bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring of bladder neoplasia by low-field magnetic resonance imaging
Authors: Smith Francis W. , Sarkar Tarun K. , Hewitt John B.
Published: July 2009

The development of magnetic resonance imaging (MRI) for human imaging was prompted by the observation that malignant tumours had a significantly longer relaxation time than normal tissue when measured by nuclear magnetic resonance (NMR) spectroscopy (Damadian, 1971). By 1979, imaging instruments using the NMR phenomenon had been developed which could make images of the human brain (Hawkes et al, 1980) and body (Edelstein et al, 1981) and, currently, high resolution images of the body are possible. Relatively little work has been published on measurement of proton spin-lattice time (T  1) in disease, more effort having been expended in the development of high resolution images, exploiting the high contrast resolution present between different tissues.
Book reviews
Authors: Young J.
Published: July 2009

This book is a comprehensively compiled practical manual about simulator practice and radiotherapy techniques. It begins with an introductory chapter which attempts to define simulation, and tabulates both simulator and personnel functions in this area. The following chapter describes the general principles behind simulation procedures, including reproducibility and quality assurance.
Book reviews
Authors: Loose Henry W.
Published: July 2009

This is another fine addition to the library of “Anglo-American” textbooks of radiology. I hope that the first author Dr F. Kelvin will forgive me recalling the fact that he trained in both medicine and radiology in London before joining the “brain drain” to America in the early 1970s.
Spasm of the deep circumflex artery causing entrapment of a guidewire
Authors: Shand J. , Teasdale E.
Published: July 2009

During Seldinger catheterization of the femoral artery the guidewire may occasionally enter the deep circumflex iliac artery. In most cases this is a minor complication requiring only redirection of the guide-wire. It may, however, provoke severe arterial spasm, trapping the guidewire which, if withdrawn, can cause stripping of the artery (Asmussen, 1984).

Two cases are reported in which the guidewire was trapped in the deep circumflex iliac artery because of spasm, this was relieved by percutaneous infiltration of local anaesthetic, allowing safe removal of the wire.
Book reviews
Authors: Jeans W. D.
Published: July 2009

The first angiogram in a human was performed 60 years ago this year, when Egas Moniz injected 7 cm3 of 70% strontium bromide into the patient's carotid artery: “ …there was a rather painful reaction …; the patient got up suddenly and radiography could not be carried out”.
Increased risk of cataract in patients receiving radiotherapy to the eye: a pilot study
Authors: Dean Geoffrey , Alderson Michael , Maximilien Remy
Published: July 2009

Of 507 persons in England and Wales identified as having had radiotherapy to the eye or eyes some years previously (after excluding those who had died and were not traced), information suitable for analysis could be obtained on 165. Of these, 23 had developed other eye disease so that the lens could not be examined. Of the other 142, 32 had certainly and one had probably developed cataract. A cataract operation had been performed on 19 persons, compared with an expected operation rate of four out of 142. The increased risk of cataract after radiotherapy to the eye is probably higher than the fivefold excess these figures for operations suggest.
Magnetic resonance imaging: the use of the inversion recovery sequence to display fetal morphology
Authors: Smith Francis W. , Sutherland Hamish W.
Published: July 2009

A number of reports of the potential use of magnetic resonance imaging (MRI) for the examination of the human fetus have appeared in the literature over the past four years (Smith et al, 1983; Johnson et al, 1984; Smith et al, 1984; McCarthy et al, 1985; Smith, 1985; Smith et al, 1985; Starket al, 1985).Even though the method is considered to be safe for the examination of pregnancies in the second and third trimester (NRPB, 1983), it has not gained wide acceptance as a method for examining abnormal pregnancy. This may be duein part to a reticence in examining the fetus and in part to the fact that spin-echo pulse sequences do not show sufficient morphological detail in the fetus to be more useful than ultrasound (Weinreb et al, 1986). The use of longtime-torepeat(TR), 2–0 s spin-echo sequences has been advocated but these images are often degraded by fetal motion artefacts (McCarthy et al, 1985). The use of calculated T1 images for the display of fetal fat and fetal morphology has been reported (Smith et al, 1983, 1984, 1985) but no detailed exploration ofthe use of inversion recovery sequences has been reported. The purpose of this study was to assess the potential value of different inversion recovery sequences for displaying fetal anatomy.

The Joint Ethical Committee of the Grampian Health Board and the University of Aberdeen has approved protocols for the study of human pregnancy in the second and third trimester.
Shades of Richard Asher?
Authors: McLeod A.
Published: July 2009

As a cardiologist, I rarely get the opportunity of looking as closely as I would like at the radiological literature. By chance, I read the paper by Shorvon et al (1987) on upper gastrointestinal endoscopic ultrasonography.
Book reviews
Authors: Harrison R. M.
Published: July 2009

This book contains reprints of fifteen medical physics papers, generally of a review nature, which have previously been published in a variety of journals (American Journal of Physics, IEEE Proceedings, Physics in Medicineand Biology, Physics Today and Medical Physics). Although the book contains no preface, it seems from the first paper that it is intended for physics teachers who wish to acquire a feel for medical physics by having a collection of review articles conveniently within the covers of a single volume. The book is divided into three sections.
Book reviews
Authors: Richardson P. J.
Published: July 2009

The Editor of this textbook is a distinguished radiographic author and the contributors specialists in their own fields and this level of expertize is reflected in the quality of the work produced. The objective of the book is to present information and guidance on the more specialized areas of radiography, their scientific background, and also to reflect the most recent imaging procedures. The book is directed at radiographers studying for the College of Radiographers Higher Diploma, but would be most helpful to student radiographers, and radiologists studying radiographic technique for the FRCR. The book is divided into 10 chapters which include tomography, paediatric and neuroradiography, trauma and skeletal radiography, radiography of the heart and great vessels and angiography.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

It is a measure of the durability and adaptability of A Textbook of Radiology and Imaging that it has now reached the fourth edition. Eighteen years have elapsed since this book filled a niche by providing a comprehensive textbook of radiology for both the trainee and the departmental library. Not only has it expanded into two substantial volumes, but the number of contributors has increased to 43.
The measurement of total filtration of diagnostic X-ray tubes
Authors: Cranley K. , Fogarty G. W. A.
Published: July 2009

New data based on calculated X-ray spectra for X-ray tubes of different target angles and various magnitudes of kilovoltage ripple are presented. Currently available published data relating the total filtration of diagnostic X-ray tubes to the measured half-value thickness (HVT) are of limited use to those carrying out such measurements. Electronic penetrameters are now widely available which allow improved accuracy in the measurement of tube kilovoltage, and the monitoring of waveforms. This has highlighted the necessity to refer to data which apply to the correct waveform ripple value, and to the correct tube target angle A wide range of data referring to 10° and 16° target angles has been calculated. An experimental example is presented where measured values of HVT on nine X-ray tubes are converted to values of total filtration, using the calculated data.
Early radiotherapy in the treatment of paraquat poisoning
Authors: Talbot A. R. , Barnes M. R. , Ting R. S.
Published: July 2009

Of 321 patients presenting to the Changhua Christian Hospital emergency services for treatment of paraquat poisoning (between January 1977 and December 1985), only one survived the development of pulmonary fibrosis. A recent case report suggested that pulmonary damage might be reversed by whole-lung irradiation (Webb et al, 1984). A request (Williams et al, 1985) to hear from clinicians who have treated cases with irradiation has resulted in only three papers, in which the patients have all died (Bloodworth et al, 1986; Williams & Webb, 1987) or had poorly documented plasma paraquat levels (Chou et al, 1987). We describe a patient with a much higher plasma level of paraquat, in whom the pressure of arterial oxygen fell to 4.7 kPa (35.7 mmHg) and who responded to treatment with a combination of dexamethasone and irradiation of the lungs.

A 17-year-old female student was admitted at 2.45 p.m. on April 5, 1986 (Day 1) after deliberate ingestion of 15 ml of paraquat (24% solution) at approximately 8.00 a.m. that day. Screening by the alkaline dithionite method (Berry & Grove, 1971) confirmed the presence of paraquat in the urine (4+) and the stomach (1+). Stomach washout was performed on admission. She was then treated with Fuller's earth and an oral mannitol purge. Paraquat was measured quantitatively by colorimetry after ion-pair extraction (Jarvie et al, 1979); 7.5 h after ingestion, the plasma paraquat level was 2.1 mg/1. At 9 h after ingestion she was transferred to our care for treatment.
Book reviews
Authors: Cooke Julie
Published: July 2009

The topic of investigational techniques in oncology could encompass the whole spectrum of radiology and pathology. However, this book, which is the edited proceedings of the eighth annual multidisciplinary symposium held at the Royal College of Radiologists, highlights in eight chapters aspects of imaging techniques. The remaining chapters are given to two highly specialized histopathological topics and the book concludes with the George Edelstyn Memorial Lecture given by Professor Einhorn.
Book reviews
Authors: Pemberton James
Published: July 2009

The idea of shock wave destruction of renal calculi was conceived in 1969. The first clinical application of extracorporeal shock wave lithotripsy (ESWL) took place in Munich some 11 years later, in 1980. This authoritative book not only deals in detail with the development of lithotripsy during those 11 years but also gives the relevant design considerations of the unit, limited as it was by geometrical, physical and biological principles. It makes fascinating reading. The remaining 12 chapters cover every aspect of ESWL from patient selection and education to the principles of treatment and the secondary manoeuvres, usually of an invasive nature, that are consequent upon the treatment.
Book reviews
Authors: Wilson A. G.
Published: July 2009

This book has been written by a consultant physician and radiologist and is aimed at junior colleagues in training, particularly those preparing for the MRCP and FRCR examinations. It is in self-assessment format.
Quality of urograms in infants: a comparison of sodium diatrizoate, metrizamide and iohexol
Authors: Rawlinson J. , Hyde I. , Williams J.
Published: July 2009

A consecutive series of 314 intravenous urograms performed in infants were reviewed and assessed for quality. The first 106 examinations were performed using sodium diatrizoate (Hypaque 270) as the contrast medium, the next 98 patients received metrizamide (Amipaque 280) and the final 110 received iohexol (Omnipaque 300). Thirty-five patients had to be excluded from the study for a variety of reasons, after which there were totals of 98 in the diatrizoate, 90 in the metrizamide and 91 in the iohexol groups. Assessing quality in terms of nephrographic and pyelographic density, sodium diatrizoate was found to be better than the non-ionic agents. Although the differences reached statistical significance they are small and unlikely to affect the information obtained in clinical practice. There was no difference in overall quality between metrizamide and iohexol. Comparing the degree of pyelographic distension and ureteric visualization using the three agents, no difference was found between the groups.
Book reviews
Authors: De La Have G. W.
Published: July 2009

The aim of this book is to provide a clearly illustrated text of both anatomy and the positioning of patients for successful radiographs. All basic or routine projections for all body parts and systems are described and illustrated in 23 chapters and 593 pages. In these respects the authors have been successful in realizing, for the most part, their objectives. The book reads well in that it is concise and visually orientated, and builds from known knowledge to the unknown.
Book reviews
Authors: Kendall B.
Published: July 2009

This is the second of four volumes written by two of the leading experts in modern interventional neuroradiology. It is an authoritative account of the treatment, by embolizing techniques, of the various types of craniofacial vascular malformations and tumours of the head and neck, including meningiomas, neurinomas, juvenile angiofibromas, branchial paraganglionomas, thyroid and parathyroid adenomas and various malignant tumours.
Text slides
Authors: Siem-Jørgensen P.
Published: July 2009

The making of slides for lectures seems to be a widespread problem as they often have to be made at the last minute. Recently, Towers and Daly (1987) have summarized some methods of slide production. In the case of text slides, a very fast method is available if one has access to a xerox photocopying machine with the facility for making reducedsize copies. The message is typed on paper but instead of paper in the photocopying machine, a transparent plastic film (acetate) originally designed for making overhead projectorfilms is used. These films are available for most copying machines at a moderate cost.
Book reviews
Authors: Finlay D.
Published: July 2009

This book is, in the main, an expansion of previous papers and correlates experiences from more than 350 cases of acute pelvic ring trauma. It is about the use of the antero–posterior radiograph, and additional inlet and outlet views, for the classification and therefore treatment of pelvic fractures. Injuries to the acetabulum are excluded.
Book reviews
Authors: Paine C. H.
Published: July 2009

This book fills an important gap in modern radiotherapy text books in setting out in detail the basic science, hardware and clinical practice for modern interstitial radiotherapy.
Book reviews
Authors: McNally N. J.
Published: July 2009

This book arose out of a course of lectures aimed at clinical trainees in medical and radiation oncology, undergraduate and graduate students, and postdoctoral fellows. This might seem to be a rather heterogeneous audience in terms of both stage of learning and interest.
Magnification of 100 mm spot film
Authors: Nepper-Rasmussen Jørgen , Halaburt Harald
Published: July 2009

Until recently, most cerebral arteriography has been performed with 24 cm × 30 cm film, which showed the structures at approximately normal size, or has been magnified by increasing the film-to-object distance. Today, digital subtraction angiography (DSA) is used increasingly for arteriography including cerebral angiography. However, the detail of, for instance, aneurysms given by the DSA system often does not provide sufficient clinical information.
The ultrasonographic appearances of hilar cholangiocarcinoma (Klatskin tumours)
Authors: Yeung E. Y. C. , McCarthy P. , Gompertz R. H. , Benjamin I. S. , Gibson R. N. , Dawson P.
Published: July 2009

The findings on ultrasound of 40 patients presenting between 1984 and 1987 who were subsequently proven pathologically to have hilar cholangiocarcinoma were reviewed. The sonograms of 17 other patients in whom pathological confirmation was not obtained but who were also presumed to have Klatskin tumours on clinical and radiological grounds, were also reviewed. All patients demonstrated intrahepatic bile duct dilatation with no evidence of free communication between the right and left hepatic ducts. A hilar mass was observed in 74% of the patients. Seventy-nine per cent of the hilar masses were of increased echogenicity relative to surrounding liver, 19% were of reduced echogenicity and 2% of mixed echogenicity. An intraluminal mass was seen in 21% of the patients and bile duct wall thickening was observed in 4%. The mass detection rate of different ultrasound equipment was also compared. In 15 patients the ability of ultrasound to predict the order of intrahepatic bile duct involvement was compared with cholangiography.
Three-dimensional shaded-surface images from positron tomography using MUP-PET
Authors: Webb S. , Ott R. J. , Flower M. A.
Published: July 2009

Three-dimensional (3D) display of tomographic data is a rapidly expanding field. In medical imaging applications attention has primarily focused on 3D display of X-ray transmission tomographic data and in particular on display of bony structure (Gillespie & Isherwood, 1986). More recently, successful 3D imaging of vascular structure with the use of contrast agents has been achieved (Gholkar & Isherwood, 1988). Although there are numerous references to 3D display of X-ray computed tomography (CT) data, including the very striking work of Hohne et al (1988), there have been far fewer attempts to create 3D images from emission tomographic data. Gibson (1983, 1988) has produced 3D displays of single photon emission computed tomography (SPECT) data. Webb et al (1987) have described two methods of generating 3D images from SPECT data, one using the MOVIE package (Christiansen & Stephenson, 1985) and the other using the “dropped perpendicular” method. The latter technique has also been implemented in the IGE STAR computer software for SPECT (Nowak, 1986). The MOVIE technique has been used by Ott et al (1986) for displaying positron emission tomography (PET) data in 3D. Cookson et al (1987) have discussed the advantages of 3D display. Bentley and Webb (1988) have reviewed current applications of 3D shaded-surface display. In this note we show some results of applying the “dropped perpendicular” technique to PET data.
Book reviews
Authors: Wilde P.
Published: July 2009

This is a well produced and comprehensive textbook covering all aspects of acute coronary intervention. Section I reviews in detail all the major thrombolytic agents with pharmacological and clinical aspects being comprehensively covered. Section II describes the clinical and technical aspects of emergency revascularization, with particular emphasis on coronary angioplasty.
Book reviews
Authors: Mould R. F.
Published: July 2009

All physicians and physicists involved in the specialty of nuclear medicine ought to purchase this Publication, which includes a statement from the 1987 Como meeting of the ICRP. It has been prepared by a Task Group of Committee 3 of ICRP and contains six chapters whose titles and sections clearly define its scope.
Book reviews
Authors: Horwich A.
Published: July 2009

This volume is in two sections. The first and shorter part (134 pp.) is devoted mainly to the hormone treatment of advanced carcinoma of the prostate. The 12 chapters derive from presentations at an EORTC symposium held in Leeds in October 1986, and include reviews of total androgen blockade (Labrie et al), LHRH-analogues in Dutch studies (Debruyne et al) and a thoughtful interim analysis of MRC Trials (Kirk). Three EORTC trials are reviewed. The published comparative studies of cyproterone acetate (CPA), medroxyprogesterone acetate, estramustine phosphate and low-dose diethylstilboestrol (DES) are summarized by deVoogt et al, who also discuss response criteria though unfortunately not including prostate-specific antigen. A preliminary report on the trial comparing orchidectomy (O), O + CPA and DES (1 mg/day) is presented by Robinson. The cytotoxic chemotherapy of prostatic cancer is dealt with in only two pages, in contrast to two detailed and rather promotional chapters from pharmaceutical company laboratories on new hormonal agents. Wide-field radiotherapy and systemic radioisotopes are not discussed at all.
Transient diverticula of the colon
Authors: Rawlinson J. , Brunton F. J.
Published: July 2009

Transient diverticula are radiological phenomena that can be observed in a minority of patients undergoing barium enema. Radiographs before and after smooth muscle relaxation are required. Diverticula seen on the early radiographs may, in some patients, disappear following the intravenous administration of 20 mg hyoscine-N-butylbromide (Buscopan). Using this technique in 441 examinations, transient diverticula have been observed in 18 patients (4.1%). They exhibit many features of established diverticula which suggests that they represent an incipient stage of the disease.
Cell kinetic changes in the follicular epithelium of pig skin after irradiation with single and fractionated doses of X rays
Authors: Morris G. M. , Hopewell J. W.
Published: July 2009

Changes in the cell kinetics of the follicular epithelium of the pig have been studied after irradiation with single and fractionated doses (30 fractions/39 days) of X rays and the results compared with previously published data for the epidermis. In the follicular epithelium there was an initial degenerative phase, during which the rate of cell depletion was independent of the radiation dose and the mode of administration. Evidence for repopulation was seen between the 14th and 18th days after single doses (15 or 20 Gy) and by the 28th day after the start of irradiation with fractionated doses (52.3–80.0 Gy). However, the degree of cell depletion and the subsequent rate of repopulation were independent of dose. The regenerative phase was characterized by an increased cell proliferation as indicated by an elevation of the labelling index. Islands of cells (colonies), with an appearance similar to cells in the normal follicular epithelium, were seen 18 days after a single dose of 20 Gy and 42 days after the start of fractionated irradiation. When compared with the epidermis, the follicular epithelium exhibited considerably less evidence of damage after both single and fractionated doses of X rays. There was a lower incidence of degenerate cells and reduced levels of cell depletion in the follicular epithelium, suggesting that cells from this region play an important role in the repopulation of the epidermis after high-dose irradiation.
Precision of determining compliance with prescribed fields from conventional portal films
Authors: Dunscombe P. B. , Fox K.
Published: July 2009

Three hundred and seventy measurements of field placement errors (FPEs) have been made by a total of 16 observers on 20 prescription-treatment film pairs taken during routine radiotherapy for cancer of the prostate. Analysis of the distributions of the measured FPEs has yielded the precision of the measurement under a variety of conditions. We report here the influence on the precision of determining FPEs of the following factors: the clinical duties of the observers, the quality of the treatment film, the relative magnification of prescription and treatment films, and whether double-exposure techniques were employed.
Results of treatment of carcinoma of the uterine cervix using the Newcastle afterloading technique
Authors: Dawes P. J. D. K. , Dean E. M. , Lambert G. D.
Published: July 2009

Eighty-seven patients with carcinoma of the uterine cervix were seen between 1 August 1977 and 31 December 1985. Seventy-one patients were treated radically. A combination of intracavitary radiotherapy, using the Newcastle manual afterloading technique, and external-beam radiotherapy was used. The actuarial 4-year survival for all Stage 1 cervical carcinomas was 84.9%. For Stage 2 cancers the actuarial local control rate was 71.1% and the survival 49.2%, and for Stage 3 cancers the 4-year actuarial local control rate was 24.3% and the survival 14.8%. Complications of treatment were confined to the bowel and bladder and occurred in 11.5% of cases. The results of treatment of Stage 1 cancer suggest that the intracavitary technique gives a satisfactory distribution of radiation. The results of treatment of more advanced cases are disappointing and suggest that improvements are possible for some patients (i.e. wedge malalignment patients). There is sufficient flexibility in the technique for it to be applied satisfactorily for most anatomical situations.
Anomalous superior vena cava causing non-visualization of the lungs in perfusion scintigraphy
Authors: Morgan A. , Evans N.
Published: July 2009

99Tcm-labelled macro-aggregated albumin (MAA) is the most commonly used agent for lung perfusion imaging. In normal circumstances following intravenous injection, almost all of the MAA, after passage through the right heart, is trapped in the pulmonary capillaries. We present a case in which the lungs were not visualized following left antecubital vein injection of 99Tcm-MAA because of anomalous venous drainage from this side into the left atrium via a persistent left superior vena cava (SVC).

A 44-year-old, previously fit man presented with a 3-day history of right-sided, pleuritic type chest pain and dyspnoea. Physical examination revealed no evidence of finger clubbing or cyanosis but there were signs which suggested the presence of a right-sided pleural effusion. A blood count showed a normal haemoglobin level but a raised white cell count with neutrophilia. Chest radiography confirmed the presence of a right-sided, pleural effusion but, even in retrospect, was otherwise unremarkable. Pulmonary embolism was suspected and intravenous heparin therapy was commenced and a perfusion lung scan requested.
Late normal tissue reactions in patients with breast carcinoma
Authors: Tomlinson M. J.
Published: July 2009

I was interested to read the paper by Bates (1988) dealing with the late normal tissue reactions experienced by patients with breast carcinoma treatedby mastectomy and post-operative radiotherapy given in either two or three fractions per week (a comparison of six fractions in 18 days with 12 fractions in 28 days). I would, however, suggest that the negative α/βratio obtained indicates that the treatment of 51 Gy in 12 fractions is notequivalent to that of 35 Gy in six fractions.
Leakage from a caesium-137 needle
Authors: Clarkson D. G.
Published: July 2009

During routine leakage checks on our stock of iridio-platinum encased caesium-137 needles and tubes, an unacceptable level of activity was detected from a number of needles. On further testing it was found that 18 gave positive indication of free activity. It was known from our records that seven of these had never been used clinically since purchase from Amersham International in 1981. The suspect sources were returned to Amersham, at their request, for inspection.
Percutaneous drainage of subphrenic abscesses
Authors: van Gansbeke Daniel , Matos Celso , Gelin Michel , Müller Patrick , Zalcman Marc , Devière Jacques , Struyven Julien
Published: July 2009

Forty subphrenic abscesses were drained percutaneously in 37 patients. These abscesses were subsequent to abdominal surgery (28 patients), biliary obstruction and/or fistula (six patients), trauma (two patients) or acute pancreatitis (one patient). The procedures were usually monitored by duplex sonography and fluoroscopy (35 out of 40 cases), with an angled subcostal approach to the subphrenic space in over 85% of the cases. Forty-three drainage catheters were inserted using the Seldinger method; 37 (86%) had a size of 12 F or more, 21 were 16 F in size. Only two out of 43 catheters were double-lumen sump drains. The clinical condition improved after insertion of the catheter in all 37 patients. Definitive successful drainage, defined as hospital discharge without complementary surgery, was achieved in 32 patients (87%), without major complications. A temporizing effect was obtained in three additional patients (8%) who underwent curative surgery for the underlying process after complete drainage of the abscess. Two patients died from multiple organ failure before their abscess healed. Considerations for successful drainage of subphrenic abscesses include a good knowledge of the subphrenic space anatomy, the use of large-bore drainage catheters and the recognition and correct management of underlying enteric, biliary or pancreatic fistulas.
Interstitial iridium-192 implantation for malignant brain tumours. Part I: Techniques of dosimetry planning
Authors: Wu Andrew , Chun Mison , Kasdon D. , Heros D. , McKeough P. , Chang H.
Published: July 2009

Interstitial implants for brain tumours with removable iridium-192 radioactive seeds have been performed using a Brown–Roberts–Wells stereotactic frame. A simple and accurate computed-tomography-guided dosimetry pre-planning technique and procedure prior to implant have been developed and are discussed.
Films, screens and cassettes for mammography
Authors: Law J. , Kirkpatrick A. E.
Published: July 2009

Various film–screen combinations intended for mammography have been compared for image quality and for dose. Image quality was assessed as in an earlier paper, using a test object having details which are both realistic and quantitative. Relative doses required to give film densities of 1.0 were measured. The Kodak MinR–MinR combination was taken as a standard against which others were compared, and in general a lower dose was accompanied by poorer image quality. The Fuji NH film with Fuji Hi-Mammo screen was the sole exception, giving slightly better image quality at about half the dose required by the MinR combination. A number of cassettes were also compared with each other and with evacuated envelopes. The Dupont Cronex cassette and three carbon-fibre fronted cassettes all performed well in image quality.
Unusual long bone changes in thalassaemia: findings on plain radiography and computed tomography
Authors: Singcharoen T.
Published: July 2009

Bone change is one of the most outstanding radiological manifestations of marrow hyperplasia in thalassaemia. The “hair-on-end” skull, a variety of radiological changes of the ribs and osteoporosis with coarse trabeculation of other bones have been well described (Moseley, 1974; Lawson et al, 1981). We have encountered three thalassaemic patients with unusual marrow proliferation in the long bones of the extremities.

An 8-year-old boy had β-thalassaemia major diagnosed in early childhood. Haemoglobin levels ranged from 3 to 7g/100 ml. Splenectomy was performed at 7 years of age. The patient still suffers from severe anaemia and frequent episodes of congestive heart failure. A plain radiograph of the skull showed widening of the diploic space with “hair-on-end” appearance, typical of thalassaemia (Fig. la).
Demonstration on computed tomography of tracheomalacia in tracheobronchomegaly (Mounier-Kuhn syndrome)
Authors: Doyle Anthony James
Published: July 2009

The appearances on computed tomography (CT) (Shin et al, 1988) and magnetic resonance imaging (MRI) (Rindsberg et al, 1987) in single cases of tracheobronchomegaly (TBM) have been described. These reports emphasize the tracheal and proximal bronchial dilatation with diverticulosis of the main bronchi. In a recent case examined by us, these features were also present but even more striking was extreme thinning and deformation of the tracheal wall and indentation anteriorly by the brachiocephalic artery. This finding reflects the tracheomalacia found in this condition. As in previously reported cases, TBM was first detected in this patient on CT after numerous negative chest radiographs.
Radiation dose to urological surgeons during X-ray fluoroscopy for percutaneous stone extraction
Authors: Law J. , Inglis J. A. , Tolley D. A.
Published: July 2009

Radiation protection of staff using X rays in UK hospitals is generally acknowledged to be satisfactory. This is supported by the fact that relatively few need to be Classified Workers under the Ionizing Radiations Regulations (HMSO, 1985). This view is based on routine measures to protect the main body of the worker, e.g. with a lead apron, and the results of routine dose monitoring, generally with monitors underneath such aprons.

There remains the problem of dose to unshielded parts of the body from procedures such as fluoroscopy where protection depends mainly on lead aprons, and where some staff are very close to unshielded X-ray beams. Doses to heads and arms of radiologists were reported earlier (Law, 1985). This paper reports doses received by one surgeon conducting percutaneous nephrolithotomy using an overcouch system. This procedure requires the surgeon's fingers, head and neck to be very close to the X-ray beam, and monitors were therefore worn on two fingers of each hand, as well as over the thyroid. Satisfactory sterile conditions were maintained.

Under the Ionizing Radiations Regulations (HMSO, 1985) there is renewed emphasis on monitoring dose to staff, and under the 1988 Regulations (HMSO, 1988) on protection of the patient there is a requirement for adequate training of all staff using X-ray equipment, not only radiologists and radiographers.
Variation of image quality with X-ray tube potential in mammography
Authors: Law J. , Faulkner K. , Smith S.
Published: July 2009

It has long been accepted in general radiology that decreasing tube potential (kV) leads to increased contrast. With tungsten target tubes there has been no cause to question this in the mammography region down to 25 kV or even below. With molybdenum targets and filters, X-ray spectra are a little more complex, owing to the molybdenum characteristic radiation. Any difference in behaviour, if it exists, will arise from this radiation, but the same broad conclusion is likely to apply here also. A further possible point of interest could be the rate at which contrast varies with kV. Most clinical experience seems to support the view that contrast does increase as kV falls, and experimental confirmation has been reported (Stanton et al, 1979) on a Mo/Mo tube assembly.
A new high-definition microfocal X-ray unit
Authors: Buckland-Wright J. C.
Published: July 2009

A new microfocal unit is described with an operating range up to 170 kVp (limited to 125 kVp for medical use), 0–1 mA and a maximum output of 75–80 W. The unit comprises a lanthanum hexaboride (LaB6) cathode, a single electromagnetic lens and a stationary oil-cooled multifaced tungsten target. The estimated source size ranges from 6 to 20 μm between 14 and 77 W. The tube's output is × 3 to × 3.5 greater than that of a conventional X-ray unit. The use of fast rare-earth film–screen systems permits exposures of most views of the patient within 1 s. The spatial resolution within these film–screen systems is 40–30 μm diameter at magnifications of × 5–10. The tube is fixed so as to project a horizontal beam and the patient table is designed to position the patient close to the source (20–30 cm) with the film placed at a focus–film distance of 1–3 m. Stereopair macroradiographs permit greater accuracy in the identification and location of radiographic features. The large magnification and resolution of macroradiographs allow direct and accurate measurement of radiographic features.
Value of bone scanning and computed tomography in fibrodysplasia ossificans progressiva
Authors: Carter S. R. , Davies A. M. , Evans N. , Grimer R. J.
Published: July 2009

Fibrodysplasia ossificans progressiva (FOP) (synonym: myositis ossificans progressiva) is an extremely rare congenital disorder characterized by unremitting heterotopic ossification associated with typical skeletal abnormalities (Rogers & Geho, 1979; Connor & Evans, 1982; Thickman et al, 1982). The prevalence in the UK population has been estimated to be less than 0.1 per million (Wynne-Davies et al, 1985) but despite this, or possibly because of it, there have been in excess of 700 publications worldwide on the subject (Illingworth, 1971) since the first description in 1692 (Patin, 1692).

We report a case of FOP presenting as a suspected soft-tissue neoplasm and discuss the value of bone scanning and computed tomography (CT) in the diagnosis and evaluation of this rare condition.

An 11-year-old boy first presented to his local Accident and Emergency department when his father noticed a large mass over the child's right scapula. The swelling was not tender and there was no history of trauma. Plain radiographs of the shoulder showed no abnormality and a clinical diagnosis of a haematoma was made. The swelling decreased in size over the next month but a further hot, tense mass developed over the left shoulder.

Biopsy of both masses was reported as showing muscle infiltrated with slender spindle cells in a myxoid stroma, and a pathological diagnosis of fibromatosis was made with the recommendation that total excision should be performed because of the risks of local recurrence.
Sarcoidosis mimicking metastatic testicular tumour
Authors: Morcos S. K.
Published: July 2009

Drs Parr and Williams (1988) have omitted to mention in their paper the interesting possibility that the intrathoracic sarcoidosis of their two cases could represent a sarcoid-like granulomatous reaction to the testicular tumour. This response is well recognized with malignant lymphomas (Brincker, 1972; Kadin et al, 1980). A recent report in Thorax described a case with a prominent sarcoid-like pulmonary granulomatous reaction to Hodgkin's disease, diagnosed 6 months before the development of the extrathoracic lymphoma, and which recurred with the exacerbations of the lymphoma (Daly et al, 1988).
New developments in the field of acute myocardial infarction imaging
Authors: Bell D. , Millar A. M. , Grayshan R. , Muir A. L.
Published: July 2009

We note the reference to our paper (Bell et al, 1988) in the letter by Jain et al (above) and the ensuing discussion of their work with 111In-antimyosin antibodies. We would point out that the aim of our study was to compare 99Tcm-DMAD with 99Tcm-PYP in myocardial infarction in the hope that the affinity for 99Tcm-DMAD for damaged myocardium compared with normal bone would facilitate better planar imaging. This was not the case and 99Tcm-PYP remains the standard imaging agent. We would agree that 99Tcm-PYP has limitations for the imaging of acute myocardial infarction, but it is cheap and readily available, and has the additional advantage that imaging is performed 2 h after administration. The sensitivity of 99Tcm-PYP imaging may well be improved through the use of single photon emission computed tomography.
Book reviews
Authors: Berman Andrew
Published: July 2009

“Pattern recognition leading to the development of differential diagnoses is the essence of radiology … This book offers differential diagnoses for a broad spectrum of radiographic patterns, not only in conventional radiography but also in ultrasound and computed tomography … A wealth of illustrations is provided … extensive cross referencing …”

from the Preface.

The author presents a well organized, thorough list of differential diagnosis of various radiological patterns, accompanied by high-quality photographs to aid him in this task.
Relative proton density and relaxation times in liver metastases during interferon treatment
Authors: Andersson T. , Ericsson A. , Eriksson B. , Hemmingsson A. , Lindh E. , Nyman R. , Oberg K.
Published: July 2009

Relaxation times and relative proton densities were calculated from magnetic resonance examinations of the liver in eight patients with liver metastases from neuroendocrine tumours. Single, spinm—echo sequences with eight different repetition times and a four-echo sequence were used to calculate T  1, and T  2 in tumour and normal liver, and the proton density tumour-liver quotient, before and during treatment with interferon. Changes over time of these parameters were compared with variations in tumour marker levels and changes in size and number of the metastases. During therapy, six out of eight cases showed a decrease in tumour T  1, five responding to therapy and one with stationary disease, while the two patients with progressive disease showed unchanged tumour T  1. The proton density quotient also decreased in a corresponding way, indicating a change in water content in tumours responding to interferon therapy. No significant change in liver T  1, tumour T  2 or liver T  2 occurred in any patient. It is thus possible to perform reliable measurements of relaxation parameters over time, which may be valuable in follow-up of tumour treatment.
The influence of type of tube and experience of the operator on performance of small bowel enema
Authors: Nicholson D. A. , Zammit-Maempel I. , Hughes M. , Kumar E. Nanda , Martin D. F.
Published: July 2009

Seventy patients underwent small bowel enema (SBE) to assess the influence of experience of the radiologist on the ease of jejunal intubation and the adequacy of SBE using two types of tubes. Comparing intubation time, intubation screening time, total screening time and total room time, we conclude that jejunal intubation is achieved easily, in a reasonable time with both types of tube, by all grades of radiologist, although the experienced operator using the Silk tube achieved intubation in a significantly shorter time. Overall patient acceptability was satisfactory (75%) but was better using the Silk tube, with which entero-gastric reflux and vomiting were less.
Radiation toxicity of indium-111–2-mercaptopyridine-N-oxide on HeLa S-3 cells
Authors: Su Hong Seong , Ford Edith H. , Greenspan Bennet
Published: July 2009

As one of a series of systematic studies to determine the cytotoxicity of radiopharmaceuticals, indium-111–2-mercaptopyridine-N-oxide (111In-mere) was studied using a monolayer of HeLa S-3 cells. Exponentially growing cells were incubated with up to 2.96MBq/ml (80 μCi/ml) of 111In-mere (molecular ratio of In/Cd to mere was 1:1000) in phosphate buffered saline for up to 240 min at room temperature. Surviving fractions were assayed by the colony-forming method. The cell uptake curve was upward concave with increasing activity and was saturated after an incubation time of 60 min. A clonogenic assay resulted in an exponential dose-survival curve with a shoulder (D0 of 0.44MBq/ml (12 μCi/ml); n = 5), and an upward concave time-survival relationship. Mere alone and decayed In-mere were non-toxic at the equivalent range, substantiating radiation-induced cytotoxicity of 111In-mere.
Distal bowel infarction following angioplasty of the internal iliac artery
Authors: Bennett I. C. , Downes M. O. , Collins R. E. C.
Published: July 2009

Percutaneous transluminal angioplasty is becoming more widely used, finding clinical application not only in peripheral vascular occlusion (Zeitler et al, 1983; Doubilet & Abrams, 1984), but also in renovascular hypertension (Levin, 1984) and coronary artery disease (Levin et al, 1985).

While success rates, particularly for peripheral vascular disease, are in the order of 90% (Katzen, 1984; Gardiner et al, 1986), there is a definite morbidity with complications occurring in about 2–5% of cases (Gardiner et al, 1985, 1986). We report a case in which angioplasty of the internal iliac artery was complicated by infarction of the distal bowel, as a consequence of previously impaired mesenteric blood flow due to radiotherapy.

A 70-year-old man presented with a history of increasing left buttock claudication over a 2-year period. He had a past history of a transitional cell carcinoma of the bladder, which had been treated 4 years previously by partial cystectomy and pelvic irradiation. He gave a precise history of left buttock pain brought on by walking 300 yards, which was relieved by rest. He admitted to being a heavy smoker for most of his life.

No tenderness or mass was evident on abdominal palpation or rectal examination. Both femoral pulses were present; in the right leg pulses were palpable to the level of the ankle, but in the left leg no distal pulses could be felt.
Magnetic resonance imaging in recurrent carcinoma of the cervix
Authors: Williams Michael P. , Husband Janet E. , Heron Christine W. , Cherryman Graham R. , Koslin D. Bradley
Published: July 2009

Twenty patients with suspected recurrent cervical carcinoma were evaluated with computed tomography (CT) and highfield magnetic resonance imaging (MRI). Histological verification of the imaging findings were available in all cases. Computed tomography and MRI were equally effective in making the diagnosis of disease recurrence. The extent of vaginal recurrence and involvement of pelvic floor muscles was better shown on MRI than on CT.
Upper-half body irradiation for oat cell carcinoma of the bronchus
Authors: Stockdale A. D. , Rostom A. Y.
Published: July 2009

Small-cell anaplastic carcinoma of the bronchus (SCCB) is considered to be a chemosensitive tumour. For many physicians, chemotherapy is the treatment of first choice. However, despite prolonged and aggressive therapy, overall 2-year survival of less than 10% may be expected (Spiro, 1985), which, for example, is very similar to the bad prognosis associated with high-grade cerebral gliomas (Bloom, 1982).

Radiotherapy has an established role in the palliation of advanced disease. We have previously investigated the use of single, large fractions of radiotherapy in patients with drugresistant multiple myeloma and shown excellent responses and prolonged survival (Rostom et al, 1984). As the majority of patients present with disseminated disease, we have investigated the use of a single fraction of radiotherapy to the upper half of the body (including the liver) in 24 patients with SCCB.

Twenty-four patients (11 male and 13 female) with small-cell anaplastic carcinoma of the bronchus have been treated with upper-half body irradiation (UHBI) since 1983. In 18 patients, this was the initial therapy. Five patients had relapsed following systemic chemotherapy, one of whom had also received radiotherapy to the mediastinum and neck. A further patient was treated prophylatically following lobectomy for a peripheral anaplastic small-cell carcinoma. Disease was classified as limited to one hemithorax or the ipsilateral supraclavicular fossa or as being more extensive (Table I). Of the 14 patients with extensive disease, two presented with epileptic fits but had negative radionuclide scans of the brain. A third had cerebral metastases confirmed by scanning.
Book reviews
Authors: Galasko C. S. B.
Published: July 2009

Although skeletal metastases occur much more frequently than primary malignant tumours of bone, very little has been written about the former, in comparison with the latter. This book makes a welcome contribution to the literature on skeletal metastases.
Book reviews
Authors: Jeans W. D.
Published: July 2009

The first edition of this reasonably priced book on radiology for medical students was published in 1982, and was successful in spite of the considerable competition from other books aimed at the same section of the market. The format chosen was one with many reproductions of radiographs, many tables listing varying causes of radiographic appearances, relatively little text, and notes in heavy type emphasizing important points in the wide margin at the side of the text.
Book reviews
Authors: Ford E. H. R.
Published: July 2009

The main subject-matter of the second edition of this atlas, as of the first, is the excellent series of colour photographs of the skeleton and of very fine prosecutions of all parts of the human body. These are labelled in great detail and accompanied by explanatory notes, and supplemented by photographs illustrating surface anatomy, resin casts of vascular and bronchial trees and other structures, selected radiographs of good quality, and in this edition for the first time, computed tomographic (CT) and magnetic resonance imaging (MRI) scans.