bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative image analysis of vertebral body architecture—improved diagnosis in osteoporosis based on high-resolution computed tomography
Authors: Mundinger A , Wiesmeier B , Dinkel E , Helwig A , Beck A , Moenting J Schulte
Published: July 2009

71 women, 64 post-menopausal, were examined by single-energy quantitative computed tomography (SEQCT) and by high-resolution computed tomography (HRCT) scans through the middle of lumbar vertebral bodies. Computer-assisted image analysis of the high-resolution images assessed trabecular morphometry of the vertebral spongiosa texture. Texture parameters differed in women with and without age-reduced bone density, and in the former group also in patients with and without vertebral fractures. Discriminating parameters were the total number, diameter and variance of trabecular and intertrabecular spaces as well as the trabecular surface (p < 0.05)). A texture index based on these statistically selected morphometric parameters identified a subgroup of patients suffering from fractures due to abnormal spongiosal architecture but with a bone mineral content not indicative for increased fracture risk. The combination of osteodensitometric and trabecular morphometry improves the diagnosis of osteoporosis and may contribute to the prediction of individual fracture risk.
Cyclosporin A-induced neurotoxicity
Authors: Monteiro L , Almeida-Pinto J , Rocha N , Lopes G , Rocha J
Published: July 2009

Acute encephalopathy is a recognized toxic effect of Cyclosporin A (CsA) in organ transplantation recipients. A 16-year-old girl presented with acute encephalopathy 2 weeks after CsA and methylprednisolone medication for idiopathic uveitis. Magnetic resonance imaging showed cortical and white matter occipital changes, which were not visible 2 months later. With expanding indication for CsA use, an increasing number of neurotoxic cases are to be expected.
Book reviews
Authors: Aktolun C
Published: July 2009

This book is designed for physicians practising in and for residents who intend to practise nuclear medicine. It gives the main topics in clinical nuclear medicine.

The book consists of 15 chapters, three appendices and six colour plates. The first two chapters concentrate on the basic physical and chemical principles of nuclear medicine. Cardiovascular, genito-urinary, endocrine, haematological, pulmonary, central nervous, gastrointestinal and musculoskeletal system imaging are discussed in the subsequent chapters. Further chapters are devoted to radio-immunoscintigraphy and therapy, gallium-67 imaging and selected topics including radionuclide pallation of bone pain due to metastases, radiocolloid therapy and lymphoscintigraphy.
Total body studies in normal British women using dual energy X-ray absorptiometry
Authors: Herd R J M , Blake G M , Parker J C , Ryan P J , Fogelman I
Published: July 2009

We report dual energy X-ray absorptiometry (DXA) studies of total body bone mineral and body composition performed in 111 normal Caucasian women (aged 42–61). Conventional DXA scans of the lumbar spine and femoral neck were also obtained and each woman completed a detailed questionnaire. Significant correlations were found between total body BMD and BMD in the lumbar spine (r = 0.76) and femoral neck (r = 0.72). We present reference range data for BMD in the total body and in seven subregions of the skeleton. Multiple linear regressions of total body BMD and BMC on weight, height and age showed that the inclusion of height compared with weight and age alone was not statistically significant. The dependence of total body BMD on weight and age was: total body BMD (g cm−2) = 1.043 + 0.0042 × weight (kg) — 0.0039 × age (years) (R = 0.46, SEE = 0.074 g cm2). Body mass derived from DXA scans correlated well with weight measured on scales (r = 0.996, SEE = 0.77 kg). Body composition measurements agreed closely with % body fat estimated from skinfold measurements (r = 0.93), body fat mass estimated from a predictive equation based on weight, height and age (r = 0.91) and % body fat estimated from a predictive equation based on body mass index (r = 0.76). Study precision gave coefficients of varation of 0.6% for total body BMD and 0.7% for % body fat.
An optical system for measuring surface shapes for radiotherapy planning
Authors: Wilks R J
Published: July 2009

A system which uses two remote cameras to obtain surface contours for radiotherapy patients is described. Two variants are presented: one which requires couch movement to obtain multiple outlines, and one utilizing a special illumination method to achieve multiple outlines from one image per camera. In addition, a technique is discussed in which the grey-scale information from the skin surface (e.g., skin marks placed by the radiotherapist) may be utilized in displaying three-dimensional surface information. The system may also be used to monitor patient position in real time during each treatment.
Soft tissue and perivisceral calcification occurring in an infant: a case of brown fat necrosis
Authors: Higgins J N P , Haddock J A A , Shaw D G
Published: July 2009

Fat necrosis is a well described cause of widespread subcutaneous calcification occurring in a young infant. In this condition the radiographic demonstration of soft tissue calcification is often dramatic but is clinically irrelevant since the diagnosis is usually evident without recourse to radiology. Visceral fat necrosis and calcification, in the absence of hypercalcaemia, have been reported occasionally in association with sub-cutaneous fat necrosis. We report a case with calcification largely confined to deep perivisceral sites without clinical signs of subcutaneous fat necrosis.
Radiotherapy—an effective treatment for vaginal verrucous carcinoma
Authors: Reinecke L , Thornley A L
Published: July 2009

Vaginal carcinoma makes up 1%–2% of all gynaecological tumours. Verrucous carcinoma of the vagina is even more rare—only 16 cases are reported in the scientific literature. A case of a complete regression after 60 Gy fractionated radiotherapy by a tumour 12 cm3 in size is reported. Most authors are of the opinion that radiotherapy causes anaplastic transformation of verrucous carcinoma. The minority view, that anaplastic transformation does not occur, is correct and is supported by our clinical and radiological data. The conflicting literature on vaginal verrucous carcinoma (VVC) is reviewed with reference to verrucous carcinoma at other sites.
Breast imaging in women under 35 with symptomatic breast disease
Authors: Brand I R , Sapherson D A , Brown T S
Published: July 2009

With the increasing utilization of mammography, young women under the age of 35 are being referred for mammographic examination more frequently. A review of the mammograms of 159 consecutive patients aged under 35 was conducted to evaluate the clinical value of the examination in the age group for whom the probability of malignancy is low. 74% of patients referred had no discrete palpable mass and presented predominantly with lumpy or tender breasts, the remaining 24% had a discrete palpable mass. In neither group did radiographic examination beneficially influence clinical management. We propose protocol where no imaging is performed in women under 35 in the absence of a palpable mass unless there is a localized bloody discharge or a strong family history or previous personal history of breast cancer. In patients with a palpable mass, ultrasound should be performed initially to identify simple cysts and if negative only then progressing to mammography.
Colour Doppler and duplex ultrasound assessment of Peyronie's disease in impotent men
Authors: Amin Z , Patel U , Friedman E P , Vale J A , Kirby R , Lees W R
Published: July 2009

280 patients (aged 28 to 74 years, mean 57) with erectile failure (EF) underwent colour Doppler and duplex ultrasound imaging (CDI) following intracorporeal papaverine. After achieving a full, or nearly full, erection visual inspection and palpation revealed plaques and/or constriction or deformity of the penis in 55 (20%) cases. 10 (4%) were known to have Peyronie's plaques prior to referral. Of these 55 patients ultrasound showed focal echogenic plaques in 14 (25%) and diffuse thickening of the tunica albuginea in 41 (75%). CDI diagnosed arteriogenic EF in 20 (36%) of these patients, venous leak in 10 (18%), arterial and venous in two (4%) and a normal response in 23 (42%). In 11 (20%) patients (seven with arteriogenic EF and four with venous leak) the plaque was seen to be affecting vessels. These results indicate that abnormalities of the tunica albuginea are far more common in patients presenting with erectile failure than previously thought. We believe that the diffuse thickening is a form of Peyronie's which is only recognized after pharmacological induction of penile erection.
Simple renal cyst: relations to age and arterial blood pressure
Authors: Pedersen J F , Emamian S A , Nielsen M B
Published: July 2009

Simple renal cysts are increasingly common with increasing age, as is elevated arterial blood pressure. We studied the natural history of simple renal cysts, and their possible association with arterial hypertension. Renal sonography was performed in an age- and sex-stratified random sample of 686 healthy volunteers aged 30–70 years. Eleven examinations were excluded for various reasons. One or more renal cysts measuring 10–47 mm were found in 35 individuals. The prevalence of simple renal cysts was 5.2%, ranging from 0% at age 30 to 9.7% at age 70. From the cross-sectional data it is estimated that the average renal cyst needs about 10 years to reach 20 mm in size. Mean arterial blood pressure increased with age, and was significantly higher in individuals with cysts (p = 0.0055). Closer analysis showed that the association was confined to and even stronger (p = 0.00066) for individuals with at least one cyst ≤20 mm. We assume that smaller cysts are more likely to be totally intraparenchymal, and therefore more able to create an internal hydrostatic pressure and thus to compress the surrounding renal tissue.
The sonographic appearances of pleural fluid
Authors: Lomas D J , Padley S G , Flower C D R
Published: July 2009

In order to document the sonographic changes of pleural fluid the appearances of 93 presumed pleural fluid collections in 89 patients were recorded. In all patients the clinical or radiographic appearances were atypical and they were referred for guided aspiration or drainage of suspected pleural fluid. Ultrasound guided aspiration was successful in 90 collections in 86 patients. It was unsuccessful in three “collections” subsequently shown or presumed to be of a solid nature. In nine of the proven fluid collections an earlier attempt at blind aspiration had been unsuccessful. 54 (60%) of the proven fluid collections had a characteristic sonographic appearance of pleural fluid as an anechoic space unrestricted within the pleura. Of the remaining 36 collections, 16 had diffuse internal echoes, 12 were confined to one area of the pleural space (primary loculation) and 13 had internal septa (secondary loculation). Dynamic signs were demonstrated in 75 (83%) of the collections as flapping movements of atelectatic lung (51), of internal septa (12), or of debris attached to the wall of the collection (25). Three (4%) of fluid collections had sonographic features indistinguishable from those of solid pleural lesions, indicating that in a small percentage of cases sonography will not reliably distinguish between solid and fluid in the pleural space.
Perfusion lung scintigraphy in primary pulmonary hypertension
Authors: Ogawa Y , Nishimura T , Hayashida K , Uehara T , Shimonagata T
Published: July 2009

15 cases of primary pulmonary hypertension were classified into two groups by patterns of perfusion lung scintigraphy. Perfusion scintigrams showed multiple, small, ill-defined defects (mottled + ve) pattern in eight cases, and the remaining seven cases had a normal (mottled − ve) pattern. The mean pulmonary arterial pressure in patients with a mottled pattern (54 ± 10 mmHg) was higher than in those with a normal pattern (42 ± 9 mmHg, p < 0.05). There were no significant differences between the two groups in right ventricular ejection fraction, partial pressures of oxygen in the arterial blood or alveolo–arterial oxygen difference. All the patients with a mottled pattern died within 2 years following the lung scintigraphy. There was a significant difference in the survival curves between the two groups. Although our statistical analysis must be evaluated with caution because of small numbers of patients it is suggested that perfusion lung scintigraphy is useful in assessing the prognosis in primary pulmonary hypertension.
The efficacy of radiotherapy in the treatment of intraocular metastases
Authors: Minatel E , Trovò M G , Forner L , Franchin G , De Paoli A , Roncadin M , Gobitti C , Bassignano G
Published: July 2009

From January 1980 to May 1991, 28 patients with intraocular metastases were seen at our Institute. Three presented with bilateral metastases and two developed contralateral involvement. Out of the 33 ocular metastases 27 were managed by radiotherapy. The most common primary tumour sites were breast (18/28 patients) and lung (3/28). 22 patients were treated with an 8 MV linear accelerator, using a 4 × 4 cm anterior direct field. The median dose was 40 Gy/20 fractions (range 28 Gy/14 fractions to 50 Gy/25 fractions). Of the 27 treatments reported, 16 resulted in a complete response (59%), six in a partial response (22%) and five resulted in no change (19%). Complete and partial responses lasted for a median time of 13 months (range of 3−89+ months). The median survival time from the start of ocular treatment was 13 months. The aim of radiation treatment is either to prevent or to postpone the visual loss caused by intraocular metastases.
Computed tomographic dacryocystography
Authors: Waite D W , Whittet H B , Shun-Shin G A
Published: July 2009

The technique of computed tomographic dacryocystography is described. It was developed in response to the pre-operative imaging requirements for transnasal endoscopic dacryocystorhinostomy, a new minimally invasive operation performed as a primary procedure to relieve epiphora. However, it is also helpful in the assessment of patients after failed conventional external dacryocystorhinostomy when the information provided will help to determine the subsequent surgical approach. In addition the technique will assist surgical planning in cases of epiphora associated with sinus surgery, facial trauma and maxillofacial tumours by determining the site and extent of pathology.
Book review
Authors: Magee T R
Published: July 2009

The aim of this book was to provide a state-of-the-art work of reference for those involved in routine investigations and research using vascular ultrasound. The editors have brought together work from 54 contributors from Europe and the United States all of whom are expert and knowedgeable in their respective fields.
Percutaneous pigtail catheter straighteners — a warning
Authors: Dick R , Tibballs J
Published: July 2009

We wish to report a potential hazard of pigtail catheter straighteners.

Following an intital unsuccessful attempt to advance a Ring Lunderquist drainage catheter (8.4 F) through a malignant biliary stricture, the catheter was exchanged for a 9 F dilator, which met with unexpected resistance in the liver tract.
Possible hazard associated with the use of the “FemoStop” groin compression device
Authors: Jackson A , Beards S C , Gillespie J E
Published: July 2009

We wish to draw your attention to a potential complication associated with the use of the FemoStop groin compressor (Radi medical systems). We have used this device routinely for the past year in our department and find it to be highly effective and of particular value where there are problems in maintaining haemostasis following angiography.
Computed tomographic cholangiography using spiral scanning and 3D image processing
Authors: Klein H-M , Wein B , Truong S , Pfingsten F-P , Günther R W
Published: July 2009

Volumetric computed tomography (CT) scans (“spiral CT”) were performed after intravenous (i.v.) cholangiography followed by additional 3D surface reconstructions of gallbladder and biliary ducts. 34 patients were investigated prior to cholecystectomy. No allergic adverse reactions were observed. The scan time was 24 s. Contrast enhancement in the extrahepatic bile duct and gallbladder were measured. All CT image series were reviewed independently by four experienced physicians (two radiologists, two surgeons) and compared for quality with conventional cholangiography on a three-point scale. The average rating for the demonstration of the biliary tract was significantly better for spiral CT than for conventional cholangiography (p < 0.01). In all cases sufficient contrast was found in the common bile duct (mean 315 HU). 3D imaging was considered to be helpful for intraoperative orientation during laparoscopic surgery.
Elevation of the larynx on normal and abnormal cineradiogram
Authors: Sundgren P , Maly P , Gullberg B
Published: July 2009

The relationship between bolus volume (2.5, 5, 10 and 20 ml) and larynx elevation during swallowing was assessed in 10 non-dysphagic and 10 dysphagic individuals without pharyngeal dysfunction. Laryngeal elevation in different types of pharyngeal dysfunction was assessed in 60 non-dysphagic and 75 dysphagic patients. All subjects were examined with liquid barium and cineradiography at 50 frames/s. The laryngeal elevation was measured at the moment when the bolus reached the level of the valleculae and at maximum elevation. Elevation of the larynx, both the initial and maximal, was not influenced by sex, age or presence of dysphagia. Elevation of the larynx at the moment when the bolus reached the valleculae, when expressed in per cent of maximum elevation, was lower with 10 and 20 ml bolus volumes compared with 2.5 ml bolus volume (p < 0.05) in the 10 dysphagic individuals. Pharyngeal dysfunction was associated with significantly lower initial elevation of the larynx, at the moment when the bolus reached the level of the valleculae, although the maximal laryngeal elevation was normal. Initial elevation was 30% lower (p = 0.03) in patients with aspiration of bolus material into the trachea, 22% lower (p = 0.007) in those with defective closure of the laryngeal vestibule without aspiration and 16% lower (p = 0.06) in those with incoordination of the cricopharyngeal muscle compared with patients without dysfunction.
Book review
Authors: Hopewell J W
Published: July 2009

This is a multiauthor book with a total of 19 chapters dealing with radiation physics, the handling and transport of radioactive material, as well as historical aspects of nuclear accidents and the medical management of accident victims. The stated objective of the text is to provide a comprehensive publication of the medical management of radiation accidents. It is intended for persons with previous background knowledge such as physicians, health physicists or radiation safety officers.
Squamous cell carcinoma of the nail bed
Authors: Berker D de , Derbyshire N
Published: July 2009

We write in reply to the report of squamous cell carcinoma of the nail bed in the February issue (Conill et al, 1993). It is rare to find this kind of pathology discussed in a radiology journal, which makes it all the more important for the presentation to be accurate and balanced. There were several elements in the article which should be addressed. The history and histolgy were incomplete. It is impossible to tell from the photomicrograph whether the neoplasm was solely intraepithelial (i.e. Bowen's disease) or whether it was invasive.
Squamous cell carcinoma of the nail bed
Authors: Conill C , Verger E , Vilalta A , Palou J
Published: July 2009

We have read with interest the comments of de Berker and Derbyshire regarding our case report of squamous cell carcinoma fo the nail bed.
Assessment of X-ray field alignment in mammography
Authors: Kotre C J , Robson K J , Faulkner K
Published: July 2009

We read the letter of Brennan and Johnson and are pleased to note that our publication (Kotre et al, 1993) has stimulated a discussion on mammographic field alignment. The measurement of field alignment in mammography is an important practical problem and it is therefore not surprising that a number of groups have been working on the same subject.
Book reviews
Authors: Ritchie D A
Published: July 2009

It is indeed a great pleasure to review the Radiology of Skeletal Trauma and the author, Lee Rogers, is to be congratulated on this remarkable achievement. This authoritative work, first published 10 years ago, has been a great success and an essential bench book in many radiology departments. This, the second edition, is much larger, comprising 1500 pages in two volumes with approximately 3000 illustrations and 4000 references. The impact of newer, up-to-date imaging techniques is reflected throughout the book with good quality CT and MR images but plain radiographs still make up 40% of all the illustrations. Its main strengths are the sheer volume of information, excellent presentation, clear and informative diagrams and high quality photography.
Ultrasound diagnosis of splenic lymphoma: ROC analysis of multidimensional splenic indices
Authors: Hess C F , Kurtz B , Hoffmann W , Bamberg M
Published: July 2009

To assess the efficacy of splenic size in the sonographic diagnosis of lymphomatous involvement of the spleen, the authors studied 31 patients with splenic lymphoma (Hodgkin's disease, 17 and non-Hodgkin's lymphoma, 14) and 218 individuals without evidence of splenic disease. All subjects were studied with both a linear and a sector transducer. The longitudinal, transverse and diagonal diameters of the spleen were measured, and two-and three-dimensional splenic indices were calculated. The analysis of the diagnostic performance of these criteria, compared by means of receiver-operating characteristic (ROC) curves, revealed that diagnosis of splenic involvement by malignant lymphoma was considerably more reliable with a sector than with a linear scanner. If the longitudinal diameter was measured with a sector scanner, sensitivities were 66% and 74%, at specificities of 95% and 90% respectively (cut-off points: 12.5 cm and 11.3 cm, respectively). For the sector scanner, there was no advantage in using other diameters or multidimensional indices. Additional ROC analysis of recently published data indicating excellent discrimination capacity of a computed tomography index revealed that these results were largely owing to patient selection. In contrast, our data suggest that the potential of current non-invasive assessment of splenic lymphoma is limited. However, ultrasound may eventually help to eliminate staging laparotomy in selected cases, e.g. in patients with low risk of abdominal disease and with increased surgical risk.
Quality assurance in obstetric ultrasound
Authors: Dudley N J , Potter R
Published: July 2009

Ultrasound examination is a routine element of antenatal care, and an accurate and reliable ultrasound service is essential for confident patient management. Qualitative findings, e.g. fetal normality and placental site, may be confirmed at delivery, but this form of audit is not suitable for fetal measurements owing to the variation in gestation at delivery and the complexity of neonatal assessment. Our aim was to develop a simple audit method applied a short time after the ultrasound scan. The method was based on assessment of measured images against measurement criteria which are clearly defined in the literature, results for each criterion being recorded in a spreadsheet. Two main forms of report were generated, the first showing overall achievement of satisfactory measurements for each sonographer, the second providing graphical information to show which criteria required greater attention by individual sonographers. Over several phases of audit problems of quality recognition and technical skill were isolated, graphical reports were used to guide tuition and the levels of performance were improved. The method itself and the results satisfy managers at all levels that standards are in place and are being maintained.
A double blind study to evaluate the tolerability of gadodiamide injection and its effect on renal function in patients undergoing cerebral magnetic resonance imaging
Authors: Lundby B , Berg K J , Lien H H , Aamdal S
Published: July 2009

Gadodiamide injection was administered intravenously to 28 patients with cancer undergoing cerebral magnetic resonance imaging (MRI). Two parallel groups were used to evaluate the safety of single doses of 0.1 and 0.3 mmol per kilogram body weight (kgbw). Adverse events, vital signs, blood chemistry, haematology and urinalysis were the principal measures of safety. Four patients, all in the 0.1 mmol kgbw−1 group, experienced a total of six adverse events. No adverse events were reported in the 0.3 mmol kgbw−1 group. No clinically significant changes in blood chemistry, haematology or urinalysis occurred. No significant changes in renal tubular function or glomerular filtration rate were observed after injection at either dose. Overall, this study suggests that gadodiamide injection is a safe and effective contrast medium for use in patients undergoing cerebral MRI at both the 0.1 and 0.3 mmol kgbw−1 doses.
The 62 MeV proton beam for the treatment of ocular melanoma at Clatterbridge
Authors: Bonnett D E , Kacperek A , Sheen M A , Goodall R , Saxton T E
Published: July 2009

A second treatment room and beam line has been constructed at the Cyclotron Unit at Clatterbridge for the purpose of using 62 MeV protons for the treatment of ocular melanoma. A uniform beam is produced by a double foil scattering system. The initial Bragg peak is spread across the target volume by the use of beam modulators. These are rotating four-vaned stepped absorbers made from Perspex. Two beam lines can be configured with different positions of modulators and range limiters. The first has a maximum penetration of 31.9 ± 0.2 mm in water and the second a penetration of 31.2 ± 0.2 mm. The second configuration has the advantage of less variation in beam penumbra, with a typical value of 1.7 ± 0.1 mm for the 90% to 10% decrement lines. The patients are treated with individually shaped collimators. Beam output varies by less than 2% over the range of collimator areas used. The resulting whole-body dose equivalent to patient has also been assessed. In the first three years of operation over 250 patients have been treated.
Primary intrathoracic rhabdomyosarcoma: a rare childhood malignancy
Authors: McDermott V G M , Mackenzie S , Hendry G M A
Published: July 2009

Primary intrathoracic rhabdomyosarcoma is a rare tumour in childhood. Three cases are presented and the radiological findings and clinical course are reviewed. The radiological manifestations are varied but a rapidly growing soft tissue mass with compression of adjacent structures is the most common. A rare association with an underlying congenital pulmonary cyst is described. The prognosis is worse than for rhabdomyosarcoma at other sites, with a predisposition for cerebral metastases.
An unusual cause of epistaxis: non-traumatic intracavernous carotid aneurysm. A case report with 12 year follow-up and review of the literature
Authors: Romaniuk C S , Bartlett R J V , Kavanagh G , Salam M A
Published: July 2009

Intracavernous carotid aneurysms are uncommon. We report the natural history and radiological appearances of a giant, non-traumatic, intracavernous carotid aneurysm which extended through the skull base to the anterior nares and caused epistaxis. The magnetic resonance imaging appearances of such an aneurysm have not been previously described. The importance of correct diagnosis is discussed.
Infected false aneurysm at the site of an iliac stent
Authors: Chalmers N , Eadington D W , Gandanhamo D , Gillespie I N , Ruckley C V
Published: July 2009

False aneurysm formation at the site of iliac artery stent placement is an uncommon but serious complication of the procedure. We report a case of infected false aneurysm at the site of an iliac stent, complicated by renal failure.
Book review
Authors: Evans S
Published: July 2009

This spiral bound, A5 size handbook is part of a short series of safety handbooks intended for use by University Radiation Protection Officers (RPOs). The handbook adequately covers the practical radiological principles associated with handling of P-32 and it contains many useful references and manufacturers' addresses. Details of the performance of different instruments to low levels of contamination are briefly presented and will help readers decide which instrument to buy for contamination measurements. Handling tools, screens and shielding boxes are discussed and should assist RPOs in equipping their laboratories to meet satisfactory protection standards.
Survival, patterns of spread and prognostic factors in uterine sarcoma: a study of 76 patients
Authors: Moskovic E , Macsweeney E , Law M , Price A
Published: July 2009

We have analysed the medical records and diagnostic imaging of 76 patients presenting to this hospital for treatment of uterine sarcoma between 1970 and 1990. Patients were divided into those presenting before 1980 (n = 22) and after 1980 (n = 54), when sectional imaging (ultrasound, CT scanning) and more modern radiotherapy and chemotherapy were introduced. No survival difference was observed between these two groups. In those patients presenting after 1980, the median age was 54 years (range 18–80), and median survival 22 months from initial diagnosis. Factors associated with a significantly improved survival included low grade (although not histological type) of initial tumour (p = 0.001) and Stage I disease at presentation (p = 0.006). In 17 patients receiving pelvic radiotherapy following initial surgery, both the time to relapse (p = 0.005) and overall survival (p = 0.045) were increased. Adjuvant chemotherapy in 19 patients did not improve outcome. Most diagnoses of relapse were established clinically; they occurred most frequently in the pelvis, followed by lung and abdomen. Pulmonary relapse was accompanied by spontaneous pneumothorax in two cases. Bone and brain metastases were uncommon (< 10%). Following diagnosis of relapse, the median survival was 9 months, with the outcome significantly worse if multiple metastatic sites were involved (p < 0.001). No survival benefit was demonstrated from either local radiotherapy or combination chemotherapy once relapse had occurred. Prognostic factors and current policies for the diagnosis and management of uterine sarcomas are discussed.
Interstitial laser photocoagulation for the treatment of prostatic cancer
Authors: Amin Z , Lees W R , Bown S G
Published: July 2009

Interstitial laser photocoagulation (ILP) is a new percutaneous technique for local ablation of deep-seated tumours. We have applied this to treat a focal abnormality in a patient with prostatic carcinoma, under local anaesthesia and sedation. Transrectal ultrasound and computed tomography (CT) were used to guide three 18G needles, inserted transperineally, into the abnormal area. A thin (0.8 mm outer diameter) optical fibre was passed down each needle, so that the tip of the fibre lay within the tumour. The other end of the fibre was connected to a portable diode laser, which was activated at 2 W for 500 s. Real-time monitoring with ultrasound showed a gradually enlarging echogenic zone around the fibre-tip and a marked increase in colour Doppler signal; the echogenicity and Doppler signal decreased within a few minutes of completing treatment. Dynamic CT treatment 10 days later showed the treated area as a non-enhancing, avascular zone. Biopsies from this region confirmed the presence of necrosis. There were no complications. ILP appears to be a safe and effective way of ablating areas of focal abnormality in the prostate.
Improved detection of abnormal left ventricular wall motion using tomographic radionuclide ventriculography compared with planar radionuclide and single plane contrast ventriculography
Authors: Metcalfe M J , Norton M Y , Jennings K , Walton S
Published: July 2009

Tomographic radionuclide ventriculography is a technique which could have major advantages over conventional planar imaging, such as better assessment of ventricular wall motion abnormalities. This possibility was therefore investigated in 100 consecutive patients undergoing routine cardiac catheterization. Following angiography, planar blood pool images were conventionally acquired and tomographic imaging performed using the Aberdeen Section Scanner. All derived wall motion data were subsequently analysed in an objective and blinded manner. The mean age was 56 (range 33–71) and 79% were male. 67 patients had experienced prior myocardial infarction, 27 were categorized as having significant and six insignificant coronary artery disease. The detection rates for patients with prior myocardial infarction were 95% for angiography, 57% for planar imaging and 90% for tomography. Even taking patients with only prior anterior myocardial infarction, the detection rates were 94%, 63% and 91% respectively. For those residual patients with significant coronary artery disease, the rates were 7%, 0% and 59% respectively. Overall for the detection of patients with significant coronary artery disease, the sensitivity was 70%, 40% and 81% respectively. Patients with insignificant coronary artery disease did not demonstrate any abnormalities using any method. These results demonstrate that tomography and angiography have similar detection rates in the presence of significant coronary artery disease and both are superior to planar imaging.
A comparative study of velocity measurements in major blood vessels using magnetic resonance imaging and Doppler ultrasound
Authors: Zananiri F V , Jackson P C , Halliwell M , Harris R A , Hayward J K , Davies E R , Wells P N T
Published: July 2009

Velocity measurements in major blood vessels were obtained in studies of volunteers using magnetic resonance imaging (MRI) and compared with Doppler ultrasound (US). The vessels studied were the abdominal aorta, superior mesenteric artery, common carotid artery, superficial femoral artery and middle cerebral artery. Using a paired t-test, no significant difference was found between velocity values estimated by MRI and US (p > 0.08). The relative advantages of each technique in radiological practice are discussed.
Bone loss in normal British women; a 5 year follow-up
Authors: Clements D , Compston J E , Evans C , Evans W D
Published: July 2009

To assess the rates of loss, forearm and spinal bone mineral were remeasured in 16 out of 18 peri- and postmenopausal women aged 45 to 60 years who had taken part in a previously reported cross-sectional study. The mean interval between measurements was 4.8 years (range 4.2–5.3 years). The mean (95% confidence interval (CI)) annual change in radial bone mineral density was −0.78%/year (−1.73 to + 0.18%; not significant) and in spinal bone mineral −2.41%/year (−3.55 to 1.27%; p < 0.001). There was considerable variation in the rate of change in radius and spine, and between individuals. There was no significant correlation between rates of bone loss at either site, or between rates of loss and the initial bone density at either the radius or spine. There was no significant correlation between the rates of change and the age or number of years post-menopause of the women. There was no significant change in the Z score for the forearm (mean −0.20; 95% CI −0.65 to + 0.25) or for the spine (mean -0.04; 95% CI −0.30 to + 0.22). There have been no previous longitudinal studies of the changes of bone density in normal British women. These results show considerable variation between individuals, and rates of change at one site cannot be predicted from measurements at another site. Untreated, some normal individuals have high rates of loss that cannot be predicted from baseline values, age or number of years post-menopause.
Simultaneous multislice imaging with an additional slice gradient in the readout stage: an idea for multislice FLASH
Authors: Zhao S , Wood B , Dodd N J , Waller M L , Hawnaur J M , Isherwood I
Published: July 2009

Conventional two-dimensional Fourier transform spin-echo multislice imaging can be performed in a time efficient manner by taking advantage of the relatively long repetition time (TR) compared with the sequence time (i.e. the time from excitation to end of signal acquisition), to observe other slices. Thus, given a sequence time of 1/n of TR, n slices can be observed with no time penalty. For some applications, however, e.g. cardiac imaging, it would be desirable to collect data for all slices of interest simultaneously and not sequentially.

One method of simultaneous multislice imaging has previously been proposed (Muller, 1988). This method uses a multifrequency rf pulse to excite all the slices of interest simultaneously. Separation of the slices is then achieved by addition or subtraction of the time domain signals by altering the phase of the slice selection pulses. For n slices, the basic imaging sequence has to be repeated n times.

We present here an alternative method to acquire multislice images simultaneously using an additional slice gradient at the readout stage to separate the slices.

As a modification of the spin warp imaging method (Edelstein et al, 1988), the 2-D FT spin-echo (SE) imaging pulse sequence is widely used in magnetic resonance (MR) imaging. Three gradients are used in the sequence, one for frequency encoding, one for phase encoding, and one for slice selection. Usually the three gradients are orthogonal to each other and usually denoted as G  x, G  y and G  z for the read, phase and slice gradients respectively.
Ossification of the thoracic ligamenta flava in a Caucasian: a rare cause of myelopathy
Authors: Arafat Q W , Jackowski A , Chavda S V , West R J
Published: July 2009

Ossification of the ligamenta flava is rare and has been described almost exclusively in Japanese people. We present a case in which ossification of the thoracic ligamenta flava caused compressive myelopathy in a Caucasian.
Book reviews
Authors: Booth J
Published: July 2009

Doctors are always gloating about their own successes or pointing out other peoples mistakes. One thing the medical profession is bad at is being honest about its own errors. Dr Guly dedicates his book to those patients who have had injuries which have been “missed”. Although increasing use of medical audit is teaching the profession to examine its errors more closely, this book is certainly to be welcomed for its honest approach.
Book review
Authors: Whitehouse G H
Published: July 2009

This monograph begins with a brief chapter by a geriatrician, emphasizing the multiplicity of disease in the geriatric age group and the influence of modern medicine on life span. The second chapter, written by a radiologist, gives a sensitive if sketchy appraisal of care of the geriatric patient in the radiology department.
Book review
Authors: Dewbury K C
Published: July 2009

This small book is designed to provide student sonographers with a step by step system for scanning and image documentation.

The core of the book consists of 20 chapters in five sections which cover the abdominal vasculature, abdominal organs, the pelvis including obstetrics, small parts applications and duplex vascular protocols.
A comparison of mammographic phantoms
Authors: Faulkner K , Law J
Published: July 2009

It is important to establish and maintain high standards of image quality in mammography in order to detect breast cancer at an early stage. A commonly used method of assessing image quality in mammography is to use test phantoms. This paper reports a comparison of seven mammographic phantoms. These are the Ackermann (DuPont, Stevenage), Barts (White and Tucker), CIRS XI (Computerized Imaging Reference Systems, USA), Leeds TOR(MAX) and Leeds TOR(MAM) (Faxil, Leeds), Newcastle, and RMI 152 (Gammex RMI, Nottingham). These phantoms were assessed on the detectability of the various details and bar patterns contained in each. Step wedges and simulated anatomical features were not assessed. The effect on phantom images of changes in contrast, caused by changing tube potential from 25 kV to 35 kV, and of changes in resolution, caused by different focal spot sizes and by different magnifications, were investigated. It was deduced from the results of this study that there was no single phantom which was clearly superior to all the others. The three phantoms which had the greatest sensitivity to changes in imaging parameters were the Leeds TOR(MAM), the Newcastle and the Ackermann (DuPont) phantoms.
Book review
Authors: Banerjee A K
Published: July 2009

All of today's radiology trainees are expected to become proficient in basic vascular and interventional procedures. Although the subject is learned best by practical experience under close supervision by an experienced radiologist, an accompanying book on the subject can be a valuable aide memoire to learning.
Resistance and pulsatility Doppler indices: how accurately do they reflect changes in renal vascular resistance
Authors: Hilson A J W
Published: July 2009

The paper of Mastorakou et al [1] is very elegant, but falls into a trap which is commoner than we like to think. Underlying the use of 131I-Hippuran for the serial measurement of renal blood flow (RBF) is the assumption that the renal extraction is both very high and does not change between studies.
Minimally invasive cancer surgery using focused ultrasound: a pre-clinical, normal tissue study
Authors: Vaughan M G , Ter Haar G R , Hill C R , Clarke R L , Hopewell J W
Published: July 2009

Using a focused 1.7 MHz ultrasound field (focal length/transducer diameter ratio of 1.7) and in situ intensities spatially averaged within the half-pressure maximum contour in the range 100–400 W cm−2, ablative lesions have been prescriptively placed singly and in arrays, in the livers and bladder walls of adult female Large White pigs. Exposures were made through the skin with up to 8 cm of intervening tissue. Ablative lesions were placed under ultrasonic guidance, and specific lesion echoes were subsequently observed in two cases. Animals were sacrificed immediately after induction of ultrasonic lesions, post-mortems were performed, as were histological examinations of normal and damaged tissue. There was clear demarcation between ablated and normal tissue. Provided that simple rules on exposure technique had been observed, there was no evidence of inadvertent tissue damage, either locally to the treatment site, or in the tissue lying between the source and the target. This study is a useful step in demonstrating the feasibility of clinical trials for the use of this technique in treating bladder tumours and solitary liver metastases.
Intracranial extramedullary haematopoiesis in postpolycythemic myelofibrosis
Authors: Ohtsubo M , Hayashi K , Fukushima T , Chiyoda S , Takahara O
Published: July 2009

Extramedullary haematopoiesis (EMH), which may occur in various types of haemodyscrasia and dyshaematopoiesis, is generally seen in the spleen, liver and lymph nodes, but rarely within the cranium. This is a case of intracranial EMH in a patient with secondary myelofibrosis which developed after the treatment of polycythaemia rubra vera.
Bone metastasis from cholangiocarcinoma showing unusual accumulation on bone scintigraphy and 67Ga scintigraphy
Authors: Takahashi I , Nakamura Y , Suzuki Y , Mitsuhashi N , Niibe H , Osada J
Published: July 2009

We report a case of bone metastasis from cholangiocarcinoma that showed intense homogeneous osseous accumulation in continuity through eight vertebrae on bone scintigraphy and 67Ga scintigraphy.
Calcification within aneurysmal bone cyst
Authors: Sharma P , Elangovan S , Ratnakar C
Published: July 2009

Aneurysmal bone cyst (ABC) usually affects older children or young adults. The radiological appearance is of a purely osteolytic expansile metaphyseal lesion with thinned out cortex and internal septations. We present a case of ABC in a 5-year-old girl which showed internal calcification and was initially diagnosed as enchondroma. However, pathological examination revealed typical appearance of ABC with large area of dystrophic calcification.
EMI patents on computed tomography; history of legal actions
Authors: Strong A B , Hurst R A A
Published: July 2009

The history of the invention of tomography has been well documented on a number of occasions. The situation regarding the Legal Actions taken by EMI, in defence of their patents, is less well known. In order to assert their position as Licensors of the important computed tomography (CT) patents, EMI had to litigate these in the USA in a series of Actions, commencing in 1976.

The patents at issue, in the realization of CT systems, is discussed in relationship with the scanner geometries (generations) and the reconstruction principles. The value of properly protecting inventions with patents is demonstrated, together with showing the eventual benefits of vigorously enforcing those patents against infringers.
Book reviews
Authors: Jackson P C
Published: July 2009

This book is well written and illustrated, providing a cleardescription of the applications of MRI in the cardiovascularsystem. The book consists of 13 chapters which includedescriptions of the basic principles of MRI, techniques specificto cardiovascular techniques and measurement, dedicatedchapters to the imaging of various cardiac pathological and physiological states, together with a chapter on magneticresonance angiography.
Parotid and parapharyngeal tumours: tissue characterization with dynamic magnetic resonance imaging
Authors: Tsushima Y , Matsumoto M , Endo K
Published: July 2009

Prospective studies were performed to characterize parotid and parapharyngeal tumours using dynamic magnetic resonance (MR) imaging. Bolus injection of gadopentetate dimeglumine and a short SE sequence were used to evaluate 23 masses including seven pleomorphic adenomas, seven Warthin's tumours and nine malignant tumours. Contrast enhancement profiles helped to distinguish the differenent types of parotid and parapharyngeal tumours. Gradual increase in intensity during the first 260 s after the injection was characteristically found in pleomorphic adenomas and adenoid cystic carcinomas. Conversely, all Warthin's tumours showed a rapid increase during the first 20 s followed by a decrease in signal intensity. The other malignant tumours showed a rapid increase during the first 20 s followed by gradual decrease or increase at a slow rate. We suggests that the gradual increase in signal intensity of pleomorphic adenoma and adenoid cystic carcinoma may be due to their hypovascularity and an abundance of interstitial regions rich in connective tissue-type mucin. Dynamic MRI shows promise in tissue characterization of parotid and parapharyngeal tumours.
Laser angioplasty: enough to make your blood boil!
Authors: Dawson P , Booth A , Machan L
Published: July 2009

Some of the effects on blood and contrast agents of a laser angioplasty device of the “hot tip” variety have been studied. This device liberates iodine from contrast agents both in the form of soluble free iodide and in the form of solid elemental iodine debris. Some of the solid iodine does not adhere to the probe but remains free and, in vivo, would be available to embolize distal vessels. The liberation of iodine occurs more readily with dimeric agents than with monomeric contrast agents regardless of whether they are ionic or non-ionic. Blood and blood/contrast agent mixtures exhibit local boiling in the vicinity of the hot tip laser probe. Blood so treated exhibits markedly accelerated clotting as indicated by measurements of whole blood clotting times. Untreated blood to which aliquots of blood treated as described above are added also exhibits accelerated clotting. The laser tip, operating in blood/iodine mixtures, becomes coated with a friable black/brown deposit which analysis reveals to be a mixture of carbon and iodine. Again, some of this particulate debris fails to adhere to the probe and is available as free embolic material. The possible practical clinical implications of these observations are discussed.