bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of image persistence in a digital angiography system
Authors: Okkalides D P , Raptou P D
Published: July 2009

Image persistence, as a characteristic of video imaging systems affecting the quality of fast moving fluoroscopic images, is shown to vary considerably. A simple quantitative method for measuring image persistence in a digital angiography system is presented, together with a series of image intensifier exposure–response curves. For the Saticon tube, used with the Siemens 3VA Digitron, it was found that persistence increased for low exposure rates and may increase to 31% at a 120 ms interval. In addition, a sharp increase in image persistence, from 8.3% to 33%, was observed within 18 months from installation of the system.
Fat suppressed magnetic resonance imaging at 0.5 T using binomial radiofrequency pulses
Authors: Redpath T W , Wayte S C
Published: July 2009

Fat suppressed MR imaging can be achieved by selectively saturating lipid protons, just before applying a conventional spin-echo rf pulse sequence. The difference in the Larmor frequency between fat and water protons is only 3.5 ppm, so that the frequency response of the suppressing pulse, or pulses, has to be carefully designed. The choice of suitable binomial and modified trains of hard rf pulses was investigated by computer simulation, phantom testing and T  1 weighted spin-echo imaging of a normal volunteer's optic nerve at 0.5 T.
Interesting ileus
Authors: Sacks A J , Goldschmidt R P
Published: July 2009

A 50-year-old black female with well controlled hypertension presented with a neck swelling and a right hypochondrial mass. She had no evidence of neurofibromatosis or mucosal neuromata and no significant family history. A chest radiograph taken on admission was normal. Serum electrolytes, glucose and full blood count were normal. Urinary vanillylmandelic acid (VMA) levels were elevated, 50.6 μxmol 1−1 (5–35 μmol 1−1) and serum catecholamine levels were markedly elevated, noradrenaline 5530 pg ml−1 (100/600 pg ml−1) and adrenaline 831 pg ml−1 (10−80 pg ml−1), while dopamine levels were normal 30 pg ml−1 (10–150 pg ml−1). Non-contrast computed tomography (CT) of the abdomen showed a mixed density 10×6×5 cm mass in the region of the right adrenal gland (Figure 1). A saggital T  1-weighted magnetic resonance (MR) scan showed a 5 × 4 cm vascular mass in the left neck, anterior to the carotid bifurcation (Figure 2).
Design features of the indwelling intrauterine tube for high dose rate intracavitary therapy for carcinoma of the cervix and some hints on its optimal use
Authors: Smit B J
Published: July 2009

A description of the indwelling intrauterine tube to facilitate high dose rate brachyradiotherapy, with some clinical results, was published previously in this journal. This communication emphasizes some important design features of this tube, which ensures optimal efficiency and ease of use.
Helical computed tomography: where is the cut?
Authors: Horrocks J A , Speller R D
Published: July 2009

The helical scanning mode in computed tomography (CT) entails continuous table movement during image acquisition. The projections acquired in this mode will not be consistent with those in the axial scanning mode. A comparison of the helical and axial modes of scanning on the IGE HiSpeed Advantage CT system (software version ZA) has been made using a contrast-detail phantom. Differences seen between the two modes include shadow and streaking artefacts and an increase in the partial volume effect in the helical scan mode.
Evaluation of tilted, optimized, non-saturating excitation pulses in 3D magnetic resonance angiography of the abdominal aorta and major branches in volunteers
Authors: Roditi G H , Smith F W , Redpath T W
Published: July 2009

Ten normotensive volunteers were imaged with FISP-3D (Fast Imaging Steady Precession) pulse sequences (a steady state gradient recalled echo, SS-GRE, technique) without and with modification by tilted, optimized non-saturating excitation (TONE) customized radio frequency (RF) pulses, for evaluation of the abdominal aorta—in particular the renal arteries. Maximum intensity projection (MIP) angiograms were constructed for each sequence in each volunteer; 15 observers “blinded” to sequence type preferred the images generated from the TONE applied sequence. Analysis showed that this preference was significant.
Prediction of birthweight by fetal ultrasound biometry
Authors: Pryce I
Published: July 2009

The method of measurement of abdominal circumference (AC) is not stated in the paper by Nzeh et al [1]. It is known [2] that measurements based on derived values of AC, such as ellipse fitting or computation from two linear measurements, differ from measurements based on tracing around the outline, the latter being approximately 5% greater. Using, for example, the Campbell formula which relies solely on AC, a 5% apparent difference in AC produces an around 10% apparent difference in the fetal width estimation (in the range of fetal weights considered in this paper).
Book reviews
Authors: Klevenhagen S C
Published: July 2009

Radiation dosimetry has made considerable progress in the last 10 years. A very useful addition to the existing literature on this subject is the book by Dr Govinda Rajan. This book provides a comprehensive and detailed treatment of radiation dosimetry in application to radiotherapy in the context of modern developments.
Book reviews
Authors: Gleeson J A
Published: July 2009

To those interested in the history of radiology and radiologists this book is a welcome addition to their library. It comprises a compendium of essays and lectures, mainly American, extending from the discovery of X-rays by Röntgen at the end of the 19th century to a final paper paying tribute to the late Ben Felson.
Phosphorus-31 metabolism of human breast—an in vivo magnetic resonance spectroscopic study at 1.5 Tesla
Authors: Twelves C J , Lowry M , Porter D A , Dobbs N A , Graves P E , Smith M A , Richards M A
Published: July 2009

We have studied the metabolism of compounds containing 31P in normal breast using magnetic resonance spectroscopy (MRS). Spectra were acquired from non-lactating pre-menopausal breast (n = 14 women), lactating breast (n = 8) and post-menopausal breast (n = 8). The standard acquisition protocol used a 5.5 cm surface coil with the volunteer prone to minimize chest wall signal contamination. In pre-menopausal non-lactating women the phosphocreatine (PCr) peak area, expressed relative to the sum of all 31P peak areas, was negatively correlated with breast size (r = −0.56,p = 0.02) suggesting that much of the PCr signal originated from the chest wall. The phosphodiester (PDE) relative peak area was positively correlated with breast size (r = 0.71; p = 0.002). Spectra could be acquired at all phases of the menstrual cycle. In sequential examinations of five women not taking the oral contraceptive pill (OCP), phosphomonoester (PME) relative peak area was significantly lower on Week 2 than other weeks of the cycle (p = 0.03). Among pre-menopausal women no clear difference was apparent between the spectra from women taking the OCP and those not taking the OCP. Lactating breast had significantly higher PME relative peak area than non-lactating pre-menopausal breast (p = 0.02), probably reflecting the higher proportion of epithelial tissue in lactation; the lower PCr relative peak area in lactating breast (p = 0.05) is probably due to the greater size of the breast during lactation. Spectra were acquired from post-menopausal women but with a relatively low signal-to-noise ratio. The only significant difference between 31P relative peak areas of breast spectra acquired from pre- and post-menopausal women was that less PCr was detected in the post-menopausal volunteers (p = 0.03), probably as a result of differences in breast size.
Plain film diagnosis in intussusception
Authors: Meradji M , Hussain S M , Robben S G F , Hop W C J
Published: July 2009

In early childhood intussusception a characteristic gas pattern is often visible on plain radiographs which can be used for diagnosis. To test this hypothesis, radiographs of 163 children with intussusception, and as many controls, were reviewed. By using multivariable analysis, it appeared that five out of seven parameters (reduced amount of gas in the jejunum; lateralization of the ileum; indiscernible caecum; reduced amount of faeces in the colon; and visibility of the intussusceptum) had discriminatory value. For each parameter a weighting (in points) was derived and the patients were classified: the higher the score the more likely that an intussusception was present. A sensitivity of 90% and a specificity of 90% were obtained.
Multiparametric classification of muscle T
1, and T
2 relaxation times determined by magnetic resonance imaging. The effects of dynamic exercise in trained and untrained subjects
Authors: Le Rumeur E , Carré F , Bernard A-M , Bansard J-Y , Rochcongar P , De Certaines J D
Published: July 2009

Muscle relaxation times can now be measured accurately with magnetic resonance imaging (MRI), distinguishing working muscles from non-working muscles. A correlation between T  2 increase and work intensity has been shown in healthy volunteers. The small amount of data on T  1 relaxation times is contradictory. In addition, all the published studies have concerned short-duration exercise in subjects of unknown training level. The goals of this study were (i) to determine T  1 and T  2 variations in thigh muscles after long dynamic exercise, (ii) to analyse the effects of training and (iii) to determine the relationship between power output and relaxation times after exercise. Sedentary men, soccer players and triathletes performed submaximal dynamic exercise at a constant heart rate for 15 min. MRI was performed before and 5 min after the end of exercise. The results showed (i) that T  1 increased in parallel to T  2 in anterior thigh muscles and (ii) that multiple correspondence analysis and hierarchical ascending classification can discriminate three subject classes according to power output, training level and relaxation times, which fitted well with our three groups of subjects.
An investigation of spinal bone mineral density measured laterally: a normal range for UK women
Authors: Lilley J , Eyre S , Walters B , Heath D A , Mountford P J
Published: July 2009

A UK normal range for 250 volunteers was established for bone mineral density (BMD) of the lumbar spine (L2–L4) measured laterally in the decubitus position. Two software defined regions of interest (“Body” and “Mid”) within the vertebral body were analysed throughout. As expected, a negative correlation of BMD with age was found for Body (r = −0.55, p < 0.001) and Mid (r = −0.56, p < 0.001). The age related bone loss from young to old (20–80 years) was 40% in L3 (Body) and 45% in L3 (Mid). In 22% of the cases only L3 could be measured owing to the influence of rib over L2 and interference of the iliac crest over L4. Age related normal ranges (± 2 standard deviations) for the three lumbar vertebra L2, L3, L4 for young normals (age 19–39 years) were found to be 0.54 to 1.02, 0.49 to 1.05 and 0.5 to 1.14 g cm−2 respectively for the Body region and 0.49 to 0.97, 0.45 to 1.01 and 0.45 to 1.13 g cm−2 respectively for the Mid region. These ranges can now be used as reference values for patients with suspected osteoporosis and possibly for future fracture prediction. The in vivo precision in 19 volunteers was found to be 4.2% and 5.6% on Body and Mid respectively. The short term (less than 1 week) in vitro precision was 3.1% and 2.7% respectively. From these data it appears that there is a greater measured age related drop in BMD in the vertebral body (measured laterally) than in the entire vertebra (measured anterior-posteriorly) indicating that the lateral measurement may prove to be more sensitive in predicting fracture. The precision of these results indicates that lateral measurements of the spine are not yet useful for monitoring individuals over short term periods and are less useful for studying the effects of drug treatment than the more traditional anterior-posterior measurement of the spine and femur.
Resistance and pulsatility Doppler indices: how accurately do they reflect changes in renal vascular resistance
Authors: Robbins M E C
Published: July 2009

We very much appreciate the comments of Dr Hilson regarding the underlying assumptions made by ourselves and other workers using 131I-Hippuran for the serial measurement of renal blood flow.

We certainly agree with all the reservations make by Dr Hilson; indeed we were aware of these prior to the studies on resistance and pulsatility indices. Unfortunately we did not make any measurements of the extraction efficiencey of 131I-Hippuran during the course of this study.
Relationship of computed tomography tumour volume to patient survival in carcinoma of the cervix treated by radical radiotherapy
Authors: Collins C D , Constant O , Fryatt I , Blake R , Parsons C A
Published: July 2009

In this retrospective study tumour volume was calculated by two different methods from the staging computed tomographic scans obtained in 1987 of 20 patients with carcinoma of the cervix. All patients underwent treatment by radical radiotherapy and the survival figures at 5 years were analysed. The aim was to identify the nature of the relationship between the true tumour volume and tumour volume obtained by measuring the maximum dimensions in each plane (“cuboid” volume). Significant correlation between the product of height × width × depth and true tumour volume was demonstrated (r = 0.983). A multivariate analysis of survival demonstrated a significantly increased relative risk for positive nodes (p < 0.03) and tumour depth > 3.8 cm (p < 0.04) or tumour width > 5.0 cm (p < 0.03). A significant difference (p < 0.02) between the median tumour volumes for early and late stage disease was present irrespective of the method used to calculate tumour volume. This study demonstrates that cuboid tumour volume can be a good reflection of the true volume; in addition, positive nodes, tumour depth and tumour width are significant determinants of survival.
The development of an interdepartmental audit as part of a physics quality assurance programme for external beam therapy
Authors: Bonnett D E , Mills J A , Aukett R J , Martin-Smith P
Published: July 2009

A cost-effective audit system has been developed that will both detect systematic error in data and procedures and evaluate the quality assurance programme provided by a physics department for radiotherapy. The audit has been developed for external beam radiotherapy and assesses one modality and one treatment machine per year. The audit is carried out on an interdepartmental basis and can be undertaken by two physicists from each department in one working day. The method of assessing the quality assurance programme and the schedule of measurements are described. The process is illustrated using the results of trial audits between the medical physics departments at Coventry and Leicester.
Biokinetics and dosimetry for [methyl-11C]thymidine
Authors: Thierens H , van Eijkeren M , Goethals P
Published: July 2009

The uptake and retention of [methyl-11C]thymidine in organs and tissues after intravenous injection were studied using positron emission tomography scanning of patients. In addition, clearance of 11C-activity from the blood was determined directly by measurements of blood-samples. 5 min after administration the activity level was already reduced to 5% of the initial activity after injection. Preferential uptake of 11C-activity was present in the liver and kidneys. A less pronounced uptake was observed in the skeletal muscle tissue, heart wall, lungs and salivary glands. The retention in these organs and tissues has a long half-life compared with the physical half-life of 11C. The absorbed dose per unit activity administered was calculated for all critical organs following the Medical Internal Radiation Dose Committee formalism. Averaging over the patients, values of 37 and 28 μGy MBq−1 were obtained for the liver and the kidneys respectively. The committed effective dose after a [methyl-11C]thymidine scan with 740 MBq, a commonly applied amount of activity for this type of scan, is 2.8 mSv.
Comparison of two methods for assessing patient dose from computed tomography
Authors: Geleijns J , van Unnik J G , Zoetelief J , Zweers D , Broerse J J
Published: July 2009

Radiation exposure of the patient during routine computed tomography (CT) examinations is known to be relatively high. In this study organ doses were determined using two methods and these served as a basis to calculate the effective dose. Thermoluminescence dosemeters (TLDs) were used to measure organ doses in an anthropomorphic Rando Alderson phantom. In addition organ doses were obtained from measurement of the computed tomography dose index (CTDI) and the application of published organ dose conversion factors. Effective dose values obtained with the Rando phantom for CT head examinations are about 1–2 mSv. For CT examinations of thorax and abdomen the estimation of effective doses with the Rando phantom yielded values of 18 and 24 mSv respectively. Effective doses determined from CTDI values were similar for CT head examinations (1–2 mSv) but were smaller for the CT thorax scan (11–15 mSv) and the CT abdomen scan (15–20 mSv). In this study effective dose values are relatively high compared with the results of other investigators who indicate effective doses and effective dose equivalents of 7–9 mSv for CT of the thorax and of 4–16 mSv for CT of the abdomen. Discrepancies between our results and those from other studies could be attributed to differences in the selected CT protocols and to differences in the phantoms employed. Measurements in an anthropomorphic phantom were laborious and time-consuming. Assessment of organ doses from CTDI values and organ dose conversion factors will therefore be the preferable method for future dose intercomparisons at different locations in The Netherlands. It should be realized, however, that this method tends to yield up to 40% lower effective dose values compared with the assessment of effective dose with a Rando phantom.
Myeloma of the breast—appearances on ultrasound and colour Doppler
Authors: Collins C D , Kedar R P , Cosgrove D O
Published: July 2009

Multiple myeloma may on rare occasions involve the breast. We report a case where a predominantly echopoor solid mass was present on breast ultrasound in a patient under treatment for multiple myeloma. There was evidence of neovascularization on colour Doppler allowing a provisional diagnosis of carcinoma to be made. Fine needle aspiration cytology, however, demonstrated numerous mononuclear cells characteristic of myeloma. The appearances on ultrasound of this lesion have not been previously described.
Imlink and continuing medical education: the use of an image transfer system to broadcast teaching cases nationally
Authors: Briley M S , Hoare M , Dobson D , Anslow P L
Published: July 2009

Imlink, a personal computer based image storage and transfer system, has been used regularly in Oxford since 1989, primarily to transmit computed tomography (CT) brain scans to the regional neurosurgery centre for management advice. Recently this system has been used to send a weekly educational programme (CT and magnetic resonance imaging neuroradiology cases) to district general hospitals.
A comparison of radiation dose in examination of the abdomen using different radiological imaging techniques
Authors: Marshall N W , Faulkner K , Busch H P , Marsh D M , Pfenning H
Published: July 2009

Typical radiation doses for abdominal examinations were determined for field sizes and entrance doses commonly selected on image intensifier based digital radiographic systems. In addition, measurements were also performed using conventional film–screen methods, a 100 mm camera combination and a phosphor storage computed radiography system. Both antero-posterior and postero-anterior projections were assessed. An anthropomorphic phantom loaded with lithium fluoride thermoluminescent dosemeters was used to measure entrance surface doses. Organ equivalent doses, deduced using normalized organ dose data, were used to calculate effective dose and effective dose equivalent. A comparison of the imaging techniques on the basis of effective dose indicated that significant dose reductions (by approximately a factor of 3) may be expected if the abdomen is imaged using a postero-anterior rather than an antero-posterior projection for a given imaging system. If digital imaging systems are used instead of a conventional film–screen technique,patient effective dose for a given projection can be lower by at least a factor of 5.
Book review
Authors: Bentley B
Published: July 2009

This is the fifth edition of a very well known and respected text. Reviewing this book stimulated me to look back at the original concept. How things have changed since the first edition in 1969. That consisted of 1160 pages by 18 contributors with a 25 page index. It was sold at £15 and its title omitted “imaging”.

The fifth edition comprises 1587 pages in two volumes with 38 authors, a 76 page index and comprehensive references. It is fascinating to compare the two, and it emphasizes the enormous changes that the last 24 years have brought to our specialty.
Rectal infarction after abdominal aortic surgery
Authors: Mackay C , Murphy P , Rosenberg I L , Tait N P
Published: July 2009

Full thickness ischaemic colitis complicates approximately 1–2% of abdominal aortic procedures. Ligation of the inferior mesenteric artery and hypotension are recognized as causative factors. It is not, however, widely appreciated that ischaemic proctitis may also rarely complicate aortic surgery, especially after complex procedures or if there has been additional interruption to the internal iliac circulation. We report a case of rectal necrosis following repair of a thrombosed aortic aneurysm in which plain X-ray appearances aided the diagnosis.
Salvage fractionated high dose rate afterloading brachytherapy in the treatment of a recurrent tumour in the middle ear
Authors: Hammer J , Eckmayr A , Zoidl J P , Moser G , Seewald D H , Track C
Published: July 2009

Re-irradiation of previously irradiated head and neck sites is associated with a high complication rate. In an attempt to reduce this complication risk, multiple fractions of high dose rate (HDR) intracavitary irradiation were used in a young patient who had developed recurrent transitional cell carcinoma in the tympanic cavity one year after radical radiotherapy. After gross surgical removal of the tumour, an afterloading probe was placed into the middle ear by a surgical approach. In 11 treatments of 3 Gy each over 4 days, a total dose of 33 Gy was delivered to a spherical volume, 1.7 cm in diameter. The patient was 24 months free of disease at the start of 1993. Audiometry shows no severe deterioration of hearing. We concluded that fractionated HDR brachytherapy can be used to achieve local control in small volume recurrences at previously irradiated sites, without the inevitability of complications.
A pensioner's plight
Authors: Fields J M , Hawthorn A B , Zammit-Maempel I , Thomas N
Published: July 2009

A 69-year-old man was admitted for investigation of a swollen, painful left leg present for 1 year. He had suffered three episodes of rigors. 4 years previously he had had a Dacron aortic bifurcation trouser graft inserted, from below the renal arteries to both common femoral arteries, for a dissecting abdominal aortic aneurysm. On examination there was a generalized increase in size of the left leg which was warmer than the right leg. There was a small effusion in the left knee joint. In view of these symptoms and his past medical history, plain radiographs of the left ankle (Figure 1)and subsequently a dynamic computed tomography(CT) scan of the abdomen (Figure 2) were performed.
The selection of age groupings for the results of radiation dose surveys in paediatric radiology
Authors: Gallacher D J , Baldock C
Published: July 2009

We have read with interest the recent paper in the September issue by Chappie et al [1] and also their previous paper [2] on doses to paediatric patients undergoing radiological examinations. In both of these papers the age groups chosen to present the survey data were as follows: less than 1 year, 1–5 years and 6–18 years.

When presenting the results of patient dose surveys in paediatric radiology it is necessary to sort the dose survey data into distinct age bands because the different age ranges correspond to certain ranges of body size and weight. Body size will affect the dose received in any given radiological procedure.
The safety of outpatient arteriography using 3F catheters
Authors: Reidy J F , Ludman C
Published: July 2009

We are very pleased to have the chance to clarify and enlarge upon the practical aspects of using 3F catheters for intraarterial digital studies. There are of course limitations of 3F catheters and we have not denied that there have been some problems with the 3F catheter sets.

In our technical note we detailed limitations of 3F catheters but despite this we feel that they have significantly reduced the invasiveness of the procedure and now allow us to carry out virtually all arteriography for peripheral vascular disease and renovascular disease as a true outpatient procedure.
Cellular sensitivity and low dose-rate recovery in Fanconi anaemia fibroblasts
Authors: Burnet N G , Wurm R , Tait D M , Peacock J H
Published: July 2009

Fanconi anaemia (FA) is a rare inherited condition characterized by developmental abnormalities and progressive bone marrow failure, which requires bone marrow transplantation for successful treatment. This involves the use of alkylating agents and total body or thoraco-abdominal irradiation. Both chemical clastogens and irradiation cause increased chromosome damage in FA cells compared with controls. In some studies FA fibroblasts have been found to be more radiosensitive than normal. From these data it has been inferred that patients with FA might be more sensitive than normal to radiotherapy. However, increased radiosensitivity of FA fibroblasts has not been a uniform finding. The radiosensitivity of fibroblasts from two FA patients was studied at high and low dose-rate (LDR), and their sensitivity compared with normal strains. Both FA strains fell at the sensitive end of the range, but both demonstrated marked dose-rate sparing, with D0.0l recovery factors of 1.23 and 1.27, similar to the normal strains. These recovery factors are inconsistent with the suggestion that FA patients are recovery deficient. The data indicate that at least some FA strains are capable of LDR recovery, and imply that these patients would probably have a clinical benefit from fractionated or low dose-rate total body irradiation.
Cachexia of the kidney—a cause of pseudo-hydronephrosis
Authors: Kedar R P , Collins C D , Cosgrove D O
Published: July 2009

Various pitfalls in diagnosing early hydronephrosis on ultrasound (US) have been recognized. We present a case where the appearances on US mimicked bilateral hydronephrosis in a patient undergoing treatment for recurrent colonic carcinoma. Comparison with a previous ultrasound examination demonstrated marked loss of renal sinus fat. Doppler studies demonstrated normal venous flow within each portion of the “dilated collecting system”. In oncology, renal cachexia should be remembered as one of the causes of pseudo-hydronephrosis.
Magnetic resonance imaging of agarose gel phantom for assessment of three-dimensional dose distribution in linac radiosurgery
Authors: Rousseau J , Gibon D , Sarrazin Th , Doukhan N , Marchandise X
Published: July 2009

An agarose gel phantom is used to evaluate the spatial distribution of the dose delivered by a linac radiosurgery device. Dependence of the absorbed dose on the T  1 relaxation time is checked. T  1 magnetic resonance images show the close correspondence between the actual absorbed dose distribution and the dose distribution expected by the treatment planning.
Necklace calcification in an infant: a sign of hypoxia; not of strangulation
Authors: Higgins J N P , Shaw D G
Published: July 2009

We read with great interest the paper by H Carty [1] describing necklace calcification in an infant but where she seems to imply direct trauma as the cause we would suggest an alternative explanation.
Organ absorbed doses in intraoral dental radiography
Authors: Ramsey L J
Published: July 2009

I refer to the interesting and useful article by Lecomber and Faulkner [1]which appeared in the November 1993 issue of the BJR.

However, some statements on the subject of the radiographic technique used and the consequent radiographic quality appear to be incorrect.

They state that the use of a bisected angle technique “will produce an isometric image on the film free from distortion”.

If it is agreed that distortion means a different degree of magnification of the image from one part to another then with any angle (excepting only 0 or 180 degrees) between film and tooth no manipulation of the central ray angulation will produce an undistorted image.
Book reviews
Authors: Williams M P
Published: July 2009

This is a collection of 30 monographs, contributed by members of the Fleischner Society. It is not a comprehensive text, but aims to be a “distillation of up-to-date information on selected topics of current interest”.
Cell survival measurements in an argon, aluminium and sulphur filtered neutron beam: a comparison with 24 keV neutrons and relevance to boron neutron capture therapy
Authors: Mill A J , Morgan G R , Newman S M
Published: July 2009

Boron neutron capture therapy (BNCT) has been advanced as a suitable alternative therapy for the treatment of glioma. BNCT involves the selective uptake of a tumour with a boron-bearing substance and subsequent irradiation with a beam of neutrons. Previous attempts with BNCT have utilized thermal neutrons, but this involves resection of the scalp prior to treatment and is only possible with superficial tumours. An alternative is to use a beam of intermediate-energy neutrons which will produce a peak in the thermal neutron fluence at depth in tissue and so enable deep-seated tumours to be treated. A neutron beam with a mean energy of ∼ 9 keV, obtained by filtering neutrons from a reactor with aluminium, argon and sulphur, has been used to explore the radiobiological advantage over thermal and 24 keV neutrons for BNCT. Irradiation of V79 and HeLa cells at various positions in a polythene phantom suggest that the beam is less cytotoxic for a given neutron fluence than the 24 keV neutron beam previously considered as an alternative to thermal neutrons for BNCT. However, optimization of boron distribution via the development of new compounds still appears to be necessary for BNCT to become a safe alternative option for the treatment of glioma.
Outcome of 249 patients attending a nuclear medicine department with well differentiated thyroid cancer; a 23 year review
Authors: Critchley M , Balan K K , Raouf A H
Published: July 2009

We have written a review paper in which we presented the results of 23 years' experience. It was not intended to be an experimental study aimed at evaluating a hypothesis.
Book reviews
Authors: Banerjee A K
Published: July 2009

This volume is the latest in the Yearbook series on diagnostic radiology. The editors have selected a wide range of articles from a range of journals listed in the beginning and summarized these with accompanying comments. There are sections on the chest, cardiac radiology, neuroradiology, the musculoskeletal system, the abdomen and paediatric radiology.
Technetium-99m hexamethylpropyleneamineoxime labelled leucocyte scanning in the initial diagnosis of Crohn's disease
Authors: Malcolm P N , Bearcroft C P , Pratt P G , Rampton D S , Garvie N W
Published: July 2009

The technetium hexamethylpropyleneamineoxime labelled white cell scan (WCS) is not widely used as a screening test for Crohn's disease primarily because, though sensitive, it is perceived as being insufficiently specific. A series of 42 patients screened for Crohn's disease by this method was analysed retrospectively. The sensitivity was 100% and specificity 91%. This performance was maintained in a subgroup of these patients with very low prevalence of disease. If appropriate criteria for interpretation are used the WCS is a specific as well as a sensitive screening test for Crohn's disease.
Is there still a role for lymphography in the management of early stage carcinoma of the cervix?
Authors: Fernando I N , Moskovic E , Fryatt I , Glaholm J , Blake P R
Published: July 2009

The value of lymphography in the management of carcinoma of the cervix is controversial and in many institutions has ceased to be used as part of routine staging. We present the results of 103 patients with carcinoma of the cervix treated by radical radiotherapy alone at the Royal Marsden Hospital between 1984 and 1990 all of whom had a staging lymphogram and computed tomography (CT) of the abdomen and pelvis as part of their routine staging prior to therapy. Our results show that 72 patients (70%) had no involved nodes detected on either CT or lymphography (LG − ve/CT − ve) while 16 patients (15.5%) were thought to have involved lymph nodes on lymphography alone but not on CT (LG + ve/CT − ve). The remaining 15 cases (14.5%) had involved lymph nodes on both CT and lymphography (LG + ve/CT + ve). There were no patients shown to have involved lymph nodes on CT with a negative lymphogram. Survival analysis on these three groups showed that patients in the LG + ve/CT + ve group did worse than the other two groups with only a 28% 5 year survival compared with 60% (LG − ve/CT − ve group) and 64% (LG + ve/CT − ve group) (p < 0.1). This effect of lymph node involvement disappeared in a multivariate analysis using Cox regression when stage came out as the strongest factor affecting survival. After controlling for stage, a further analysis of patients with only stage I and II disease has shown that patients who were LG + ve/CT + ve still did significantly (p < 0.05) worse (30% 5 year survival) than the other two groups: LG − ve/CT − ve (62% 5 year survival) and LG + ve/CT − ve (78% 5 year survival). The lymphogram result in the LG + ve/CT − ve group altered clinical management in 5/6 patients with stage I or IIA disease who avoided radical surgery and who were given a parametrial boost to the site of lymph node involvement. The possible benefit of this additional treatment to explain the higher survival rate of patients in the LG + ve/CT − ve group is discussed further. We conclude that lymphography still has a limited role to play in patients with early stage disease (I or IIA) who do not appear to have involved lymph nodes on CT scanning.
Recurrent upper tract urothelial tumours: the use of loopography following cystectomy for bladder cancer
Authors: Noble J , Amin Z , Kessel D , Rickards D
Published: July 2009

Recurrent upper tract tumours following cystectomy for transitional cell carcinoma are not uncommon. Conventional follow-up to identify preclinical recurrent disease often involves a combination of excretory urography and urine cytology. This study investigates the possible advantages of loopography in the follow-up of these patients. 41 patients who had undergone cystectomy and ileal loop diversion for transitional cell carcinoma of the bladder were studied. At the time of evaluation with a loopogram, eight out of 41 (19.5%) were symptomatic. Loopography was well tolerated by all of the patients with no reported side-effects or complications from the procedure. Six out of 41 (14.6%) of the loopograms demonstrated an abnormality with recurrent transitional cell carcinoma identified in two patients. In only one case was excretory urography necessary where a ureteric stricture prevented retrograde imaging of the upper tract. Loopography is a safe and well-tolerated investigation for the follow-up of these patients. Excretory urography should be reserved for cases where upper tract imaging is impaired because of obstruction within the loop or ureters.
Non-invasive assessment of diffuse liver disease by in vivo measurement of proton nuclear magnetic resonance relaxation times at 0.08 T
Authors: Keevil S F , Alstead E M , Dolke G , Brooks A P , Armstrong P , Farthing M J G
Published: July 2009

44 patients with a range of parenchymal liver diseases diagnosed by biopsy or laboratory investigations underwent proton nuclear magnetic resonance (NMR) relaxometry of the liver at 0.08 T. T  1 maps were produced using an interleaved saturation recovery and inversion recovery sequence and T  2 maps using a four echo Carr–Purcell–Meiboom–Gill sequence. Significantly raised relaxation times compared with a previously studied group of 42 normal volunteers were found in groups of patients with alcoholic cirrhosis (p < 0.001 for T  1 and T  2), chronic active hepatitis (CAH) (p < 0.01 for T  1 and T  2) and minor liver abnormalities (p < 0.01, T2 only). T  1, was significantly higher in cirrhotics than in patients with CAH (p < 0.002) and minor abnormalities (p < 0.001). This suggests a role for relaxometry in the confirmation of the presence of cirrhosis (sensitivity = 75%, specificity ≈ 97% taking T  1 > 266 ms as a positivity criterion). Reduced T  2 values were found in patients with liver iron overload prior to venesection (p < 0.001 versus normals, p < 0.02 versus venesected patients). Although this latter test has relatively low sensitivity and specificity, it may have a role in the monitoring of treatment for iron overload.
Mesenteric arterial rupture following blunt abdominal trauma: demonstration by computed tomography
Authors: Campbell R S D , Zammit-Maempel I
Published: July 2009

We thank O'Sullivan et al for their comments, and agree largely with the points that have been made.

With regard to CT examination of multitrauma patients; ideal techniques may not always be possible or indeed applicable, but may need to be modified in a given situation. In our case the CT scan demonstrated an extensive traumatic rupture of the thoracic aorta.
Book reviews
Authors: Williams J W
Published: July 2009

This book is intended primarily as a guide to normal radiological anatomy for medical students, although the authors feel that the book may also be of value to medical personnel working in the field of diagnostic imaging.
Book reviews
Authors: Padley S
Published: July 2009

This book is a revised translation of a German edition originally published and copyrighted in 1991. This English language version contains over 1000 illustrations divided into 12 well organized chapters. The great majority of illustrations are chest radiographs but there is ample correlation with other imaging modalities from bronchography to magnetic resonance scanning. The illustrations throughout are very high quality reproductions.
The relationship of pulmonary interstitial emphysema to subsequent type of chronic lung disease
Authors: Cochran D P , Pilling D W , Shaw N J
Published: July 2009

Chronic lung disease of prematurity (CLD) can be classified using the chest radiograph taken on day 28 into type 1 (homogeneous opacification) or type 2 (the presence of cystic change) and it has been suggested that the presence of pulmonary interstitial emphysema (PIE) leads to the development of type 2 CLD. To further study this relationship we examined the chest radiographs taken on days 1–7, 14, 21 and 28, of 202 infants treated at Liverpool Maternity Hospital between January 1980 and December 1989 who developed CLD. 39% (54/137) of infants who developed type 1 CLD had suffered from PIE compared with 78% (51/65) with type 2 CLD (p < 0.001). There was no difference in the incidence of PIE in infants who developed CLD and subsequently died compared with those who survived. In the infants who survived there was no significant difference in length of oxygen dependency between those who suffered from PIE (median 99 days oxygen dependent) and those who had no PIE (median 105 days). We conclude that the presence of PIE is associated with subsequent development of type 2 CLD but is not a prerequisite for this radiographic type of chronic lung disease. Of those infants who survive to develop CLD, the presence of PIE does not alter prognosis in terms of duration of oxygen dependency or mortality.
Computed tomography of suspected lumbar disc protrusion in a district general hospital: outcome of scanning at L3/4
Authors: Lord P
Published: July 2009

115 patients referred for computed tomography of suspected lumbar disc protrusion were surveyed retrospectively. In 42% of patients, signs and symptoms were clearly confined to the L5 or SI root; in these cases, an abnormality at L3/4 on computed tomography did not result in surgery at L3/4.
Should broadband ultrasonic attenuation be normalized for the width of the calcaneus?
Authors: Blake G M , Herd R J M , Miller C G , Fogelman I
Published: July 2009

Broadband ultrasonic attenuation (BUA) is a measure of ultrasound transmission through the calcaneus that is dependent on bone thickness as well as the density of scattering centres. This report examines whether the normalization of BUA (units dB MHz−1) for calcaneal width (nBUA: units dB MHz−1 −1) improves the discrimination of clinical studies. BUA and calcaneal width were measured in 200 women using a contact ultrasound (CUBA-Research) system and nBUA evaluated by dividing BUA by bone width. 150 subjects were early post-menopausal and the remaining 50 were osteoporotic women with confirmed vertebral crush fracture. The ability of BUA and nBUA to differentiate between the two groups of subjects was compared using receiver operating characteristic (ROC) analysis. The areas (and standard errors) under the ROC curves were 0.878 (0.033) for BUA and 0.910 (0.028) for nBUA. The difference (and standard error) between the areas under the ROC curves was 0.033 (0.026) and was not statistically significant.
Use of a double inversion recovery pulse sequence to image selectively grey or white brain matter
Authors: Redpath T W , Smith F W
Published: July 2009

The design of a double inversion recovery (DIR) sequence, to image selectively grey or white brain matter, is described. Suitable choice of inversion times allows either cerebrospinal fluid (CSF) and white matter to be suppressed, to image the cortex alone, or CSF and grey matter to be suppressed, to image the white matter. The DIR sequence was found to give clear delineation of the cerebral cortex.
Asymmetrical development of the gyri recti presenting as a suprasellar mass: case report and description of six further cases
Authors: Ward S C , Ahuja A , Ma H T G
Published: July 2009

Asymmetrical appearances of normal anatomical structures can sometimes mimic pathology. We present a case where asymmetry of the gyri recti was interpreted as a suprasellar mass on axial CT scanning. The true nature of the apparent abnormality was revealed by coronal magnetic resonance imaging (MRI). We also present six further cases where asymmetrical gyri recti were noted as incidental findings on coronal MRI scans. This is a common, but important, normal anatomical variant, which should not be mistaken for pathology.
Bowel infarction with splenic air embolism: computed tomography findings
Authors: Frola C , Cantoni S , Turtulici I , Loria F
Published: July 2009

Computed tomography (CT) is used increasingly as an early radiological examination in patients with suspected bowel infarction because it provides information about the intestinal wall, mesenteric circulation and peritoneal cavity [1,2]. Other disorders that present with similar symptoms such as intraabdominal abscess, pancreatitis and ulcerative colitis can be excluded [3]. CT can demonstrate small amounts of air within the bowel wall, in the spleno–mesenteric–portal venous system and in the peritoneal cavity, making it possible to differentiate portal venous gas from pneumobilia. The authors describe a patient in whom a specific diagnosis of bowel infarction was made on the characteristic CT findings. Furthermore, air embolism was observed in the splenic parenchyma. This finding has not been previously reported in bowel infarction or in any other abdominal disorder.
Book reviews
Authors: Cherryman G R
Published: July 2009

Once I understood the title I wanted to read this. I knew the methods of Talairach and Tournoux have been used by successive generations of neurosurgeons to plan operations and more recently by radiologists interested in brain function to interpret PET and MR images. Talairach and Tournoux believe that in order to understand the function of a structure and to explain the consequences of a lesion a reference system is needed to situate the structure within the entire brain mass. In Referentially Oriented Cerebral MRI Anatomy they have taken their own well rehearsed reference system and applied it to MRI imaging of cerebral grey and white matter.
Radiation dose to the lens from computed tomography scanning in a neuroradiology department
Authors: Maclennan A C , Hadley D M
Published: July 2009

The radiation dose to the lens was measured by thermoluminescent dosimetry on 194 patients undergoing routine head and neck computed tomography scanning in a neuroradiology department. The results are lower than previously reported: brain scans, mean value 5.1 mGy; orbital scans, mean value 18.5 mGy; and direct coronal pituitary scans, mean value 1.9 mGy. These lower values in axial brain scans are due to use of the supraorbital meatal baseline for radiographic positioning.
The effects of local X-irradiation on the distensibility of the rectum in rats
Authors: Tamou S , Trott K R
Published: July 2009

Proctometry was performed on female Wistar rats following irradiation of the rectum with single doses of 15, 18 and 22 Gy of X-rays. The results indicated a progressive increase in distensibility until week 29 after irradiation which was attributed to degenerative changes in the intestinal wall. A major factor which determines colorectal pressure is the neuromuscular activity, however, neuromuscular transmission was not affected by irradiation.
An aid to barium meal in the infant
Authors: Shaw D G
Published: July 2009

A simple aid to feeding babies contrast medium is discussed.
Book review
Authors: Hately W
Published: July 2009

This text, which runs to almost 400 pages, represents an excellent and highly detailed account of the ultrasound diagnosis of disease in both the intracranial and extracranial circulation. The physical and technical principles of Doppler ultrasound are clearly described with discussion of the relevant instrumentation. Basic anatomy and underlying haemodynamic considerations are well covered.
Renal transplant artery stenosis—three cases where magnetic resonance angiography was superior to conventional arteriography
Authors: Gibson M , Cook G , Gedroyc W M W
Published: July 2009

Stenosis of renal transplant arteries is a common cause of graft dysfunction and hypertension. Conventionally it is investigated by intraarterial digital subtraction angiography (IA DSA). Recently three-dimensional phase contrast magnetic resonance angiography (MRA) has been used successfully as a non-invasive method of assessing renal transplant arteries. We report three cases where MRA was superior to IA DSA in the detection of renal transplant artery stenosis.
Hepatocellular carcinoma diagnosed radiologically, treated by transcatheter arterial embolization and limited-field radiotherapy
Authors: Jackson J E
Published: July 2009

I was disappointed to read the case report by Le Pechoux et al [1] describing the radiological diagnosis of a hepatocellular carcinoma treated by transcatheter arterial embolization and limited-field radiotherapy. That the authors should have submitted this paper is bad enough, but for a reputable British journal to have accepted it is inexcusable. It is well known by radiologists that the majority of solitary hepatic tumours cannot be reliably diagnosed by radiological means alone and biopsy is mandatory in most patients. There are very few exceptions to this rule.

The tumour described by the authors of this paper is large and has a very well defined border. On computed tomography (CT) it shows early and marked contrast enhancement to a greater degree than normal hepatic parenchyma.