bluuebunny/crossref_metadata_2025 huggingface dataset:
Eye splashes during invasive vascular procedures
Authors: Davidson I R , Crisp A J , Hinwood D C , Whitaker S C , Gregson R H S
Published: July 2009

In recent years there has been an increased awareness among health care workers regarding possible risk of nosocomial transmission of blood borne pathogens. The aim of this study is to document the risk of contamination of radiologists' eyes during invasive vascular procedures. Radiologists performing these examinations were asked to wear glasses throughout. After each examination the glasses were inspected for droplets. 150 procedures were performed on 123 patients (M = 80, F = 43). 10 procedures (6.7%) resulted in splashes to glasses. In four of these cases the radiologist was not aware of the “eye splash” nor was there a spray event to account for it. Radiologists were aware of 13 spray events (8.7% of all procedures). There was a significantly increased risk of spray events and eye splashes during thrombolysis (χ2 = 14.93, p < 0.001) and of spray events during angioplasty when compared with perfemoral arteriography (χ2 = 8.816, p < 0.01). Procedures lasting longer than 30 min were associated with a significantly increased risk of spray events (χ2 = 5.63, p < 0.02). Significantly more eye splashes were associated with more than two catheter changes (χ2 = 8.912, p < 0.01). It is suggested that protective eye wear should be used routinely during invasive vascular procedures.
The effects of sublethal damage recovery and cell cycle progression on the survival probability of cells exposed to radioactive sources
Authors: Zaider M , Wuu C S
Published: July 2009

Cell progression through the mitotic cycle during low dose rate irradiation may alter notably the survival probability, particularly when a fraction of the dose is delivered during a sensitive phase of the cycle. In this paper we indicate that the consequences of this phenomenon, commonly believed to lead to an “inverse dose rate effect”, may be significantly modulated (and even cancelled) as a result of (a) interactions among sublethal lesions produced in different phases of the mitotic cycle, and (b) variations in these lesions' production rates and repair ability from one phase of the cycle to another. The mathematical model presented (and accompanying numerical examples) takes into account the possibility of changes (e.g. radioactive decay) in the dose rate during exposure.
Oesophageal duplication cyst causing left lung collapse and hypoperfusion
Authors: Holemans J A , Rankin S C
Published: July 2009

Oesophageal duplication cysts are very rare congenital abnormalities. We report a case of one sited in the middle third of the oesophagus causing stenoses of both pulmonary arteries, with collapse of the left lung due to left main bronchus obstruction.
Book reviews
Authors: Faulkner K
Published: July 2009

This short report supersedes various previous reports published by the International Commission on Radiation Units and Measurements. Report 51 provides a useful summary of the various quantities used in radiation protection.
Off-resonance binomial composite pulses in 2D and 3D fat/water imaging at 0.5 T
Authors: Zhu X P , Hutchinson C E , Chilvers P B , Morris G A , Hawnaur J M , Taylor C J
Published: July 2009

A new method of acquiring two-dimensional (2D) and three-dimensional (3D) fat/water decomposed images on a 0.5 T magnetic resonance (MR) imaging system is described. The method uses a gradient-recalled echo (GRE) sequence incorporating a composite 121 pulse, originally used for magnetization transfer contrast (MTC) experiments, for frequency-selective pre-saturation. By applying the 121 pulse off resonance, a sharp discrimination between the chemically shifted water and fat signals may be obtained using a composite pulse as short as 4 ms. Phantom studies demonstrate that suppression ratios as high as 50:1 are achievable. The new method has been applied to volunteers and patients, and good fat/water images of limb, abdomen, head and neck obtained. The new method can be incorporated into other pulse sequences related to GRE, such as phase contrast (PC) and time-of-flight (TOF), and represents the first practical (i.e. rapid) method for 3D fat/water imaging at an operating field as low as 0.5 T.
Radiotherapy portal verification: an observer study
Authors: Bissett R , Boyko S , Leszczynski K , Cosby S , Dunscombe P , Lightfoot N
Published: July 2009

In many radiotherapy facilities radiotherapy portal verification is currently a subjective process based on the visual comparison of a treatment or portal image with a prescription or simulation image. The reliability of this process is unknown. We describe here a study in which 16 observers (oncologists, physicists and therapists) independently evaluated the geometric accuracy of 530 treatment fields on 45 patients. The treatment images were acquired by the BEAMVIEWTM on-line portal imaging system (Siemens Medical Laboratories, Concord, CA, USA). Illustrative examples of the large variation in observers' assessments of the same field are given. The kappa statistic is used to evaluate the degree of agreement between observers and between on-line (at the treatment unit) and off-line (in a quiet viewing room) assessments. The best interobserver agreement was between the four oncologists contributing to the study although this level of agreement was rated only as “fair”. Comparison of on-line and off-line decisions made by therapists exhibited “poor” agreement. This study has provided statistical confirmation of the suspicions of many workers in the field of radiotherapy portal verification, viz that the subjective evaluation of field accuracy is unreliable. However, the degree of unreliability is surprisingly large. The inconsistencies between observers documented in this study need to be clearly acknowledged in the development of protocols for the clinical use of on-line portal imaging systems. Acceptable reliability in radiotherapy portal verification will only be achieved when subjective decision making is eliminated.
Giant pararectal varices—computed tomographic appearances
Authors: Walsh G , Williams M P
Published: July 2009

Computed tomography (CT) accurately identifies the presence of paraoesophageal, upper abdominal and anterior abdominal wall varices in portal hypertension. We present a case of giant pararectal varices and describe the value of dynamic contrast-enhanced CT in reliably establishing the nature of these structures.
Book reviews
Authors: Brada M
Published: July 2009

It is a pleasure to see a coherent multi-author textbook written by experts and focusing on all aspects of one speciality. Brain Tumors in Children is an excellent and in-depth text. The book covers all aspects of paediatric neuro-oncology from epidemiology, conventional and molecular pathology through detailed discussion on management of individual tumour types to the vexed problem of complications.
Book reviews
Authors: Barrett N
Published: July 2009

Dr Banerjee must be congratulated on tackling such a broad topic and including many investigative modalites. The bibliography is excellent, with a very helpful list of suggestions for further reading that allow the reader immediate access to up-to-date information.
Ultrasound-guided percutaneous fine needle puncture of the gallbladder for studies of bile composition
Authors: Hussaini S H , Kennedy C , Pereira S P , Wass J A H , Dowling R H
Published: July 2009

Ultrasound-guided percutaneous fine needle puncture of the gallbladder (PFNP-GB) is invaluable for diagnostic and research purposes, but there are few reports about its safety. We therefore describe the efficacy and side-effects of 43 consecutive gallbladder punctures in 39 patients. PFNP-GB was successful in 40/43 (93%), but failed in three. Bile was completely aspirated in 28 of the 40 (70%) successful procedures. After 36 of the 43 punctures (84%), the patients remained asymptomatic, although on seven occasions (16%) the patients complained of right upper quadrant pain 0.5–12 h after the procedure. In six of these, the pain resolved in 2–24 h, although one developed a leucocytosis (22×l091−1). The seventh patient developed pyrexia and signs of generalized peritonism, which settled with conservative therapy. Ultrasonographic abnormalities of the gallbladder wall were seen in five of the seven symptomatic patients, consisting of: (i) an increase in the thickness of the gallbladder wall (n = 5) from less than 2 mm to 4–14 mm; (ii) peri-cholecystic collections (n = 2) measuring 5 and 11 mm in diameter; (iii) an intraluminal mucosal flap (n = 1); (iv) an intraluminal echogenic layer (n =1); and (v) a 12 cm intraabdominal haematoma in the patient with generalized peritonism. Predictors of pain were: (i) the number of needle “passes” (3.7 ±0.8, range 2–8, in patients with pain vs 2.0 ± 0.2, range 1–6, in pain-free patients, p<0.02); (ii) the absence of gallbladder stones (p<0.03); and (iii) incomplete aspiration of bile from the gallbladder (p<0.02). PFNP-GB is an effective way of sampling fresh gallbladder bile, although there is a 16% risk of inducing pain and/or ultrasonographic changes in the gallbladder.
Book reviews
Authors: Cherryman G R
Published: July 2009

The key to the use of MRI in solving clinical problems in the head and neck is the understanding of anatomy. MRI can produce images that approach cadaver sections in quality. The more the reader can see the more he/she needs to know. MRI of Head and Neck Anatomy is an attempt to produce an atlas sufficiently well labelled to aid the interpretation of complex and difficult MR images.
Audit of the value of double reading magnetic resonance imaging films
Authors: Wakeley C J , Jones A M , Kabala J E , Prince D , Goddard P R
Published: July 2009

100 consecutive magnetic resonance imaging (MRI) examinations were reviewed independently by two radiologists. Patients were selected so that the anatomical areas of clinical interest coincided with the special interests of the reviewers. The reviewers were both consultant radiologists, one with 3 years' and the other with 6 years' experience of MRI. Hard copy images from the MRI examinations were reported independently by both reviewers. Of the 100 MRI examinations, there was full concordance of opinion in 61/100. Of the remaining 39 cases, four (10%) were considered “minor unrelated” differences, 12 (31%) “minor related” differences and 23 (59%) “major related” differences resulting in a significant change in patient management.
The diagnostic implication of falcine calcification on plain skull radiographs of patients with basal cell naevus syndrome and the incidence of falcine calcification in their relatives and two control groups
Authors: Ratcliffe J F , Shanley S , Ferguson J , Chenevix-Trench G
Published: July 2009

The purpose of our study was to identify the incidence of falcine calcification shown on plain skull radiographs in people with basal cell naevus syndrome (BCNS) and in their relatives compared with a normal population. A population of people with BCNS and their relatives was identified on non-radiological grounds and the incidence of falcine calcification on skull radiographs in each of these two groups was compared with the incidence of falcine calcification in a control group of people and of a larger group who attended casualty departments. Falcine calcification was graded into dense, fine but definite, and faint. 85 people with BCNS had nearly 100% incidence of falcine calcification in adults. 83 first degree unaffected relatives showed no excess over “normal” incidence of falcine calcification. In the 970 casualty patients some falcine calcification was common (>20%) in males over 30 and in females over 50 years of age. It occurred earlier and was more common in males than in females. Dense calcification occurred in 5–7% of females and males over 60 years of age. Dense calcification was rare (<2%) under the age of 40 years. In conclusion, falcine calcification should be regarded as the fourth major feature and a very important diagnostic feature of BCNS. An adult labelled as a BCNS sufferer without falcine calcification probably has not got the syndrome. The genetic defect responsible for the metabolic defect resulting in dural calcification is probably the same as, or in close linkage disequilibrium to, that responsible for the major clinical features of the syndrome. The age and sex distribution of falcine calcification in a general hospital casualty population is described.
Clinical amplitude/velocity reconstructive imaging (CARD) — a new sonographic method for detecting breast lesions
Authors: Richter K
Published: July 2009

X-ray mammography and breast ultrasound are methods for the detection of breast lesions, especially cancers. They work in a complementary manner, but only X-ray mammography can be used for screening purposes because the recent sonographic techniques are not as cost-effective, not as fast as mammography, observerdependent and, in some instances, not reliable enough. A new ultrasound method is described which uses an X-ray-identical examination set-up and the following two properties of breast lesions: change of echo patterns behind the lesion and increased sound velocity, especially within malignant lesions. These features can be imaged on a reference structure, a reflecting plate positioned on the side of the breast which is opposite to the transducer. Results of pre-operative examinations of 80 patients with 39 benign and 52 malignant lesions are reported. Clinical, histopathological, and especially X-ray mammography findings are compared. Five cancers were not detectable by ultrasound but had clear suspicious signs on X-ray mammography. Nine cancers were not detected by X-ray mammography but were clearly visible with the new sonographic examination. By the combination of X-ray mammographic findings and their behaviour with the new sonographic method some lesions could correctly be identified as benign. The new sonographic method works in a complementary way to X-ray mammography. By further technical development it could be automated and probably performed as easily, as fast and as reproducibly as X-ray mammography. Using this method systematically in combination with X-ray mammography the detection rate of breast cancer could possibly be increased and unnecessary biopsies of benign lesions could be prevented.
All's well that ends well (with apology to W Shakespeare)
Authors: Hussain S M , Ginai A Z
Published: July 2009

An 82-year-old male presented with a faint left iliac fossa pain. 8 years earlier he had undergone a sigmoid resection because of an adenocarcinoma (Dukes BI). He had remained well and without any signs of recurrence since the operation. The physical examination of this healthy looking man showed no abnormalities. Except for a positive faeces benzedine, the laboratory findings were normal.
Book reviews
Authors: King S
Published: July 2009

This book has been written by three distinguished radiologists with great experience in the field of paediatric hepatobiliary disease. It is a handbook which presents the spectrum of liver problems in children by means of angiographic and cholangiographic findings.
Book review
Authors: Bain G , Dixon A K
Published: July 2009

This pocket atlas literally does fit into a jacket pocket! It is designed as a reference for “medical students, residents and staff physicians in all specialities dealing with the pelvis”. In this aim it succeeds handsomely.
Ultrasound of the Achilles tendon after surgical repair: morphology and function
Authors: Rupp S , Tempelhof S , Fritsch E
Published: July 2009

Ultrasound is a well established method for the examination of the Achilles tendon. The objective of the study was to provide answers to the following questions: What ultrasonographic structural changes are long lasting after surgical repair? How important is ultrasound with regards to the functional evaluation of late results? 60 patients were examined at an average 11 years (2–19) after surgical repair of Achilles tendon rupture. In only four patients sonographic morphology of the tendon was according to the non-injured side. A variety of distinct basic alterations in ultrasound morphology was found: a hypoechogenic ribbon ventrally to the dorsal paratenon (n=40), spots of hypoechogenic areas in the tendon (n=18), dishomogeneous hyperechogenicity with preservation (n=12) or dissolving (n=22) of its fibrillar components along the longitudinal axis. In most of the cases the paratenon was thickened or could not be differentiated. In the dynamic ultrasound examination gliding mechanism of the achilles tendon was limited in 41 patients. Extensive functional subjective and objective parameters of all patients were evaluated in an Achilles tendon score. The results were rated as excellent (n=18), good (n=29), satisfactory (n=12) and poor (n=l). There was no statistical correlation between ultrasound morphology and clinical outcome. Therefore, it was concluded that ultrasound examination is able to reveal long-lasting alterations in echogenicity of the tendon but is only of limited value with regards to evaluation of the functional results after surgical repair.
Book reviews
Authors: Faulkner K
Published: July 2009

This book is the proceedings of an international symposium on “measurement assurance in dosimetry” which was organized by the International Atomic Energy Agency. The meeting was held in Vienna on 24–27 May 1993. The main thrust of the meeting was towards radiotherapy doesimetry in so far as nine of the 10 sessions were principally directed towards this speciality.
Book reviews
Authors: Coulden R
Published: July 2009

As stated in the preface of this book the last ten years have seen a profound change in the techniques and practice of cardiovascular intervention. It is no longer enough to be proficient with the use of a guide wire and a balloon. A new speciality is emerging and the exponents of this speciality need to be familiar with vascular physiology and pathology, molecular biology, the physical principals of vascular radiology, as well as having a background in cardiology and interventional techniques. There is a need for a comprehensive up-to-date text for trainees and devotees alike and this book very largely fits the bill.
The early years of radiotherapy with emphasis on X-ray and radium apparatus
Authors: Mould R F
Published: July 2009

Radiotherapy apparatus, both X-ray and radium, is reviewed for the first 4 decades of this century and the developments during this period are outlined, emphasizing the more important growth points. Radiation dose measurement units and radiation protection features of equipment are also included.
Fractures of the lateral process of the talus—the value of lateral tomography
Authors: Whitby E H , Barrington N A
Published: July 2009

We present three cases of fractures of the lateral process of the talus, where routine anteroposterior and lateral radiographs showed an abnormality but were insufficient to assess the degree of bony injury, which is important for clinical management. Lateral tomography provided good diagnostic and anatomical detail. The diagnosis and treatment of this unusual and often missed fracture is discussed.
The demonstration of aortocaval fistulae by helical computed tomography
Authors: McWilliams R G , Lindsay K A , Chalmers A G
Published: July 2009

We report the helical computed tomography findings in two patients with spontaneous aortocaval fistula (ACF) complicating abdominal aortic aneurysm. The use of overlapping slices produced high quality multiplanar reformats which provided anatomical information about the likely site of the ACF and also the relationship of the renal arteries to the neck of the aneurysm.
Book reviews
Authors: Freer C
Published: July 2009

This is a monumental text covering all aspects of imaging of the spine with magnetic resonance. Each chapter begins with a test image but this is no “quiz” book. There is a wide range of clinical material, diagnostic and therapeutic, along with discussion of alternative diagnostic techniques especially computerized tomography.
Book reviews
Authors: Golding S J
Published: July 2009

Something of a misnomer, I would say. The amount of diagnostic information will strike many readers of this journal as lightweight and “scientific foundations and management…” be regarded as a better title for this book “by leading orthopaedists” on osteoporosis, Paget's disease and neoplasms.
The measurement of nuchal translucency with transabdominal and transvaginal sonography—success rates, repeatability and levels of agreement
Authors: Braithwaite J M , Economides D L
Published: July 2009

The objective of this prospective observational study was to assess the abilities of transabdominal sonography (TAS) and transvaginal sonography (TVS) to measure nuchal translucency (NT) and to establish the levels of agreement between the two scan mode measures. The study was carried out in the Fetal Medicine Unit and 242 pregnant women were recruited from a routine dating scan clinic. All patients underwent TAS and TVS, and two separately obtained measurements of the NT were recorded. The ability to measure NT and the repeatability and levels of agreement between the scan mode measures was assessed. A measurement of NT was obtained in 92% and 90% of fetuses using TAS and TVS, respectively, and in 100% of fetuses by combination of the scan modes. Failure to measure NT with TAS was due to inability to obtain mid-sagittal views because of unfavourable fetal lie or poor resolution, especially in patients with high body mass indexes. Although there was generally good correlation between the two scan mode measurements, a significant overmeasuring of NT was observed with TAS (mean difference ± SD: 0.10 ± 0.29 mm, p<0.01). The repeatability coefficients were 0.40 mm and 0.22 mm for TAS and TVS, respectively. An examiner needs to have the ability and equipment to perform TAS and TVS to consistently measure NT. Considering the overmeasurement of NT with TAS and the improved repeatability with TVS, measurements of NT in a screening programme for chromosomal abnormalities should be by TVS, at least when a prior TAS reveals a value close to a threshold level.
Proceedings of the British Medical Ultrasound Society
Authors: Lamb G , North A
Published: July 2009

AIM: To assess the role of ultrasound in management of patients with symptomatic total hip replacements (THR). MATERIALS AND METHOD: 26 patients with symptoms following THR (2–11 years post-surgery) were examined sonographically using a 5–6 MHz curvilinear transducer (Diasonics Prisma) over a 12 month period. Any fluid collection was aspirated for bacteriology and any soft tissue masses were core biopsied for histological assessment. Ultrasound appearances as well as transducer compression tenderness were noted. RESULTS: Ultrasound diagnoses included: wear debris granulomata, 14 (definite, 5; probable, 6; possible, 3); prosthetic infection, 3 (2 with sequestra at level of femoral component tip); trochanteric wire problems, 10 (granulation tissue formation, 3; bursa formation, 3; infection, 2; haematoma, 1; compression tenderness without focal ultrasound abnormality, 1); femoral shaft fracture, 1; greater trochanter fracture, 1; acetabular screw granulation tissue, 1; heterotopic ossification, 3; ?ceramic femoral head fracture, 1; normal study (but possible early loosening on X-ray), 3. CONCLUSION: Ultrasound is an extremely useful method of initial evaluation of symptomatic total hip replacements.
Risk and benefit associated with radiation dose in breast screening programmes—an update
Authors: Law J
Published: July 2009

This paper discusses and attempts to estimate the very small numbers of women attending the UK Breast Screening Programme for whom the risk of cancer induction may exceed the probability of cancer detection. It updates a previous paper on the same topic. Variations in breast dose between individuals, due to differences in breast size and in numbers of views and films taken, are considered and revised. New data on cancer induction and its variation with age at exposure have been employed. The overall effect of these changes is generally to improve the balance of benefit against risk compared with the previous paper referred to, the very few exceptions being categories where the numbers of women in question remain of the order of one in a million. The implications for certain alternative screening schedules and for some current trials are also discussed, the conclusions being again reasonably reassuring.
Tangential breast irradiation
Authors: Rodger A
Published: July 2009

Neal et al [1] are to be congratulated on the thoroughness of their review of tangential breast irradiation dosimetry. No radiation oncologist would disagree that current breast dosimetry is anything less than grossly imperfect. Most would also agree that it is questionable that improved dosimetry will improve cosmetic outcome. The latter is dependent not only on radiation dose, fractionation and volume, but also on surgical techniques and their sequelae. Therefore, one doubts that a “carefully controlled randomized controlled trial” is feasible.
Book reviews
Authors: Osborn S
Published: July 2009

This little book sets out to give non-technical managers of radiation protection services sufficient technical material to enable them to work with the scientists involved. It outlines the scientific background of the various radiations and their biological effects, and the relevant UK legislation and recommendations. There is a comprehensive bibliography of over 100 references.
Book reviews
Authors: Tait D M
Published: July 2009

This new book is written by senior radiographers from the Cookridge Cancer Centre in Leeds. Aimed at students of radiotherapy, both doctors and radiographers, and qualified staff, the book aims to provide a grounding in basic science which is constantly linked to practical advice on the safe delivery of good quality radiotherapy.
Book reviews
Authors: Kerslake R W
Published: July 2009

To the majority of musculoskeletal radiologists, the prospect of a new multi-author book entitled Diseases of Bone and Joints should arouse great interest. Yet for many, that initial surge of enthusiasm will be dampened on reading the subtitle Cell Biology, Mechanisms and Pathology. After all, aren't we primarily interested in images and their interpretation rather than the niceties of histopathology? Those who discard prejudice and venture beyond the cover of this volume will be rewarded by an excellent and authoritative text that has due regard for the importance of radiological and histopathological correlation.
Book reviews
Authors: Hately W
Published: July 2009

An advantage of this textbook is that it provides an overview of the radiology of the genitourinary tract in a single 500 page volume. In the preface to the first edition it was stated that the book was aimed at: general radiologists requiring a concise update in the subject, radiology and urology residents, urologists, nephrologists and medical students.
Body magnetic resonance angiography and its effect on the use of alternative imaging—experience in 1026 patients
Authors: Hartnell G G , Hughes L A , Longmaid H E , Finn J P
Published: July 2009

Time-of-flight magnetic resonance (MR) angiography has been described for numerous applications but the number of patients described in published reports is usually relatively small. There is little information concerning the general utility of MR angiography in the body, outside the cranial circulation, or its effect on use of other imaging studies. Utilization of two-dimensional (2D) time-of-flight MR angiography over a 3 year period was reviewed to determine its accuracy and impact on other imaging modalities. Cranial and cardiac studies were excluded. Correlation was made with alternative imaging and surgical findings. Between January 1990 and December 1992 2D time-of-flight MR angiography was used to examine 1026 patients. MR angiography was used most frequently to examine the venous system. There was a slight reduction in the use of alternative imaging with two exceptions. When chest MR venography was performed, alternative imaging was completely abolished. Also, contrast portal venography was virtually eliminated. Five errors(0.2% of total MR angiography examinations) were recorded. Time-of-flight MR angiography, especially MR venography, is accurate and can replace contrast venography for abdominal and thoracic applications. Cost and limited availability means that other imaging, usually ultrasound, often precedes MR angiography.
The impact of digital imaging on patient doses during barium studies
Authors: Broadhead D A , Chapple C-L , Faulkner K
Published: July 2009

Barium studies performed on 10 digital and four non-digital fluoroscopic systems were monitored with dose–area product meters as part of a Regional Patient Dosimetry Audit programme. The data have been collected using a computer to read and reset the dose–area product meter and also to collect patient and examination details. A comparison of dose–area product measurements from digital and non-digital fluoroscopy units on over 10000 barium studies is presented. The data have been corrected according to patient size. The mean size corrected dose–area product for a barium meal examination was found to be 7.62 Gy cm2 for a digital set compared with 15.45 Gy cm2 for a non-digital set with 2462 and 1308 patients included in each measurement series, respectively. Dose–area products were also a factor of approximately two lower for barium enema, barium swallow and barium follow-through examinations performed on digital systems.
Historical note
Authors: Dawson Peter
Published: July 2009

This month we move back to the first half of the century to examine some of the earliest work on contrast media.

It was demonstrated in the 1920s that iodine was an excellent X-ray absorber at diagnostic energies but that inorganic iodide solutions were both painful and toxic. Chemists in Berlin, searching for a “magic bullet” against syphilis, synthesized a large number of compounds just a handful of which were monoiodinated pyridones. They were found to be partially selectively excreted in the urine and were consequently dubbed “uroselectans”. Some of these compounds were used by Moses Swick to perform the first IVU. These early molecules were patented as intravascular contrast agents.
Chronic mesenteric ischaemia as a cause of abnormal bowel uptake of labelled leucocytes
Authors: Ingram G , Reeder A , Tait N P , Tanner A R
Published: July 2009

Chronic mesenteric ischaemia is often difficult to diagnose. A high level of clinical suspicion is needed and further investigation requires invasive procedures. We present a case where weight loss and abdominal pain were dominant features and initial interpretation of a labelled leucocyte scan suggested inflammatory bowel disease. Subsequent investigations excluded this possibility and chronic ischaemia was confirmed at autopsy. Positive small bowel images using 99Tcm-HMPAO labelled leucocytes may indicate chronic ischaemia.
Book reviews
Authors: Sheridan M B
Published: July 2009

Ultrasonography has been an essential tool in the investigation of patients with suspected gastro-intestinal disease for many years. As stated in the preface there have been significant changes in the treatment of various gastro-intestinal diseases and improvements in ultrasound technology over the last five years and the aim of this book is to give an overview of the up to date applications of ultrasound in gastroenterology.
The appearance of “early” chest radiographs and the response to surfactant replacement therapy
Authors: Dimitriou G , Greenough A , Giffin F J , Karani J
Published: July 2009

We have assessed whether the appearance of the chest radiograph performed within the first 2 h of birth was predictive of the response to exogenous surfactant replacement therapy (SRT), as indicated by changes in sensitive indices of disease severity, that is lung volume (functional residual capacity (FRC)) and oxygenation (a/A ratio). 18 premature infants who received two doses of a synthetic surfactant (Exosurf) were studied. The appearances of chest radiographs taken prior to the first and immediately after the second dose of SRT were scored for lung volume, degree of inflation, presence of opacification, interstitial shadows and air bronchograms. At similar times, FRC was measured and the a/A ratio calculated. Although following SRT, the chest radiograph score decreased (p>0.01) and the FRC (p<0.01) and a/A ratio (ns) improved, there was no significant relationship between the change in chest radiograph score and either the change in FRC or a/A ratio. In addition, only the post-SRT chest radiograph appearance correlated significantly with the respective FRC, a/A ratio and outcome (death or oxygen dependency beyond 28 days). Although the appearance of an early chest radiograph is frequently used as an indicator of the need for SRT, these results demonstrate that, unlike the post-SRT radiograph, it is a poor predictor of the response to SRT and outcome.
Optimization of radiographic technique for chest radiography
Authors: Warren-Forward H M , Millar J S
Published: July 2009

Over 1500 patients undergoing chest radiography in the West Midlands have been monitored for entrance surface doses using lithium borate thermoluminescent dosemeters. In total 63 X-ray tubes were monitored from 30 hospital departments. The mean patient entrance surface dose is 0.15 mGy, and the 75th percentile entrance surface dose is 0.18 mGy. A reference level of 0.18 mGy has been recommended for PA chest radiography in the West Midlands. Image quality has been assessed on patient radiographs. Departmental radiologists were responsible for assessing radiographs taken within their hospital. Independent analysis was performed by a control radiologist. Film–screen processor sensitivity has been assessed on 48 film-screen processor combinations. Significant differences were observed between the nominally quoted sensitivities and the measured sensitivities. Only 26% of systems produced measured sensitivities within 10% of the nominal values. A four variable regression model, explaining 78% of the variance, provided the best description for the variation in patient dose. These variables were actual sensitivity, applied potential, generator waveform and radiographic quality. Four recommendations have been made to lower patient doses; these are: (1) an increase in applied potential to a minimum of 90kVp; (2) a film–screen sensitivity of 400; (3) optimization of processor performance and (4) regular radiological audits to reduce repeat rates to a level of 5%. If all of these recommendations are followed, an estimated overall entrance surface dose saving of 53% would result. Changing the applied potential alone will see the variation in the mean entrance surface dose from non-gridded systems reduce from a factor of 4 to a factor of 2.
Thyratron performance—dependence on mounting in a medical linear accelerator
Authors: Balakrishnan I S , Jayaraman R , Bhaskar B K , Lakshmanan A V
Published: July 2009

A thyratron is an important component of a medical linear accelerator. The working life of a thyratron has been found to be dependent on its physical orientation in the accelerator. This observation is a result of maintaining accelerators for over 15 years.
Renal scintigraphy in the diagnosis of urinary extravasation
Authors: Al-Janabi M A , Ahmad R , Kumar K A S , Critchley M
Published: July 2009

Renal scintigraphy is a sensitive method for disclosing urinary extravasation. Its role following a road traffic accident is clearly presented in this case report. It is concluded that such a study can fill an important gap between the clinical and intravenous urography assessment and the more invasive studies in trauma victims.
Primary non-Hodgkin's lymphoma of the bladder
Authors: Amin R
Published: July 2009

Primary lymphoma of the bladder is uncommon. Less than 75 cases have been reported so far in the literature. Two further cases are reported here and relevant literature is reviewed.
Book reviews
Authors: Banerjee A K
Published: July 2009

This book, written by Professor Lange from Germany, is a new addition to the literature in urological radiology. It is divided into four parts; the first part deals with imaging techniques, the second with the normal renal tract and its imaging, and the final two sections cover diseases of the upper renal tract and provide a comprehensive list of differential diagnoses.
Long-term survival after embolization of potentially lethal bleeding malignant pelvic tumours
Authors: Hendrickx Ph , Orth G , Grunert J-H
Published: July 2009

Transcatheter embolization was performed in 45 patients suffering from potentially lethal bleeding originating from malignant tumours in the pelvic region. In 21 cases, the basic disease was rectosigmoidal and in 20, gynaecological in origin. Uncommon bleeding sites were embolized in four other cases. The median survival time (Kaplan-Meier) was 6 months. Most patients died from tumour cachexia. In 10 cases (22%), recurrent bleeding occurred, in three of these with lethal consequences. Successful reembolization was performed on seven patients. The different embolization materials used showed a minor impact on the therapeutic result. Embolization therapy proved to be an effective measure in potentially lethal malignant pelvic bleeding. Gianturco, Anderson and Wallace (GAW) coils should be given preference where there is urgency, as they are accurate, easily and quickly insertable, and cause few complications.
Spinal metastasis from carcinoma of the penis
Authors: Jacob R , Jyothirmayi R , Kumar A , Nair M K , Rajan B
Published: July 2009

Carcinoma of the penis has a well documented metastatic pattern, regional lymph nodes being the predominant site of involvement. Distant metastasis is extremely rare, with a reported incidence of 1–10%. Osseous metastasis is even rarer and no case of metastasis to the spine has been reported previously. We present a case of carcinoma of the penis metastasizing to the spine.
A lateral will do? (1)
Authors: Whitehouse R W
Published: July 2009

Whilst I am in complete agreement with the view expressed in the article by Tyrrell et al [1], which recommends the continuing routine acquisition of at least two views for the plain radiographic assessment of the lumbar spine, I feel the lateral view used to illustrate the article demonstrated abnormalities which warrant further comment.
Ultrasound of the Achilles tendon after surgical repair: morphology and function
Authors: Rupp S
Published: July 2009

Dr Maffulli, in her letter, has discussed some interesting aspects related to our paper.

The basic concept of our work was a cross-sectional study beyond the “endpoint” of the healing process.
Book reviews
Authors: Faulkner K
Published: July 2009

This book contains the proceedings of the 29th annual meeting of the National Council on Radiation Protection and Measurements which was held in April 1993. These proceedings comprise an opening scientific session followed by four case studies interspaced with the Taylor Lecture.
Calculation of computed tomography dose index to effective dose conversion factors based on measurement of the dose profile along the fan shaped beam
Authors: Jansen J Th M , Geleijns J , Zweers D , Schultz F W , Zoetelief J
Published: July 2009

The variation in computed tomography dose index (CTDI) to effective dose conversion factors between different types of CT scanner is large (i.e. a factor of about 2 due to differences in beam shaping filters). Consequently, scanner specific conversion factors have to be applied. For some types of scanner, however, detailed information on the construction of beam shaping filters is not provided by the manufacturers. It is of interest to investigate the use of measured dose profiles for the calculation of conversion factors. Based upon measured dose profiles, two appropriate photon spectra selected on the basis of measured half value layers, gender specific adult phantoms Adam and Eva, and the Monte Carlo neutron and photon radiation transport code (MCNP), organ and effective dose conversion factors are calculated. To validate the method, a comparison is made between results for measured and calculated beam profiles for a Philips Tomoscan 350. The results in terms of effective dose per slice per unit of CTDI are compared with published data. Relative difference in conversion factors per slice averaged over all slices used for the calculations is 13 ± 4% between the two spectra, 10 2 ± 0 2% between measured and calculated beam profiles and 50±191% between the phantoms of different gender. The relative difference between the averaged results for the Adam and Eva phantoms and published results for a hermaphrodite phantom is on average equal to or less than 15 ± 13%, depending on the spectrum and beam profile used, although larger differences can occur for specific slices. It is concluded that CTDI to effective dose conversion factors can be derived on the basis of measured beam profiles.
Comparative study of dose values and image quality in mammography in the Madrid area
Authors: Chevalier M , Morán P , Vaño E
Published: July 2009

During 1990–1992 a study of dose and image quality in mammography was carried out in the Madrid area. Values of air kerma and mean glandular dose per film estimated at 14 public and private centres (17 X-ray units) by means of the Leeds TOR(MAX) mammographic phantom and from a sample of patients were reported in a previous paper. This second paper describes image quality results obtained by the same Leeds TOR(MAX) phantom. Inferior image quality was found for units without a grid (most of them older systems) and/or using aluminium filtration. In units with a grid, inferior image quality was due to the low optical density of the images, the use of inadequate image receptors and the use of an aluminium filter. Image quality results were compared with the standards of the UK Breast Screening Programme and proposed European Guidelines. It is concluded that mammography image quality might be considered as acceptable when TOR(MAX) phantom films achieved at least 10 lp mm−1 and 1.2% for high contrast resolution and threshold contrast visibility (6 mm details) respectively.
External anal sphincter defects: correlation between pre-operative anal endosonography and intraoperative findings
Authors: Romano G , Rotondano G , Esposito P , Pellecchia L , Novi A
Published: July 2009

In order to correlate operative findings with external anal sphincter (EAS) defects identified on anal endosonography (AES), 30 faecally incontinent patients undergoing overlapping sphincteroplasty or total pelvic floor repair were investigated by AES before and after surgery. Endosonic findings were correlated with the appearance of EAS at operation. 21 out of 22 defects seen at surgery had been pre-operatively detected by AES (one false negative). Post-operatively the sphincteroplasty was clearly evident on AES. In three cases of failure it showed an extensive hypoechoic area and these patients underwent dynamic graciloplasty. Endosonography is the method of choice for pre-operative imaging of EAS, having an established role in identifying sphincter defects and correlating well with intraoperative findings. Post-operatively, it has the potential to identify breakdown of the previous repair, allowing prompt surgical intervention. Endosonography is helpful in planning the best type of operation following sphincter injury and is useful in auditing the results of surgery.
Non-Hodgkin's lymphoma presenting as an encasing pleural mass
Authors: Wittram C
Published: July 2009

Parnell and Frew [1] presented an unusual cause of lobulated circumferential pleural thickening.
Air versus carbon dioxide insufflation in double contrast barium enemas: the role of active gaseous drainage
Authors: Farrow R
Published: July 2009

We share Dr Jobling's desire to see an increase in the use of measures to reduce post procedural pain following double contrast barium enema. While we have shown that active drainage techniques are as effective as using carbon dioxide in reducing post procedural pain, the additonal turning required with the active drainage technique does make carbon dioxide the preferred option.
Is computed tomography of the body overused? An audit of 2068 attendances in a large acute hospital
Authors: Naik K S , Ness L M , Bowker A M B , Robinson P J A
Published: July 2009

Computed tomography (CT) delivers a substantial proportion of the medical radiation dose to the population. The National Radiological Protection Board (NRPB) recommends that “CT examinations should only be carried out after there has been proper clinical justification for the examination of each individual by an experienced radiologist”. The aim of this study was to review the indications for body CT in a large acute hospital in order to identify groups of patients in whom CT might not be “clinically justified”. We reviewed the age, sex and diagnosis of all patients undergoing CT of the abdomen and pelvis (including lumbar spine) in our department in 1992. All requests had been checked by a senior radiologist before booking. CT was performed in 1078 male patients and in 990 females. Patients examined for benign disease were younger (mean age 52 years) than patients with malignant disease (mean age 57 years). Of 915 examinations performed for benign disease, 293 (32%) were orthopaedic in nature and included 255 (87%) for back pain. CT was carried out for benign non-orthopaedic disease in 97 women under 50 years old, usually following other tests with inconclusive or normal results. 49 of these examinations were reported as normal. Of 191 patients who had more than one CT examination, 158 (83%) were undergoing follow-up for malignant disease. All 39 patients who underwent CT on three or more occasions had life-threatening conditions, either malignancy or complicated acute pancreatitis. We have been unable to find substantial numbers of patients in whom CT was performed inappropriately. Substitution of magnetic resonance imaging (MRI) for CT of the spine will help population dose reduction. The benign condition responsible for the largest radiation dose from CT is complicated acute pancreatitis, and it may be possible to substitute MRI for CT in these patients Women under 50 years old with normal CT form an important group for clinical audit.
Daily quality control programme in mammography
Authors: Nassivera E , Nardin L
Published: July 2009

The Medical Physics Department of S.Chiara Hospital (Trento, Italy) has developed, promoted and organized a quality control programme in mammography in the Department of Diagnostic Radiology. The aim of this paper is to describe the procedure for daily quality control carried out by the radiological technologist and analysed by the medical physicist, and also to discuss some interesting results obtained in the various departments during 1994. A sensitometric strip provides the film characteristic parameters to meet the requirements of DIN 6868 Part II (base plus fog level, average gradient, relative speed, maximum density, speed index and contrast index). A test phantom radiograph provides information on the detection of microcalcifications and simulated tumours (high and low contrast resolution) as well as on the central background density and the contrast. The exposure time-current product, mAs, needed to expose the phantom is always noted. Characteristic parameters of the two systems are compared with limiting values given by International Protocols or with the permissible ranges calculated in advance. It has been possible to discover variations in the performance of mammographic and automatic processing units due to the quality control programme. In one department, for example, the malfunctioning of the automatic exposure control device was observed. In another, replacement of mammography films and the automatic processing unit resulted in a better image quality.