bluuebunny/crossref_metadata_2025 huggingface dataset:
Book reviews
Authors: Pilling D. W.
Published: July 2009

This Atlas is a most beautifully produced book which correlates the ultrasound pictures with morbid anatomy and in some cases radiographic appearances also. About one-third of the book is devoted to normal anatomy, much of this in very early pregnancy correlating the radiographic appearances of aborted fetuses with morbid anatomy at a stage where ultrasound resolution is not good enough to demonstrate the anatomy clearly.
Book reviews
Authors: Butler J.
Published: July 2009

This long-awaited book has finally arrived. It has been several years since a good general text on radiation chemistry has been published and indeed most of the earlier works are now out of print. It is therefore not surprising that two have appeared at the same time (c.f. The Chemical Basis of Radiation Biology by C. von Sonntag). I have delayed reviewing this book until I could compare them. Fortunately, there is little overlap in the scope and depth of these publications and personally I would seriously consider buying both of them.
Book reviews
Authors: Alcock C. J.
Published: July 2009

This fairly slim book (284 pages of text) is one of 37 volumes in the series “Cancer Treatment and Research”, which have been published inthe last 6 years. The Series Editor, William L. McGuire, states in the Forward that the aims of this series are t6 produce “authoratative articles on the diagnosis andmanagement of particular malignancies”, head and neck cancer in this instance.
Book reviews
Authors: Haar G. R. Ter
Published: July 2009

This book contains the proceedings of the NATO Advanced Study Institute Conference on “Physics and Technology of Hyperthermia”, Urbino, Italy, 26 July-9 August, 1986. It is therefore a multiauthor volume, containing 29 chapters by 18 different experts. In common with most proceedings of this type, it has been produced mainly in “camera-ready copy” form. Although not specifically stated, it appears that the book is aimed more at engineers and physicists than at clinicians interested in hyperthermia.
Book reviews
Authors: Lerski R. A.
Published: July 2009

There is increasing interest in the application of whole-body nuclear magnetic resonance (NMR) spectroscopy to medicine, even though its true clinicalvalue has been slow to be demonstrated and no routine applications have been identified. Manufacturers have tended to confuse the choice of NMR imaging equipment by linking imaging and spectroscopy capability in high-field systems. Such systems demonstrate increased signal-to-noise in proton imaging but less contrast and are substantially more expensive than low-field systems.
Film processing for mammography
Authors: Law J. , Kirkpatrick A. E.
Published: July 2009

The effect of processing time and temperature on image quality in mammograms was investigated over the ranges 2.5—4 min and 30—36°C Image quality results from seven processors of different manufacture and different processing methods, operated at a range of times and temperatures, showed the same image quality except for one which received little use. Effects of these parameters on the patient dose required were also considered, longer times up to 4 min and higher temperatures up to 36°C being advantageous. No variation was found with processor design or mechanism of action. Implications for screening programmes are briefly discussed and an optimum regime of 3.5 min and 36°C is suggested.
Osteomesopyknosis: benign axial osteosclerosis
Authors: Griffith T. M. , Fitzgerald E. , Cochlin D. Li.
Published: July 2009

Osteomesopyknosis is a rare, recently described autosomal dominant condition which is characterized by benign osteosclerosis restricted to the axial skeleton (Simon et al, 1979; Maroteaux, 1980). It may produce chronic, low-grade back pain in the thoracic and lumbar regions or be discovered as an incidental finding during some other radiological investigation (Maroteaux, 1980; Stoll et al, 1981; Proschek et al, 1985). Awareness of the existence of this disease entity may avoid confusion with superficially similar sclerosing bone conditions such as osteopetrosis, pyknodysostosis and renal osteodystrophy.
Computed tomography of pineal region ependymoma
Authors: Clarke J. C.
Published: July 2009

The occurrence of supratentorial ependymoma in the pineal region is well recognized (Ringertz et al, 1954; Sano, 1983); however, the appearances on computed tomography (CT) have not been previously reported. Such a case is described here, and it is suggested that this rare tumour should be included in the differential diagnosis of pineal region neoplasms.

A 48-year-old woman presented with a history of episodes of ataxia and jerking of the left arm of several months duration, which were unaccompanied by any impairment of consciousness. Headaches had been present for 6 weeks with occasional vomiting and she had a 14-year history of insulin-dependent diabetes which had become increasingly difficult to control. On admission she was drowsy and disorientated in time and person and place. Neurological examination revealed bilateral papilloedema with limitation of upward gaze and pronounced truncal ataxia.
Microscopic tumour embolism: an unusual cause of ventilation-perfusion mismatch
Authors: Rawlinson John , Ackery Duncan
Published: July 2009

Microscopic tumour emboli are a rare complication of malignant disease. That they may cause multiple perfusion defects on radionuclide lung images without affecting ventilation is not widely recognized (Datz,1980). We report a case of such emboli causing ventilation-perfusion (V/Q) mismatch in a patient with no antecedent history of malignancy.

A 59-year-old woman presented with a 5-month history of progressive exertional dyspnoea and intermittent pleuritic chest pain. There were no other respiratory symptoms and shehad never smoked. Systematic enquiry and past medical history were unremarkable. Examination showed her to be dyspnoeic at rest with a respiratory rate of 40/min, pulse of 100/min and blood pressure of 190/110 mmHg. A right ventricular heave was palpable, the jugular venous pressure was raised by 2 cm and bilateral pleural rubs could be heard. Achest radiograph was normal. Bipedal venography showed extensive bilateral deep vein thromboses and perfusion image susing technetium-99m-labelled albumen microspheres demonstrated multiple, small, peripheral defects throughout both lung fields (Fig. 1). The ventilation studies using krypton 81m showed a normal pattern (Fig. 2).
Non-ionic contrast agents, red cell aggregation and coagulation
Authors: Dawson Peter , McCarthy Peter , Allison David J. , Garvey Brendan , Bradshaw Ann
Published: July 2009

The second generation non-ionic contrast agents were introduced into clinical practice in the UK some 5 years ago. Since that time, and not withstanding their relatively high cost, they have enjoyed ever-increasing clinical application because of the many advantages they offer over previously available agents. These advantages include greater patient comfort (Dawson et al, 1983a; Dawson, 1985), greater patient safety in “high-dose” procedures (Dawson & Pitfield, 1982; Dawson & Hemingway, 1987) and, the evidence would suggest, a lower incidence of major, adverse, life-threatening idiosyncratic reactions (Schrott et al, 1986; McClennan, 1987).

There has, of course, been controversy surrounding the cost of the non-ionic contrast agents but, this apart, there has been little to detract from their success story until recently. In the last year, two papers have appeared, one in the European (Raininko & Ylinen, 1987) and one in the American literature (Robertson, 1987), both concerned with the haematological effects of non-ionic contrast agents, which have raised fundamental questions about their safety in angiography. The paper by Raininko and Ylinen (1987) drew attention to the irregular aggregates of red cells formed when human blood is in contract with high concentrations of non-ionic agent. These irregular aggregates are similar to those seen when red cells are exposed to 5% glucose solutions (Ryden & Oberman, 1975; Wilson, 1980).
Comment on the recent results of Hopewell, Morris and Dixon-Brown on radiation myelitis produced by irradiation of very short segments of rat spinal cord
Authors: Yaes Robert J. , Gorman Steven , Berner Barry , Kalend Andre , Maruyama Yosh
Published: July 2009

Recently, we proposed a model for radiation damage to normal tissue (Yaes & Kalend, 1988), based on the assumption that, because of the limited mobility and reproductive capacity of stem cells (Hellmann & Botnick, 1977) in adult mammalian organs, for each organ there is a maximum volume, which we have called the “critical volume”, that can be repopulated and repaired by a single surviving stem cell. When a critical volume is totally depleted of stem cells, irreparable damage results; however, a single surviving stem cell within the critical volume prevents the damage from occurring. These assumptions constitute the “local stem cell depletion hypothesis” (Yaes & Kalend, 1988).

For the spinal cord, we represent the critical volume as a transverse “slice” of thickness t, assumed to be small compared with lengths of spinal cord usually irradiated clinically. If irreparable damage occurs to a single slice, the long motor and sensory tracts passing through it would be damaged, giving rise to radiation myelitis.
Volume effect in spinal cord
Authors: Hopewell J. W. , van der Kogel A. J.
Published: July 2009

The recent short communication by Yaes etal (1988) and correspondence from Withers and Taylor (1988) make extensive reference to experimental studies by Hopewell et al (1987a) and van der Kogel (1987) on the effects of field size on the response of the rat spinal cord to X irradiation. The objective of these communications was to compare the results of the experimental observations with the predictions of recently proposed models (Withers et al, 1988; Yaes & Kalend, 1988) for dose–volume effect relationships in organs in which so-called functional subunits (FSU) are organized in series.

The underlying basis of the two models is similar and we do not propose to comment on their relative merits. We recognize that such models are of value in radiological research, but we support the view that they do not represent a substitute for careful experimental studies. Concepts such as FSUs, which have some common characteristics with other complication probablity models such as the “tissue rescuing unit” (Hendry & Thames, 1986) and “the local stem cell depletion” model (Yaes & Kalend, 1988), may have a strong mathematical basis and stress the potential importance of tissue organization in radiation effects, but their biological existence and relevance is difficult to prove.
A technique for the removal of retained balloon bladder catheters
Authors: Bisset R.
Published: July 2009

I read with interest the article by Walters et al (1988) describing a technique for needle puncture of retained catheter balloons using a perineal approach. Percutaneous balloon puncture is now accepted as a safe and effective method of balloon deflation in cases of retained bladder catheters. However, it is an invasive technique with a definite morbidity and has at least a theoretical risk of possible major complications in a small number of cases. In the case described in this paper the bladder catheter is shown after removal but it does not appear to have been examined to find the cause for obstruction of deflation. In fact only one of the references quoted attempted to explain the cause of obstruction of balloon deflation (Pitt, 1970).
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

Because of the work of a few pioneers, who include the authors of this atlas, ultrasound is now accepted as having an important role in the diagnosis of breast disease.
Book reviews
Authors: de Bruyn R.
Published: July 2009

This monograph of 111 pages is the second German edition with its first English translation. The aim of the book is to supply guidelines to those less acquainted with neonatal hip scanning both in the type of equipment used, method of examination, measuring techniques, as well as sources of error. This book should be of great interest to orthopaedic surgeons as well as paediatricians and radiologists and is a useful review of the extensive literature on this subject.
Book Reviews
Authors: Savage John R. K.
Published: July 2009

This is a timely and useful document giving a thorough and, I think, very balanced review of this topic which has become an area of increased public concern in recent years following several press reports of ill health amongst those living in proximity to electric power transmission lines.
Fast magnetic resonance imaging of intracerebral metastatic disease
Authors: Williams Michael P. , Cherryman Graham R. , Husband Janet E. , Heron Christine W.
Published: July 2009

The appearance of intracerebral metastases imaged with a multi-slice fast imaging sequence (FLASH) is described. Images were obtained using a Siemens 2.0 T Magnetom operating at 1.5 T. Results of the FLASH imaging sequence at different values of repetition time, different values of “flip angle” and different numbers of acquisitions are described both qualitatively and quantitatively. At low flip angles, both tumour and oedema appear brighter than surrounding white matter. Increasing the flip angle tends to make oedema brighter than both tumour and white matter and increasing the flip angle still further makes tumour and oedema darker than white matter. A major limitation of this technique is that the low flip angle images, in particular, suffer from low signal-to-noise ratios. High flip angle FLASH images have higher signal-to-noise ratios but show similar contrast behaviour to T1-weighted spin–echo images and are likely to be no better as a screening sequence for intracerebral metastases. All the FLASH sequences showed a sensitivity to changes in magnetic susceptibility. This made small intratumoral haemorrhages and basal ganglia “calcification” easier to detect than on spin–echo images but also caused susceptibility artefacts in images around the base of the skull.
Computed tomographic and angiographic findings in renal oncocytoma
Authors: Neisius D. , Braedel H. U. , Schindler E. , Hoene E. , Alloussi Sch.
Published: July 2009

Nine cases with histologically proven renal oncocytoma are presented. In all cases, ultrasonography gave the first indication of a tumour and intravenous urography was tumour-specific in only six, whilst angiography was so in only four of the cases with peripheral extension beyond the normal organ limits. Examination by computed tomography showed retrospectively, in the three cases with smaller oncocytomas up to 3 cm in diameter, findings that seemed promisingly characteristic: without contrast medium, the tumour appeared homogeneously hyperdense in comparison with normal renal parenchyma, but homogeneously hypodense after injection of contrast medium. One of the smaller oncocytomas, however, showed regions of heterogeneity both with aqd without contrast medium. Only one oncocytoma of 4 cm diameter presented the central stellate, low-attenuation “scar” described by Quinn et al. The angiographic criteria cited by Ambos were fulfilled in only three of the larger oncocytomas. In four of the cases, the tumour was enucleated and the organ left in situ on the basis of frozen section diagnosis. Those patients with tumours extending outside the organ or those of questionable diagnosis on frozen section were treated by nephrectomy. In one patient, the pathologist suspected metastasis from the thyroid; hemithyroidectomy confirmed on oncocytic adenoma of the left thyroid lobe.
The last illness factor: a District experience
Authors: Russell J. G. B.
Published: July 2009

The term “last illness factor” is used to indicate the proportion of diagnostic X-ray exposure which occurs in the patient's last illness. An assessment was made of this by determining the number of radiographic examinations made in the patients' last illnesses of persons dying in 1985 in Manchester Central District, and comparing this with the 1985 workload in the diagnostic department. This suggests the last illness factor is about 5% and is thus very small compared with the other factors to be taken into account in assessing the harm from diagnostic radiation.
Gynaecological treatments using the Selectron remote afterloading system
Authors: Dean E. M. , Lambert G. D. , Dawes P. J. D. K.
Published: July 2009

The Manchester method of gynaecological treatment using radium 226, ovoids and a flexible intrauterine tube has been used in many centres. In Newcastle, the Manchester technique was used until 1971, when a manually afterloaded system (MAS) using caesium 137 and two source trains was introduced. In 1985, the MAS was replaced by the Selectron remote afterloading system (RAS), which also uses caesium-137 sources. The dosimetry of this remote system has been designed to produce the same shape of isodose distributions as the MAS, but shorter treatment times. The applicator design and the dosimetry of the system used in Newcastle are discussed. Dose rates achieved by the RAS are more than double those currently produced by the MAS, and a reduction in prescribed dose of 10–20% is being made. The percentage of ward staff receiving monthly doses of more than 0.2 mSv has fallen from 78% to 18% since the introduction of the remote afterloading system. The almost-cylindrical isodose distributions facilitate matching of external beam treatments using a central lead wedge to the intracavitary treatments, and work is in progress to develop this technique.
Dynamic contrast enhancement of asbestos-related pulmonary pseudotumours
Authors: Taylor Paul M.
Published: July 2009

Several authors have described the condition of round atelectasis or pulmonary pseudotumour (Schneider et al, 1980; Cho et al, 1981; Tylen & Nilsson, 1982; Doyle & Lawler, 1984). Features have been identified on chest radiographs and computed tomography (CT) enabling differentiation of these lesions from bronchial carcinoma (Cho et al, 1981; Doyle & Lawler, 1984). The effect of intravenous contrast enhancement on the CT appearances of these lesions has not been previously recorded. Three cases of asbestos-related pulmonary pseudotumour are described which showed significant contrast enhancement. The importance of this observation is that contrast enhancement does not provide an additional criterion for separation of pseudotumour from bronchial carcinoma.
Diffuse hepatic calcification
Authors: Kerlin Paul , Ash Mark , Strong Russell , Mitchell Keith
Published: July 2009

Hepatic calcification is an uncommon finding. When present it is usually focal and associated with either tumours or infective processes. Diffuse hepatic calcification is rare and, to our knowledge, there is only one other case reported in the literature. In the case of Shibuya et al (1985) diffuse hepatic calcification was attributed to a period of prolonged, severe hypotension secondary to ventricular tachycardia and gastrointestinal bleeding. In the present case we attribute the calcification to infarction of macronodules in a cirrhotic liver.
A geriatric plum
Authors: Jeyagopal N. , Hearn F. , Cummins E.
Published: July 2009

A 76-year-old retired manager presented with shortness of breath. On examination he was found to have normal blood pressure and signs of left upper lobe collapse. He was also noted to have a protruberant abdomen and an easily palpable, large mass in the lower abdomen, but the patient denied symptoms suggestive of prostatic hypertrophy. Both testes were absent from the scrotum. Blood biochemical tests for liver and renal function were normal.
Efficacy of cimetropium bromide as pre-medication for double-contrast barium enema
Authors: Golfieri G. , Porta E. , Imbimbo B. P. , Muzio F.
Published: July 2009

In recent years, the double-contrast barium technique for examination of the lower gastrointestinal tract has come into wide use (Federle & Goldberg, 1983). Although many radiologists employ a smooth-muscle relaxant in the belief that colonic relaxation increases the diagnostic accuracy of the examination, this is not unanimously agreed in the literature.

Cimetropium bromide (scopolamine N-cyclopropylmethyl bromide) is a new antimuscarinic agent with strong antispasmodic activity on smooth muscle of the gastrointestinal tract (Schiavone et al, 1985). The drug has been employed for various disorders that include spasm of the musculature of the gastrointestinal, biliary and genitourinary tracts (Scarpignato & Bianchi Porro, 1985; Albano et al, 1987). There are two studies of its use as pre-medication for endoscopy of the upper gastrointestinal tract (D'Imperio et al, 1984; Parente et al, 1985; Bianchi Porro et al, 1987) and one for the radiological examination of the stomach and duodenum (Frigerio et al, 1986).
The metacarpal index in homozygous sickle-cell anaemia
Authors: Calder John F.
Published: July 2009

Walker et al (1988) quote our article (Wachira et al, 1982) as a clinical report of arachnodactyly in sickle cell disease. It was in fact a survey of 316 hand radiographs in Kenyan Africans who did not have sickle cell disease.
Book reviews
Authors: Prescott Mary C.
Published: July 2009

The aim of this publication is to produce state-of-the-art reviews in a variety of areas encompassed by the field of nuclear medicine. It succeeds in this and contains some excellent reviews. However, with one exception, the 10 articles which make up the book are written by authors practising in the USA and, inevitably, its emphasis on some techniques reflects North American rather than British practice. The chapter on “Radionuclide evaluation of brain death”, for instance, would be unlikely to be included in any review originating in Britain.
Book reviews
Authors: Epenetos A. A.
Published: July 2009

This book, containing 502 pages, 20 chapters and 2650 references, claims to be the first book on biological response modifiers in cancer treatment. It is a comprehensive and up-to-date review of the state-of-the-art in biotherapy. The book is written in a pleasant style, with diagrams, tables and illustrations intermingled with text.
A critical appraisal of “out-of-hours” radiography in a major teaching hospital
Authors: Clarke J. A. , Adams J. E.
Published: July 2009

The use of plain radiography performed outside normal working hours was studied at the Manchester Royal Infirmary to determine the costs of the service and where possible financial savings could be made. The annual cost of “out-of-hours” radiography was estimated to be in order of £250000. During a selected 2-week period, 84% and 76% of all examinations performed on Accident and Emergency patients and inpatients, respectively, were found to be normal. Previous reports suggest that the number of radiographs requested in the Accident and Emergency department can be reduced without detriment to patients by the implementation of appropriate clinical guidelines. We consider that if similar guidelines were developed and applied to the use of out-of-hours radiography, substantial savings could be made. We estimate that in our hospital these savings could amount to 18% of the current expenditure on this service.
In vitro induction of chromosomal aberrations in human lymphocytes, with and without boron 10, by radiations concerned in boron neutron capture therapy
Authors: Lloyd D. C. , Edwards A. A. , Prosser J. S. , Finnon P. , Moquet J. E.
Published: July 2009

A beam consisting of mainly 24 keV neutrons has been constructed for radiobiological studies to evaluate the potential of these particles for treating deep tumours by the boron capture reaction. The induction of chromosomal aberrations in human lymphocytes in vitro was examined and a linear dose effect with a relative biological effectiveness similar to fission neutrons was obtained. For samples placed at depths in a plastic phantom the aberration yields declined with depth at a rate matching the fall in the sum of dose due to proton recoils and neutron capture in nitrogen 14. The presence of boron 10 at 30 μg ml−1 did not affect the aberration yield. By using the mixed sample method, the probability of interphase death or mitotic delay in cells crossed by an a particle or lithium–7 ion produced in the boron capture reaction was shown to be close to 1.0. Thus these cells are prevented from coming to mitosis in culture. The implications for boron capture therapy are that this filtered beam has a “high LET” effect which could lead to poor normal tissue sparing. However there may be a significant therapeutic advantage due to a high probability of killing tumour cells that have incorporated boron 10.
Biophysical interpretation of the response of Chinese hamster cells to 24 keV neutrons
Authors: Holt P. D.
Published: July 2009

The response of V79 Chinese hamster cells to a 24 keV neutron spectrum has been compared with data for the response of V79 cells to a range of higher neutron energies. The linear energy transfer (LET) distributions of the neutron spectra were calculated and the expected responses of the cells to the different spectra were calculated using published track-segment data on the response of V79 cells to charged particles with various LET values. The response of the cells to 24 keV neutrons was predicted satisfactorily by the LET distribution, in spite of the fact that the maximum range of the recoil protons is only 0.5 μm. The response was not correctly predicted by the microdosimetric parameter evaluated in a 1 μm diameter sphere.
Primary plasmacytoma of the oesophagus
Authors: Davies R. A. , Boxer D. I.
Published: July 2009

Primary plasmacytoma of the gastrointestinal tract is rare, most commonly affecting stomach or small bowel and less frequently the colorectum. No previous report of plasmacytoma of the oesophagus has appeared in the radiological literature.

A 69–year–old widow presented with a 2-week history of a bubbling sensation on swallowing. There was no history of weight loss, malaise or constitutional upset.
Does it pay to be optimistic?
Authors: Davison M.
Published: July 2009

The three principles recommended by the International Commission on Radiological Protection (ICRP) for restricting radiation dose are justification, optimization and dose limitation. Only the first two can be applied to medical exposure of patients. Justification is a clinical matter, but optimization is very much a technical matter. The optimization principle is more fully described as keeping doses “as low as reasonably achievable”, usually abbreviated to ALARA, but with the condition that economic and social factors are taken into account. This second part is often ignored but is crucial to any discussion of optimization. The ALARA concept has now been incorporated into the statutory requirements of the Ionizing Radiations Regulations 1985 applying to staff, and the 1988 Regulations applying to patients (HMSO, 1985, 1988). However, this still leaves open the question of how low is reasonably achievable.

Publication 37 of the ICRP (ICRP, 1983) discussed the use of cost-benefit analysis and gave examples, applying the technique to various general operational procedures and design problems, and in particular to the use of rare-earth screens and carbon fibre materials. The cost-benefit technique has been developed by the National Radiological Protection Board (NRPB) in documents ASP4 and ASP9 (NRPB, 1981, 1986).

The “cost” is the amount of money spent on protection. The “benefit” is not readily determined and so the concept of detriment has been introduced with a monetary figure put on it to allow comparisons.
Book reviews
Authors: MacLarnon J. C.
Published: July 2009

The editors of Orthopaedic Radiology have assembled a series of essays on a variety of topics by authors working in these specialities, some of national, some of international renown. The publishers have produced a convenient and handsome volume of nearly 550 pages, illustrated by radiographs of aboveaverage quality and the text is virtually faultless. The concept behind the book is good. Professor Hughes explains in the preface that there were two main objectives, the first to indicate the range of investigative techniques available and the second to identify orthopaedic problems for which radiology can be useful.
Book reviews
Authors: Hunter S.
Published: July 2009

Martinus Nijhoff have a reputation for producing small monographs, quickly published and dealing in depth with techniques and this publication is very typical of a number that have been produced. It deals mainly with the “in” technique of colourcoded Doppler flow imaging (to give it its full name), with the physics and technological changes on which this process depends as well as some clinical evaluation.
Book reviews
Authors: Jeans W. D.
Published: July 2009

This is the fourth of a series of radiological reviews published in alternate years since 1981 and based on papers given at meetings, in this case in Salzburg in 1986. The series is designed to combine European and North American experience in radiological advances, although of the 61 authors listed, only nine are working in the United States.
Book reviews
Authors: Robbins M. E. C.
Published: July 2009

This book is based on a series of lectures presented by leading clinicians and experimentalists at the Ninth Annual Multidisciplinary Symposium on Clinical Oncology organized by the Royal College of Radiologists and the International Society for Radiation Oncology. This was held in London in February 1987 and discussed the biological and clinical bases of. the effects of radiotherapy. The lectures presented at this meeting have been updated and make up the nineteen separate chapters included in this volume. In the majority of cases experimental observations are followed by clinical findings.
Book review
Authors: McKenzie Alan L.
Published: July 2009

This book is the fourth in the Medical Science Series, and is aimed at physicists with an interest in radiation dosimetry.

After a radiophotoluminescent (RPL) substance has been exposed to ionizing radiation, it can be made to fluoresce in proportion to the absorbed dose by illuminating it with an ultraviolet source. This is to be distinguished from irradiated TLD materials which are made to glow by heating them. This book describes the properties of RPL and makes a case for widening its use in personal and environmental monitoring and in medicine, particularly radiotherapy dosimetry.
Clinically unsuspected complications of arterial surgery shown by post-operative digital substraction angiography
Authors: Teeuwen C. , Eikelboom B. C. , Ludwig J. W.
Published: July 2009

Intravenous digital subtraction angiography was performed within 20 days of 678 vascular reconstructions as a routine post-operative evaluation. After 339 carotid endarterectomies, 34 patients showed a stenosis of >30% and six occlusions were seen. In 157 patients after aortic aneurysm repair, we found five anastomotic aneurysms and seven stenoses of >30%. After aortic bypass surgery, 77 patients were evaluated and nine stenoses were found; no anastomotic aneurysms were seen. In 105 patients with femoro-distal bypass procedures, occlusion was reported in 11 cases and stenosis in 13 cases. One patient had two anastomotic aneurysms. To summarize, major abnormalities were present in 81 cases (12.7%) and consisted of 59 stenoses of >30%, 17 occlusions and six patients with anastomotic aneurysms. Most of these were unexpected and were reason for more critical follow-up or re-operation.
Some indicative parameters on diagnostic radiology in Spain: first dose estimations
Authors: Vañó E. , González L. , Calzado A. , Morán P. , Delgado V.
Published: July 2009

The Medical Physics Group at the Complutense University of Madrid has been co-ordinating, for approximately 1 year, a project on optimization of radiation protection in diagnostic radiology, in co-operation with the other states of the European Community. Exhaustive data on the subject, which offer accurate results on patient dosimetry for the different types of examination, are the final aim of the project. So far, it has been possible to analyse in detail the data from the National Institute of Health (NIH), which manages the care of about 96% of the Spanish population, plus the findings from several hospitals, outpatient centres and private clinics of the community of Madrid, which allowed us to perform the first dose estimations and to extrapolate them to the rest of Spain. The following estimations are presented: annual frequency of different examinations, their variation from 1985 to 1986, number of diagnostic rooms used for a given minimum of annual examinations, organ doses for different examinations, effective dose-equivalent, genetically significant dose for some examinations, as well as the collective dose.
Aortic tumours: report of a case and review of the literature
Authors: Schipper Jaap , van Oostayen Jacques A. , den Hollander Jan C. , van Seyen Andries J.
Published: July 2009

We present a case of a leiomyosarcoma originating in the wall of the descending aorta and give a review of 27 previously reported cases of aortic neoplasms. An extraluminal aortic leiomyosarcoma has not been reported before in the literature.
Hepatic venography in the surgical assessment of hepatic tumours
Authors: Odurny Allan , McLoughlin Michael J. , Colapinto Ronald F. , Sniderman Kenneth W.
Published: July 2009

Hepatic venography was performed on 80 patients with hepatic tumours for the pre-operative assessment of resectability. Sixty-six patients subsequently underwent laparotomy, 27 undergoing hepatic resection. Forty-two patients had metastases from colo-rectal primaries, 19 hepatocellular carcinoma and 19 a variety of other tumours. The type and frequency of the abnormalities shown on venography were noted for each tumour category and for their hepatic segmental distribution. The results of venography were compared with those of arteriography, computed tomography and ultrasound and with the findings at laparotomy. Displacement was the commonest abnormality seen while encasement or obstruction occurred less frequently and tumour invasion was rare. The sensitivity of venography in correctly identifying the segmental distribution of tumour deposits was 41%. Sensitivity was poorest with tumours in the left lobe (31%) and bilobar tumours (0%). Venography was most sensitive in detecting tumour involvement of the major segmental hepatic veins and inferior vena cava (100%). Peripheral colo-rectal metastases frequently produced no venographic abnormality. Hepatic venography provides no additional information to arteriography, computed tomography or ultrasound in patients with peripheral or bilobar tumour deposits. Some additional information may be obtained with central tumours and venography is the most accurate means of detecting tumour involvement of the major segmental hepatic veins.
Renal neoplasms in a family
Authors: Laurence V. M. , Robinson A. C. R.
Published: July 2009

Malignant tumours of the kidney are uncommon, renal cell carcinoma, the adult variety, accounting for 2% of all adult malignancies, whilst nephroblastoma, an enbryonic tumour of childhood, affects one per 200 000 children per year under the age of 15 years and constitutes 7% of childhood neoplasms (Bullimore & Mott, 1982). Both of these tumours occur in sporadic and hereditary forms. We report a family in which the mother had renal cell carcinoma and her son nephroblastoma. This has only been reported once before (Campbell et al, 1987).

In January 1975, a previously healthy 4-year-old boy presented with right-sided abdominal swelling. He had one healthy brother aged 9 months. Family history was otherwise unremarkable. Physical examination revealed a large abdominal mass. No other abnormalities were detected.
Costing imaging procedures
Authors: Russell J. G. B.
Published: July 2009

Dr Bretland (1988b) has omitted an important factor from his calculations of the cost of oral cholecystography—that of the harm done by ionizing radiation. This has been calculated at £5–10 000 man-Sv−1 (Russell & Webb, 1987). Since this estimate was made, our perception of fatal cancer induction has at least doubled (International Commission on Radiological Protection (ICRP), 1987) so it is reasonable to take £10 000 as the value of avoiding a man-Sv.
Intravenous digital subtraction angiography in non-specific aorto-arteritis
Authors: Sharma Sanjiv , Aggarwal Shashi , Talwar K. K. , Rajani Mira
Published: July 2009

We have studied 40 patients with non-specific aorto-arteritis (Takayasu's disease) using intravenous digital subtraction angiography (DSA). The aorta, its major branches and (in 18 patients) pulmonary arteries were evaluated to determine the degree and extent of involvement. No complications related to the procedure were encountered. Good quality diagnostic images were obtained in 39 out of 43 instances. The unsuccessful examinations were in patients with congestive cardiac failure, and in one patient who would not co-operate. Aortic wall thickness and mild involvement of the descending aorta in the region of the diaphragm could not be assessed. Intravenous DSA is acceptable for the diagnosis and follow-up of aorto-arteritis in suitable patients.
Sickle-shaped scapulae in a patient with the Pierre Robin syndrome
Authors: Bezirdjian Diran R. , Szucs Richard
Published: July 2009

We report a patient with Pierre Robin syndrome who also has scapulae of an unusual appearance and speculate that this anomaly may represent yet another skeletal change to be associated with this syndrome. We reviewed the literature and did not find this association described previously.

A 5-year-old white girl was transferred to our institution after a 2-week hospitalization elsewhere for fever, cough, tachypnoea and wheezing. A chest radiograph on the day of admission to a community hospital showed infiltrates in the right middle and left lower lobes and the patient was started on antibiotics.
Cystic haemangioma of the spleen: findings on ultrasound and computed tomography
Authors: Duddy M. J. , Calder C. J.
Published: July 2009

A case of cystic haemangioma of the spleen is reported. Although haemangioma is the commonest benign tumour of the spleen, the majority are of the small capillary type found incidentally at autopsy. Symptomatic cystic haemangioma is rare. Even less common is the diagnosis considered pre-operatively. This has been facilitated in recent years by non-invasive imaging modalities.

The appearances on computed tomography (CT) and ultrasound and the duplex ultrasound properties are described and correlated with the pathological findings. The use of duplex ultrasound has not previously been reported for this tumour.
The jockey with a mass in the thigh
Authors: Davies A. M. , Evans N. , Grimer R. J.
Published: July 2009

A 40-year-old professional jockey presented with a 2- week history of severe pain in the right knee region which commenced whilst riding. Examination revealed a firmmass, 10 cm × 5 cm, within the soft tissues of the medial aspect of the right distal thigh. All laboratory investigations were normal. The radiological investigations of the right femur included plain radiography (Fig. 1) and computed tomography (CT) (Fig. 2). A bone scan revealed a solitary, non-homogeneous area of increased uptake in the right distal femur.
Aid to localization for computed tomographic biopsy and aspiration procedures
Authors: Turner M. J. , Ball P.
Published: July 2009

In computed tomography (CT)-guided biopsy and aspiration procedures, various methods of precise localization have been described (vanSonnenberg et al, 1981; Frederick et al, 1985; Onik et al, 1986). When such refined methods are not available, the scanner's registration scale is normally used but the first attempt at a slice through a desired level may miss its target.
The cost of imaging procedures
Authors: Jeans W. D.
Published: July 2009

I was interested to see the letter by Dr Russell (1989) on attempts to cost the harm resulting from radiation used in diagnostic radiology.
Book reviews
Authors: Tait Diana
Published: July 2009

The introduction to this book is a succinct and seductive justification for establishing a code for clinimetric measurement. The already widespread adoption of clinimetric ratings and indices underlines an acceptance of the science in principle, but the author emphasizes the science's lack of principles. The aim of this book, therefore, is to structure a system for rating clinical information, such that observation of human phenomena can produce scientifically credible data.
Book reviews
Authors: Dean Elizabeth M.
Published: July 2009

This is a useful and interesting book for any physicists and radiotherapists dealing with brachytherapy treatments. It is well written and up to date in the techniques and developments it describes, and is a good reference book for those people already involved in brachytherapy techniques, since there is sufficient detail on purchase, testing, calculation and safe handling of sources. All necessary subject areas are covered and therefore each topic is dealt with fairly concisely, but there are sufficient references for further study.
Book reviews
Authors: Tait Diana
Published: July 2009

Pediatric Tumors of the Genitourinary Tract is intended to be a clinical reference text collating the most current information available on management of this group of rare tumours. This volume is edited by Bruce Broecker, MD and Frederick Klein, MD who are both specialists in surgery, the former being in paediatrics and the latter in urology. However, contributions have been gathered from a number of specialties so that this volume brings together current views from pathologists, haematologists, medical oncologists, paediatricians and radiotherapists, in addition to some major contributions from surgical specialists.
Clinical applications of high-definition microfocal radiography
Authors: Buckland-Wright J. C. , Bradshaw C. R.
Published: July 2009

Recent advances in technology have lead to the development of a high-definition microfocal X-ray unit allowing macroradiographic examination of different parts of the body at × 5 to × 10 magnification and with a high spatial resolution. Its applications in the study of a number of arthritides, metabolic and some other bone diseases are described in terms of early detection of diagnostic features. Emphasis is placed on the advantages of direct accurate measurement of these features, providing a precise evaluation of disease progression and response to therapy.
Paediatric brachytherapy. I. The role of brachytherapy in the multidisciplinary therapy of localized cancers
Authors: Plowman P. N. , Doughty D. , Harnett A. N.
Published: July 2009

Paediatric brachytherapy is rarely practised but has definite benefit in certain situations. Case reports illustrate the role of current brachytherapy strategies both as radical and salvage procedures and in the multidisciplinary management of childhood cancers.
Radiation dose to neonates on a Special Care Baby Unit
Authors: Faulkner K. , Barry J. L. , Smalley P.
Published: July 2009

Neonates on a Special Care Baby Unit often require radiography to monitor the progress of their treatment and as a result can have a large number of radiographs taken during their stay in hospital. The skin entrance dose was estimated from a knowledge of the technique factors, X-ray tube output and backscatter factors. Normalized organ dose data were employed to estimate the radiation dose to a number of critical organs. A number of methods of reducing the radiation dose to neonates were investigated. Initially, this involved changing the radiographic technique factors and introducing a lead rubber adjustable collimator, placed on top of the incubator, in addition to the light beam diaphragms on the X-ray tube. It was deduced from the results of calculations that these modifications to the radiographic examination technique had reduced the average entrance dose per radiograph from 92 μGy to 58 μGy, a reduction of 37%. Later, a rare-earth film-screen combination was introduced to replace the existing fast calcium tungstate screens. This enabled the average entrance dose per radiograph to be reduced to 39 μGy, a further reduction of 33%. The mean radiation dose to a neonate is mainly determined by the number of radiographs taken and this is dependent on the clinical symptoms.
A comparison of two different T-grain films in rare-earth screens with a standard film–screen combination for intravenous pyelography and bone examinations
Authors: Logan Hugh , Daly Lesley , Masterson James
Published: July 2009

T-grain film is claimed to give significantly improved image quality, allowing the use of faster screens without loss of quality and thus reducing radiation dose. We tested this claim for two systems. In each case comparison was made with our usual screen–film combination, Agfa Curix RP1 film with Kodak Xomatic Regular screens (a nominally 200 speed system). The systems tested were Kodak TMatG in Kodak Lanex Medium screens (300 speed) and Agfa STG in Kodak Lanex Regular screens (400 speed). The Agfa STG–Lanex Regular system performed less well than the standard system for intravenous pyelograms (IVPs), bones and soft-tissue detail. Its speed advantage was not apparent below 70 kV. The Kodak TMatG-Lanex Medium system was better than the standard system for IVPs but not as good for bones. It gave virtually no speed advantage below 90 kV. Kodak T-grain film in a medium-speed, rare-earth screen was found to be better than the standard system for IVPs. Agfa T-grain film in a fast rare-earth screeen was unsatisfactory for IVPs. Neither combination was as good as the standard system for bones.
Radiological appearances of colonic ring staple anastomoses
Authors: Daly B. D. , Crowley B. M.
Published: July 2009

The radiographic appearances of colonic staple ring anastomoses are presented. Staple ring disruption on plain abdominal radiographs in the early post-operative period suggests dehiscence of the bowel anastomosis and is an indication for urgent water-soluble contrast medium enema to confirm the diagnosis. Rectal stenosis can develop as a late complication of staple anastomosis and may be detected on barium enema.
An iodine-125 applicator designed for irradiating blood vessels growing into the cornea of the eye
Authors: Hering E. R. , Sealy R. , Korrubel J. B. , Hill J.
Published: July 2009

The invasion of the traumatized cornea by blood vessels is a well known complication and is often associated with graft rejection. Graft acceptance may be improved by the induction of endarteritis with β radiation but the corneal stroma may be so changed by the necessary dose of radiation (commonly 4500–5000 cGy in three or four fractions) as to significantly increase the risk of sloughing (Macfaul & Bedford, 1970). To overcome this problem, we have designed and made an 125I eye applicator to produce an extremely narrow radiation field for treating the vascularization at the base of the cornea only. The anterior part of the cornea receives a very small dose of about 11% of that given to the base and is sufficiently large to receive a 6 mm corneal transplant.

The use of 125I seeds in gold applicators for treating malignant conditions of the eye has been well documented (Sealy et al, 1980). Our applicator is designed to achieve a field width of 0.4 mm at the base of the cornea. Seeds were positioned in a gold applicator, a cross-section of which is shown schematically in Fig. 1.
Ultrasound diagnosis of gallbladder perforation in a case of xanthogranulomatous cholecystitis
Authors: Houston J. P. , Sampson M. A. , Collins M. C.
Published: July 2009

Cholelithiasis is a common disease and perforation and carcinoma of the gallbladder are well recognized complications. Xanthogranulomatous cholecystitis is an uncommon form of cholecystitis which is being recognized with increasing frequency. We report a case in which gallbladder perforation was diagnosed by ultrasound in a patient in whom all four conditions coexisted.

A 73-year-old woman presented with a 1-month history of rapidly worsening dementia following an episode of abdominal pain. Nine days before admission to hospital an abdominal swelling had been noticed. On examination she was pyrexial with a neutrophilia; there was a large, tender, fluctuant epigastric mass, pointing through erythematous skin.