bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-operative neutron irradiation
Authors: Courdi A.
Published: July 2009

Glaholm and Harmer (1988) reported a prospective study of post-operative irradiation with neutrons (five patients) or photons (nine patients) in patients with soft-tissue sarcomas. The unacceptable late tissue damage in the neutron group led to the termination of the trial.

These results, although based on a small number of patients, support the radiobiological data. Absence of a gross tumour may not be a proper indication of neutron therapy, since it deprives the radiotherapist of both the hypoxic and kinetic gain factors.
Post-operative neutron irradiation
Authors: Glaholm J. , Harmer C.
Published: July 2009

The theoretical advantages for the use of external-beam fast neutron therapy in the treatment of soft-tissue sarcoma are not in dispute, indeed these were the rationale for conducting the reported randomized study of neutrons versus photons.
Book reviews
Authors: White F. E.
Published: July 2009

This short book covers virtually all aspects of neck ultrasound, with the notable exception of assessment of the carotid arteries and the use of Doppler. It is made up of seven chapters, the first of which describes the anatomy of the neck and examination techniques. There are then chapters on the thyroid, parathyroids and salivary glands, discussing the clinical features, pathology and, to some extent, the management of conditions likely to be encountered.
Book reviews
Authors: Butler P.
Published: July 2009

“Cerebral angio-CT” is the name given by the authors to the technique of rapid sequential scanning through a region of interest in a variety of planes following an intravenous infusion of contrast medium. Infusion rates, scan planes and scanning intervals are given in quite exhaustive detail although these relate only to the General Electric 9800 and 9000–2 CT scanners. The protocols will need to be adapted for other scanners.

The volume is profusely illustrated with high-quality scans and clear expositions of intracranial vascular anatomy. Conversely, the text falls far short of what might be reasonably expected from an American publisher. The standard of the translation from the Japanese is poor, resulting in many very clumsy and sometimes barely comprehensible statements. Spelling errors are frequent.
Book reviews
Authors: Carr Denis H.
Published: July 2009

The book starts with a nicely annotated section on normal anatomy of the mediastinum, bronchi and fissures. The remainder of the book is divided into chapters on parenchyma, hila and airways, mediastinum, cardiovascular system, pleura, diaphragm and chest wall. There are 209 cases, all well illustrated, each with a short and cogent description. Most cases are supplemented by references which are listed by chapter at the end of the book.
The effects of angiotensin II on Doppler signals from a soft-tissue tumour
Authors: Taylor P. M. , Moreman B. , Rimmer S. , Isherwood I.
Published: July 2009

A 10 mHz continuous-wave Doppler system has been used to detect blood flow within a sarcoma implanted in a rabbit's ear. The effects of vasoconstriction produced by intravenous angiotensin II were studied. Criteria are described that enabled differentiation of the Doppler signals from the tumour from those of the adjacent central artery. The effect of vasoconstriction upon these criteria is also described.
Radiation-induced cell death by chromatin loss
Authors: Campbell Ian R. , Warenius Hilmar M.
Published: July 2009

A model is proposed which relates reproductive death of cells caused by radiation to loss of chromatin at cell division. This loss of chromatin can occur through chromosomal deletions or through the formation of asymmetrical chromosomal exchanges. It is proposed that smaller doses of radiation produce fewer chromatin breaks, which are more likely to be accurately repaired, compared with larger doses. Consequently, smaller doses of radiation are less efficient in causing cell death, leading to a shoulder on the cell survival curve. Experimental evidence supports this model, and the fit between the derived formula and experimental cell survival curves is good. The derived formula approximates to the linear-quadratic equation at low doses of radiation.
Iotrolan in selective bronchography via the fibreoptic bronchoscope
Authors: Morcos S. K. , Baudouin S. V. , Anderson P. B. , Beedie R. , Bury R. W.
Published: July 2009

The standard technique of selective bronchography via the fibreoptic bronchoscope using Dionosil aqueous suspension (Glaxo) as described by Flower and Shneerson (1984) has disadvantages. The medium is a thick suspension and is extremely difficult to inject. Direct injection into the suction channel may cause blockage if the channel is not adequately cleaned. Furthermore, Dionosil may induce chemical pneumonia, lung collapse and compromise of lung function if a large volume is used (Flower & Armstrong, 1986). It also augments the adverse effect of bronchoscopy on arterial oxygen saturation (Goldman et al, 1987).

These difficulties have prompted the idea of using a different type of contrast medium that can be injected directly into the suction channel of the bronchoscope without the attendant complications. The physicochemical properties of iotrolan, a non-ionic dimer, suggest that it could be useful in selective bronchography. It is iso-osmolar with blood at a concentration of 240mgIml−1 with a viscosity of 3.9 cP at 37°C. At a concentration of 300 mgl ml−1 it is slightly hyperosmolar (320 m osm kg−1) and the viscosity is 8.1 cP at 37°C. Animal work and clinical evaluation have indicated that this medium is comparable in safety to the other low-osmolar media that are currently in wide clinical use, possibly with better neural tolerance (Hammer & Deisenhammer, 1985).

The aim of this study was to assess the safety and efficacy of iotrolan 240 in a group of patients requiring selective bronchography.
Book reviews
Authors: Pilling D. W.
Published: July 2009

One would think that with ultrasound such a well established technique in obstetrics, extending back over 20 years, a book devoted almost entirely to normal anatomy would be superfluous. This is, however, most certainly not the case with this present text, which has been most carefully and painstakingly produced and crystallizes the author's extensive experience of ultrasound over more than 20 years.
Book reviews
Authors: Windeyer B.
Published: July 2009

This book is described by the author as a cultural history of cancer in the United States, starting in 1887. It is not a detailed study of cancer research, of therapy or of the experiences of patients. He concentrates on elucidating the ways that the dread disease has reflected social and personal careers during the modern industrial era of United States history.
Nuclear medicine in the 1990s: a quantitative physiological approach(1988 Mayneord Lecture)
Authors: Ott R. J.
Published: July 2009

Technological developments in X-ray computed tomography (CT), ultrasound and magnetic resonance imaging (MRI) in the last 10 years have provided radically improved qualitative diagnostic information relevant to a wide range of human diseases. The impact of these advanced technological processes is difficult to quantify in absolute terms but diagnosis is certainly greatly aided by the wealth of precise morphological information now available. However, human disease often presents with no specific anatomical changes and those seen may be late effects of earlier biochemical processes, which have remained undetected until the patient presents with advanced symptoms. Radionuclide imaging techniques can show physiological changes that are a direct consequence of these biochemical mechanisms, but, so far, nuclear medicine has disappointingly made only a limited impact on both the aetiology and diagnosis of disease. This paper examines the limitations of nuclear medicine in the context of the need for basic information relating to biochemical function of the human body and proposes that positron emission tomography (PET) could become more widely available and could radically increase the clinical impact of imaging with radionuclides.

It will be useful to examine some aspects of the morphological imaging techniques that make CT, ultrasound and MRI successful diagnostic modalities, prior to considering the value and limitations of radionuclide imaging. This will lead on to a discussion of possible ways in which PET may contribute to clinical nuclear medicine with the aim of presenting a possible scenario for the coming decade.
Book reviews
Authors: Whitehouse G. H.
Published: July 2009

At first sight it may seem an anachronism to have a new book devoted to a single radiographic technique. There is certainly little new to say on hysterosalpingography. Nevertheless, it is still a commonly performed procedure and one which remains a first-line investigation in female infertility.
Book reviews
Authors: Britton K. E.
Published: July 2009

This is a fun book, and as the preface states, “This slim volume could have been titled ‘A Quick and Dirty Guide to Radioimmunoimaging’.” The authors aim to target readers over 40, as radioimmunoscintigraphy postdated their training period. They attempt to provide “a simplified clearly written explanation” and largely succeed.
Book reviews
Authors: Lindsay K. W. , Valentine A. R.
Published: July 2009

This is the first of two volumes devoted to the surgical aspects of intracranial arteriovenous malformation, which together comprise the third volume of a series of four on microneurosurgery. Five of its nine chapters are contributed by authors other than Yasergil and his immediate collaborators, and deal with embryology, Doppler ultrasound, neuroradiology, anatomy of the cortical blood vessels and anatomy of the calcarine sulcus.
Book reviews
Authors: Snowdon S. L.
Published: July 2009

The subjects covered within this book will be of particular value to anaesthetists as indicated by the title, although the approach may also be of interest to radiologists. There is certainly a need for a text dealing with the interpretation of radiographs encountered during intensive care and the peri-operative period of relevance to anaesthesia.
Book reviews
Authors: Barrington N. A.
Published: July 2009

This pocket quiz book is based on a combination of clinical photographs and radiographs of soft tissue and bony injuries related to sporting activities. Some examples of other conditions presenting after, but not due to, injury are included. The diagnosis, together with other comments related to management and complications, is provided at the rear of the text. Of the 200 cases shown, 87 are purely radiological. The quality of the colour prints and of most of the radiographs is good.
Book reviews
Authors: Robinson P. J.
Published: July 2009

This book is a collection of 500 independent true/false type multiple-choice questions, each of five parts. The questions are arranged into sections, each covering one major body system or clinical specialty. The questions are similar in style to those used in the FRCR Part II examination, concentrating largely on the interpretation of radiological procedures but also including some relating to techniques and others on relevant clinical aspects of disease.
Percutaneous interventional uroradiology
Authors: Rickards D. , Jones S. N.
Published: July 2009

In the recent past, intervention in the urinary tract was the sole domain of the urological surgeon or the general surgeon with an interest in urology. With the advance of radiologically-guided interventional techniques, the approach is now multidisciplinary, involving surgeons, radiologists and pathologists. Some traditional methods of treating common urological complaints are now defunct. The implications of this are profound. They include shorter hospital inpatient stays, less use of general anaesthesia, easier planned patient management and, above all, decreased cost of patient treatment. Both patient morbidity and mortality have been reduced and, on the whole, the procedures are more acceptable.

Technology is advancing rapidly and newly acquired skills are often rather short-lived as primary therapeutic tools. For instance, extracorporeal lithotripters have reduced the demand for percutaneous nephrolithotomy, but such skills must still be practised and perfected for the treatment of complications and because not all patients are suitable.

This review concentrates on percutaneous renal work (Table I) and stresses current concepts. Specific interventional procedures are not described in detail.

Many interventional procedures, e.g. antegrade pyelography, can be performed on fluoroscopy units readily available in all X-ray departments. Ideally, a dedicated interventional suite is needed to satisfy both urologist and radiologist. The interventional room itself needs to be serviced by a recovery area and a nursing station where sterile trolleys can be prepared.
The radiographic differentiation of pulmonary oedema
Authors: Rocker G. M. , Rose D. H. , Manhire A. R. , Pearson D. , Shale D. J.
Published: July 2009

A radiographic scoring system has been reported to have a high diagnostic accuracy in the differentiation of pulmonary oedema of renal, cardiac and capillary origin. In the present study, a similar scoring system was used in 51 patients with radiographic appearances of pulmonary oedema due to renal failure (n = 16), cardiac failure (n = 13) and to adult respiratory distress syndrome (ARDS) (n = 22). Evidence of increased pulmonary capillary permeability to transferrin was sought in all patients using a double-isotope method to derive a protein accumulation index (PAI). Using the clinical diagnosis of each type of pulmonary oedema as the “gold standard”, sensitivity, specificity and accuracy for the chest radiographic scoring system in pulmonary oedema of cardiac origin were 46, 84 and 75%, respectively. For renal patients these values were 63, 86 and 78% and for ARDS, 89, 33 and 77%. For the PAI in ARDS, sensitivity was 85%, specificity 67% and accuracy 86%. The radiographic scoring system failed to distinguish between pulmonary oedema of renal and cardiac origin and cannot be considered of diagnostic value, but it was more successful in assessment of ARDS. Radiographic appearances suggestive of capillary injury and increased capillary permeability to transferrin occurred in all groups and such findings are not specific to ARDS as currently defined.
Total or partial percutaneous renal ablation in the treatment of renovascular hypertension: radiological and clinical aspects
Authors: Iaccarino V. , Russo D. , Niola R. , Muto R. , Testa A. , Andreucci V. E. , Porta E.
Published: July 2009

In 15 patients with renovascular hypertension, considered unsuitable for angioplasty or surgery, percutaneous renal ablation was performed by injection of ethanol into the renal vasculature. Partial or complete renal ablation was confirmed by follow-up intravenous pyelography or arteriography. Patients were followed-up for a mean of 24.8 months after therapy and blood pressure was improved in all patients with five being cured. This study shows that percutaneous renal ablation is a useful and successful method of therapy for renal hypertension, and that it should be considered in patients unsuitable for surgery or angioplasty.
Fetal fat measurement by magnetic resonance imaging
Authors: Deans H. E. , Smith F. W. , Lloyd D. J. , Law A. N. , Sutherland H. W.
Published: July 2009

A method to assess the average percentage of fetal fat with respect to other fetal tissue is described. This method was then used to assess the percentage of fat in 13 normal fetuses who had a magnetic resonance imaging (MRI) examination late in pregnancy (38–41 weeks). The scans of a further 13 fetuses of diabetic mothers and one case of intrauterine growth retardation (IUGR), all of whom had MRI examinations in the last 3 years, were reviewed and similar calculations were carried out. Whilst the percentage fat range in the normal group was large, it was still possible to discern a difference between the normal, diabetic and IUGR cases.
Microcomputer processing of film radiographs
Authors: Tait W. H. , Hanson M. E.
Published: July 2009

An inexpensive image processing system, assembled from commercially available components and driven by “in-house” software, was tested as a means of processing radiographs obtained in a radiology department. In this preliminary study, the main interest was to investigate, through subjective appraisal, the ability of the system to recover the image quality of poorly exposed radiographs. Subsidiary objectives were to obtain some information regarding the specification limits of the system and its components, as well as some quantitative estimate of its advantages for clinical diagnosis. The system was used to process a set of film radiographs of an anthropomorphic chest phantom, produced under conditions that were designed to provide a wide range of image qualities. Following this, four sets of randomly ordered processed and unprocessed images were formally assessed by a group of experienced observers. Consensus opinion from the group indicated that significant improvement could be obtained through simple image processing. Some radiographs regarded as unacceptable became, after processing, acceptable to viewers.
A flexible image archiving system using a personal computer and optical disk
Authors: Parkin A. , Norwood H. , Erdentug M. A. , Hall A. J.
Published: July 2009

Diagnostic imaging departments generate large amounts of image data from several sources (nuclear medicine, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), digital radiography). There is often a requirement to preserve the raw data, which creates a need for a stable, large-capacity storage facility. Image archiving facilities are usually provided by the manufacturer of the imaging device and are based on magnetic tape or floppy disks. These are inherently slow and take up a large amount of storage space.

Here, we describe the application of a personal computer and optical disk as an image archiving device, which brings the advantages of large capacity, low cost and savings on storage space.

Images are stored in a variety of formats, which vary between manufacturers and even between different machines of the same manufacturer.

Image archiving facilities based on magnetic tape have the advantage of large capacity but the data transfer rate is low (approximately 0.1 Mbytes/s), data are written serially so access time is long and the tape reels occupy a large amount of floor space (a busy CT scanner may generate one reel of tape per day). Added to this is the high cost of tapes and the requirement periodically to rewind and rewrite the tapes to preserve image quality.
Primary malignant melanoma of the vagina
Authors: Constant O. , Blake P.
Published: July 2009

Primary malignant melanoma of the vagina is a rare tumour. We report a case, showing the appearances on transverse axial and reformatted sagittal computed tomography (CT), and discuss the management and prognosis.
The cost of imaging procedures
Authors: Russell J. G. B.
Published: July 2009

Dr Jeans (1989) asked for reassurance that diagnostic radiology can be financially justified when the possible harm caused ionizing radiation is costed.

I don't think one needs to involve money in this assessment. For instance, take a large radiation dose examination such as barium enema. If we take 100 patients aged about 60 years having a barium enema, we would discover about two have cancers. If one of these is then cured we have saved a life.
Intraoperative localization of an osteoid osteoma
Authors: Thomas N. B.
Published: July 2009

I was interested in the description of a simple, but apparently very effective, technique to aid in the intraoperative localization of an osteoid osteoma by Todd et al (1989).

I must, however, point out that the radiograph in their paper (Fig. 1) stated to show “no abnormality”, quite clearly demonstrates sclerosis of the distal capitate in keeping with the clinical diagnosis of an osteoid osteoma.
Book review
Authors: Dixon Adrian
Published: July 2009

This will prove to be a very useful book for medical students and people starting their radiographic or radiological careers (e.g. Part I FRCR candidates). It has no text; just images with accompanying line drawings. Indeed the quality of the contributions by Alyce Norder and John Allen, who prepared the line drawings, has considerably helped make this book the success that it is.
Book review
Authors: Loose Henry
Published: July 2009

This detailed book must be the definitive treatise on benign strictures of the biliary system. The authors' experience is based on treatment of 229 such strictures and this must be the largest series published to date.
The anatomy of the first sacral nerve root sheath shown by computed tomography
Authors: Moore N. R. , Dixon A. K. , Freer C. E. L.
Published: July 2009

Analysis of 25 patients with normal computed tomographic appearances at the lumbosacral junction revealed wide variation in the anatomical level at which the first sacral nerve root sheaths were seen emerging from the theca. In nine patients (36%), the SI nerve root sheaths were first recognized at the level of the lumbosacral disc. In 14 patients (56%), the sheaths emerged cranial to the disc; it is possible that these patients may be more prone to neurological complications related to disc or facet joint disease, especially if the sheath is laterally sited within the lateral recess. Conversely, that minority of patients (two, 8%) in whom the root sheaths emerge caudal to the disc level may be relatively protected from neurological complications.
A simple technique for intraluminal irradiation in oesophageal tumours using the high-dose-rate Microselectron
Authors: Burt P. A. , Notley H. M. , Stout R.
Published: July 2009

The majority of oesophageal cancers present at an incurable stage and any treatment is aimed at relieving unpleasant symptoms, the most important of which is dysphagia. Unless this is satisfactorily relieved, the demise of the patient is usually rapid with marked weight loss and gross wasting. Unpleasant terminal events ensue as the patient finally cannot even swallow his own saliva. Palliative external-beam radiotherapy has been used with limited success but the established methods of relieving the obstruction include repeated dilatation and the insertion of specially designed tubes at oesophagoscopy (e.g. Mousseau-Barbin or Celestin tubes). Recently, laser treatment has been used with benefit. None of these methods are ideal for palliation as they usually require hospital admission and often repeated oesophagoscopy, and may be associated with major morbidity. An easy method of palliating these patients has been eagerly awaited.
Atlanto-axial rotary fixation: diagnosis by functional computed tomography
Authors: Moss J. G. , Sellar R. J. , Bradnock B.
Published: July 2009

The term atlanto-axial rotary fixation was first coined in 1968 (Wortzman & Dewar, 1968). It is an unusual condition, which refers to fixation of the atlas on the axis usually within the normal range of atlanto-axial rotation. The diagnosis can be difficult to make on plain radiography and many cases present late only to require open surgery (Fielding & Hawkins, 1977). Recently,functional computed tomography (CT) has been successfully used in a patient with atlanto-axial rotary fixation (Kowalski et al, 1987) and we discuss its value in our patient.
Clinical evaluation of a digital signal-processing device for real-time speckle suppression in medical ultrasonics
Authors: Loupas T. , Allan P. L. , McDicken W. N.
Published: July 2009

Although the field of medical ultrasound imaging has experienced significant advances during the last few years, ultrasound images still suffer from a type of acoustic noise called speckle, which represents a major source of image quality degradation (Kremkau & Taylor, 1986). Speckle is an interference effect caused by the addition by the transducer of echoes scattered by tissue inhomogeneities of size and spacing too fine to be resolved (Morrison et al, 1980; Wells & Halliwell, 1981). The resulting granular pattern depends on both the imaging system and the tissue being imaged in such a complicated way that, although it could be possible to use the statistical properties of speckle for tissue characterization (Wagner et al, 1987), a human observer cannot isolate the true tissue information simply by visual inspection of the image. There are several reasons that make a speckle-free image desirable.

1. Speckle limits the resolution of small structures and reduces the ability of a human observer to detect low-contrast lesions (Smith & Lopez, 1982; Lowe et al, 1988).

2. Since speckle is a machine-dependent artefact, it introduces unnecessary image variability between different scanners (Chivers et al, 1986).

3. The human visual system is very sensitive to random intensity fluctuations (noise). Although no experimental data exist for medical ultrasound, it has been observed in other areas where this phenomenon is also encountered, that speckle reduces the efficiency of a human observer by causing viewer fatigue (Rawson et al, 1976).
Changes in relative biological effectiveness with depth of neutron beams
Authors: Hall E. J.
Published: July 2009

The paper by Dr Hornsey and colleagues that appeared in the November issue of the British Journal of Radiology (Hornsey et al, 1988) had a pleasantly familiar message. In fact, the principal conclusions drawn were made previously some years ago in papers appearing in the British Journal of Radiology describing data obtained on the NASA cyclotron at Cleveland, where neutrons are generated by 43MeV (p→Be) (Hall et al, 1982, 1983). The pertinent observations are:

(1) There is (or may be) a change of relative biological effectiveness (RBE) with depth for high-energy neutron beams.
Book reviews
Authors: Durant K.
Published: July 2009

The sections in this book are derived from papers given at the 22nd San Francisco Cancer Symposium in 1987. Fractionation was also the theme of the 1967 symposium, and the editors point out that in the intervening decades, despite progress in heavy particle irradiation, brachytherapy, hyperthermia, sensitizers and monoclonal antibodies, optimal administration of ionizing radiation remains uncertain. The papers examine this uncertainty in great detail and nearly all the main workers currently involved in the investigation of fractionation are represented here.
Book reviews
Authors: Linch David
Published: July 2009

This multi-author book is an authoritative review of the longterm effects of chemotherapy and radiation on bone marrow function. The editors must be commended on their choice of authors who have not only made contributions to the field but are also able to write clearly and concisely. The bibliographies at the end of each chapter are in general good and will be of considerable help to the reader wishing to pursue an issue further.
Book reviews
Authors: Sampson Charles B.
Published: July 2009

Many nuclear medicine personnel I know are for one reason or another “too busy”. Most agree that it is a good idea to keep up to date with current developments and the Radiopharmacy and Radiopharmacology Yearbooks are welcome developments in this area.
Book reviews
Authors: Dixon Adrian , Freeman Alan
Published: July 2009

This series by Churchill Livingstone is very good and could be said to have“captured” this market. By focusing on one clinical area, here the gastrointestinal tract, the team of writers can produce an up-to-date account which usually surpasses those found in comprehensive textbooks. The danger is that too many such books appear and this particular issue competes directly with Computed Tomography of the Gastrointestinal Tract, Including the Peritoneal Cavity and Mesentery edited by Morton Meyers.
Bone marrow scintigraphy in the diagnosis of post-traumatic avascular necrosis of bone
Authors: Tawn D. J. , Watt I.
Published: July 2009

A series of 19 patients, who were clinically suspected of developing avascular necrosis of bone following fracture, were entered into a pilot study comparing the use of bone marrow scintigraphy with conventional skeletal scintigraphy. Two-phase bone scintigraphy, using 600 MBq of 99Tcm-HMDP, and perfusion and late-phase nanocolloid scintigraphy, using 370 MBq of 99Tcm-nanocolloid, were performed on each patient. In both methods, photon deficiency at the site of interest was taken to indicate avascularity. The perfusion phase of both methods was found to be unhelpful. Agreement between methods was obtained in 18 patients (95%). Six patients had abnormal nanocolloid scans, one of which was normal on the conventional bone scintigram. The remaining 13 patients had no evidence to suggest avascularity in either method. Three of the patients with abnormal scans have had hip replacement surgery following which avascularity of the femoral head was confirmed. 99Tcm-nanocolloid scintigraphy is thus shown to be a very sensitive method of demonstrating avascularity of bone following trauma.
Ultrasound in suspected obstruction complicating renal transplantation
Authors: Straiton J. A. , McMillan M. A. , Morley P.
Published: July 2009

The findings of regular ultrasound examination of 439 renal transplants in 419 patients performed during a 16-year period were reviewed to determine the significance of collecting system dilatation. Dilatation was observed in 80 cases, 34 of these proving to be obstructed. Pelvic dilatation was an insignificant finding except when appearing within a month of transplantation. One third of cases developing pelvic dilatation within a month showed progressive dilatation with obstruction subsequently confirmed. The majority of cases developing unheralded dilatation of pelvis and calyces were obstructed and all such patients require further investigation. Recurrence of dilatation following relief of obstruction was associated with recurrent obstruction in eight of nine cases. Consideration of ultrasound appearances allows more critical selection of patients for further investigation when dilatation is seen.
Relative safety of intravenous digital subtraction angiography over other methods of carotid angiography and impact on clinical management of cerebrovascular disease
Authors: Stevens J. M. , Barter Susan , Kerslake R. , Schneidau Andrea , Barber C. , Thomas D. J.
Published: July 2009

Data from a multicentre survey based on three London teaching hospitals on the relative safety and clinical utility of intravenous carotid digital subtraction angiography (DSA) over intra-arterial DSA and conventional carotid angiography are presented. The incidence of stroke during intra-arterial DSA was 0.7% (n = 538) and during conventional angiography was 0.8% (n = 780). The incidence of stroke during intravenous DSA was zero (n = 3710). When it constituted the initial investigation, intravenous DSA achieved a 93.8% replacement value over intra-arterial studies as a whole (n = 474) and 89% replacement value for patients having carotid endarterectomy (n = 99). It was also noted that the installation of DSA equipment at one unit coincided with a sixfold increase in the number of carotid angiographic examinations and an almost threefold increase in carotid endarterectomies.
New scans from old: digital reformatting of ultrasound images
Authors: Halliwell M. , Key H. , Jenkins D. , Jackson P. C. , Wells P. N. T.
Published: July 2009

Two-dimensional images obtained using ultrasound have been digitized from videotape recordings and stored within a maximum of 240 digital memory planes to form a three-dimensional data set using a commercially available image processing unit. This data set has been manipulated to produce images in planes perpendicular to the original scan set. The reformatted images represent not only the scans that could have been obtained by rotating the scan head but also demonstrate planes that are not accessible by conventional scanning. The system has been evaluated with a tissue-equivalent phantom to determine the geometric accuracy of the reformatting process. Clinical material has also been used to evaluate the practical value of such a technique and to highlight difficulties that may be encountered in its routine use.
Organ doses from cardiac and carotid digital subtraction angiography
Authors: Mustafa A. A. , Janeczek J.
Published: July 2009

Estimates of mean organ doses from cardiac and carotid digital subtraction angiography (DSA) are obtained from measurements done using a Rando-Alderson tissue-equivalent phantom. Thermoluminescent dosemeter chips and discs were calibrated and used for all measurements in the primary and scattered radiation fields. Skin doses as well as mean doses received by the thyroid, lung, lens of the eye, breast, uterus and the ovaries were measured. A 30° right anterior oblique (RAO) cardiac DSA study produces a beam entrance dose of about 121 mGy at a rate of 0.48 mGy/frame. The highest mean organ dose from cardiac DSA was to the lung with a value of 14.4 mGy. The rest of the organs received doses below 1 mGy. In carotid DSA, the mean entrance doses resulted from the RAO, left anterior oblique, and the Towne's view projections give an average of 168 mGy at a rate of 8.4 mGy/frame. The highest mean organ dose from the three projections, 21 mGy, was received by the thyroid. The uterus and ovaries received the lowest doses from both procedures with values below 0.04 mGy. Patient and phantom surface exposures were compared using an exposure area product system. Hence, exposure conditions used for measuring organ doses on the phantom were adjusted to resemble those used for patients.
Sustained complete remission of Stage IVb carcinoma of the cervix with cis-platinum, methotrexate and bleomycin chemotherapy
Authors: Burnet N. G. , Blake P. R.
Published: July 2009

The prospects for women with invasive carcinoma of the cervix have changed relatively little over the last 30 years and this has encouraged studies of the addition of chemotherapy to radiotherapy for the treatment of advanced disease. Combination drug treatment can now produce responses in a substantial number of patients with advanced disease, although this is at the cost of toxicity, and the number of durable responses achieved is only small. This should, however, serve to encourage further work, especially since occasional patients may show dramatic benefit. We report such a case.

A 42-year-old accountant presented with a history of a smelly, green vaginal discharge and backache. On direct questioning a history of menorrhagia was also elicited. She was para 2 + 0 and had never had a cervical smear. There was no other relevant history.

Clinical examination revealed a large tumour involving the cervix and she was admitted for full assessment including examination under anaesthetic (EUA). In theatre, she was seen to be bleeding from a tumour involving the whole cervix and the left parametrium was thickened and fixed to the pelvic side wall.
Atypical amyloidosis of bone
Authors: Daly B. D. , Moore D. P.
Published: July 2009

Amyloid deposits involving bone have usually been considered to be indistinguishable from lytic metastases or myeloma deposits (Resnick, 1981). Bone or joint involvement by amyloidosis is recognized to occur in up to one in seven cases of multiple myeloma (Stoker, 1986). We present a rare case where amyloidosis of bone mimicked the appearances of a cartilaginous tumour in a patient who presented simultaneously with myeloma.

A 60-year-old man presented with a 6-month history of malaise and weight loss. He had no relevant past history and was on no medication. On examination he was cachectic and a painless, hard swelling was noted at the medial end of his left clavicle. On questioning, the patient admitted that this lesion had been gradually increasing in size over a 2-year period.

Laboratory investigations revealed a haemoglobin of 10mg/ dl with an erythrocyte sedimentation rate (ESR) of over lOOmm/h, plasma urea and creatinine elevated to four times normal levels and a heavy proteinuria (>35g/l) with positive Bence-Jones protein. A bone marrow aspirate containing 20% primitive plasma cells confirmed a diagnosis of multiple myeloma.
Asymptomatic haematuria and abnormal urine cytology
Authors: Rao Aroor , Kagan A. Robert , Steckel Richard J.
Published: July 2009

An abnormal urine cytology is always regarded as a serious finding. Therefore, it is important to locate promptly the source of abnormal cells. However, the initial radiological examination can be normal, in which case the source of abnormal cells should be investigated further by direct endoscopic techniques.

A 72-year-old Caucasian woman was seen in October 1985 with a history of asymptomatic microscopic haematuria for over 20 years. She had been investigated several times, including intravenous urograms and cystoscopies that had been negative. In 1979, however, she was reported as having an “abnormal urine cytology”, which was confirmed again in 1983. Intravenous urograms and cystoscopies performed at these times were again negative. The patient was lost to followup until 1985 when a repeat urine cystological examination was positive. A subsequent intravenous urogram showed a nonfunctioning right kidney (Fig. 1). A retrograde pyelogram revealed localized narrowing of the right ureter near the pelvic brim, with marked hydronephrosis; there also appeared to be irregularity of the right ureter near its junction with the renal pelvis, suggesting the possibility of a papillary tumour (Fig. 2).
Proton nuclear magnetic resonance imaging as a predictor of the outcome of photodynamic therapy of tumours
Authors: Moore James V. , Dodd Nicholas J. F. , Wood Brian
Published: July 2009

The ability to monitor non-invasively and at early times, the cytotoxic efficacy of a cancer treatment in an individual subject, plainly of great potential clinical value. In a recent publication, Naruse et al (1986) showed proton nuclear magnetic resonance (NMR) images of a rat glioma that had been treated 48 h previously by radiofrequency (RF) hyperthermia. Regions of high signal intensity were readily distinguishable and were equated qualitatively with histological necrosis caused by the heat treatment. These increases in signal intensity almost certainly reflected an increase in water content associated with oedematous changes in the tumour. This might expected after in vivo hyperthermia, where an important contribution to the toxic effect is vascular collapse with subsequent secondary ischaemic necrosis of sheets of tumour cells (reviewed by Reinhold & Endrich, 1986).

A similar form of damage occurs after photodynamic therapy (PDT), the combination of non-toxic photosensitizing drugs and non-thermal power densities of visible light (Star al, 1986), and it appeared to us that NMR imaging might be useful in assessing damage in this new form of cancer treatment. We have shown elsewhere that NMR images taken soon after a PDT treatment correspond quantitatively with histologically defined cell killing at the same interval (Dodd etal, 1989) and we present preliminary experimental results in which we relate quantitatively proton NMR images and the overall therapeutic outcome measured by tumour regrowth delay.
Transient circular narrowing of the cervical oesophagus
Authors: Dantas Roberto O.
Published: July 2009

In patients with dysphagia, Ekberg et al (1988) described a transient circular narrowing within the cervical oesophagus.

We published a case report of a 26-year-old woman with similar radiological findings (Dantas et al, 1985). The patient had had earlier surgery to correct the emergence of the right subclavian artery from the left side of the aortic arch, after complaining of dysphagia of 4 months duration.
Book reviews
Authors: Gishen Philip
Published: July 2009

This small, soft-covered textbook is aimed at the limited audience attempting the film viewing session of the Final Fellowship examination of The Royal College of Radiologists. It does not read particularly well and suffers from pictures of radiographs that are not always optimal in size and clarity.
Book reviews
Authors: Fogelman Ignac
Published: July 2009

This book is part of a series on contemporary issues in nuclear imaging and deals with bone scanning and densitometry. Topics covered include a review of bone and growth metabolism, the normal bone scan, its use in various pathological conditions, and the more recent developments of single photon emission computed tomography (SPECT), and the theory and application of bone mineral measurements.
Asymmetric field arc rotations
Authors: Palta Jatinder R. , Ayyangar Komanduri M. , Suntharalingam Nagalingam , Tupchong Leslie
Published: July 2009

Optimal treatment planning of target volume that surrounds a vital critical structure is often very difficult. Treatment techniques using moving beam therapy with fields asymmetric with respect to rotational axis of the collimator head allow treatment of such target volumes with minimal dose to critical structures. The availability of independent motion of the collimator jaws on new medical accelerators allows easy setting up of asymmetric treatment portals. Therefore, treatment techniques utilizing asymmetric field arc rotations with acceptable dose distributions have been possible.
Variation of tumour radiosensitivity with time after anaesthetic
Authors: Nias A. H. W. , Perry P. M.
Published: July 2009

Transplanted C3H mouse mammary tumours were given single doses of X irradiation in air or oxygen at 1 atmosphere (atm) with or without anaesthesia of the recipient mice by ketamine and diazepam. The radiation response to single doses of 25 Gy was determined in terms of the time taken to reach 3.5 times the treatment volume. Under all conditions there was more growth delay in tumours irradiated in pure oxygen than in air. In both air and oxygen, the radiation response for anaesthetized animals tended to fall below the level for non-anaesthetized ones when only lOmin had elapsed after the administration of anaesthesia. After 25 min, the response in air was back to the level for the non-anaesthetized animals but the oxygen group now showed significant sensitization compared with the oxygen without anaesthetic group. After 40 min, the air group now showed slight sensitization and the oxygen group still showed significant sensitization by the anaesthetic. These results demonstrate the importance of the time interval between anaesthesia and irradiation of mouse tumours.
Primary malignant fibrous histiocytoma of a metacarpal bone: a new localization
Authors: Dock Wolfgang , Hajek Paul , Wittich Gerhard , Kumpan Wolfgang , Grabenwöger Florian
Published: July 2009

Malignant fibrous histiocytoma (MFH) is a common tumour of the soft tissues (Ros et al, 1984); it is rare in bone but the predilection sites in bone are the distal metaphysis of the femur and the proximal metaphysis of the tibia. We present a patient with MFH of a metacarpal bone.

A 72-year-old man presented with pain in his right second metacarpal region. Duration of symptoms was 5 months with increasing swelling in the past 4 weeks. There was no history of previous trauma or malignancy. Clinical examination revealed a tender second metacarpal of the right hand.
Book reviews
Authors: Preston B. J.
Published: July 2009

The anatomy of the structures on the posterior aspect of the knee is complex and most radiologists require help with the interpretation of images obtained by computed tomography (CT) and magnetic resonance imaging (MRI). This book gives just the aid that is required.
Book reviews
Authors: Renton P.
Published: July 2009

This moderately priced and sized volume covers many topics which will be of great interest to orthopaedic surgeons, especially, I would have thought, those in training. There are some gems: Freeman and Railton on knee prostheses, Neer on shoulder arthroplasty and Galasko on the treatment of skeletal metastases. Some of the many topics are less well covered, as is inevitable in multi-author volumes.
Book reviews
Authors: Finlay David
Published: July 2009

Although I have not been impressed by the other books in this series, I feel this volume is of value. The book is titled as Rheumatologic Disorders, but, in fact, includes other related conditions, particularly in the spinal chapter. There is a good section on the approach to joint disease divided into the basic appearances and then the use of these to form a clinical diagnosis.
Book reviews
Authors: Stuttle A. W. J.
Published: July 2009

The aim of the book is to provide concise information concerning recent developments in the radiopharmaceutical sciences. There are five main articles which cover reporting of adverse reactions in Europe, a study from the Netherlands relating to the absorbed radiation dose from nuclear medicine investigations, the effect of drugs and concomitant therapy on the biodistribution of radiopharmaceuticals, formulation controls and preliminary clinical studies conducted with 99Tcm-3-iodo 2,4,6-trimethyl IDA and a review of the radiopharmacology of immunoglobulins with special emphasis on monoclonal antibodies.
Uterine leiomyomata: sonographic mimicry
Authors: Borgstein R. L. , Shaw J. J. , Pearson R. H.
Published: July 2009

Leiomyomata (fibroids) are the commonest uterine tumours and they may vary widely in their sonographic appearance. We describe a case in which the appearance was that of a missed abortion and discuss the limitations of ultrasound in the differential diagnosis of fibroids. This case also highlights some of the benefits of peroperative sonography.

A 43-year-old Caucasian woman presented with heavy vaginal bleeding 4 days after the end of a normal period.
Ductal adenoma of the breast: mammographic appearances and pathological correlation
Authors: Moskovic E. , Ramachandra S.
Published: July 2009

Ductal adenoma of the breast is a little known and only recently described lesion. However, it is an important diagnosis to make since it is benign, despite simulating malignancy on both clinical examination and mammography.

A 72-year-old woman was referred to the Breast Unit at the Royal Marsden Hospital, complaining of a feeling of “thickening” within the lateral aspect of the left breast. Clinical examination revealed no discrete mass but there was a slight area of nodularity lateral to the left nipple, which was asymmetrical when compared with the corresponding area on the right.
An interesting radiation protection finding around a linear accelerator
Authors: Conere Tom , Weatherburn Henry , Wassem Bernard
Published: July 2009

While commissioning an Asea Brown Boveri (ABB) Dynaray-LA20 linear accelerator, some unexpected results were obtained during radiation leakage measurements around the treatment head, as reported below.

Basically, radiation dose measurements were being made to confirm that the accelerator complied with International Electrotechnical Commission (IEC) requirements, as specified by BS 5724, Section 2.1 (British Standards Institution (BSI), 1984). These were undertaken using a Nuclear Enterprises Ionex dosemeter Type 2500/3 in conjunction with a Farmer Type 2571 0.6 cm3 thimble ion chamber, following the protocol detailed in paragraph 31.3 of BS 5724, Section 2.1 (British Standards Institution (BSI), 1984). These were undertaken using a Nuclear Enterprises Ionex dosemeter Type 2500/3 in conjunction with a Farmer Type 2571 0.6 cm3 thimble ion chamber, following the protocol detailed in paragraph 31.3 of BS 5724, Section 2.1.
Visits to controlled areas in X-ray departments
Authors: Goddard B. A.
Published: July 2009

The Southampton Health District receives many requests from school children who wish to visit X-ray departments as part of their school activities. Such visits could prove beneficial in terms of future recruitment.
British Standards specification for balloon dilatation catheters
Authors: Hartnell George
Published: July 2009

Some of your readers may like to know that a draft specification for balloon dilatation catheters has been prepared by the British Standards Institution.
Radiological appearances of colonic ring staple anastomoses
Authors: Daly B. D. , Crowley B. M.
Published: July 2009

We welcome the comments of Mr Chan and Mr Davidson on our paper. We would, however, emphasize that we have recommended an urgent water-soluble “contrast” enema only in those cases where both a disrupted staple ring and the clinical situation have suggested dehiscence of the anastomosis.