonary malformation characterized by the overgrowth of the terminal respiratory structures. Approximately 200 cases have been reported in the literature and the antenatal diagnosis by ultrasonography has been described in several case reports. We report two cases of this condition where the diagnosis was made antenatally. In the second case, the early diagnosis of the lethal microcystic form of the abnormality at a gestational age of 18 weeks allowed the elective termination of the pregnancy. This is the earliest diagnosis of this form of CCAM that has been reported.

A 28-year-old woman (gravida 3, para 1) was referred for a detailed antenatal scan after a scan at another hospital revealed multiple cysts within the right hemithorax. The detailed scan showed a single fetus of an estimated gestational age of 25 weeks (biparietal diameter, 6.8 cm; femur length, 4.5 cm; trunk circumference, 20.5 cm). There were multiple cysts in the right thorax with displacement of the mediastinum to the left (Fig. 1). There was no polyhydramnios or fetal hydrops. A differential diagnosis of diaphragmatic hernia or congenital cystic adenomatoid malformation of the lung was made. The baby was delivered vaginally at 36 weeks and was clinically well. A chest radiograph showed patchy opacification in the right lower zone, but there was no evidence of a diaphragmatic hernia.
Book reviews
Authors: Reidy J. F.
Published: July 2009

Interventional radiology has undergone great developments in the last 15 years or so and further advances continue to be made. Though many procedures are performed as elective, non-emergency cases, (e.g. angioplasty) many are performed as emergency procedures. This book concentrates on those procedures that are performed as emergencies or acute cases. The goal of the three editors (radiologists from the Medical College of Virginia) “is to provide a broad coverage of the problems, management, and appropriate interventional techniques in the traumatized/emergent pateint”. The 23 chapters cover the complete range of interventional radiology and more, with contributions from 25 predominantly American interventional radiologists.
The variation of wedge factors with field size on a linear accelerator with wedge tray beneath secondary collimators
Authors: Dean Elizabeth M. , Davis J. Bernard
Published: July 2009

We refer to the recent technical note by Thomas (1990) in which the variation in wedge factor with field size was discussed. The linear accelerator used to produce the results in that article was a Dynaray LA 20 (Asea-Brown Boveri), in which the motorized wedge lies between the beam monitor and the movable, secondary collimators (Fig. 1a). We suggest that this wedge factor variation with field size may not occur with all designs of linear accelerator.
The prognostic significance of radiologically detected knee joint effusions in the absence of associated fracture
Authors: Lord P.
Published: July 2009

If Maskell and Finlay (1990) had also studied the prognosis of patients whose radiographs did not show a knee joint effusion, then they might have produced a more meaningful, statistical conclusion concerning the prognostic significance of the presence of such an effusion, perhaps in terms of estimated relative risk. As presented, their data are uncontrolled.
Is the coned lateral lumbosacral junction radiograph necessary for radiological diagnosis?
Authors: Lipton M. E. , Pellegrini V. , Harris I.
Published: July 2009

The lumbar spine radiographs of 400 orthopaedic outpatients were reviewed to determine if the absence of the coned lateral lumbosacral junction radiograph would lead to a loss in diagnostic accuracy. In 84 (21%) patients the antero-posterior and lateral lumbar spine radiographs failed to visualize adequately the lumbosacral junction. In these patients the coned lateral lumbosacral junction radiograph resulted in 17 (4.5%) diagnoses which would otherwise have been missed. The diagnoses were spondylosis (11), spondylolisthesis (3), spondylolysis (1), Paget's disease (1) and infection (1). Absence of the coned lateral lumbosacral radiograph will result in inadequate demonstration of the lumbosacral junction and a loss in diagnostic accuracy.
Metallic staples refluxing to the upper urinary tract: a source of renal calculi in patients with ileal conduit urinary diversion
Authors: McCarthy P. , Cheung L. , Hanno P. , Pollack H. M.
Published: July 2009

Surgical stapling devices to close the proximal end of the isolated loop of an ileal urinary conduit have been used since the early 1970s (Assadnia et al, 1972). However, the occasional development of calculi forming around the metal staples has deterred uniform acceptance of this technique in spite of its advantages of speed and decreased post-operative morbidity (Assadnia et al, 1972; Bergman et al, 1978).

We describe two patients who presented to this hospital in recent months, in whom surgical staples migrated proximally into the renal pelvis, becoming the nidus for stone formation in one of the patients.
Fetal blood sampling from the intrahepatic vein for rapid karyotyping in the second and third trimesters
Authors: Nicolaidis Peter , Nicolini Umberto , Fisk Nicholas M. , Tannirandorn Yuen , Nasrat Hassan , Rodeck Charles H.
Published: July 2009

One hundred and twelve fetuses with structural anomalies (n = 84), intrauterine growth retardation (n = 21) or amniotic fluid volume disorders (n = 7) detected by ultrasound underwent blood sampling from the intrahepatic vein for rapid karyotyping. The procedure was successful in 95.5%. 12.5% of the fetuses had an abnormal karyotype. Fetal bradycardia was observed in two fetuses (1.8%) and intraperitoneal bleeding in three (2.7%). There were three procedure-related losses but these were not due to the intrahepatic vein sampling itself. Fetal blood sampling is the method of choice for rapid karyotyping in the second and third trimesters, and the intrahepatic vein is an alternate site when access is difficult or failure to sample occurs at the placental cord insertion. Additional advantages of fetal blood sampling at the intrahepatic vein include absence of cord complications, reduced risk of fetal blood loss and fetomaternal haemorrhage, and the lack of need to confirm the fetal origin of the sample.
Stage distribution of breast cancer: a basis for the evaluation of breast screening programmes
Authors: Bull A. , Mountney L. , Sanderson H.
Published: July 2009

Stage at presentation can be predictive of future mortality rates. A change in stage distribution will be indicative of the effect of a programme. All registrations for 1985 aged over 50 years were staged from case notes and, to assess whether a stage drift is already occurring, cases that presented in 1975 were also staged. The accuracy and completeness of the Wessex Cancer Register for this particular cancer was assessed and further sources of registration identified. There was a significant difference between 1975 and 1985 stage distributions. If the Southampton and Salisbury service achieves the same success as the Gavleborg County trials, 4.61 deaths will be prevented at 5 years for each annual cohort of cases. For individual breast screening programmes, effectiveness is better monitored by analysis of stage distribution than of mortality rates.
Assessment of a radiotherapy beam analyser
Authors: Mills J. A. , Martin-Smith P.
Published: July 2009

A Protea Systems Corporation Radiation Beam Analyser (RBA-3) was acquired by this department with a view to providing non-Physics personnel with an easyto- use system to monitor both photon and electron output. The manufacturer describes the RBA-3 as not only fulfilling the above requirement reliably but also as providing a check on field flatness and symmetry. It is one of several commercially available systems for this type of application.

Having acquired the RBA-3 and made appropriate Perspex build-up, its performance was assessed. The accuracy and precision of the RBA-3 was compared with the standard routine calibration facilities used in the department.

Standard dosimetry calibrations and output checks are made using both NE 2570 and NE 2500/IONEX electrometers with NE 2571 graphite chambers. Machine calibrations are maintained in accordance with uncertainties specified in ICRU 24 and are done in the standard manner. A 10 cm × 10 cm field is set at a source-skin distance (SSD) equal to the source to axis distance (SAD) of high energy machines. The chamber is placed 5 cm deep in a closed water phantom which has been cross calibrated against an open water phantom. Field symmetry is monitored weekly using the closed water phantom and monthly using a full field inair scanner. The flatness of the accelerators at Coventry are in compliance with the IEC specification (1979) which concerns the uniformity variation across a field area defined geometrically relative to field edges determined at 50% of the central axis dose.
A comparison between iotrolan, a non-ionic dimer, and a hyperosmolar contrast medium, Urografin, in hysterosalpingography
Authors: Brokensha Candice , Whitehouse Graham
Published: July 2009

For hysterosalpingography, there were no significant differences between the non-ionic dimeric contrast medium iotrolan (300 mgI/%) and Urografin (370 mgI/%) with regard to ease of application or radiographic quality, and both agents were equally suitable. There were no significant differences between two groups of patients with regard to pain due to instrumentation, pain at the time of injection and pain up to 2 h after the procedure. There was a significant difference (p = 0.04) between the two groups with respect to delayed pain, when iotrolan was associated with a lower incidence and decreased severity of delayed pain. There were no differences in the incidence of nausea, vomiting, headache and syncope. No allergic phenomena were seen in either group.
Sling left pulmonary artery with congenital airway stenosis: non-invasive investigation and conservative management?
Authors: Hendry G. M. A. , Edmunds A. T. , Marshall T. G. , Chalmers N.
Published: July 2009

A 3-month-old boy presented with a short history progressive respiratory distress and stridor. A chest radiograph showed mediastinal shift to the right. A high-kV radiograph showed apparent complete occlusion of the right main bronchus (RMB) about 1 cm from the carina.

At bronchoscopy the RMB was thought to be compressed an extrinsic mass. Adequate ventilation was impossible. Blood gases showed respiratory acidosis. A thoracotomy failed reveal any mass compressing the RMB. Repeat bronchoscopy confirmed a “pit-like” RMB orifice and an inflamed and narrowed left main bronchus (LMB). A brief cardiac arrest followed bronchoscopy. He was successfully resuscitated with adrenaline instilled into the endotracheal tube. Post-operatively, ventilation pressures of 60/15 were required to maintain slight chest movement and acceptable blood gases. He was treated with nebulized adrenaline, ribavirin, steroids and antibiotics. He gradually improved and was extubated after 11 days.
Metastatic squamous carcinoma in the neck: an anatomical and physiological study using CT and SPECT 99Tcm(V) DMSA
Authors: Watkinson J. C. , Lazarus C. R. , Todd C. , Maisey M. N. , Clarke S. E. M.
Published: July 2009

Technetium-99m (99Tcm)(V) dimercaptosuccinic acid (DMSA) is a new tumour imaging agent that has been used to image squamous cell carcinoma (SCC) of the head and neck. This study has been undertaken to compare clinical examination with computed tomography (CT) (anatomical) and SPECT 99Tcm(V) DMSA (physiological) imaging in the evaluation of metastatic SCC of the neck. Twenty-five patients with head and neck cancer were studied. Computed tomography was as sensitive but more accurate than clinical examination in predicting the presence of cancer. SPECT 99Tcm(V) DMSA was inferior to both techniques in identifying metastatic disease. There is no role for SPECT 99Tcm (V)DMSA imaging in the management of patients with SCC metastatic to the neck.Combined imaging with CT offered no advantages over anatomical imaging withCT alone. There is no role for CT in the routine evaluation of the clinically N0 neck and the role of CT of the neck in the management of patients with metastatic SCC is discussed.
Spontaneous disappearance of a staghorn calculus
Authors: McGann G. , Grant D. , Miller R.
Published: July 2009

A case of spontaneous dissolution of a staghorn calculus is presented. Disappearance of such a stone in the absence of long term antimicrobial therapy has not been described previously.

A 68-year-old insulin dependent diabetic woman was admitted to hospital with a 3 day history of malaise, confusion and vomiting. On examination she was pyrexial with tenderness in her lower abdomen. A clinical diagnosis of pyelonephritis was made.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

This monograph consists of the proceedings from the Fourth International Symposium on Detection of Breast Cancer which took place in Copenhagen during 1988. The contents are entirely concerned with radiological aspects of breast screening. Some distinguished American radiologists, Feig, McLelland and Sickles, have each made several contributions. Those who are interested in the subject will already be familiar with much of the presented work.
Dosimetric accuracy at low monitor unit settings
Authors: Bomford C. K.
Published: July 2009

I read with interest the article by Das et al (1991) and appreciate the authors' concern over the accuracy of dosimetry systems at high dose rates and low monitor unit settings.

The purpose of writing this letter is to underline that, in the UK, the accuracy of patients' treatments should not be jeopardized as suggested, in that short exposures on linear accelerators have been deprecated for the past 20 years (HMSO, 1972; DHSS, 1975; NRPB, 1988).