bluuebunny/crossref_metadata_2025 huggingface dataset:
Time- and dose-related changes in the white matter of the rat brain after single doses of X rays
Authors: Calvo W. , Hopewell J. W. , Reinhold H. S. , Yeung T. K.
Published: July 2009

Following the local irradiation of the rat brain with single doses of 17.5–25 Gy of X rays, necrosis of the white matter was seen after a latent interval of > 26 weeks. At 39 weeks and 52 weeks after irradiation the incidence of necrosis was doserelated. The doses associated with a 50% incidence of necrosis in the white matter (ED50) at these times were 23.45 ± 0.49 and 20.98 ± 0.91 Gy, respectively. At both these times the incidence of necrosis was higher in the fimbria than in the capsula interna and the corpus callosum. This reflects a variation in the latency time for the appearance of necrosis. Necrosis occurs earlier in the fimbria. In the corpus callosum and the capsula interna the latency times for the appearance of necrosis were also dosedependent. In the latent period prior to the onset of necrosis of the fimbria, a number of dose-related changes were seen in the vasculature and the associated astroglial cells. These changes, which included blood vessel dilation, blood vessel wall thickening, endothelial cell nuclear enlargement and the hypertrophy of perivascular astrocytes, were highly correlated and when combined appeared to represent a “unit of tissue injury”. The incidence and severity of this “unit of tissue injury” apparently increased with time after irradiation until necrosis ensued. These dose-related vascular/glial changes were preceded by a reduction in the endothelial cell and vascular density. No early changes were seen in the number of glial parenchymal cells.
Changes in relative biological effectiveness with depth of the Clatterbridge neutron therapy beam
Authors: Hornsey Shirley , Myers R. , Parnell C. J. , Bonnett D. E. , Blake S. W. , Bewley D. K.
Published: July 2009

We have measured the biological equivalence of the Clatterbridge neutron therapy beam [p(62)-Be] and the Hammersmith neutron therapy beam [d(16)-Be] using the mouse intestinal crypt assay. The ratio (NDR) of Clatterbridge neutron (n + γ) dose relative to Hammersmith neutron dose (n + γ) was found to be 1.2–1.13 over a dose/fraction range of 1.8–9 Gy at 2 cm deep in a Perspex phantom. It is shown that the effectiveness of the Clatterbridge beam was reduced with penetration into the phantom because of hardening of the beam to a maximum reduction of 11% at 12 cm deep in the phantom. The hardening of the beam with depth of penetration will need to be taken into account by clinicians in assessing the tumour dose and tissue tolerance. Relative biological effectiveness values for the Clatterbridge and Hammersmith neutron beams were also measured. All neutron doses for both Hammersmith and Clatterbridge beams are total doses (n + γ) which comply with the European protocol for neutron dosimetry and include the γ-ray component of dose.
An analysis of the changes to radiation dose distributions resulting from the use of simulator computed tomography
Authors: Redpath A. T.
Published: July 2009

The use of a radiotherapy simulator linked to a treatment planning computer to produce computed tomographic (CT) images for radiotherapy planning was described by Redpath and Wright (1985). The outlines of the external body contour and any inhomogeneous structures are extracted automatically from the CT image by a contouring algorithm available in treatment planning software. Experimental results with phantoms have shown this technique to be accurate to ±5 mm. Prior to the availability of CT images, the standard method of obtaining body outlines was to use the range finder on the simulator to measure the focus–skin distance at 10° intervals around the patient. These values were typed into a computer which produced a life-sized outline approximated by a polygon. The method was difficult to use when the range finder was pointing up from below the horizontal, and obviously gives no information on the positions of internal structures which have to be estimated from radiographs. Again, experiments with phantoms have shown this method to be accurate to ±20 mm in determining the body contour in the region accessible to the range finder. The contour was completed by relating its position with respect to the simulator couch top through knowledge of the depth of the isocentre and the antero-posterior separation of the patient.
An afterloading technique suitable for the oral cavity and oropharynx and capable of adaptation for use with remote afterloading units
Authors: Dawes P. J. D. K. , Gaffney C. C. , Jewers D. , Deans E. M.
Published: July 2009

Implantation of carcinomas of the tongue with radium 226 or its substitutes is a highly successful method of treatment (Paterson, 1963). The commonly used techniques have two disadvantages: first, they are not truly afterloading, and secondly, none of them is easily applied to tumours of the base of tongue. The loop technique described by Henschke et al (1963) is difficult to use in this area mainly because of the problems associated with afterloading the radioactive wire. A non-looping technique for interstitial implants of the base of tongue has been described by Vikram and Hilaris (1981), which is dependent on the fact that polyethylene softens when soaked in saline solution and can be punctured by fine needles to secure the “crossing” catheter with fine silk. However, this method is not satisfactory with the nylon tubes commonly used in the UK. The technique described below is simple and can easily be adapted for use with remote afterloading machines, using either iridium 192 or caesium 137.
Book reviews
Authors: Newman Hugh
Published: July 2009

This multi-author volume in the Recent Results in Cancer Research series addresses experimental and clinical aspects of hyperthermia in oncology.The preface is written in rather strange English, and does not really tell the reader what the book is about; nevertheless, this volume does provide a comprehensive review of the subject, which should prove useful to physicists, biologists and clinicians.
Ultrasound diagnosis of cholangiocarcinoma at the confluence of the hepatic ducts (Klatskin tumours)
Authors: Karstrup S.
Published: July 2009

The findings on ultrasound of 31 consecutive patients with pathologically proven Klatskin tumours are reviewed. In all patients, ultrasound disclosed dilated intrahepatic bile radicles and normal common bile ducts. A well defined, rounded, solid tumour mass was detected in 11 (35%) patients. Compared with the findings at surgery or autopsy, ultrasound disclosed eight of 12 tumours presenting as extraductal masses. In 16 patients with tumour growth predominantly along the bile ducts, ultrasound disclosed poorly demarcated echogenic tissue high in the hepatic hilum in four cases. In only two patients was it possible to detect tumour spread. Ultrasound-guided, fine-needle aspiration biopsy was performed in seven patients revealing malignant cells in five cases and fine-needle tissue biopsy was performed in two cases revealing malignant tissue. The presence of intrahepatic dilated bile radicles with normal-sized common bile ducts should raise the possibility of a high bile duct carcinoma. If a tumour lesion is detected we suggest the use of ultrasound-guided, fine-needle biopsy.
The radiobiology of 24 keV neutrons
Authors: Morgan G. R. , Mill A. J. , Roberts C. J. , Newman S. , Holt P. D.
Published: July 2009

HeLa human carcinoma cells and V79 Chinese hamster fibroblasts have been irradiated in vitro with a beam of neutrons with a nearly pure 24 keV spectrum. The relative biological effectiveness (RBE) of the filtered neutron beam relative to 60Co γ radiation was determined by irradiation of cell cultures “free-in-air”. The values obtained for the RBE at 37% survival were 5.8 ± 0.8, at a dose of 0.69 ± 0.06 Gy for the HeLa cells and 3.14±1.1 at a dose of 1.09 ± 0.091 Gy for the V79 cells. Cytogenetic analysis of the damage in irradiated V79 cells gave an RBE of 6.7±1.4. Irradiation in a polyethylene phantom markedly attenuated the beam's biological effect. For both cell lines 2 cm of polyethylene virtually eliminated cell killing. Addition of boron 10 to the medium led to increased cell killing and a value of 4 was obtained for the RBE of the 10B(n, α)7Li reaction in HeLa cells.
The interpretation of dose calculations and cell-survival measurements for the boron neutron capture therapy of brain tumours with 24 keV neutrons
Authors: Mill A. J. , Harrison K. G.
Published: July 2009

Monte-Carlo computer codes have been used to estimate the distribution of doses to borated and unborated tissues in head-sized phantoms when exposed to beams of 2 keV and 24 keV neutrons. For the application of such beams to boron neutron capture therapy (BNCT) these calculations show the superiority of 2 keV neutrons over 24 keV neutrons and the importance of using large-area beams. A 24 keV neutron beam has been used to irradiate HeLa cell cultures in vitro, with and without the addition of 10B, at various depths within a narrow polyethylene phantom. Survival data obtained from these experiments have been used to estimate depth-damage profiles for normal (unboronated) and tumour (boronated) brain tissues when exposed to 24 keV neutrons. A good differential between damage to normal and tumorous tissue is obtained under suitable irradiation conditions. Although lower–energy neutrons are probably preferable, these results demonstrate the possibility of using beams of 24 keV neutrons for the BNCT of brain tumours.
Magnetic resonance imaging of hypothalamic hamartomas
Authors: Beningfield S. J. , Bonnici F. , Cremin B. J.
Published: July 2009

Hamartomas of the hypothalamus are congenital neuronal malformations, usually of the tuber cinereum, that extend postero-inferiorly into the interpeduncular cisterns. The tissue consists of normal neural elements in normal proportions. Developmentally, the tissue displacement probably arises when the ventral aspect of the neuraxis is approaching the anterior tip of the notochord in the 5th to 6th week of fetal life (Diebler & Ponsot, 1983). These lesions of the hypothalamic region usually present as either true isosexual precocious puberty at a young agge or as seizures and behavioural problems. Both presentations may be combined. The seizures may take the form of gelastic epilepsy in which clonic facial grimaces are accompanied by bubbling or laughing noises.

Precocious puberty in children is a complex problem. It may be central (hypothalamic–pituitary) or peripheral (due to gonadal or other causes unrelated to the hypothalamic–pituitary system) in origin.

Indications about which type exists will come from the clinical examination and hormonal/steroid studies. If peripheral precocious puberty is present, the radiologist will be required to examine the abdomen to exclude adrenal or ovarian causes (Rieth et al, 1987). If central, then the best methods are computed tomography (CT) or magnetic resonance imaging (MRI) to exclude malformations, cysts or tumours in the hypothalamic region.

A 26-month-old black boy was presented by his mother who had noticed that the child had had a large penis and scrotum since birth.
Gastro-oesophageal leiomyoblastomas and multiple pulmonary chondromas: an incomplete variant of Carney's triad
Authors: Mazas-Artasona L. , Romeo M. , Felices R. , Criado P. , Espinosa H. , Yanguela J. , Peiron M. J.
Published: July 2009

It is unusual for two tumours of completely different origins to occur simultaneously in the same patient. Such an occurrence was described in 1969 when the association of a gastric tumour and a pulmonary hamartochondroma was noted (Vio et al, 1969). In 1977, Carney et al described four patients with co-existing gastric epithelioid leiomyosarcomas (leiomyoblastomas), pulmonary chondromas and functioning extra-adrenal paragangliomas and suggested their occurrence together should constitute a syndrome (Carney et al, 1977; Carney, 1979).

Since 1974, a number of cases have been reported showing some or all of the features of Carney's triad. Most of these patients have presented because of gastric tumours which are in most cases either leiomyoblastomas (Muller et al, 1974; Appelman & Elwig, 1976; Carney et al, 1977; Tisell et al, 1978; Knake & Gross, 1979; Grace et al, 1981; Cuilleret et al, 1984; Mishkin et al, 1985) or leiomyosarcomas (Chander et al, 1981; Dajee et al, 1982; Chahinian et al, 1983). Pulmonary chondromas are the second most common component of the syndrome and paragangliomas the least common, possibly because the latter tend to appear late.

We present a case of a 12-year-old girl with multiple gastric leiomyoblastomas and pulmonary chondromas. So far, after 6 years follow-up, a paraganglioma has not been detected. This patient is an example of an incomplete Carney's triad.

A 12-year-old girl was admitted to hospital in 1980 for investigation of possible pulmonary hydatid disease discovered on routine examination by her GP.
The aortic pole
Authors: Wright J. F. C. , Vassallo D. J. , Dundas D. D.
Published: July 2009

An 81-year-old Polish gentleman underwent emergency repair of a leaking abdominal aortic aneurysm with a straight-woven Dacron graft. A large left-sided retroperitoneal hacmatoma was noted at that time. Eight days post-operatively, he developed a pyrexia and left-sided abdominal tenderness. Ultrasound demonstrated a fluid collection in the retroperitoneum anterior to the psoas muscle and inferior to the lower pole of the left kidney. A needle aspirate of this revealed blood-stained fluid and Bacteroides were cultured from both this specimen and venous blood.
Biological equivalence between fractionated radiotherapy treatments using the linear-quadratic model
Authors: Deehan C. , O'Donoghue J. A.
Published: July 2009

In the linear-quadratic (LQ) model the parameters α and β, usually appearing as the ratio α/β, are used to describe the response of normal tissues to radiation insult. Different radiation-induced biological end-points in specific tissues and organs are associated with characteristic α/β ratios (Barendsen, 1982; Thames et al, 1982; Fowler, 1984). Although the α/β ratios for human tissues are not well defined, in contrast with those derived from animal experiments, the LQ model has been used clinically to address questions relating to changes in fraction size and number. An example of such a question is: if a commonly used treatment schedule is replaced by another with dose fractions of different size, what total dose should be given? The LQ model can be used to calculate a total dose which makes the two schedules equivalent for some particular biological end-point. For other biological end-points the two schedules will not be equivalent.

The approach outlined above involves a choice of options, since each value of α/β gives rise to a different prediction of total dose. In the simplest case, where only the broad categories of acute and late normal tissue responses and effects on tumours are considered, three alternatives exist. The necessity to choose between options in questions of schedule equivalence is a consequence of using any “tissue-specific” isoeffect model and is not unique to the LQ model.

The question addressed in this paper is: can alternative treatments to a particular fractionated schedule be found which are equivalent for all biological end-points, i.e. are there generally-equivalent treatments?
The measured height of the lumbosacral disc
Authors: Stabler John
Published: July 2009

In their paper on lumbar disc heights, Nicholson et al (1988) give average measurements and standard deviations to within one-hundredth of a millimetre.
Book reviews
Authors: Dawson P.
Published: July 2009

This lavishly illustrated book, running to some 700 pages, is a six-author work from Duke University Medical School. It is the second edition of an established work and is now very comprehensive, having been expanded to take account of the development of digital angiography, the introduction of new angiographic contrast agents and the blossoming of interventional angiography.
Book reviews
Authors: Weir J.
Published: July 2009

This multi-author work containing articles from America, Britain and Europe comes from the internationally known Thoraxcenter in Rotterdam. Its parentage should therefore be unimpeachable, but unfortunately there is little actual input from the Center itself and none at all from the editor. The work is divided into three sections: contrast echocardiography, tissue characterization and left ventricular function.

Contrast echocardiography began in the late 1960s using iodocynanine green and had a vogue in the late 1970s and early 80s before the advent of Doppler ultrasound.
Book reviews
Authors: Hansell D.
Published: July 2009

This slim collection of multiple-choice questions is one of a growing number available to the haunted Final Fellowship candidate. The book is divided into 10 papers of 30 questions. There are a few extremely brief explanatory notes in the answer section but most questions are merely annotated true or false.
Book reviews
Authors: Lord Brian I.
Published: July 2009

“No wrecks and nobody drownded …

This book publishes the main papers presented at the 1987 UCLA Symposium on Recent Advances in Leukaemia and Lymphoma. At nearly 600 pages and 53 articles, the book is too big to pick out individual papers. It is, however, of a uniformly high standard and provides a comprehensive coverage of the subject. It includes cytogenetic studies, viral leukaemogenesis, the haemopoietic growth factors and interleukins, a section on cell culture and stem cells and a final one on gene transfer. While a further section on clinical aspects and therapy is included and some of the problems of diagnosis and prognosis are discussed, there is little nourishment for the physician trying to cure patients.
Book reviews
Authors: Owen J. P.
Published: July 2009

The title of this little soft-backed book betrays its North American origins to any British reader. It is a delightful, profusely illustrated synthesis, full of concentrated wisdom.

Dr Landay has aimed his text at physicians, medical students and other health professionals. To any radiologist who regularly involved in a similar spectrum of teaching it will clear that the book is not totally suited to all its intended recipients. Physicians, surgeons and trainee radiologists — yes, but for undergraduate medical students — no. It relies on certain level of knowledge and experience that these students do not possess.
Book reviews
Authors: Dick Robert
Published: July 2009

Unfortunately, I cannot enthuse about this book edited by three North American radiologists. Its stated main goal is to provide a concise practical guide to biopsy, aspiration and drainage for the practising radiologist. In effect, the advice is often too concise and insufficient emphasis is placed on possible severe complications of procedures.

The first and longest chapter is the best, covering general considerations of percutaneous biopsy and drainage. Many of Book reviews the biopsy instruments and drainage sets used in the UK are included.
Book reviews
Authors: Berry R. J.
Published: July 2009

This book is well titled, as Richard Mould is, among scientists, an outstanding story teller. He has used his personal links within the Soviet Union to assemble what must be the definitive collection of photographic records of the response to the Chernobyl nuclear accident. In his preface he states that his objective was to produce an historical account of what happened before, during and after the accident, rather than embroiling himself in the political issues of the implications of the Chernobyl accident for future exploitation of nuclear power.
Book reviews
Authors: Savage John R. K.
Published: July 2009

This report aims to provide a comprehensive data base and dose assessment for exposure to radiation of the population of the USA. Every possible significant source has been considered and evaluated in making estimates and drawing up tables. These sources have been included within one of six categories which form the major sections of the report. Sandwiched between an Introduction and a Summary and Conclusions, the sections are as follows:

“Public Radiation Exposure from Natural Background”; dealing with naturally occurring radionuclides in the environment, external cosmic radiations and natural isotopes in the body.
Book reviews
Authors: Blake Peter
Published: July 2009

This short book concerning the diagnosis and management of mesothelioma is timely as the incidence of asbestos-related tumours is increasing. An initial chapter on epidemiology, pathogenesis and pathology describes the different types of asbestos and the relationship of this both to mesothelioma and carcinoma of the bronchus.
Technetium-99m hydroxymethylene diphosphonate scanning of acute injuries to the lateral ligaments of the ankle
Authors: Maurice Hugh , Watt lain
Published: July 2009

Technetium-99m hydroxymethylene diphosphonate scans were performed on 29 consecutive patients with acute ankle ligament injuries. Scanning reliably differentiated a severe from a minor injury. Severe injuries gave a diffuse uptake on the scan and the minor injuries a more localized increase in uptake.
Polyorchidism diagnosed by ultrasound
Authors: Cadigan P.
Published: July 2009

Polyorchidism is a rare condition of uncertain embryological origin. It is most often diagnosed as an incidental finding in young males undergoing repair of an inguinal hernia (Sujka et al, 1987).

We report a case presenting as an intermittently painful scrotal swelling which was diagnosed preoperatively by ultrasound. Although the ultrasound findings in polyorchidism have been described preoperatively twice before (Rifkin et al, 1983; Goldberg et al, 1987), to our knowledge this is the first such report from Britain.

A 21-year-old man presented with a history of intermittent pain in the left testicle for 1 year. Examination revealed what was thought to be a swelling below the left testis and the patient was referred for ultrasound examination.
Late normal tissue reactions in patients with breast carcinoma
Authors: Bates Thelma D. , Scott O. C. A.
Published: July 2009

We agree with Dr Tomlinson's algebra, but we question her conclusion. She points out that an assumed α/βratio of would correctly predict the direction of the difference in observed normal tissue response for γrays and X rays. However, any value of α/βgreater than −0.7865 and less than 9.35 would lead to the same predictions.
Diagnostic radiation, pregnancy and termination
Authors: Russell J. G. B.
Published: July 2009

If a pregnant woman is exposed to diagnostic ionizing radiation, the possible sequelae may give cause for concern to the parents and to the medical advisors. If the exposure occurs in the first half of the pregnancy the question may arise as to whether the pregnancy should be terminated. To help allay these worries the Radiation Protection Committee of the British Institute of Radiology (BIR) issued a statement in 1973 expressing the consensus of national and international experts. This indicated that exposures of 100 mGy or less to the uterus did not justify abortion on radiological grounds.
Costing imaging procedures
Authors: Bretland P. M.
Published: July 2009

Dr Russell is quite right to suggest that an element representing in financial terms the harm done by ionizing radiation should be added to the costs of imaging procedures, but it is a different kind of cost, calculated in a different way.
Radiological evaluation of temporal bone disease: high-resolution computed tomography versus conventional X-ray diagnosis
Authors: Fritz P. , Rieden K. , Lenarz T. , Haels J. , Winkel K. zum
Published: July 2009

Sixty-two patients with different temporal bone lesions were prospectively examined by high-resolution computed tomography (CT) and conventional plain radiography, including pluridirectional tomography. High-resolution CT enabled aclear diagnosis in 80% of cases, conventional radiology in 63%; 1.6-times more bone information was recorded by high-resolution CT which is clearly superior for imaging cholesteatomas, metatastases and inflammatory processes and for evaluating osseous destruction. With regard to pathological soft tissue or effusions filling the tympanic cavities, conventional radiology shows poor sensitivity (0.61). High-resolution CT is the most sensitive method for the imaging and classification of temporal bone fractures,including labyrinthine damage and ossicular chain injuries. Only in cases of atypical fractures with an unfavourable relationship to the CT planes, can carefully directed tomography be more effective. In most cases high-resolution CT replaces conventional radiology and should be the method of choice for comprehensive radiological examination of the temporal bone.
Patient doses from computed tomography in Manitoba from 1977 to 1987
Authors: Huda Walter , Sandison George A. , Lee Ting Y.
Published: July 2009

The number of patients undergoing computed tomographic (CT) examinations in the province of Manitoba is reported for the period 1977–1987. The annual patient throughput has increased from 4.2 per 103 population in 1978 to 18.2 per 103 population in 1987. Over the same period, the per capita population dose from CT has increased from 4.2 to 81.0 μSv. This substantial rise has occurred because of an increase in patient throughput, higher radiation doses associated with modern CT scanners and an increasing proportion of (higher dose) body CT studies. The mean patient dose on a second generation (EMI 5005) scanner was about 1.4 mSv, whereas the corresponding doses on third generation scanners operating in Manitoba were 3.9 mSv (GE 9800) and 5.6 mSv (Siemens DRH).
Possibility of retrospective dosimetry for persons accidentally exposed to ionizing radiation using electron spin resonance of sugar and mother-of-pearl
Authors: Nakajima Toshiyuki
Published: July 2009

An electron spin resonance (ESR) dosemeter was used to measure ESR absorption spectra of sugar and shell buttons made of mother-of-pearl, for the purpose of evaluating the external dose to exposed inhibitants in the vicinity of a radiation accident. The ESR absorption intensity of sugar was proportional to dose in the range from about 30 mGy to 6×l04 Gy. The lifetime of the free radical created in both sugar and shell buttons by radiation was stable for at least 6 months after irradiation. If sugar and shell goods left in or around houses since the occurrence of the Chernobyl reactor and the Brazilian accidents were obtained, it would be possible to estimate from them the integrated external dose to exposed people.
Autopsy assessment of the Gunther vena caval filter
Authors: Mahendran M. , Gwilt D. J. , Finch O. P. Fitzgerald , Jalloh S.
Published: July 2009

The Gunther vena caval filter has been in clinical use forsome years. Accounts of findings at post-mortemexamination in animals are available (Gunther et al,1985), but there are no detailed human autopsy reports.

We describe the findings at post-mortem examinationof a patient who had a filter inserted 2 months prior toher death.

A 63-year-old lady had a history of recurrent deep venous thrombosis and pulmonary embolism, despite long-term anticoagulation therapy. She also had severe osteoarthritis of her hips, worse on the left, and needed a total hip replacement.
Book reviews
Authors: Cundall B.
Published: July 2009

As the title states, the book covers three topics: microwave radiation, light derived from sources other than lasers, and finally, lasers and their applications. The book is written by a medical physicist and the text is specifically directed towards those who work or have concerns in this area.

For each of the above topics, the underlying physics of the radiation and its means of generation are discussed.
Book reviews
Authors: Bradshaw John R.
Published: July 2009

This book is based on the author's personal experience of more than 5000 documented cases studied with a 0.6 T superconducting MRI system in Amsterdam.

A very brief summary of the basic physical principles of MRI is followed by a useful description of various technical considerations such as pulse sequences; some anatomical structures displayed by them; tissue differentiation; artefacts; flow phenomena and surface coils. A short section on MRI studies of special regions such as the pituitary follows. The 14 subsequent chapters cover all the major disease processes and include affections of the brain, orbit, larynx, neck and temporomandibular joints. Spinal disorders and the use of contrast agents are also covered.
Book reviews
Authors: Valentine A. R.
Published: July 2009

This book is basically in two parts. The first 35 pages present a discussion of the physics of NMR, while the following 90 pagescomprise an atlas of head and neck images. The book is handsomely presented, but the images, which are produced from a 0.35T superconductive system, whilst of reasonable standard, are not of the highest quality currently available. They are exclusively spin-echo sequences, and tissue contrast could have been increased with alternative sequences.
Book reviews
Authors: Hill C. R.
Published: July 2009

Until very recently it would have gone without saying that angiography was exclusively an X-ray based technique. The development of flow-sensitive NMR imaging sequences has been one factor in altering that perception but what now seems likely to be a much more powerful and versatile tool in the investigation of the vascular system is being provided by ultrasound. The use of the Doppler frequency shift for observing blood flow is an old trick, but two comparatively recent developments have enabled that phenomenon to be exploited in a manner that is clinically practicable in a wide range of applications.
Radiobiological assessment of permanent implants using tumour repopulation factors in the linear-quadratic model
Authors: Dale R. G.
Published: July 2009

By combining existing linear-quadratic equations relating to decaying-source therapy with an assumed tumour repopulation factor, it has been possible to devise a method for the radiobiological assessment of permanent implants. For calculation purposes there is a time after which an implant can no longer be considered effective in sterilizing tumour cells. This “effective” treatment time for a permanent implant can be approximately defined in terms of the radionuclide decay constant, the potential doubling time, the initial dose-rate and the value of α in the tumour α/β ratio. The analytical technique has been applied to a specific intercomparison of commonly encountered implants using 125I and l98Au, and suggests that, even in the most favourable cases, the former radionuclide offers few radiobiological advantages. Although not specifically discussed here, the method can also be applied to the assessment of various forms of biologically targeted radiotherapy.
Outpatient myelography: an acceptable and cost-effective technique
Authors: Choudhri A. H. , Rowlands P. C. , Barber C. J. , Johnson J. , Stevens J. M.
Published: July 2009

Sixty-five patients with stable low back pain had their lumbar myelography performed as outpatients, staying in the department for 1 h after the examination. The incidence of post-myelogram headache was similar to that reported for inpatients. No serious after-effects occurred in the study group. The vast majority of patients preferred to be at home following the study. It is concluded that outpatient myelography is safe, less expensive and preferred by the patients.
A large trial of intravenous Conray 325 and Niopam 300 to assess immediate and delayed reactions
Authors: McCullough Mark , Davies Peter , Richardson Ros
Published: July 2009

The trial was designed as an investigation into the incidence of both immediate and delayed reactions to the intravenous administration of Conray 325 (sodium iothalamate) (844 patients) and Niopam 300 (iopamidol) (855 patients) for urographic examination. Information was obtained from questionnaires returned by patients about a week after their examination, with a response rate of 81%. Significant differences were found in the incidences of both types of reactions to the two media with respect to nausea and vomiting, arm pain, and taste in the mouth, which was commoner in patients receiving Conray 325, whereas the incidence of delayed skin rashes and parotid swelling was commoner with Niopam 300. The occurrence of a flu-like illness, so-called “iodism”, was found to be equal for the two contrast media.
Giant central disc prolapse: a pitfall in computed tomographic diagnosis
Authors: Buirski G.
Published: July 2009

The diagnosis of lumbar disc prolapse by computed tomography (CT) is now well established and is often the initial investigation in patients with sciatica (Buirski, 1987). Myelography, however, is still necessary when the CT findings do not correlate with the clinical features or when an intrathecal abnormality is suspected. Occasionally, giant extruded disc fragments may lie within the central spinal canal either above or below the adjacent disc level. If the central canal is totally occupied by the disc then the characteristic CT appearances of an extradural mass may not be readily apparent. The case reported below illustrates this problem and a useful radiological sign on CT is discussed.

A 26-year-old woman initially presented in April 1987 with back pain associated with walking. This was treated conservatively with anti-inflammatory drugs and physiotherapy with good symptomatic relief. In October she noted paraesthesiae in both feet and shortly after developed pain down the right thigh.
Demonstration of vertebral body end plate veins by magnetic resonance imaging
Authors: Saywell W. R. , Crock H. V. , England J. P. S. , Steiner R. E.
Published: July 2009

The venous drainage of the vertebral end plate capillary bed is via a plexus of post-capillary venules in the subchondral region, which drains into a horizontal subarticular collecting vein. This vein then joins the anterior internal vertebral venous plexus. There are also anastomotic connections through vertical tributaries to the basi-vertebral system of veins (Crock et al, 1973; Crock, 1983) (Fig. 1).

The end plate venous plexus may be important in the pathogenesis of symptoms in the syndrome of internal disc disruption, in which catabolites and disc proteins leak out of the disc into the systemic circulation via the end plate veins, producing local and systemic features of hypersensitivity reactions (Gurdjian et al, 1961; Nachemson, 1969; Crock, 1970). The plexus is also important in maintaining the integrity of the normal intervertebral disc, as diffusion of nutrients takes place across the end plates (Urban et al, 1976; Bernick & Caillet, 1982).

Although demonstrated in dogs and post-mortem specimens, the end plate veins have not previously been demonstrated by in vivo imaging.
Incorporating the time factor into the linear-quadratic model
Authors: van de Geijn J.
Published: July 2009

In recent years the linear-quadratic (LQ) model (Kellerer et al, 1971; Chadwick & Leenhouts, 1973) has become the model of choice for the description of single-dose radiation damage in in vitro as well as in vivo biological systems. This model has been used to describe both tumour and normal-tissue responses to fractionated radiotherapy and continuous lowdose-rate irradiation. A useful overview can be found for instance in Thames and Hendry (1987), which also contains further references. In particular, work by Douglas and Fowler (1976), Thames et al (1982) and Barendsen (1982), and more recently by Dale (1986a, b; Dale et al, 1988) has been of great influence.

A potential shortcoming of the LQ model as it is presently used is the inability to address the issue of proliferation during treatment of both tumour cells and early reacting normal tissues. In a recent paper (van de Geijn, 1988), a new model was introduced that also describes damage to both tumours and early reacting (ER) normal tissues to fractionated radiotherapy, in terms of either the two-component or the linear-quadratic model, but with the added advantage of incorporating the effects of proliferation and time.
Book reviews
Authors: Leech Graham J.
Published: July 2009

This book aims to provide a basic primer in the clinical applications of Doppler ultrasound in cardiology. To understand how Doppler ultrasound is used to measure blood velocity and, in particular, to appreciate its limitations, requires some appreciation of the physical principles of the method. Thus, many clinicians find the opening chapters of texts on Doppler rather daunting. To try to overcome this difficulty, the authors have compressed the discussion of blood flow and the theory of continuous-wave and pulsed Doppler into a total of eight pages. The problem is that this leaves several aspects unmentioned and what is provided contains half-truths and even fallacies.
Book reviews
Authors: King D. M.
Published: July 2009

In considering the choice of new textbooks for the departmental library the average United Kingdom radiologist, working with diminishing budget and increasing prices, may be forgiven for quickly dismissing a 228-page textbook concerned solely with transrectal ultrasound of the prostate. Thirty per cent of males over the age of 50 will, however, show latent carcinoma of the prostate and perhaps radiologists should be taking both this disease and its method of imaging more seriously.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

These two companion volumes provide an anatomical atlas based mainly on computed tomography but also including some magnetic resonance images. There are clearly annotated line drawings on the pages facing the images. The illustrations are uniformly clear and large. Where appropriate, scout views show the sectional level of the CT scans. There is a good balance between unenhanced and contrast-enhanced scans. A useful feature is the explanatory notes which advise on positioning and scanning technique.
Book reviews
Authors: Hansell David
Published: July 2009

This is the second edition of a book which first appeared in 1979. Comparing the list of chapters of the two editions, there has been a considerable shift in the emphasis given to the various imaging techniques described. In their foreword to the current edition the editors contend that the newer techniques of ultrasound, computed tomography and magnetic resonance imaging have completely supplanted intravenous urography and arteriography in the detection of renal tumours. Indeed, intravenous urography does not seem to merit much attention anywhere in this edition and it is not even given an entry in the index; this is a sign of the times. All of the 23 contributors are either German or American. There is no noticeable repetition of material but the style of English is sometimes poor; on the first page there is a reference to bioptic material and other irritating examples of faulty anglicization are scattered throughout the book.
Book reviews
Authors: Pilling D. W.
Published: July 2009

This is the report of a WHO study group, consisting of some of the most eminent paediatric radiologists from around the world. Their brief was to try to establish how diagnostic imaging should be used in paediatrics, taking into account the widely differing resources available across the world.

Inevitably such a document cannot be too controversial, and whilst the reviewer would not accept all the statements made nor all the recommendations, most of the criticisms would be minor.
The localization of myocardial ischaemia with technetium-99m methoxy isobutyl isonitrile and single photon emission computed tomography
Authors: West D. J. , Najm Y. C. , Mistry R. , Clarke S. E. , Fogelman I. , Maisey M. N.
Published: July 2009

Thirty-two patients with suspected coronary artery disease were studied by single photon emission computed tomography (SPECT) imaging with oblique reconstructions of the myocardium following the intravenous administration of technetium-99m methoxy isobutyl isonitrile at peak exercise. All patients also underwent three-vessel coronary angiography. The SPECT technique produced very detailed images allowing easy delineation of localized myocardial defects. Segmental myocardial uptake defects were compared with diseased vessels as shown at angiography. A good correlation was shown between right coronary artery (RCA) disease and mid and proximal inferior segments and between left circumflex (LCx) artery disease and mid and proximal lateral segments, allowing accurate localization of a defect to one of these two vessels' territories. Sensitivity and specificity of detection of disease of the RCA and LCx artery were high. Defects associated with a lesion of the left anterior descending vessel were more variable.
Magnetic resonance imaging of the infant heart at 1.5 T
Authors: Smith M. A. , Baker E. J. , Ayton V. T. , Parsons J. M. , Ladusans E. J. , Maisey M. N.
Published: July 2009

Magnetic resonance (MR) has been found to be of value in many fields of medicine but has yet to find an established place in the study of diseases of the heart. Published studies of the heart have demonstrated its ability to identify areas of acute myocardial infarction (Been et al, 1985b) and old infarcts (Higgins et al, 1984b), to recognize hypertrophic cardiomyopathies (Been et al, 1985a), pericardial effusions (Stark et al, 1984) and constrictive pericarditis (Soulen et al, 1985). It is, in addition, possible to measure ventricular volumes (Longmore et al, 1985) and images containing blood-flow-related data can be acquired (Ridgway & Smith, 1986; Underwood et al, 1987).

Magnetic resonance imaging (MRI) has been suggested to have a particularly valuable role in the study of the anatomy of the congenitally malformed heart (Higgins et al, 1984a) and imaging studies of a limited number of cases have been published (Jacobstein et al, 1985a,b; Boxer et al, 1986; Didier & Higgins, 1986; Didier et al, 1986; Fletcher & Jacobstein, 1986; von Shulthess et al, 1986). However, in these studies from a small number of research centres there is very little experience in the use of MRI in infants. Since 90% of patients with congenital heart disease present in the first year of life (Hoffman & Christianson, 1978), if MRI is to play a role in the investigation of congenital cardiovascular abnormalities it is essential to be able to image infants within the first year.
Effect of cirrhosis on accuracy of 99Tcm-tin colloid scintigraphy and ultrasound scanning in diagnosis of hepatocellular carcinoma
Authors: Powell-Jackson P. R.
Published: July 2009

In reply to the letter of Goldfarb, Ongseng and Finestone, we have no evidence to support or refute the contention that the gallium–radiocolloid dual-tracer method is the most accurate, non-invasive imaging technique for HCC diagnosis. We would be interested to see their detailed results.
51Cr-EDTA/99Tcm-MDP ratio: a simple non-invasive method for assessing renal osteodystrophy
Authors: Nisbet A. P. , Shaw P. , Taube D. , Edwards S. , Maisey M. N. , Mashiter G.
Published: July 2009

We have used 99Tcm-MDP to develop a measure of overall skeletal activity for use in renal disease. The method utilizes the relative clearances of 99Tcm-MDP and 51Cr-EDTA from the blood after simultaneous injection. This is expressed as a ratio and the upper limit in normals is 1.4. This ratio has been evaluated in 42 patients with chronic renal failure and compared with appearances of left-hand radiographs. The ratio was elevated in these patients and the level corresponded to the degree of severity of the subperiosteal resorption. Similarly, there was a close correlation between the ratio values and the serum alkaline phosphatase measurements and parathyroid hormone values. Thirty-three patients had sequential studies performed at intervals of up to 2 years. Twenty-one patients showed no change on clinical, biochemical or bone scan evaluation. Of these, only one patient showed a change in ratio value of greater than 20%. Twelve patients showed evidence of change based either on clinical, biochemical or bone scan alteration and all 12 patients showed changes in ratio values greater than 20%. The 5lCr-EDTA/99Tcm-MDP ratio appears to offer not only a single plasma sample method for the detection and evaluation of renal bone disease, but our results also suggest that it may be valuable in the follow-up of these patients.
Endoscopic correction of vesico-ureteric reflux by subureteric Teflon injection: follow-up ultrasound and voiding cystography
Authors: Blake N. S. , O'Connell E.
Published: July 2009

The technique of subureteric Teflon injection for the correction of vesico-ureteric reflux was first described by Puri and O'Donnell in 1984. The Teflon granuloma that occurs after the injection anchors the submucosal ureter, thereby preventing reflux. This paper reviews the ultrasound and cystographic findings in 88 patients with 115 refluxing ureters followed-up for periods ranging from 3 months to 3 years. Reflux disappeared in 91 ureters (79.1%) and the degree of reflux improved in 22 ureters (19.1%).In this follow-up study, the size of the granuloma on ultrasound was assessed in relation to the number of injections, the total volume of Polytef paste used and the outcome of the procedure. A well circumscribed granuloma was seen at the orifices of 92 ureters. There was no ureteric granuloma evident in 23 ureters and Teflon plaques were found at the trigone in six patients. Complications were rare. One large granuloma caused severe obstruction requiring re-implantation. The size of the granuloma appears to depend on individual tissue reaction rather than on the other factors. The presence or the size of the granuloma bears no direct relationship to the success of the procedure.
A pressure valve for pneumatic reduction of intussusception
Authors: Kenney Ian J. , Lutkin John E.
Published: July 2009

The pneumatic reduction of ileocolic intussusception in childhood has been attracting increasing attention of late (Miles, 1988; Paes et al, 1988). The problem of finding a system to limit and monitor safely the air pressure used has been solved in as many ways as there are radiologists doing the procedure.
“Out-of-hours” radiography
Authors: Maurer H-J.
Published: July 2009

I agree fully with the statements of Clarke and Adams (1988) in their recent paper. However, the cause of so-called unnecessary X-ray examinations being requested, especially those performed “out-of-hours”, is not only due to lack of consideration and the craze for completeness, but also stimulated by the fear that if a necessary investigation is omitted because of lack of clinical experience on the part of the doctor making the request, there may be fear of litigation following a mistaken diagnosis.
The diagnosis of tumours involving the parapharyngeal space by computed tomography
Authors: Whyte A. M. , Hourihan M. D.
Published: July 2009

Tumours arising within or adjacent to the parapharyngeal space are usually large at presentation and present difficulties in the choice of surgical approach. The findings on contrast-enhanced computed tomography (CT) of 30 patients with mass lesions in this region are presented. Contrast-enhanced CT can provide reliable information regarding the size and extent of a mass, its site of origin and likely histological type, as well as its relationship to surrounding neurovascular structures.