bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiotherapy treatment planning of brain tumours using MRI alone.
Authors: Beavis A W , Gibbs P , Dealey R A , Whitton V J
Published: June 2014

MRI of the brain can provide images of very high quality revealing detailed information especially concerning the extent of abnormalities. As such MRI has great potential in the radiotherapy (RT) planning of brain tumours. However MRI has rarely been used alone as the basis for treatment planning primarily due to concern over potential geometric distortions. Treatment planning using MRI has therefore usually been carried out in conjunction with CT images. This work demonstrates that geometric distortions can be minimized by using a relatively small field-of-view, an increased receiver bandwidth, and a fast spin echo acquisition sequence, and that it is thus possible to perform RT planning using MRI.
Failure to detect intrauterine growth restriction following in utero exposure to MRI.
Authors: Myers C , Duncan K R , Gowland P A , Johnson I R , Baker P N
Published: June 2014

Echo planar imaging is a form of MRI with short image acquisition times, which permits in utero fetal imaging without motion artefacts. Echo planar imaging has been used to measure accurately fetal organ volume and to assess placental function. Two small animal studies have suggested the possibility of intrauterine growth restriction consequent upon MRI. We thus performed a prospective study of pregnancies in which fetuses were exposed to echo planar imaging, compared with a control group in which there was no in utero echo planar imaging exposure. There were no significant differences between the groups when maternal age, parity, proportion of smokers and proportion of Caucasian women were compared. Although the gestational age of delivery was lower in the echo planar imaging group, the proportion of women delivering prematurely was not significantly different. Although infant birthweights were significantly lower in the MRI group, the corrected birthweight for gestational age centiles (individualized birthweight ratio) was not significantly different between the two groups. In utero exposure to echo planar imaging thus did not have a marked effect on intrauterine fetal growth. A 10 year follow-up study of all infants imaged in utero is being performed.
MR imaging of primary pancreatic leiomyosarcoma.
Authors: Paciorek M L , Ross G J
Published: June 2014

Primary leiomyosarcoma of the pancreas is a rare neoplasm with only 17 reported cases in the literature. Although the ultrasonic and computed tomographic appearances have been described, the magnetic resonance features of pancreatic leiomyosarcomas have not. In this report, we describe the MR characteristics of a primary pancreatic leiomyosarcoma which was an incidental finding on ultrasound. The unenhanced T1 weighted and T2 weighted images were the most useful in tumour localization whereas the enhanced images actually obscured the tumour within the pancreas. Differentiation from the much more commonly occurring adenocarcinoma was impossible.
Posterior vertebral rim fractures.
Authors: Beggs I , Addison J
Published: June 2014

Fracture of the posterior vertebral endplate is a cause of low back pain in adolescents and young adults. Clinically it resembles an acute disc prolapse with low back pain and radiculopathy, but may present with neurogenic claudication due to spinal stenosis in older patients. The lesions may be incidental findings. Plain radiographs are diagnostic in about 40% of cases. CT shows the fracture fragment and vertebral defect in most cases but the fracture fragment may be overlooked on MRI. Accurate diagnosis is essential as the surgical technique for disc herniation is inadequate for endplate fractures. In this pictorial essay we review the imaging findings.
CT angiography in vascular intervention for steno-occlusive diseases: role of multiplanar reconstruction and source images.
Authors: Sugahara T , Korogi Y , Hirai T , Hamatake S , Komohara Y , Okuda T , Ikushima I , Shigematsu Y , Takahashi M
Published: June 2014

The aim of this study was to assess the efficacy of CT angiography for steno-occlusive diseases before and after interventional procedures, focusing on the role of multiplanar reconstruction (MPR) and source images. 17 patients with 20 steno-occlusive lesions underwent CT angiography before and after interventional procedures. For each lesion, the percentage stenosis obtained on CT angiography was compared with that on conventional angiography. In addition, MPR and source images were evaluated for the presence of wall thickening and calcification before interventional procedures, and the presence of dissection and luminal shape after interventional procedures. These findings were compared with those of conventional angiography. Although the percentage stenosis depicted on CT angiography correlated well with that on conventional angiography, MPR and source images clearly demonstrated the effect of intervention and the residual stenosis. MPR and source images clearly depicted wall thickening, wall calcification, the presence of dissection and the luminal shape. CT angiography provides useful information before intervention, while MPR and source images are of value in evaluating arterial wall abnormalities and morphological changes associated with interventional procedures.
Percutaneous biopsy of small hepatic lesions using an 18 gauge automated needle.
Authors: Yu S C , Lau W Y , Leung W T , Liew C T , Leung N W , Metreweli C
Published: June 2014

This study evaluates the efficacy of ultrasound guided percutaneous biopsy using an 18 gauge automated side-cutting needle in the diagnosis of small (< or = 3 cm) focal hepatic lesions. 137 consecutive percutaneous biopsies of 131 different small (< or = 3 cm) focal hepatic lesions were included. 11 biopsies were performed on lesions of < or = 1 cm in diameter, 56 were on lesions 1.1-2 cm in size and 70 on lesions 2.1-3 cm in size (average 2.3 +/- 0.7 cm; median 2.3 cm; range 0.7-3 cm). The biopsy specimen was sufficient for diagnosis in 135 cases (98.5%). The sensitivity for diagnosing malignancy was 96.4%; specificity was 100%, positive and negative predictive values were 100% and 94.6%, respectively; accuracy was 97.8%. There was no statistically significant difference in the diagnostic efficacy for lesions of different pathology and size. No significant post-biopsy complication occurred. It is concluded that the 18 gauge Temno needle is safe and effective in diagnosing small hepatic lesions.
In vivo semiconductor dosimetry as part of routine quality assurance.
Authors: Millwater C J , MacLeod A S , Thwaites D I
Published: June 2014

This paper describes the initial physics testing necessary before diodes can be used for in vivo dosimetry as well as the development of a protocol for clinical use in head and neck treatment and the preliminary results acquired. 50 patients were entered into the pilot study. A total of 300 treatment set-ups were measured (184 entrance doses and 116 exit doses). Wedged and unwedged components of each field were measured separately, making the total number of entrance doses 284 and total number of exit doses 207. There was no significant systematic deviation in the measured entrance dose compared with the expected (mean +0.4%, SD 2.7%). Discrepancies between the observed and expected entrance doses of greater than 5% were recorded in 6% (16/284) of measurements. The mean of the measured exit doses was 2.4% lower than expected (SD 4.8%). Discrepancies between the observed and expected exist doses of greater than 5% were recorded in 32% (67/207) of measurements. Possible causes for these discrepancies are discussed. Overall analysis of the data for individual patients suggest that in one patient out of the 50 there may have been a delivered target volume dose discrepancy of greater than 5% (+6.5%). The significance of the results and the implications for routine use are discussed.
Image processing and spiral CT of the thorax.
Authors: Richenberg J L , Hansell D M
Published: June 2014

The data set of the thorax acquired by spiral CT is volumetric. Such data can be processed so that conventional axial sections are supplemented by reconstructed images, in an attempt to answer specific clinical questions. This review considers three reconstruction techniques: multiplanar reformation, three-dimensional rendering and sliding-thin slab reconstruction. Their relative benefits and limitations are considered, as are the implications of image processing in general.
Ultrasound guided fine needle aspiration cytology in abdominal tuberculosis.
Authors: Suri R , Gupta S , Gupta S K , Singh K , Suri S
Published: June 2014

Although barium studies and CT are useful in assessing abdominal pathology in tuberculosis, imaging findings are not always specific and a histopathological or bacteriological confirmation is often required. The aim of the present study was to evaluate the role of ultrasound (US) guided fine needle aspiration cytology (FNAC) in the diagnosis of abdominal tuberculosis in patients with non-palpable lesions detected on US/CT. FNAC was performed on 31 sites in 30 patients. The sites included enlarged lymph nodes (n = 14), focal lesions in liver (n = 2) and spleen (n = 8), and thickened bowel in the ileocaecal region (n = 7). The results were classified cytomorphologically into four groups: (1) definite evidence of tuberculosis; (2) presumptive evidence of tuberculosis; (3) suggestive of tuberculosis; and (4) negative for tuberculosis. 18 of the 31 FNACs (58%) revealed a positive diagnosis of tuberculosis (definite evidence in nine patients and presumptive evidence in nine patients). 13 of the 31 FNACs (42%) showed either necrosis alone (n = 4) or negative results (n = 9). Zeihl-Neelson staining for acid-fast bacilli on direct smear was positive in only nine patients (29%). Splenic and lymph nodal FNAC had a high sensitivity (87.5% and 78.6%, respectively) in the diagnosis of tuberculosis. None of the bowel and liver FNACs was diagnostic. No complications were encountered. US guided FNAC offers a safe and accurate method of achieving a diagnosis in patients with suspected abdominal tuberculosis who present with radiologically demonstrable but non-palpable lesions, especially those involving lymph nodes and spleen.
Radiation dose and image quality in spiral computed tomography: multicentre evaluation at six institutions.
Authors: Scheck R J , Coppenrath E M , Kellner M W , Lehmann K J , Rock C , Rieger J , Rothmeier L , Schweden F , Bäuml A A , Hahn K
Published: June 2014

The purpose of this study was to evaluate the correlation of radiation dose with image quality in spiral CT. Seven clinical protocols were measured in six different radiological departments provided with four different types of high specification spiral CT scanners. Central and surface absorbed doses were measured in acrylic. The practical CT dose index (PCTDI) was calculated for seven clinical examination protocols and one standardized protocol using identical parameters on four different spiral CT scanners with a dedicated ionization chamber inserted into PMMA phantoms. For low contrast measurements, a cylindrical three-dimensional (3D) phantom (different sized spheres of defined contrast) was used. Image noise was measured with a cylindrical water phantom and high contrast resolution with a Perspex hole phantom. Image quality phantoms were scanned using the parameters of the clinical protocols. Images were randomized, blinded and read by six radiologists (one from each institution). PCTDI values for four different scanners varied up to a factor between 1.5 (centre) and 2.2 (surface) for the standardized protocol. A greater degree of variation was observed for seven clinical examination protocols of the six radiological departments. For example, PCTDI varied up to a factor between 1.7 (cerebrum protocol) and 8.3 (abdomen paediatric protocol). Low contrast resolution correlates closely with dose. An improvement in detection from 8 mm to 4 mm sized spheres needs approximately a ten-fold increase in dose. Noise shows a moderate correlation with PCTDI. High contrast resolution of clinical protocols is independent of PCTDI within a certain range. Differences in modern CT scanner technology seem to be of less importance for radiation exposure than selection of protocol parameters in different radiological institutes. Future discussion on guidelines regarding optimal (patient adapted) tube current for clinical protocols is desirable.
Contribution of the cortical shell of vertebrae to mechanical behaviour of the lumbar vertebrae with implications for predicting fracture risk.
Authors: Andresen R , Werner H J , Schober H C
Published: June 2014

In the diagnosis of osteoporosis using single energy quantitative CT (SE-QCT) on the axial skeleton, only spongy bone mineral density (BMD) is used at present. Although the density of cortical bone is also determined by most QCT methods, it is not used for evaluation. The objective of this study was to determine the extent to which the cortical bone of the lumbar vertebral bodies accounts for their load-bearing capacity and failure behaviour, and to use this information to suggest improvements in the differential diagnosis of osteoporosis. Investigations were conducted in a clinical, theoretical-numerical and biomechanical-experimental context. Cortical (BMDC) and spongy (BMDS) bone mineral density was measured by SE-QCT/85 kV on 179 patients (68 males, 111 females). These bone densities were matched with the vertebral body fractures previously determined from conventional X-rays. A finite element model was used to study the variation in structural and material parameters of the vertebral body. 19 vertebral bodies that had been removed post-mortem were available for the biomechanical-experimental investigations. Spongy and cortical bone densities were also determined by SE-QCT on these vertebral bodies. Their failure load was then measured in the axial compression test. These investigations show that, in addition to the spongiosa, the cortical shell plays an important role in the load-bearing capacity of the vertebral body. If the spongiosa is weakened due to a loss of BMD, the residual load-bearing capacity of the vertebral bodies is increasingly shouldered by the cortical bone. The lower susceptibility to fracture in men compared with women when spongy bone mineral density is reduced can thus be attributed to the lack of a reduction in cortical bone mineral density. It is recommended that the BMDC also be evaluated in future, especially in the diagnosis of bone mass losses in women, to improve the estimation of the individual fracture risk.
An experimental method to determine the effective luminescence efficiency of scintillator-photodetector combinations used in X-ray medical imaging systems.
Authors: Cavouras D , Kandarakis I , Bakas A , Triantis D , Nomicos C D , Panayiotakis G S
Published: June 2014

The scintillator effective luminescence efficiency, which may be defined in terms of the scintillator's X-ray luminescence efficiency and the scintillator-photodetector spectral matching and geometrical configuration, was studied for various X-ray imaging applications. Four scintillator materials Gd2O2S:Tb, Y2O2S:Tb, ZnSCdS:Ag and CsI:Na were used to prepare test screens. They were evaluated in relation to various photodetectors used in X-ray imaging, such as radiographic films, photocathodes, and photodiodes. Effective luminescence efficiency was determined for a range of X-ray tube voltages (50-140 kVp) by measuring the light flux emitted per unit of incident exposure rate and the spectra of the light emitted by the four scintillators. Scintillator-photodetector combinations resulting in higher image brightness level were determined for different X-ray imaging systems. Findings indicate that CsI:Na is very efficient with orthochromatic radiographic films, Gd2O2S:Tb could be useful in conventional or digital fluoroscopy and in CT and ZnSCdS:Ag could be employed in some medium to low voltage digital radiography applications.
Evaluation of carborane-containing porphyrins as tumour targeting agents for boron neutron capture therapy.
Authors: Miura M , Micca P L , Fisher C D , Gordon C R , Heinrichs J C , Slatkin D N
Published: June 2014

A number of carborane-containing porphyrins were administered to mice bearing subcutaneously transplanted mammary carcinomas. Administration was via serial intraperitoneal (i.p.) injections to assess their relative toxicities and tumour affinities. Three analogues of the natural porphyrin heme and four tetraphenylporphyrins (TPPs) were given at total doses of 78-245 micrograms g-1 body weight. The water-insoluble TPPs were less toxic to mice, and delivered greater amounts of boron to tumour than did the water-soluble TPPS and the heme analogues. One such compound, NiTCP-H, delivered more than 100 micrograms B g-1 to tumour tissue with a tumour:blood boron concentration ratio greater than 500:1 and a tumour: brain boron concentration ratio greater than 50:1, 4 days after the last of six i.p. injections given over 2 days. Another TPP analogue, NiTCP, delivered approximately 50 micrograms B g-1 to tumour with similar boron concentrations in normal tissues. Neither compound was toxic to mice at total doses of approximately 200 micrograms g-1 body weight. In contrast, the heme analogues were toxic and, with the exception of VCDP, delivered less boron to tumour than NiTCP and NiTCP-H. The two porphyrins with the greatest potential for application to boron neutron capture therapy (BNCT), NiTCP and NiTCP-H, yielded higher tumour:blood and tumour:brain boron concentration ratios in mice than could be achieved with p-boronophenylalanine (BPA) and sodium mercaptoundecahydrododecaborate (BSH), the compounds which are currently being used in clinical trials of BNCT in the treatment of glioblastoma. The boron delivered by each of the porphyrins tested remained in tumour tissue longer than did boron delivered by either BPA or BSH. The copper and nickel chelates of these porphyrins behave identically in vivo. The former offer the potential for imaging by 67Cu-mediated single photon emission computed tomography (SPECT) to aid BNCT treatment planning.
A comparative study of radioprotection by Ocimum flavonoids and synthetic aminothiol protectors in the mouse.
Authors: Devi P U , Bisht K S , Vinitha M
Published: June 2014

The radioprotective effects of two flavonoids, orientin (Ot) and vicenin (Vc), obtained from the leaves of Ocimum sanctum, and the synthetic compounds WR-2721 and MPG (2-mercaptopropionyl glycine) have been compared by examining chromosome aberration in cells of bone marrow in irradiated mice. Healthy adult Swiss mice were injected intraperitoneally (i.p.) with 50 micrograms kg-1 body weight of Ot or Vc; 20 mg kg-1 of MPG; 150 mg kg-1 of WR-2721 or double distilled water (DDW). They were exposed to whole body irradiation of 2.0 Gy gamma radiation 30 min later. After 24 h, chromosomal aberrations were studied in the bone marrow of the femur by routine metaphase preparation after colchicine treatment. Radiation (2 Gy) increased the number of aberrant cells from less than 1% in controls to almost 20%. Pre-treatment with all the protective compounds resulted in a significant reduction in the percentage of aberrant metaphases as well as in the different types of aberration scored. Vc produced the maximum reduction in percent aberrant cells while MPG was the least effective; Ot and WR-2721 showed an almost similar effect. However, WR-2721 was the most effective against reduction of complex an almost similar effect. However, WR-2721 was the most effective against reduction of complex aberrations, followed by Vc. Neither flavonoids had any systemic toxicity, even at 200 mg kg-1 body weight. Considering the low dose needed for protection and the high margin between the effective and toxic doses, the ocimum flavonoids may be promising for human radiation protection.
Percutaneous placement of a self-expandable stent for treatment of a malignant pulmonary artery stenosis.
Authors: Müller-Hülsbeck S , Bewig B , Schwarzenberg H , Heller M
Published: June 2014

Venous stent placement is widely accepted as the treatment of stenoses caused by external tumour compression to reduced clinical sequelae. We report percutaneous stent placement into a severely obstructed right pulmonary artery in a 73-year-old female patient. The underlying disease was a medistinal tumour mass of unknown aetiology. Pulmonary perfusion was successfully but temporarily restored by the intervention.
Differential diagnosis of lymph node lesions: a semiquantitative approach with colour Doppler ultrasound.
Authors: Steinkamp H J , Mueffelmann M , Böck J C , Thiel T , Kenzel P , Felix R
Published: June 2014

The aim of this study was to evaluate reactively enlarged cervical lymph nodes and nodal metastases in patients with squamous cell carcinoma, as well as nodes involved by malignant lymphoma, by means of colour Doppler ultrasound (CDUS) and to describe perfusion sites for each nodal group in order to determine if typical flow patterns exist for nodes with different pathology. In a prospective study, 63 untreated patients with palpable cervical lymph node enlargement (n = 208) underwent examination with CDUS. The sites of perfusion were subdivided into three groups: central, peripheral and hilar perfusion. The intensity of perfusion was subjectively quantified in a semiquantitative scale from 0 (no perfusion) to III (high perfusion). Finally, the overall perfused area of the lymph nodes was measured and the percentage of perfused nodal area was calculated. CDUS showed perfusion in 178 of 208 lymph nodes. Histological examination showed 49 reactively enlarged lymph nodes, 82 containing metastases and 47 with lymphoma. Reactively enlarged lymph nodes showed characteristically intense hilar perfusion (91.8%), whereas nodal metastases had mainly peripherally located flow (84.1%) of intensity grades I-III. Lymph nodes invaded by malignant lymphoma were highly perfused, showing colour signals in the centre as well as in the nodal periphery (78.7%). In conclusion, perfusional patterns may provide useful additional information in the differential diagnosis of cervical lymphadenopathy.
Computed tomography findings in an inflamed meckel diverticulum.
Authors: Hughes J A , Hatrick A , Rankin S
Published: June 2014

Meckel diverticulum, the commonest congenital abnormality of the gastrointestinal tract, may be difficult to diagnose. Appearances on CT are often non-specific unless there is connection to the umbilicus or a complication has occurred. We report a case of an inflamed Meckel diverticulum seen on CT.
123I-MIBG SPECT of Merkel cell carcinoma.
Authors: Watanabe N , Shimizu M , Kageyama M , Kitagawa K , Hayasaka S , Seto H
Published: June 2014

131I-MIBG may be useful in the detection of neuroendocrine tumours. Merkel cell carcinoma is a neuroendocrine tumour of the skin. We evaluated a patient with Merkel cell carcinoma using 123I-MIBG single photon emission computed tomography (SPECT) which demonstrated tumour accumulation of the radiotracer in the right eyelid. This result suggests that 123I-MIBG SPECT may be useful in the evaluation of Merkel cell carcinoma.
Focal fatty change in segment IV of the liver occurring after gastrectomy.
Authors: Yamagami T , Arai Y , Takeuchi Y , Sueyoshi S , Inaba Y
Published: June 2014

In some cases, focal fatty change of the liver parenchyma has been attributed to local systemic venous inflow replacing the portal venous supply. However, no reports of focal fatty change in the dorsal portion of segment IV of the liver caused by direct inflow of an aberrant pancreaticoduodenal vein (APDV) through the parabiliary venous system (PVS) are available. We report a 60-year-old woman with focal fatty change in segment IV of the liver which occurred after gastrectomy with APDV shown on CT performed during selective gastroduodenal arteriography.
Comparison between the efficacy of dimeric and monomeric non-ionic contrast media (iodixanol vs iopromide) in urography in patients with mild to moderate renal insufficiency.
Authors: Stacul F , Cova M , Assante M , Hougens Grynne B , Haider T
Published: June 2014

Non-ionic dimers induce less diuresis than non-ionic monomers, resulting in increased opacification of the urinary tract in intravenous (i.v.) urography. This double blind, comparative, randomized, parallel trial compared the efficacy of iodixanol (non-ionic dimer) and iopromide (non-ionic monomer) in 100 patients with mild to moderate renal insufficiency (serum creatinine of 135 to 265 mumol l-1) who underwent i.v. urography. A total dose of 600 mgI kg-1 bw of iodixanol (320 mgI ml-1) or iopromide (300 mgI ml-1) was injected. Radiographs were blindly evaluated by three radiologists who analysed different parameters (renal border visualization, nephrogram density, calyceal filling and density, papillary blush detection, delineation of collecting ducts, renal pelvis opacification, visualization of ureters, bladder density, bladder distention). Densitometric evaluation on the renal pelvis and bladder was also performed. Iodixanol showed better filling and density of the calyces (p = 0.004), more frequent detection of papillary blush (p = 0.003) and better opacification of the renal pelvis (p = 0.006). No significant differences between the two contrast media were found in regard to other parameters. In conclusion, the results confirmed theoretical expectations. The non-ionic dimer iodixanol is to be preferred to a non-ionic monomer such as iopromide in i.v. urography on patients with impaired renal function.
The diagnostic X-ray protection characteristics of Ytong, an aerated concrete based building material.
Authors: Tsalafoutas I A , Yakoumakis E , Manetou A , Flioni-Vyza A
Published: June 2014

Ytong is a widely used building material. The X-ray attenuation properties of Ytong for broad beam geometry conditions and for tube potentials in the 50-140 kVp range are investigated. Comparisons with published data for concrete and other building materials are made. The results suggest that Ytong is not suitable for primary X-ray shielding in common diagnostic installations. However, walls of Ytong, typically 15-20 cm thick, may offer adequate protection in dental and mammography installations, as well as in low workload diagnostic installations as a secondary barrier.
Colon ischaemia secondary to barolith obstruction.
Authors: Champman A H , el-Hasani S
Published: June 2014

A case is described of an elderly woman who developed an obstructing barolith in the sigmoid colon following a barium enema. Colonic ischaemia developed in the proximal colon. Predispositions and prevention of baroliths are discussed.
Imaging of pancreatic trauma.
Authors: Patel S V , Spencer J A , el-Hasani S , Sheridan M B
Published: June 2014

This pictorial review discusses the imaging findings in acute pancreatic injury and its delayed complications. These findings are related to key decisions in surgical management. Emphasis is placed on the difficulty of acute diagnosis using CT and the pivotal role of endoscopic retrograde pancreatography (ERP) in the definition of ductal anatomy with delayed diagnosis.
Optimization of magnetic resonance imaging parameters for left ventricular wall motion studies at 0.5 T.
Authors: Pennell D J , Manzara C C , Underwood S R , Longmore D B
Published: June 2014

Magnetic resonance cine imaging of left ventricular wall motion at rest or during stress may be used to assess myocardial function, infarction and viability, or reversible ischaemia. Whilst interpretation of the cines rests critically on image quality, there is little in the literature which systematically examines the optimal imaging parameters for such wall motion studies at rest or during stress. This study was designed to examine several imaging parameters for cine optimization using a conventional 0.5 T scanner. Gradient echo imaging was performed in two groups of volunteers with varying echo times and flip angles. The period between excitations was 80 ms (simulating a resting heart rate) in one group, and 40 ms (simulating tachycardia during stress) in the other group. Short axis imaging yielded the highest contrast between blood and myocardium for both repetition times (rest p = 0.02; stress p < 0.001) compared with the long axes, because of magnetic saturation of blood moving slowly in-plane. Contrast was higher at end-diastole than end-systole for the long axes (rest p < 0.0001; stress p < 0.0002), but not significantly different in the short axis. Increasing the echo time and flip angle resulted in increased signal but eventually caused motion artefact and magnetic saturation of blood. The optimal parameters were an echo time of 14 ms and a 45 degrees flip angle for resting heart rates, with the flip angle falling to between 35 degrees and 45 degrees for tachycardia. The choice of imaging parameters is therefore a compromise between improved signal and unwanted artefacts, although the latter are less evident in the short axis plane, which yields the best contrast results because of high blood inflow effects.
Solitary fibrous tumour of the prostate.
Authors: Kelly P M , Baxter G M
Published: June 2014

Solitary fibrous tumours are rare, benign neoplasms that are most commonly found in the pleura and less commonly on other serosal surfaces. Their cell of origin and aetiology are uncertain. A case of solitary fibrous tumour of the prostate is presented. We believe this to be the first case of this lesion to arise in this gland. Solitary fibrous tumours of the prostate may be confused with granulomatous prostatitis or carcinoma as all three may present with a nodule on rectal examination and appear as a hypoechoic nodule on transrectal ultrasound.
Radiation induced liver injury detected by particulate reticuloendothelial contrast agent.
Authors: Padhani A R , Husband J E , Gueret Wardle D
Published: June 2014

Radiation induced liver injury detected by a particulate reticuloendothelial MR contrast agent is described in a patient with metastatic colon cancer. The irradiated hepatic parenchyma failed to darken after ferumoxide administration. This finding suggests that detection of metastatic disease after ferumoxide contrast agents may be impaired in patients who have previously received upper abdominal radiation treatment.
Quantitative dynamic contrast enhanced MRI of recurrent pelvic masses in patients treated for cancer.
Authors: Hawnaur J M , Zhu X P , Hutchinson C E
Published: June 2014

Recurrent tumour and post-treatment inflammatory masses may be difficult to differentiate on T2 weighted and post-contrast T1 weighted MR sequences. The purpose of this study was to assess the value of quantitative analysis of enhancement patterns in improving the separation of tumour recurrence from benign post-treatment masses in the pelvis. 32 patients with a total of 44 benign or malignant pelvic masses arising more than 6 months after treatment by surgery and/or radiotherapy were studied. After localizing the lesion on T1 and T2 weighted sequences, sequential T1 weighted spoiled gradient recalled echo (SPGR) images were obtained through the mass during bolus intravenous injection of 0.1 mmol kg-1 of Gd-chelate. Analysis of the maximum enhancement and proportion of maximum enhancement by 30, 60 and 90 s after onset of injection was performed prospectively by radiologists using standard manufacturer's software. Semi-automated analyses using software to provide irregular regions of interest and automated signal intensity measurements were also performed. Maximum enhancement was significantly greater in tumour recurrence than fibrosis following surgery, with better separation between the two groups using computer assisted analysis (p < 0.001) than manual analysis (p < 0.05). Separation between post-radiotherapy tumour recurrence and benign post-radiotherapy masses reached statistical significance for manual measurements of maximum enhancement (p < 0.05) but not for computer assisted analysis. There was no significant difference in enhancement rates between benign and malignant masses in post-radiotherapy patients. Measurement of the maximum enhancement of a mass alone does not reliably separate lesions in the post-radiotherapy patient but may be helpful when considered together with signal intensity and morphology on conventional MRI sequences.
Design of a PC controlled test device for the study of patient motion in X-ray radiology: first applications and results.
Authors: Guibelalde E , Vañó E , Fernández J M , Molinero A , Alberdi J , Merillas A
Published: June 2014

Simulation and study of patient motion should be undertaken for different imaging techniques since all new radiological techniques or equipment must pass through evaluation processes to verify their functional capability and assess their performance compared with other equipment. A device to study the effects of motion on X-ray image quality was designed and built. The main goal of the PC controlled device developed by our group is to allow the adaptation of different phantoms and test objects. Preliminary experiments for the evaluation of different thorax screen-film systems were carried out by simulating respiratory motion. It is concluded that moving objects should be included for the comparison of screen-film systems since predictions based only on findings in stationary test conditions could lead to false conclusions.
Direct percutaneous transrenal embolization for renal artery injury following percutaneous nephrostomy.
Authors: Cowan N C , Traill Z C , Phillips A J , Gleeson F V
Published: June 2014

The use is reported of percutaneous transrenal embolization for renal artery injury during percutaneous nephrostomy. If a nephrostomy catheter is seen to transfix the renal pelvis, the possibility of injury to a large renal artery must be considered. The misplaced nephrostomy catheter should be withdrawn over a guidewire. Percutaneous renal artery embolization may enable rapid arrest of life threatening haemorrhage.
Metastases to the pancreas.
Authors: Merkle E M , Boaz T , Kolokythas O , Haaga J R , Lewin J S , Brambs H J
Published: June 2014

Disparity in prognosis and management between primary and secondary pancreatic tumours makes recognition of metastases to the pancreas on CT and MRI an important goal. Three different patterns of secondary pancreatic tumours may be seen: localized, multifocal, or diffuse enlargement. CT findings include hypodense lesions, which show rim enhancement following intravenous contrast medium. On MR examination, the lesions are usually hypointense on T1 weighted and hyperintense on T2 weighted images.
The discovery of radium in 1898 by Maria Sklodowska-Curie (1867-1934) and Pierre Curie (1859-1906) with commentary on their life and times.
Authors: Mould R F
Published: June 2014

This review celebrates the events of 100 years ago to the month of publication of this December 1998 issue of the British Journal of Radiology, when radium was discovered by the Curies. This followed the earlier discovery in November 1895 of X-rays by Röntgen, which has already been reviewed in the British Journal of Radiology [1] and the discovery in March 1896, by Becquerel, of the phenomenon of radioactivity, which introduces this review. This is particularly relevant as Marie Curie was in 1897 a research student in Becquerel's laboratory. Marie Curie's life in Poland prior to her 1891 departure for Paris is included in this review as are other aspects of her life and work such as her work in World War I with radiological ambulances (known as "Little Curies") on the battlefields of France and Belgium, early experiments with radium and the founding of the Institut du Radium in Paris and of the Radium Institute in Warsaw. Wherever possible I have included appropriate quotations in Marie Curie's own words [2-4] and each section is related in some way to the life and work of Maria or Pierre. This review is completed with details of the re-interment of the bodies of Pierre and Marie on 20 April 1995 in The Panthéon, Paris.
The management of peripheral arterial aneurysms using percutaneous injection of fibrin adhesive.
Authors: Loose H W , Haslam P J
Published: June 2014

Most peripheral arterial aneurysms are pseudoaneurysms and are iatrogenic or related to trauma. They can be treated by several techniques that can be performed by the radiologist, negating the need for surgery. Ultrasound guided compression repair is usually the treatment of choice, but is not always successful. The number of available treatment options reflects the varying site and nature of pseudoaneurysms and perhaps the lack of a consistently reliable method. We have successfully treated 13 patients with peripheral aneurysms (11 femoral, 1 popliteal and 1 posterior tibial aneurysm) using a commercial fibrin tissue adhesive. The method involves percutaneous injection of the adhesive components using ultrasound and screening control, following successful occlusion of the aneurysm neck by angioplasty balloon.
The presence and significance of lymphadenopathy detected by CT in primary sclerosing cholangitis.
Authors: Johnson K J , Olliff J F , Olliff S P
Published: June 2014

Patients with primary sclerosing cholangitis (PSC) are at increased risk of developing cholangiocarcinoma, which adversely affects their survival especially after orthotopic liver transplantation. All CT scans of patients with PSC referred to the Liver Unit at the Queen Elizabeth Hospital since 1992 were reviewed. The location of any lymph node with a short axis diameter greater than normal was documented. The incidence of lymphadenopathy and cholangiocarcinoma was also documented. 36 scans are reviewed, including eight with cholangiocarcinoma as well as PSC. Abdominal lymphadenopathy was present in 26 cases (66%) and 45 separate lymph node groups were involved in these patients. There were eight cases of cholangiocarcinoma; five were detectable on CT, but only four had significant lymphadenopathy. The remaining three cases of cholangiocarcinoma were not detectable on CT and only one of these had lymphadenopathy. Follow-up of the remaining patients has not demonstrated the development of cholangiocarcinoma. Lymphadenopathy is commonly demonstrated by CT in PSC patients, but does not imply malignancy and should not exclude a patient from undergoing liver transplantation. Conversely cholangiocarcinoma may develop without significant lymphadenopathy.
Entrance skin dose estimates derived from dose-area product measurements in interventional radiological procedures.
Authors: McParland B J
Published: June 2014

Patient skin doses resulting from interventional radiological procedures have the potential to exceed threshold doses for deterministic effects such as erythema and epilation. If the irradiation geometry is known, the entrance skin dose can be estimated from the measured dose-area product. For each of 10 non-coronary interventional procedures, a nominal geometry was identified. From a previous survey of patient dose-area products, the entrance skin doses were estimated under the assumption that all procedures were performed with the nominal geometry specific to it. An analysis of the uncertainties in these doses caused by realistic deviations from the nominal geometry was also performed and it was shown that the estimated entrance skin dose values are at least to within 40%, and generally to within about 30%, of those actually received. For example, the median estimated entrance skin doses for the posteroanterior and lateral projections of cerebral angiography were 100 and 110 mGy. respectively, and for hepatic angiography 425 mGy. The largest entrance skin dose estimate for a single projection was for the angiography component of a CT arterial portography procedure at 670 mGy. Comparisons between entrance skin dose estimates obtained from this study are made with data from other interventional radiology patient dose surveys.
Gallstone ileus with impaction at the neck of a Meckel's diverticulum.
Authors: Nakamoto Y , Saga T , Fujishiro S , Washida M , Churiki M , Matsuda K
Published: June 2014

We report a case of gallstone ileus in which the stone impacted at the neck of a Meckel's diverticulum. CT demonstrated the gallstone as a calcified mass in the lower abdomen. Gallstone ileus was diagnosed although a more accurate diagnosis was not obtained pre-operatively. The site of impaction was not typical and a blind loop filled with contrast materials was evident. We believe that this is the first report demonstrating this rare condition with imaging.
The significance of spontaneous resolution of breast calcification.
Authors: Seymour H R , Cooke J , Given-Wilson R M
Published: June 2014

Spontaneously resolving breast microcalcification is a rarely reported occurrence. A retrospective review was carried out on 33 cases of resolving benign and indeterminate microcalcification identified from 108,000 screening mammograms from the South West London Breast Screening Service. Four further cases are reported from The Jarvis Breast Screening Centre. No interval cancers were identified in women with microcalcification which initially showed benign appearances. However, 36.4% of the group with resolving indeterminate microcalcification subsequently developed cancers. It is recommended that this change should prompt full investigation and close follow-up or excision. While the majority of spontaneously resolving microcalcification is associated with benign processes, it is concluded that a significant proportion of disappearing indeterminate microcalcification is associated with malignancy.
Sonographic detection and characterization of musculoskeletal and subcutaneous tissue abnormalities in sickle cell disease.
Authors: Sidhu P S , Rich P M
Published: June 2014

Pain due to bone marrow infarction is common in homozygous sickle cell disease (SS disease). Musculoskeletal pathology may be responsible for persistent atypical symptoms. We have assessed the frequency and ultrasound appearances of soft tissue and joint abnormalities in SS disease. SS disease patients with atypical musculoskeletal symptoms were examined with ultrasound over a 2 year period. Ultrasound findings were correlated with those at surgery or percutaneous drainage. 31 episodes in 23 patients were referred for ultrasound. There were 36 abnormalities in 18 patients: abscess (n = 15), effusions (n = 5), soft tissue induration (n = 12), fat necrosis (n = 2), haematoma (n = 1) and reactive lymph node (n = 1). Five examinations were normal. Soft tissue abnormalities in patients over the age of 14 years were associated with intramuscular injections: fat necrosis (n = 1), haematoma (n = 1), indurated soft tissue (n = 1) and abscess (n = 7). Soft tissue abnormalities with no underlying cause were seen in seven patients: abscess (n = 4), indurated soft tissue (n = 2) and fat necrosis (n = 1). Ultrasound is the imaging modality of choice for delineating these abnormalities and allows percutaneous drainage.
Rectal adenocarcinoma: assessment of tumour involvement of the lateral resection margin by MRI of resected specimen.
Authors: Blomqvist L , Rubio C , Holm T , Machado M , Hindmarsh T
Published: June 2014

The aim of the present study was to investigate whether MRI could predict tumour involvement of the lateral resection margin on resected rectal cancer specimens. 26 specimens obtained after total mesorectal excision were examined in the sagittal and axial plane on a clinical 1.5 T MR system using phased-array surface coils. The shortest distance between the deepest point of tumour penetration and the lateral resection margin was measured. This distance is referred to as LRM. The results were correlated to measurements on digital images of giant histopathological sections. The total number of lymph nodes and lymph node metastases was also counted. LRM was less than or equal to 1 mm (a distance considered for non-radically excised tumours) in eight of the histopathological specimens. On MR images of the resected specimen, LRM was less than or equal to 1 mm in seven of these specimens. LRM was shorter in MR examinations than in histopathological giant sections in 11 specimens. The sensitivity, specificity, positive and negative predictive values for prediction of tumour involvement of the lateral resection margin (LRM < or = 1 mm) by MR of the resected specimen were 88%, 78%, 64% and 93%, respectively. Presence of lymph node metastases could not accurately be predicted by MR. However, it is concluded that the presence of a tumour free lateral resection margin can be predicted by MRI of resected rectal specimens when this exceeds 1 mm.
Multiple regression analysis of octanol/water partition coefficients of non-ionic monomeric radiographic contrast media with the combination of three molecular descriptors.
Authors: Violon D
Published: June 2014

A multiple non-linear regression equation is calculated for the correlation of the octanol/water partition coefficient of nine non-ionic monomeric radiographic contrast media molecules with a combination of three molecule describing parameters (heat of formation, dipole and ovality). Good correlation is obtained (proportion of variance explained, R2, is 0.9093). This simple equation can be used prospectively in the design of new compounds analogous to the used series. It was used to calculate prospectively the partition coefficient of another compound of the same family, iomeprol.
Diagnostic image quality of mobile neonatal chest X-rays and the radiation exposure incurred.
Authors: Lowe A , Finch A , Boniface D , Chaudhuri R , Shekhdar J
Published: June 2014

A study was undertaken to identify the variation of entrance skin doses (ESDs) in mobile neonatal chest radiography with regard to the European Commission (EC) reference dose and to examine potential relationships with image quality and radiographic techniques. Five sites from the former North West Thames region participated. All mobile neonatal radiographic techniques were surveyed. Dose-area product per examination was directly measured and the ESD calculated. Image quality criteria were developed from those published by the EC. Image quality was graded by two independent observers. Over the five sites, 144 examinations were recorded. Calculated ESDs ranged up to 160 microGy, with an appreciable variation not only between sites but also within sites. A clear relationship between actual rather than nominal speed and dose over all sites was demonstrated (r = -0.95, p = 0.013). No correlation between image quality and dose was noted (r = -0.044, p = 0.665). Neonatal imaging systems at participating sites, within the North Thames region, comply with EC guidelines on patient dose and image quality for mobile chest X-rays. Significant variation in ESDs was encountered between sites with no discernible relationship with image quality or the employed radiographic techniques as described by the EC. The strong inverse relationship between ESDs and actual rather than nominal speed suggests a neglected aspect of radiation protection.