bluuebunny/crossref_metadata_2025 huggingface dataset:
99Tcm-HMPAO single photon emission computed tomography in partial epilepsy: a preliminary report
Authors: Smith D. F. , Smith F. W. , Knight R. S. G. , Roberts R. C. , Gemmell H. G.
Published: July 2009

In the pre-operative assessment of patients being considered for temporal lobe surgery, accurate lateralization and localization of the epileptic focus is mandatory. Surface electroencephalography (EEG) can be misleading and confirmatory evidence, preferably non-invasive, of the site of the epileptic focus is valuable. Sixteen patients with partial epilepsy, six of whom were considered to be good surgical candidates, had technetium-99m hexamethylpropylene amine oxime (99Tcm-HMPAO) scanning. In those patients with poor epileptic control and a well localized EEG focus, there was a correlation between EEG and HMPAO scan abnormalities, whilst in all patients where no correlation existed, the HMPAO scan was normal. We conclude that 99Tcm-HMPAO single photon emission computed tomography may be a useful non-invasive, adjunctive investigation in the preoperative assessment of patients with partial epilepsy.
The influence of Buscopan on adverse reactions to intravascular contrast media
Authors: Sharma Sanjiv , Rajani Mira , Khosla Anil , Misra Nalinikant , Goulatia R. K.
Published: July 2009

We have analysed the ability of prior intravenous Buscopan (hyoscine butylbromide) injection to influence the incidence and severity of adverse reactions to intravascularly administered, iodinated, ionic contrast medium in 258 consecutive digital subtraction angiographic (DSA) examinations. Adverse reactions were seen in 7.9% of the intravenous and 2.4% of the intraarterial DSA examinations. The incidence of adverse reactions with and without prior Buscopan injection during intravenous DSA examinations was 8.2% and 7.1%, respectively and during intra-arterial DSA examinations was 5.6% and 1.5%, respectively. This difference is not statistically significant (χ2-test). We conclude that prior intravenous injection of Buscopan has no influence on the incidence or severity of adverse reactions to intravascular contrast media.
The correlation of histopathological, microradiographic and ultrasonographic features in disease of the prostate gland
Authors: Jones D. R. , Griffiths G. J. , Parkinson M. C. , Evans K. T. , Roberts E. E. , Davies R. Li. , Harrison T. J. , Peeling W. B.
Published: July 2009

The histopathological, microradiographic and ultrasonographic features of corresponding areas of 100 cadaveric prostates were examined and correlated statistically to investigate their relationship. Benign glands are seen to be related to reticular structure and mid-range echoes. Benign prostatic hyperplasia is related to microadenomatous structure and mid-range echoes, whilst cancer is related to amorphous structure and low echoes. A small number of cancers have irregular calcification present and these tumours are related to high echoes. The structure of the prostate gland is therefore related to its pathology and explains its ultrasound echogenicity.
Induced fluid movement within a giant ovarian cyst demonstrated by echo-planar imaging
Authors: Worthington B. S. , Chapman B. , Ordidge R. , Coxon R. , Stehling M. K. , Symonds E. M. , Mansfield P.
Published: July 2009

Over 50% of ovarian tumours are of epithelial origin occurring as solid carcinomas and mucinous or serous cysts, the majority of which can be readily categorized as benign or malignant. However, approximately onefifth of the cysts, whilst showing some histological feature of malignancy, lack evidence of stromal invasion and are therefore reported as borderline malignancy. Serous cystadenomas may be unilocular or multilocular and vary in size from a few centimetres to enormous dimensions where they come to occupy most of the pelvis and abdominal cavity. In approximately 50% of cases the tumours are bilateral. Some have intracystic papillary ingrowths or solid areas in one or more loculi, and invasion of the cyst wall with tumour extension onto the serosal surface indicates the transition from a cystadenoma to a cystadenocarcinoma.

A giant serous cyst of the ovary has been imaged by echo-planar imaging (EPI) (Mansfield, 1977) and the features observed compared with the operative and pathological findings. The EPI technique permits the acquisition of single images in a time of 64 ms. On physical examination, a fluid thrill was readily elicited and deformation of the cyst during imaging induced flow patterns within the cyst contents which were clearly visualized and studied in real time.
Sonographic demonstration of renal tumour extension into the contralateral renal vein
Authors: Carvalho Preston
Published: July 2009

Extension of renal tumour into the ipsilateral renal vein with or without inferior vena cava (IVC) extension is well recognized and it is mandatory to examine carefully the ipsilateral renal vein and IVC when there is evidence of a renal tumour (Goncharenko et al, 1979; Amis & Hartman, 1984). Extension of tumour into the contralateral renal vein, detected or imaged antemortem, has, however, not been described previously.

A 60-year-old Caucasian woman presented with a 2-week history of pyrexia, right loin pain, night sweats and malaise. On examination she had a tender right renal mass. Routine biochemistry was normal; the serum creatine was 69 mM/litre. Haemoglobin was 10.5 g/dl, the white cell count was 10400 ml and the platelet count was 497000/ml.
Spontaneous regression of multiple bone metastases in malignant melanoma
Authors: O'Connell M. E. A. , Powell B. W. E. M. , O'Connell J. M. , Harmer C. L.
Published: July 2009

Everson and Cole (1966) in their classic monograph defined spontaneous regression of malignant disease as “the partial or complete disappearance of a malignant tumour in the absence of all treatment or in the presence of therapy which is considered inadequate to exert a significant influence on neoplastic disease”. It is generally agreed (Fauvet et af, I960, 1964; Cappefaere et al, 1973) that regression of malignant melanoma must fulfil at least the following criteria:

1. clinical and histological diagnosis of melanoma;

2. no therapeutic manipulation that could account for the regression;

3. clinical observation of regression of existing lesions including radiographs, photographs, etc;

4. if possible, histopathological studies of tissue sites where regression has presumably occurred.

We describe a case of spontaneous regression of multiple bone metastases following palliative radiotherapy in a patient with malignant melanoma and discuss the possible mechanisms.

In September 1985, a 40-year-old Scotsman was referred to the Roual Marsden Hospital following local excision of a pigmented lesion on the dorsal surface of the distal part of the left forearm. The lesion had been present for 5 years and for the previous 6 months had increased in size and depth of colour and bled on trauma. The only other medical history of note was vagotomy for duodenal ulceration 20 years previously.
Spontaneous pneumothorax with metastatic seminoma
Authors: Chippindale A. J. , Patel B. , Eddleston B.
Published: July 2009

Spontaneous pneumothorax is an uncommon manifestation of malignant neoplasm affecting the lung, and is seen mainly in cases of primary lung carcinoma and metastatic sarcoma, (Dines et al, 1973; Wright, 1976). We describe a patient who developed spontaneous, bilateral pneumothoraces whilst undergoing intensive chemotherapy for metastatic seminoma of the testis.

An 18-year-old male patient with widespread metastatic disease from seminoma testis was admitted for his third course of chemotherapy. He had presented to his general practitioner 3 months previously with episodes of haemoptysis, and was found to have Stage 4 testicular tumour.
Kinetics of recovery from sublethal radiation damage
Authors: Hopewell J. W. , van den Aardweg G. M. J. M.
Published: July 2009

We acknowledge with interest the letter from Drs Guttenberger and Thames commenting on our re-analysis of data on the kinetics of repair of sublethal radiation damage (Hopewell & van den Aardweg, 1988). We welcome this opportunity to respond since the topic has important implications for clinical radiotherapy. Reference to this very recently submitted letter was made in two previous publications by one of the authors (Thames, 1989; Thames et al, 1989).

Before discussing the important points raised by their letter, it is first essential to correct an unjustified assertion made in the above-mentioned publications (Thames, 1989; Thames et al, 1989), namely that any analyses based on plots of the percentage unrepaired dose are hampered by the selective exclusion of data points, specifically those with the longer interfraction intervals, and that this biases the results. In the studies carried out on pig skin, no data points were excluded or repeated to obtain a favourable result.
The immediate film in intravenous urography
Authors: Russell J. G. B. , Weller J. M.
Published: July 2009

In routine examinations it is important to expose only those views that contribute to the diagnosis.

We reviewed 239 consecutive intravenous urographic examinations in all of which an “immediate film” had been exposed immediately after the end of the injection.
Book reviews
Authors: Clay A. M.
Published: July 2009

The aim of this manual is to provide useful information to student nuclear medicine technicians and radiographers, and a practical reference text for departments wishing to widen the range of tests offered to the clinician.

The manual contains 11 chapters, each of which is devoted to a particular organ. Each chapter begins with an introduction to the organ, detailing the radiopharmaceuticals that can be used and the results that can be obtained, together with clinical indications for each test.
Book reviews
Authors: Dawson P.
Published: July 2009

This slim volume of some 240 pages is an up-to-date and well written review of the state of the art in non-ionic contrast media. It has been prepared under the auspices of Schering in Berlin and, as a result, is not surprisingly very much concerned with new Schering products.
Book reviews
Authors: Renton P.
Published: July 2009

This textbook is, quite simply, excellent. I had in fact already ordered a copy before being asked to review it! To have some 500 pages devoted to the radiology of the foot gives an indication of the comprehensive nature of this beautifully illustrated text. Chapters include Anatomy, Diagnostic Techniques, Trauma, The Arthritides, Neoplasms, Infections and Paediatric Disorders.
Book reviews
Authors: Freeman Alan
Published: July 2009

Considering its importance, the oesophagus remains a neglected organ often falling uncomfortably between the interests of the gastroenterologist, thoracic surgeon, general surgeon and the ENT specialist.

Likewise, although every general radiologist needs a good working knowledge of the oesophagus, specialist interest may be exhibited by the GI radiologist, thoracic radiologist as well as the “CT man”.
Book reviews
Authors: Stuttle Alan
Published: July 2009

The book comprises 22 review articles based on lectures of the first and second training course in Radiopharmacology and Radiopharmacy, organized by the joint Committee on Radiopharmaceuticals (ENMS & SNME). The book covers a wide range of topics under the broad categories of Radiochemistry, Radiopharmacy, Radiopharmacology and Radiopharmaco-kinetics.
Magnetic resonance: boundless possibilities … or possible boundaries
Authors: Young I. R.
Published: July 2009

Silvanus Thompson was a cultivated and learned man in the sense recognized by the Victorians, but, sadly, largely a thing of the past. He touched many things, improving them all, including translating Gilbert's De Magnete. When he was active, the use of electricity and magnetism in medicine were matters of keen interest, but one can only guess at what a world adapting to Röntgen's wonderful discovery would make of today's evolution of a magnet-based method of observation and measurement into, possibly, the most powerful in vivo diagnostic tool yet discovered. However, it is a reasonable guess that a mind as flexible and receptive as that of Silvanus Thompson would have embraced it with euphoric excitement.

Perhaps the single most exciting thing about whole-body magnetic resonance (MR) is its scope. It is possible to design procedures for an almost indefinite repertoire of different studies, each more elaborate than the last and capable of more refined interpretation. The only snag—often mentioned with a sense of resignation—is that the process may take a long time. This reflects the fact that the sensitivity of the technique is limited, and that signal-to-noise ratio (SNR) considerations affect everything that is attempted.

Nuclear magnetic resonance (NMR) aficionados are inclined to cloak their activities with a miasma of acronyms and jargon, leading to in vivo spectroscopy, in particular, being viewed as almost impenetrable in its mystique, though imaging can often seem little less opaque.
Ultrasound examination of lymph nodes in the hepato-duodenal ligament
Authors: Lyttkens K. , Forsberg L. , Hederström E.
Published: July 2009

Ninety patients, found to have lymph nodes in the hepato-duodenal ligament (HDL) on ultrasound examination were reviewed over a one-year period in order to define the diseases in which such nodes can be found. The patients were divided into four main groups: benign liver disease (n = 31), malignant disease (n = 26), disease of the gallbladder or the biliary tree (n = 14) and a group with various benign, most inflammatory diseases (n = 19). In 40% of the patients (36/90), the lymph nodes in the HDL were the only sign of disease on ultrasound examination, and the majority of those were in the benign group.
The response of the pig lung to fractionated doses of X rays
Authors: Rezvani M. , Hopewell J. W.
Published: July 2009

A radionuclide 133Xe clearance technique has been used to assess changes in the regional gas exchange capacity of the lung after the irradiation of part of the lung of pigs with fractionated doses of 250 kV X rays. Changes in the gas-exchange capacity of an irradiated volume of lung were compared with a similar volume of unirradiated lung in each animal. The results from the lung function tests were converted into quantal data on the basis of the percentage of lung function tests in animals showing a ≥ 15% impairment of function in the irradiated lung compared with contralateral unirradiated lung in the same animal. From those quantal data, ED50 values (± SE) were obtained for each fractionation schedule. These ED50 values were used to determine time-dose-fractionation relationships for both early and late radiation-induced damage to the lung. There was apparently no recovery phase between the early and late phases of damage to the lung. In general, ED50 values for the late effect were slightly lower than those for the early effect, but this only proved significant when measurements obtained at 4 weeks after treatment were included. Varying the period for the assessment of early and late damage did not have a major effect on the results but did suggest that late damage was established in pigs by 39 weeks after irradiation. The linear-quadratic model did not provide a satisfactory fit to the fractionation results for pig lung. However, a modified nominal standard dose equation did provide a better description of the findings. A value of 0.44 ± 0.06 was obtained for N exponent in the equation for both early and late lung damage when the single-dose data points were included in the analysis. The value of the N exponent was increased to 0.52 ± 0.08 when the single-dose data were excluded. This increase was not significant.
Low-field cine magnetic resonance imaging
Authors: Jones Richard A. , Metcalfe Malcolm J. , Redpath Thomas W. , Smith Francis W. , Walton Stephen
Published: July 2009

The spin warp technique (Edelstein et al, 1980) is now the most commonly used method of image formation for nuclear magnetic resonance (NMR) studies. This technique combines frequency and phase encoding of positional information onto the signal to allow subsequent image reconstruction. Each line of data in a scan is subject to the same frequency-encoding procedure but has a unique amount of phase encoding. Since the sampling is relatively fast, the signal can be considered to be a sample at a particular point in time. For cardiac imaging, we need to ensure that for each phase encoding we are sampling the same point in the cardiac cycle if the final image is to be an accurate representation of that point in the cardiac cycle. This is achieved by synchronizing the data sampling with the patient's electrocardiogram (ECG) signal. If we sample at a number of points in each cardiac cycle, we can acquire a number of images which represent different stages of the cardiac cycle (Fig. 1). These images can then be viewed individually or in the form of a closed loop to enhance the perception of the motion in the images. This technique is commonly referred to as cine NMR or cine magnetic resonance imaging (MRI).

To provide sufficient sampling points within the cardiac cycle, the pulse sequence must have a short repetition time; hence a gradient–echo, rather than a spin–echo, is used.
Aneurysms involving the intrapetrous internal carotid artery: a rare cause of Horner's syndrome
Authors: Rawlinson J. , Colquhoun I. R.
Published: July 2009

Aneurysms involving the intrapetrous carotid artery are a rare cause of Horner's syndrome and only three cases appear to have been described previously. These aneurysms vary in their mode of clinical and radiological presentation depending on the direction of expansion of their sac. Non-invasive radiological investigation may demonstrate striking abnormalities, but the definitive diagnosis can only be made by angiography.

A 19-year-old woman who was 34 weeks pregnant complained of an attack of severe migrainous headache, which had left her with a drooping left eyelid. This attack was similar to many she had experienced since the age of 8 years, but none previously had been followed by neurological deficit. She gave no history of head injury or middle ear infection. Examination revealed left Horner's syndrome, in addition to partial left 8th, 9th and 10th cranial nerve palsies. All other tests were normal. Radiological investigation was deferred until she had delivered her baby.

Plain radiographs of the skull base (Fig. 1) showed a large area of pressure erosion of the medial half of the floor of the left middle cranial fossa with a scalloped margin. Unenhanced axial computed tomographic (CT) sections defined a soft-tissue mass impressing the nasopharynx and obliterating the left fossa of Rosenmuller. Magnetic resonance imaging (MRI) confirmed the presence of a mass lesion eroding the base of the skull in region of the carotid canal (Fig. 2).
Chemical protectors: their potential application against occupational radiation hazards
Authors: Devi P. Uma
Published: July 2009

The last two decades have seen a tremendous effort to find suitable chemicals that can be used for normal-tissue protection in tumour radiotherapy. The most promising compound so far is the synthetic phosphorothioate derivative of cysteamine (WR-2721), studied extensively for its protective effect in mammals and man (Yuhas, 1980). The initial enthusiasm was dampened by the discovery that repeated injections of this drug in man produced undesirable toxic side effects (Utley et al, 1976; Turrisi et al, 1983), as well as by the controversy regarding the preferential protection of normal tissues by the drug (Denekamp et al, 1983).
Atlanto-axial rotary fixation
Authors: Featherstone T. , Tayar R. , Palmer M. K.
Published: July 2009

We read with interest the paper by Moss et al (1989) on the diagnosis of atlanto-axial rotary fixation by functional computed tomography (CT). We have recently seen two young adults with resistant torticollis but no neurological symptoms following minor neck trauma. Routine antero-posterior, open-mouth, upper cervical spine radiographs revealed some asymmetry of Cl on C2, and subsequent CT of both patients confirmed the presence of atlanto-axial rotary fixation.
Book reviews
Authors: Hutton J. B.
Published: July 2009

The main authors of this A4 format book are two experienced radiographers working in collaboration with several consultant dental surgeons, a representative of Siemens Ltd, and the College of Radiographers. The slim volume is a collection of articles previously published in Radiography, together with a supplement, and is intended to provide general radiographers with not only an insight into dentistry, so that the value of various radiographic techniques becomes apparent, but also a resumé of the shortcomings of some of these techniques.

The first chapter is divided into two to deal initially with a history of the development of dental panoramic tomography, the principles and practice of the technique and radiation doses. There are also illustrations of normal radiographic anatomy and the results of faulty patient positioning. The second half outlines the shortcomings of the panoramic technique with particular reference to width of focal trough, production of secondary shadows, image overlap and superimposition.
Book reviews
Authors: Lamb G.
Published: July 2009

This relatively compact book, edited by R. A. Lerski, consists of 15 chapters written by different authors and covers the physics and many medical applications of diagnostic ultrasound.

The first five chapters are devoted to basic physics including chapters on Doppler and performance checks. The information and diagrams are clearly presented and subheadings within chapters are clearly labelled in bold print. Each of these chapters is between 10 and 15 pages in length. However, the one concerning performance checks runs to nearly 30 pages and I feel that this is a little long when considered in relation to the length allowed for other chapters.
Book reviews
Authors: Wilson A. G.
Published: July 2009

This is the fourth volume of a completely rewritten version of Analysis of Roentgen Signs in General Radiology (1973). It replaces the previous Volume 2 and has grown considerably, from about 500 to 1000 pages. It now has just over 1000 figures and about 1300 references, the most recent being 1985. The emphasis is on conventional radiology and computed tomography and these represent the bulk of the illustrations with a little MR, including a short appendix on MR in congenital heart disease. There are 13 chapters with I. Meschan as an author in all but one and five other contributors to seven chapters (R. E. Bechtold, M. L. Bertrand, B L. Carter, A. G. Formanek and R. D. Pugatch).

The 13 chapters cover the chest (wall, pleura, diaphragm, lungs, air passages and mediastinum) and congenital and acquired diseases of the heart and great vessels with new ones on the breast, larynx and the paediatric chest.
Radiobiological rationale for compensation for gaps in radiotherapy regimes by post-gap acceleration of fractionation
Authors: Wheldon T. E. , Barrett A.
Published: July 2009

It is now recognized that clonogenic tumour cells may repopulate vigorously during radiotherapy. Gaps in treatment schedules which lead to prolongation of overall treatment time may therefore cause sparing of tumour. Acute-responding normal tissues will also be spared if repopulation by surviving stem cells takes place. However, it is unlikely that stem cells in lateresponding normal tissues repopulate significantly over the time-scale of a conventional treatment regime; these tissues will therefore experience little or no sparing as a result of a gap. This poses a dilemma since tumour cell repopulation implies that an increased therapeutic effect in the post-gap phase of treatment may be necessary to compensate for any prolongation of treatment time, but it is difficult to achieve increased tumour effect without also increasing damage to late-responding normal tissues. Neither increased total dose nor increased fraction size is able to achieve this. A possible solution is provided if total treatment time can be held constant, with unchanged total dose and fraction size, by use of twice-daily conventionally sized dose fractions administered after the gap. Provided the twice-daily fractions are sufficiently spaced (not less than 6–8 h apart), the result will be to offset repopulation in tumour and acute-responding normal tissues without additional impairment of late-responding normal tissues. The feasibility of the approach depends on being able to complete treatment by the time originally intended; it is therefore more readily applicable to gaps occurring early rather than late in a treatment schedule. The strategy should be especially advantageous for tumours with rapid repopulative potential in sites where risk of damage to late-responding normal tissues imposes limitation of dose.
Dosimetric intercomparison in the British Institute of Radiology fractionation study of 3F/week versus 5F/week in radiotherapy of laryngo-pharynx cancer
Authors: Barrett J. H. , Davy T. J. , Dixon-Brown A. , Goodman D. , Lawson R. C. , Ormsby P. L. , Saunders J. E. , Williams P. C. , Fowler J. F. , Wiernik G.
Published: July 2009

A dose intercomparison was carried out by the National Physical Laboratory between the seven radiotherapy centres which contributed the largest number of patients to the British Institute of Radiology fractionation study of three fractions per week versus five fractions per week in clinical cancer treatment. Six of the centres showed remarkable agreement within the acceptable limits of error of the measurements. In one centre there appeared to be a physical dose discrepancy of 2.8% which was materially less than could be detected clinically.
Bilateral pneumothorax as a presenting feature of metastatic angiosarcoma of the scalp
Authors: Lawton P. A. , Knowles S. , Karp S. J. , Suvana S. K. , Spittle M. F.
Published: July 2009

Angiosarcoma of the scalp is a rare highly malignant tumour which frequently metastasizes to lung (Holden et al, 1987). Here we report a case of bilateral pneumothorax in a man with apparently localized angiosarcoma of the scalp This case illustrates the need to be aware of the aggressive nature of this tumour and to suspect metastases when pulmonary complications develop.

In June 1988, a 77-year-old man presented with a 6 week history of an enlarging lesion on his scalp. On examination, there was a 3 cm diameter pink-purple nodule with several smaller satellite lesions extending for a further 1 cm. There were no palpable lymph nodes. A biopsy of this lesion showed it to be an angiosarcoma. The scalp lesion was completely excised and the area grafted. The histology of the excised lesion confirmed an angiosarcoma which was completely excised but close to the deep excision line.
Digging for a diagnosis
Authors: Jäger H. R. , O'Donnell C. , Sinha J.
Published: July 2009

A 45-year-old man presented with a 1 week history of progressive painless jaundice. An ultrasound examination at the referring hospital indicated distal common bile duct (CBD) obstruction.

Six years previously he had noticed swelling around both mandibular angles and an orthopantomograph had shown two rounded radio-opaque masses in these areas (Fig. 1). One year later, the patient had a colectomy with an ileo-rectal anastomosis.
Effective dose equivalent in dual X-ray absorptiometry
Authors: Pye D. W. , Hannan W. J. , Hesp R.
Published: July 2009

The technique of dual photon absorptiometry (DPA) has been established for many years for the measurement of bone mineral density of the lumbar spine and femoral neck. Its use, however, has been mostly restricted to centres with specialized interests. A recent development of the technique has been the replacement of the dual energy isotope source by a dual energy X-ray source. This technique is referred to as dual X-ray absorptiometry (DXA), dual energy X-ray absorptiometry (DEXA) or quantitative digital radiography (QDR). Scanners based on this system are now available from several manufacturers. The use of an X-ray source has resulted in improved image resolution, shorter scan times, better precision (in vivo reproducibility of about 1%) and a reduction in radiation exposure per scan. The improved performance of the new machines has led to a wider use of the absorptiometry technique, which is now capable of fulfilling a screening role.
Changes in relative biological effectiveness with depth of neutron beams
Authors: Nias A. H. W.
Published: July 2009

In his letter on this subject in the August issue of the British Journal of Radiology (Hall, 1989), Professor E. J. Hall suggests that “the change of RBE [relative biological effectiveness] with depth is generally not seen for high energy neutron beams…where the neutron spectrum produced has a single peak”.
Changes in relative biological effectiveness with depth of neutron beams
Authors: Hall Eric J.
Published: July 2009

(1) The point at issue in my letter (Hall, 1989), and the paper on which it was a comment (Hornsey et al, 1988), was the biological consequences of the difference in neutron spectra characteristic of the reactions involving protons on beryllium versus deuterons on beryllium; 14 MeV D–T neutrons are quite different. They can hardly be regarded as high-energy neutrons, and are nominally monoenergetic except for scattered neutrons from the collimator, and a large γ-ray component.
Book reviews
Authors: Rees Michael R.
Published: July 2009

It has taken a little time for the research interest in digital imaging techniques for the heart to be accepted into clinical practice. Initially the interest was in intravenous digital subtraction and whether this technique could replace direct coronary and ventricular catheterization. This has proved not to be the case. The focus of interest has now changed to the quantification of angiographic information and data processing. The opportunity that digital imaging gives in the storage and analysis of angiographic data is proving to be a very exciting development area in cardiac diagnosis. One or two books have been published recently dealing with this broad topic; however, this publication is a collection by two of the accepted leaders in the field.
Book reviews
Authors: Nikjoo Hooshang
Published: July 2009

Application of Monte Carlo simulation methods to radiological and medical physics problems has become popular in recent years, and this is a timely contribution to the literature on the subject for the learners and investigators in the field.

The book contains seven chapters. The first is devoted to a brief discussion of the elements of probability and statistics with emphasis on binomial and Poisson distributions. The next chapter is concerned with the random number generators (as the fundamental input of the Monte Carlo technique) and tests of randomness and their applications.
Superselective embolization using a co-axial catheter technique
Authors: Olliff S. , Thomas S. , Karani J. , Walters H.
Published: July 2009

A method of superselective embolization of 0.64 mm or 0.89 mm coils using a coaxial catheter system is described. The normally functioning parts of an organ can be easily preserved. A number of clinical cases are briefly described which illustrate the application of this method. It is particularly suited to the control of bleeding points in diseased organs or precious organs such as transplants where embolization of a larger volume of tissue would have serious consequences.
Gastrointestinal histamine and histamine formation capacity after gastric irradiation in mice
Authors: Man W. K. , Li S. K. , Spencer J. , Baron J. H. , Michalowski A. S.
Published: July 2009

Mice were exposed to a single dose of 9 or 15 Gy of X rays directed to the stomach. Histamine and histamine formation capacity (HFC) in the oxyntic region of the stomach were assayed at regular intervals for 7 weeks. After 9 Gy, mean gastric mural histamine fell to 61% of the control value (p<0.0l) 7days after irradiation while HFC rose to 172% (p<0.05). Both histamine and HFC returned to control values within 2 weeks after irradiation. With 15 Gy, on Day 7, histamine fell to 46% (p<0.0l) and HFC rose to 260% (p<0.05). Histamine concentration remained low (less than half of the control value) while HFC returned to normal. These dose-dependent changes in histamine were observed neither elsewhere in the gut nor in the circulating blood. Further groups of mice were exposed to 3, 6, 9 or 15 Gy to the stomach, with gastric histamine and HFC assayed on Day 7. Histamine concentration was inversely related to dose (r= –0.59, p<O.001) and HFC was directly dose dependent (r = 0.52, p<0.001). These results suggest that irradiation of the stomach may reduce gastric histamine without inducing a general histamine release. The depletion of the gastric histamine store may explain the inhibitory effect of irradiation of the stomach on gastric acid secretion.
A sweet solution to a contrast problem
Authors: Foulner Deryck
Published: July 2009

Prior to a computed tomographic (CT) examination, it is our custom to sedate most children under the age of 4 years with oral chloral hydrate syrup. In children who have been fasted, sedated thus, and not given an oral contrast agent, we have noticed opacification of both gastric and duodenal lumena (Fig. 1). It was decided to investigate this phenomenon.

The scans were performed on an Elscint 2400 at 120kVP and 252 mA. The various constituents of the chloral hydrate syrup were scanned in plastic medicine cups atop a body phantom (Table I).
Conversion coefficients from fluence and air kerma to dose equivalent quantities
Authors: Rossiter M. J.
Published: July 2009

Following the publication of the International Commission on Radiation Units and Measurements Report 39 (ICRU, 1985), the British Committee on Radiation Units and Measurements issued a memorandum (BCRU, 1986) recommending the adoption of the quantities ambient dose equivalent H*(d) and directional dose equivalent H'(d) for area monitoring in the UK, and conversion coefficients and conversion relationships from fluence and air kerma to these quantities were given in an appendix. The promulgation of these conversion coefficients was in advance of any specific recommendation on conversion coefficients by the ICRU. The BCRU undertook to review the situation following any subsequent recommendations by the ICRU.
Book reviews
Authors: Pilling D. W. , Farquharson R. G.
Published: July 2009

This book tackles two separate subjects, the first being obstetric ultrasonography. This is not a comprehensive text, but a series of seven chapters, each covering a separate aspect of obstetric ultrasound. Each chapter discusses some basic findings and assumes very little background knowledge, but also goes into some detail of each subject, thus trying to satisfy the different requirements of the beginner and the expert.
Book reviews
Authors: Finlay David
Published: July 2009

This is a very ambitious book. The stated aim of the book is “To help the emergency physician get through the night”, and it is about the radiology of acute trauma and disease. The book is split into chapters: the skull, the face, spine, chest, abdomen, pelvis and hips, extremeties and the paediatric patient. Each chapter includes sections on radiographic technique and anatomy, pathology and normal variants. Information on the use of computed tomography, ultrasound and arteriography is included where indicated.
Past and revised risk estimates for cancer induced by irradiation and their influence on dose limits
Authors: Richardson R. B.
Published: July 2009

The present is a time of great change in the assessment of radiation risk and its influence on dose limits. The main sources of risk estimates arise from irradiation for medical reasons and from the use of atomic weapons. The effects of radiation on humans and animals are reviewed by such august bodies as the International Commission on Radiological Protection (ICRP), the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) and the Biological Effects of Ionizing Radiation (BEIR) Committee in the USA. Over the years they have developed many of the concepts that give structure to the science of limiting radiation-induced cancers and other harmful effects. These concepts are mentioned here for completeness and because they also provide relative stability in a time of change.

Central in its importance on radiation risk estimates is the analysis of excess cancer risks of the Japanese bomb survivors which was based on a dosimetry system (T65DR) devised in 1965. Reassessment commenced in the early 1970s, with a new dosimetry system employed in the extended study of the Nagasaki and Hiroshima populations in 1985. The considerable debate that the new “DS86” dosimetry of the Japanese Life Span Study has caused reminds us again of the key position of this Japanese population in influencing radiation risk estimates and protection regulations.
Does scrotal ultrasound reduce the need for orchidectomy in the clinically malignant testis?
Authors: Milner S. J. , Blease S. C. P.
Published: July 2009

Many recent studies have confirmed the ability of ultrasound to elucidate scrotal pathology, but its place in the work-up of specific testicular problems is not yet fully defined. We investigated 15 cases where a firm clinical diagnosis of testicular malignancy was made. All cases progressed to orchidectomy. Scrotal ultrasound refuted the diagnosis of malignancy in seven cases with subsequent histological proof of benignity. However, the nature and extent of the benign disease was such that, on review, orchidectomy was considered to be the most appropriate method of treating the patient. We contend that in the case of firm clinical diagnosis of testicular malignancy, an ultrasound diagnosis of benignity will not alter management, and it is therefore not an essential part of the work-up in this group of patients.
Response of murine small intestine to combined treatment with fostriecin and X rays
Authors: Rao K. R. , Fritz-Niggli H.
Published: July 2009

This radiobiological investigation was based on the measurements of crypt cell survival in mouse small intestine when the animals were injected with a single dose of fostriecin or streptomycin, and subsequently irradiated to the whole body with graded doses of X rays. The experimental data obtained indicated that fostriecin decreased the isoeffect dose to murine intestine by a factor of 2.3, whereas streptomycin did not influence the radiation response. The biological effects of fostriecin on various tumour cell systems in vitro and in vivo are briefly reviewed. The possible basic mechanisms involved in the radiosensitizing action of fostriecin and the implications of these results in the radiation protection of normal tissues are discussed.
Peripheral doses of two linear accelerators employing universal wedges
Authors: McParland Brian J.
Published: July 2009

The peripheral dose (PD) is defined as the dose delivered to tissues outside the collimated radiotherapy beam. This absorbed dose will be of clinical concern if any uninvolved radiosensitive or critical structures outside the beam were to receive dosages approaching their tolerance levels. Sources of the PD include head leakage (transmission through the collimation system), collimator scatter, scatter and secondary particle production from a beam modifier (tissue compensator, wedge filter or shielding) present in the beam and scatter arising from within tissue. A fifth source, that due to radioactivity induced within the patient by a high-energy beam, is not considered in this work.

In the past, several studies have been undertaken to characterize the peripheral dose as a function of beam modality and quality, field dimension, the separation between the radiation source and the patient and the presence and composition of a beam modifier (Keller et al, 1974; Scrimger & Kolitsi, 1979; Nusslin & Hassenstein, 1980; Fraass & van de Geijn, 1983; Greene et al, 1983; Kase et al, 1983; Starkschall et al, 1983; Greene et al, 1985; Sherazi & Kase, 1985; Francois et al, 1988). Peripheral doses at specific clinical sites, such as the contralateral breast (Fraass et al, 1985) and the gonads (Yau et al, 1981), have also been measured on patients and within anthropomorphic phantoms. In general, these studies indicate that the PD decreases approximately exponentially with distance from the beam edge.
Mammographic depiction of Poland's syndrome
Authors: Cooper Richard A. , Johnson Matthew S.
Published: July 2009

Poland's syndrome is a group of congenital anomalies of the chest wall, with or without involvement of the ipsilateral upper extremity. We present the first case of Poland's syndrome diagnosed by mammography and thefirst example of Poland's syndrome in the mammographic literature.

A 39-year-old woman with in situ carcinoma of the cervix was noted, on physical examination, to have a small right breast with fullness in the upper outer quadrant of that breast. A subsequent mammogram shows a hypoplastic right breast and absence of the right pectoralis major muscle (Fig. 1). The patient was unaware of her anomaly.
Spontaneous disappearance of tuberculous psoas abscess calcification
Authors: Whitaker S. C. , Preston B. J. , McKim-Thomas H.
Published: July 2009

Calcified psoas abscesses are a characteristic feature of tuberculosis of the thoraco-lumbar spine. We present a case in which well established calcification has almost completely disappeared, several years after any antituberculous treatment. A review of the English literature has revealed no previous report of this finding.

The patient, now a 48-year-old woman, first presented at the age of 6 with back pain and radiographic features of spinal tuberculosis at T12/L1. Bilateral calcined psoas abscesses developed over thenext few months. Management was first by bed rest and later, at the age of 12, by postero-lateral drainage with spinal fusion. By this time abscess calcification was well established. The patient then remained relatively well until the age of 33, when she developed girdle pain due to further vertebral destruction at a higher level (T8–T12).
Pneumonia, diagnosed on the abdominal radiograph, as a cause for acute abdomen in children
Authors: Spencer P. A. S.
Published: July 2009

Three cases of acute abdomen in children are described where a diagnosis ofpneumonia was recorded as the cause of the abdominal pain. In each case, pulmonary consolidation was identified on the plain abdominal radiograph. Thediagnostic value of plain abdominal radiographs in children is increased bydeliberately including the lung bases.

Acute abdominal pain is a common cause of paediatric emergency referral andadmission to hospital. Acute appendicitis is the most common identifiable organic cause (Drake, 1980). Extensive lists can be made of other possible causes (Table I), arid investigations are directed to reaching a working diagnosis within a few hours of admission.
Medicolegal aspects of medical radiation exposure
Authors: Ross W. M.
Published: July 2009

It is well known that untoward events may follow the exposure of human beings to ionizing radiations. As some such events may ensue after medical (in addition to other) exposures, it is appropriate to consider possible resultant legal complications of medical radiation exposures.

The contents of this communication are based on practice in the UK, and concentrate on those aspects of the subject which relate to the direct effects of ionizing radiation, to the exclusion of such important aspects such as the “chemical” effects of contrast media and the “mechanical” effects of interventional radiology. It is fully recognized thatthose two aspects are almost wholly responsible for the unenviable positionof radiology (including both diagnostic radiology and nuclear medicine), high in the league table of specialities causing problems for the medical defence bodies. In recent years there have been very few examples in diagnostic radiology related to dose, except in pregnancy, though very many in the other categories. In therapy there have been few cases at all, and not all associated with dose.
The influence of tube type and operator experience on performance of small bowel enema
Authors: Bartram Clive
Published: July 2009

Recent correspondence (Bisset, 1989) concerning the techniques and different types of nasogastric tubes mentions the re-use of tubes after sterilization. A problem common to many tubes is manipulating the guidewire once the tube has become slightly softened by chemical sterilization.
Alterations in body and skin temperatures caused by MRI
Authors: Dennis J. A. , Saunders R. D.
Published: July 2009

The recent paper by Shellock et al (1989), which describes skin and body temperatures and cutaneous blood flow in six volunteers before, during and after magnetic resonance imaging (MRI) procedures performed at high specific energy absorption rates (SARs), is critical of some aspects of the NRPB recommendations (NRPB, 1983) for limiting patient (and volunteer) exposure to radiofrequency (RF) magnetic fields during MRI. The paper, and other recent papers by these authors, are a welcome addition to our knowledge of the effects of RF absorption in the human body, which was rather more limited when NRPB formulated its recommendations.
Silicone implant to prevent visceral damage during adjuvant radiotherapy for retroperitoneal sarcoma
Authors: Ball A. B. S. , Cassoni A. , Watkins R. M. , Thomas J. Meirion
Published: July 2009

The incidence of local recurrence after surgery for retroperitoneal sarcoma is reduced by high-dose adjuvant radiotherapy but treatment is restricted by the effects of irradiation on adjacent viscera. By securing a silicone gel-filled implant (breast prosthesis) in the tumour bed after excision of the tumour, adjacent viscera are displaced from the site of maximum irradiation and may thereby be protected. We used this technique in three patients in whom excision of a retroperitoneal sarcoma was followed by high-dose adjuvant radiotherapy. Post-operative radiotherapy was well tolerated but local recurrence developed in one patient, and delayed perforation of the large bowel occurred in another. Both cases underwent further surgery at which the implant was removed. The same two cases also developed asymptomatic hydronephrosis on the side of the implant, attributed to local fibrosis.
The variation of wedge factors with field size on a linear accelerator
Authors: Thomas S. J.
Published: July 2009

When a wedge filter is used to modify the dose distribution in a beam of megavoltage X-rays, the beam intensity is reduced. The reduction of beam intensity is quantified by a factor called the wedge factor (WF) defined as follows: where measurements are performed in water at the depth of maximum build-up.

It is assumed by the authors of several treatment planning systems that the wedge factor doses do not vary with field size. Palta et al (1988) presented measurements for a range of square field sizes with 4 MV and 6MV X rays, showing that there can be considerable variation of wedge factor with field size, especially for a 60° wedge, and that errors in dose of up to 7% can occur by ignoring this variation.

This technical note presents the results of similar measurements on 8 MV and 16 MV beams with a 60° wedge. The variation of wedge factor for a range of rectangular field sizes has also been investigated; this was done to see whether the variation follows an equivalent square law, or whether one should follow the practice of one commercial planning system by considering only the dimension in the wedged direction.