bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observer variation in ultrasound assessment of the thyroid gland
Authors: Jarløv A E , Nygård B , Hegedüs L , Karstrup S , Hansen J M 
Published: July 2009

Abstract
In order to determine observer variation in the assessment of the thyroid gland by ultrasonography, two specialists (one endocrinologist and one radiologist) independently evaluated 76 thyroid glands, and assessed the sonogram as homogeneous, inhomogeneous, containing a solitary solid lesion or a solitary cyst in each of 152 thyroid lobes. The observed agreement between the two observers ranged from 0.80 to 0.91. By the use of the kappa coefficient the observed agreement was adjusted for change agreement. Kappa can vary from − 1 (total disagreement) to + 1 (total agreement) and kappa values between 0.55 and 0.60 were found. Among 152 lobes a solitary solid lesion, i.e. a nodule, was found in 22 lobes by the two observers; however, they only agreed on a classification in 10 lobes (45%). Clinicians should be aware of the moderate agreement between observers in thyroid ultrasonography.
The management of stroke during intraarterial thrombolysis
Authors: Nyamekye I , Beard J , Gaines P 
Published: July 2009

Abstract
Intraarterial thrombolytic therapy is being increasingly used in the treatment of acute limb ischaemia. When strokes occur during thrombolytic therapy treatment is usually stopped because of the suspicion of cerebral haemorrhage. If the stroke is not haemorrhagic then stopping the treatment jeopardizes the ischaemic limb. If the stroke is proven to be non-haemorrhagic on computed tomography (CT) then the thrombolytic therapy should be recommenced. We present three case histories of patients who suffered a stroke during thrombolytic therapy over a 30-month period, in whom CT confirmed non-haemorrhagic stroke and we suggest that managing the ischaemic limb with anticoagulant and thrombolytic therapy can be safe in the early period following the stroke. We also discuss the probable aetiology of the strokes and whether cardiac echocardiography should be performed in these patients.
A reference frame designed to use external numeric references during simulation for tumours located in the head
Authors: Niël C 
Published: July 2009

The interest in three-dimensional radiation therapy planning and conformal beam therapy is increasing rapidly as the equipment necessary for these techniques becomes commercially available. Compared with classical two-dimensionally planned two- and three-field irradiation this new treatment mode can achieve higher tumour doses with simultaneous reduction of radiation dose to surrounding normal tissue by the use of five or more external, multi-leaf collimated radiation beams. Beam positioning, however, can diverge from the treatment plan as assessed by computer planning since (often complex) anatomical structures are used as a reference to position the irradiation beams at the time of simulation. We therefore developed a reference frame to enable the use of external numeric references in the craniocaudal, anteroposterior and laterolateral direction as a guide for beam positioning on the simulator. In this study we evaluate the accuracy of such a frame and the reproducibility of its use.
Four lucite (polymethylmethacrylate) arcs were constructed with holes drilled every centimetre. All arcs were identical in form, size and location of the holes. Two identical frames were constructed by connecting two arcs (Figure 1a) by the use of one lucite rod at the top (Figure 1b) and two lucite plates at the base (Figure 1c), the latter having two metal rods perpendicular to the plates to ensure reproducible positioning of the frame by corresponding holes in the base plate of the immobilization set-up (Figure 1d).
Isolated atraumatic third nerve palsy: clinical features and imaging techniques
Authors: Renowden S A , Harris K M , Hourihan M D 
Published: July 2009

Abstract
We have reviewed 34 consecutive patients imaged for an isolated third nerve palsy over a 2-year period. With pupil sparing the third nerve palsy was most often due to ischaemic microvascular disease. The commonest cause of a third nerve palsy with pupillary involvement was a posterior communicating artery aneurysm. Clinical features such as speed of onset, pain and completeness of palsy were not reliable in the diagnosis of either the nature or the location of the cause. Pupillary involvement was however often associated with a compressive lesion. Imaging along the whole course of the nerve is recommended for adequate evaluation.
Child abuse—necklace calcification—a sign of strangulation
Authors: Carty H 
Published: July 2009

Abstract
Strangulation has been postulated as one cause of cerebral hypoxia in child abuse. This report describes the finding of necklace calcification in an infant with rib fractures and a metaphyseal fracture and an admission of a shaking injury. The calcification is likely to represent fat necrosis as the result of strangulation.
Angioplasty gives good results in critical lower limb ischaemia. A 5-year follow-up in patients with known ankle pressure and diabetic status having femoropopliteal dilatations
Authors: Jeans W D , Cole S E A , Horrocks M , Baird R N 
Published: July 2009

Abstract
137 consecutive patients with known ankle pressures and diabetic status had attempted femoro-popliteal dilatation for lower limb ischaemia in an English provincial teaching hospital. All except one were followed until failure or death to assess survival and amputation rates. Non-diabetic patients with critical limb ischaemia had a 5 year survival rate of 62.2% (SE 17.1) compared to 50.5% (SE 7.0) for claudicants, with no significant difference on logrank testing. Diabetics had a relative risk of amputation of 11.2 compared to non-diabetics. Patients with pre-treatment ankle pressures of 50 mm or less had a relative risk of amputation of 2.6 compared to those with higher resting pressures. It is concluded that angioplasty should be the treatment of first choice in critical lower limb ischaemia whenever it is technically possible. Including patients with rest pain in the critical ischaemia group does not significantly affect cumulative patency rates.
Craniospinal axis irradiation: an improved electron technique for irradiation of the spinal axis
Authors: Li Chun , Muller-Runkel R , Vijayakumar S , Myrianthopoulos L C , Kuchnir F T 
Published: July 2009

Abstract
In this work we review the dosimetric features of craniospinal axis irradiation in the areas of matching cranial and spinal fields, with reference to the normal structures within the spinal field. The implications of the use of photon or electron modalities for the spinal port were evaluated. A novel method of matching the cranial photon and the spinal electron fields involving a computer-aided junction design is presented. The technique involves moving the photon beam in three steps to degrade its penumbra to match that of the electron field. Thermoluminescent dosimetry in a Rando phantom and computed tomography-based dose–volume histogram study for an illustrative paediatric case were used to compare the dose to normal structures within the spinal field. Our results show that the use of electrons for the spinal field leads to better sparing of deep seated normal structures. In the case of bone marrow, the use of a customized bolus for the spinal field results in an improved dose distribution, making electrons potentially superior to photons for radiobiological reasons.
Computed tomography and magnetic resonance in the diagnosis of intraventricular cerebral masses
Authors: McConachie N S , Worthington B S , Cornford E J , Balsitis M , Kerslake R W , Jaspan T 
Published: July 2009

Abstract
We describe a series of 60 cases of patients with masses arising within the cerebral ventricles. The site and relative frequency is noted for each histological type. The differential diagnosis depends on patient age and sex, site, morphology and number of masses, presence and type of hydrocephalus and the characteristics of the mass on computed tomography (CT) and magnetic resonance (MR) images. A review of the literature has been performed and this information collated with our own experience to give detailed descriptions of the typical features of each intraventricular mass. Attention is drawn to intraventricular neurocytoma, a recently described tumour that may be mistaken histologically for intraventricular oligodendroglioma or ependymoma. A comparison is made of the value of CT and MR in the diagnosis of intraventricular masses.
Computed tomographic scanning of L3/4 in suspected disc prolapse: is it necessary?
Authors: de Vos Meiring P , Gandhi M , Nakielny R A 
Published: July 2009

Abstract
Computed tomography (CT) scanning is an accepted first line investigation for suspected lumbar prolapsed intervertebral disc disease (PID). However, it does involve ionizing radiation and any possible reduction in the dose is desirable. A questionnaire was sent to a random selection of 60 CT centres in the UK to confirm that a routine scan of the three lower lumbar levels is current practice in a majority of centres, regardless of symptomatic presentation. All orthopaedic CT referrals over 2 years for suspected lumbar disc disease in Sheffield were studied retrospectively. Of 486 cases, 99 (20%) were shown to have disc disease, of which 16 (3.3%) had disease at the L3/4 level. Of these 16 cases, 11 were suspected clinically. Analysis of the long-term outcome of the five unsuspected cases showed that in none did the CT findings make any significant contribution to this outcome. These results have altered our practice. Two-level scanning is now performed routinely and three-level scanning is only performed when specified clinical or radiological indications are present.
Scintigraphic evaluation of sialadenitis
Authors: Hughes P M , Carson K , Hill J , Hastings D 
Published: July 2009

Abstract
Salivary gland scintigraphy using 99Tcm sodium pertechnetate and a 20-min dynamic data acquisition with a sialogogue at 10 min was employed as the primary imaging modality in sialadenitis in 32 patients. Paired asymptomatic glands within the study group were used to establish control values for a number of computer-derived functional parameters. The shape of the activity-time curve was described as: H = hyperactive, N = normal, M = median, S = sloped, F = flat, 0 = obstructed. Of seven patients who had ductal stones on plain films, two passed stones prior to sialography and had normal curves, whole the remaining five patients had Type O curves. Parametric evidence of gland dysfunction was identified in an additional seven symptomatic glands, six being hyperactive; histology identified an acute inflammatory infiltrate in the only excised gland in this group. Glandular hypofunction was identified in one case, in which histology revealed extensive fibrosis and glandular atrophy. Type M and S curves were found in 28 glands, 75% of which were asymptomatic. Only one gland was indicated as hypoactive by calculated parameters, and this showed a Type S curve. Scintigraphy and plain films represent the least invasive and, we feel, the most suitable primary method of investigating sialadenitis. Conventional contrast sialography may be reserved for cases with no identifiable stone but an obstructed curve. The use of functional parameters and curve morphology to determine gland dysfunction other than obstruction is non-specific, probably insensitive and is unlikely to alter clinical management. We propose an algorithm for the investigation of sialadenitis.
67Ga scintigraphy in HIV antibody positive patients; a review of its clinical usefulness
Authors: wassie E , Buscombe J R , Miller R F , Ell P J 
Published: July 2009

Abstract
We reviewed the results of 67Ga scintigraphy in HIV antibody positive patients in order to determine how the result affected management. Case records of 37 HIV antibody positive patients undergoing 67Ga scintigraphic studies over a 31 month period were examined. New and additional information was provided by 67Ga scintigraphy in 22 studies (53%). In 13 studies (32%) there was a positive effect on patient management. 67Ga scintigraphy was most useful in differentiating Pneumocystis carinii pneumonia from Kaposi's sarcoma in the chest and for the diagnosis of unsuspected lymphoma. Factors which reduced the effectiveness of 67Ga scintigraphy included empirical use of antibiotics in patients with suspected infection and the low specificity of the test.
Evaluation of a region growing algorithm for segmenting pelvic computed tomography images during radiotherapy planning
Authors: Neal A J , Sivewright G , Bentley R 
Published: July 2009

Abstract
A clinical evaluation of a computer segmentation algorithm was performed to determine whether the incorporation of such an algorithm into a radiotherapy treatment planning computer would increase the speed of segmentation and therefore increase user productivity. Six pelvic computed tomography (CT) data cubes were manually segmented akin to current radiotherapy practice on three occasions and the mean times for each data cube recorded to provide baseline measurements. The same images were then segmented using the new region growing algorithm, backed up by manual segmentation and contour editing tools where necessary, and the times compared with the baseline for each data cube. The results confirm that this algorithm can decrease segmentation times by a factor of 2.4 without compromising the quality of the final plan (p &lt;0.0001). Most of this time gain is from a rapid segmentation of the pelvic bones and external contour rather than the soft tissues of the pelvis. We conclude that such algorithms will be of value for segmenting large pelvic CT data cubes for radiotherapy planning by making the procedure less labour intensive.
Comparison of spiral-acquisition computed tomography and conventional computed tomography in the assessment of pulmonary metastatic disease
Authors: Collie D A , Wright A R , Williams J R , Hashemi-Malayeri B , Stevenson A J M , Turnbull C M 
Published: July 2009

Abstract
In a prospective study, spiral-acquisition computed tomography (SACT) of the thorax was evaluated in 104 patients with extrathoracic malignancy and suspected pulmonary metastases, and was directly compared with conventional computed tomography (CCT) in 23 patients. The following parameters were assessed: lesion detectability; the effect on lesion detectability of reconstruction of scans at 5 mm and 10 mm slice increments; breathing artefact and slice misregistration. The radiation dose of the two techniques was measured using thermoluminescent dosimeters placed within an anthropomorphic chest phantom, and the visibility of simulated metastases inserted into the phantom was also compared using CCT, standard SACT and SACT with pitch greater than 1.0. Where metastases were present, SACT scans showed significantly better lesion detectability than CCT scans (p &lt; 0.001). Image reconstruction of SACT data at 5 mm increments conferred no significant advantage in lesion detectability over 10 mm increment reconstructions. Compared with CCT,SACT scans showed reduced breathing artefact, and a complete absence of slice misregistration (p &lt; 0.01). Phantom measurements of radiation dose and resolution were similar for both techniques. Increasing the pitch of the spiral in SACT caused only a small decrease in phantom resolution, but with the advantage of a reduction in the radiation dose. Spiral-acquisition CT is superior to conventional CT for the assessment of pulmonary metastatic disease.
New sonographic finding in renal infarction
Authors: Kodama K , Matsuura K , Yamashita R , Yamanaka T , Terao N , Yaginuma T 
Published: July 2009

Abstract
We observed a unique sonographic finding in a patient with right global renal infarction associated with anabdominal aortic dissection. Sonography in the acute phase revealed a highly echogenic and thickened perirenal fascia without demonstrable abnormality of the renal parenchyma. This finding may be helpful inthe early diagnosis of renal infarction by routine sonography.
Comparison of technetium-99m nanocolloid and indium-111 leucocytes in the diagnosis of orthopaedic infections
Authors: Finlay D B L , Belton I P 
Published: July 2009

We would like to make the following response to the letter from Dr Stewart and colleagues regarding our paper.
We appreciate some marrow uptake is expected as well as liver and spleen uptake. As, however, our diagnostic criteria was an increase in uptake relative to the rest of the marrow, we do not believe that any of the images obtained were non-diagnostic.
The clinical utility of transrectal ultrasound and digital rectal examination in the diagnosis of prostate cancer
Authors: Shapiro A , Lebensart P D , Pode D , Bloom R A 
Published: July 2009

Abstract
The development of high definition transrectal ultrasound probes has led to an increased interest in the ability of transrectal ultrasound of the prostate (TRUS) to assist in the diagnosis and management of prostate cancer. The present study was designed to examine the correlation of TRUS with digital rectal examination (DRE). The study group comprised 471 patients in whom the results of (a) DRE, (b) TRUS, and (c) histology of tissue obtained by transrectal biopsy of the prostate (TB), were all available. In those patients where both TRUS and DRE were negative, but prostate specific antigen (PSA) was greater than 10 μg ml−1, six random biopsies were performed. In all other cases the biopsies were TRUS directed to the suspicious lesion. There were 142 cases in whom both DRE and TRUS were negative or only mildly suspicious of malignancy. TB in these cases was positive for cancer in 17 cases (12%). In a further 126 cases, TRUS was positive for cancer, while DRE demonstrated no suspicious nodule. TB was positive in only 17 of these cases (13.5%). Similarly, in the 31 cases in which DRE was positive but TRUS was negative, TB was positive in only three cases (10%). In the 172 cases in whom both DRE and TRUS were positive, 99 biopsies were positive (57.5%). It was concluded from this study that DRE remains the most valuable single examination in the diagnosis of prostate cancer. TRUS increases the sensitivity of DRE if both are positive. When there is a discrepancy between the two examinations, the biopsy yield is low. When both are positive, a high cancer yield is obtained, TRUS having added value in directing the biopsy needle to the suspicious site. TRUS is thus a valuable adjunct to DRE in the diagnosis of prostate cancer.
Localization of Lipiodol-radioiodine in hepatic metastases from renal cell carcinoma
Authors: Stansby G , Bhattacharya S , Hilson A J W , Lane D M , Hobbs K E F 
Published: July 2009

Abstract
Lipiodol, an iodinated derivative of poppyseed oil, is selectively retained in hepatocellular carcinoma and has been used as a vehicle to deliver localized doses of chemotherapeutic and radioactive agents to such tumours, thereby reducing the problems of external beam irradiation and the systemic toxicity of chemotherapy. We describe the first reported case where Lipiodol-targeted radiotherapy has been administered to a patient with secondary renal cell carcinoma in the liver. Localization was good and there were no complications. This case suggests that in future such patients may benefit from this therapy for unresectable lesions.
Prone oblique positioning for computed tomographic arthrography of the shoulder
Authors: Turner P J , O'Connor P J , Saifuddin A , Williams J , Coral A , Butt W P 
Published: July 2009

Abstract
Computed tomographic arthrography(CTA)of the shoulder is currently the best investigation of the unstable shoulder. 47 patients had CTA in the prone oblique position to assess its ability to demonstrate both anterior and posterior capsular mechanisms simultaneously. The first five patients were also scanned supine oblique to allow direct comparison with the prone oblique position. All studies were reviewed retrospectively by three musculoskeletal radiologists with regard to how well the relevant structures were demonstrated. In the prone oblique position, the anterior capsule was well shown in 98%, anterior labrum 98%, posterior capsule 91%, posterior labrum 89%, subscapularis tendon 98%, biceps tendon 100% and biceps tendon proximal insertion 78%. In 86% of cases both anterior and posterior structures were well seen simultaneously. In the five cases that also had supine imaging the prone oblique images were superior. The cause of poor demonstration of structures was invariably insufficient intraarticular air. It is concluded that the prone oblique is an excellent technique for CTA of the shoulder and should become the standard position for assessing shoulder instability.
Imaging studies for emphysematous pyelonephritis
Authors: Bistrup C , Christensen J 
Published: July 2009

We have the following comments to make regarding the questions raised by Chaudhuri and Fink about our article [1].
In our article we emphasized the different radiological diagnostic modalities which may be employed in the diagnosis of emphysematous pyelonephritis (EPN). We agree with Chaudhuri and Fink that a complete work-up of a patient with EPN includes an estimation of renal function.
Magnetic resonance neurography of the median nerve
Authors: Howe F A , Saunders D E , Filler A G , McLean M A , Heron C , Brown M M , Griffiths J R 
Published: July 2009

Abstract
A magnetic resonance imaging sequence, combining fat and flow suppression with T 2 weighting, has been used to produce high conspicuity images of the median nerve within the carpal tunnel. Standard maximum intensity projection techniques were then used to produce three-dimensional (3D) reconstructions of the nerve. Comparison of 3D projections with the wrist in a neutral position and wrist flexed at 45° depicted changes in the shape and course of the median nerve through the carpal tunnel of normal volunteers. In some cases of carpal tunnel syndrome evidence of a localized compression was observed. A 3D image of a nerve may help in the diagnosis of peripheral neuropathy and be an aid to surgery of or near major nerves.
Magnetic resonance imaging in myelodysplastic syndromes
Authors: Lewis S , Wainscoat J S , Moore N R , Golding S J 
Published: July 2009

Abstract
In this study we used magnetic resonance imaging (MRI) to examine the axial bone marrow of 11 patients with myelodysplastic syndromes (MDS). T 1 weighted images showed a reduction in signal intensity in all patients. The degree of reduction in signal intensity correlated with bone marrow cellularity rather than percentage blasts or French–American–British Co-operative group (FAB) classification. T 2 weighted images showed an increase in signal intensity in 10 out of 11 patients; however, reliable grading was not possible using this sequence. Both T 1 and T 2 weighted images indicated a homogeneous pattern of disease within the axial skeleton in MDS. We have also shown that iron deposition in multiply transfused patients is a significant factor influencing signal reduction. The results of this study suggest that MRI may have a diagnostic role in MDS but is unlikely to be of value in staging.