bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective assessment of a new graduated hookwire for the localization of impalpable breast lesions
Authors: Flanagan J J , Conry B G , Rubin G , Mills P , Bentley P G 
Published: July 2009

Abstract
The benefits of the addition of site specific variable graduations to a conventional mammographic localizing wire were assessed in a prospective multidistrict study. Six surgeons and five radiologists localized lesions in 31 patients in three District General Hospitals. The advantages of the graduated wire were shown to be greater ease and accuracy of radiological localization with easier surgical excision and a smaller resected breast specimen.
A method of brachytherapeutic treatment of tracheal stoma recurrence in head and neck cancer
Authors: Schäfer U , Schmilowski G M , Micke O , Mohring R , Willich N 
Published: July 2009

Abstract
Tracheal stoma recurrence after external beam irradiation in patients with laryngeal carcinoma is a serious complication. Treatment can often only be of a symptomatic nature. A simple method of brachytherapeutic treatment is described, consisting of a special flab applicator combined with a tracheostomal tube. The presented applicator system is suitable for treatment of the tracheostomal recurrence as well as the surrounding skin. It can be applied easily and is well tolerated by the patient, while at the same time achieving a good palliative effect.
A rapidly expanding testicular mass due to a ruptured ovarian follicle
Authors: Ablett M J , Masters J , Elliott S T 
Published: July 2009

Abstract
An ovotestis is the commonest gonad in the small number of patients who are true hermaphrodites. In the majority of ovotestes, testicular and ovarian tissue is arranged end-to-end. There has been only one previous report of the sonographic appearances of an ovotestis. We present the sonographic findings in a patient who developed a rapidly enlarging upper pole testicular mass, which was found on histology to be a ruptured ovarian follicle with spermatogenesis occurring within the adjacent testicular tissue.
Posterior pituitary ectopia and hypopituitarism—magnetic resonance appearances of four cases and a review of the literature
Authors: Denton E R E , Powrie J K , Ayers A B , Sonksen P H 
Published: July 2009

AbstractIn four patients presenting in childhood with varying degrees of hypopituitarism, magnetic resonance imaging (MRI) showed a reduction in size of the normal pituitary fossa contents and an absent or very narrow stalk. A high signal intensity, enhancing area at the base of the stalk, having the appearances and signal characteristics of the posterior pituitary, was seen in each case. We discuss the case histories and MR findings in our patients and review the relevant literature.
Patient doses in bone mineral densitometry
Authors: Huda W , Morin R L 
Published: July 2009

Abstract
Procedures were developed to compute effective dose equivalent (HE) values for patients undergoing bone mineral densitometry (BMD) measurements such as dual energy X-ray absorptiometry (DEXA) and quantitative computed tomography (QCT). Representative values of HE were determined for patients undergoing each type of BMD procedure. Typical DEXA measurements are associated with an HE of about 2.5 μSv. For QCT, the values of HE are 300 μSv for single energy techniques and 1 mSv for dual energy techniques, respectively. By comparison, a single well collimated abdominal X-ray examination often taken in conjunction with DEXA studies results in an HE of about 100 μSv. BMD patient doses are at the lower end of the exposure range encountered in diagnostic radiology. As a result, radiation dose is not a primary factor in choosing the method for BMD determination.
Effective doses for coronary angiography
Authors: Leung K C , Martin C J 
Published: July 2009

Abstract
A detailed study of dose data has been made for 100 coronary angiography examinations performed on a digital X-ray unit. Dose–area product (DAP) data have been analysed in terms of fluoroscopy and radiography for different projections. Projections patterns were similar for all cardiologists studied and the contribution to DAP from fluoroscopy was 32%. Data for 10 patients, selected because the percentage contributions to DAP from fluoroscopy and radiography were similar to the mean for the group, were used to derive conversion factors from DAP to effective dose. The mean DAP was 14 Gy cm2 and the effective dose 3.1 mSv. Conversion factors, based on the same protocol, were derived for a range of tube potentials and filtrations for use in estimation of effective doses with other units.
Patient doses from CT in New Zealand and a simple method for estimating effective dose
Authors: Poletti J L 
Published: July 2009

Abstract
A 1992 survey of doses to patients from CT scanning in New Zealand found that CT contributes 81 μSv per capita per annum, representing about 17% of the collective dose from medical irradiation. Because of the significance of CT, estimates of patient dose are now included in the National Radiation Laboratory (NRL) routine surveys of CT scanners. For some models of CT scanner, normalized organ dose data from Monte Carlo studies are available, enabling the calculation of the effective dose. For scanners for which there are no normalized organ dose data, it is shown that the computed tomography dose index (CTDI), determined at 1 cm depth in Perspex phantoms and normalized for mAs, may be used to estimate the effective dose. Estimates of effective dose derived from the CTDI may then be used to formulate reference dose levels, against which individual scanner doses may be compared.
A comparison of doses and techniques between specialist and non-specialist centres in the diagnostic X-ray imaging of children
Authors: Kyriou J C , Fitzgerald M , Pettett A , Cook J V , Pablot S M 
Published: July 2009

Abstract
A dosimetric survey of 14 routine X-ray examinations in children was carried out between 1993 and 1995. Two children's hospitals and four general hospitals took part in the survey which involved the calculation and measurement of nearly 3000 doses. Entrance surface doses (ESD) were calculated from exposure factors for radiographic procedures, and dose–area products (DAP) were recorded for both radiographic and fluoroscopic procedures. Doses were in good agreement with earlier studies, but for some procedures were significantly lower than those reported from other European countries. The main dose influencing factors for radiographic procedures were found to be the speed of the film–screen system and the use of an antiscatter grid. For the main head/trunk examinations, specialist centres often delivered higher doses to the younger children as a result of widespread use of a grid. In fluoroscopy, where the main dose influencing factors were the use of a grid and the dose rate dependence of the image intensifier, the children's hospitals consistently delivered significantly lower doses. Both ESDs and DAPs were found to increase with patient age for the main head/trunk examinations, although in some cases (AP/PA chest) this relationship was weak. The dependence of dose on age necessitates the subdivision of the paediatric sample into a number of age categories. It is suggested that all authors use the same age groupings.
Assessment of osteopenia from spine radiographs using two different methods: the Chingford study
Authors: Masud T , Mootoosamy I , McCloskey E V , O'Sullivan M P , Whitby E P , King D , Matson M B , Doyle D V , Spector T D 
Published: July 2009

Abstract
Two methods for diagnosing radiological osteopenia in thoracic (TS) and lumbar (LS) spine radiographs were assessed: a subjective conventional method (A) and a semiquantitative method (B), by comparing them with bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DEXA), in a population of “normal” women aged 45–70 years (n = 818). For both methods there was good intraobserver and interobserver reproducibility. BMDs were significantly lower with increasing radiological osteopenia grades (p&lt;0.001), and remained lower after adjustment for age and body mass index (p&lt;0.01). The proportion of subjects with DEXA-defined osteoporosis rose with increasing radiological osteopenia grades for both methods. The worst osteopenia categories identified 29.7–55.3% of women with DEXA-defined osteoporosis, compared with 6.1–11.7% in the “normal” categories. Both methods, however, showed a large degree of overlap of BMDs between the various radiological osteopenia grades. The sensitivity and specificity of method A in diagnosing osteoporosis were 45.3% and 78.4%, respectively, for the TS and 19.0% and 94.3%, respectively, for the LS. For method B the sensitivities and specificities were 8.8% and 96.1%, respectively (TS), and 10.2% and 95.6%, respectively (LS). Although both methods have poor sensitivities, “definite” or “high” grade osteopenia should be an indication for bone densitometry The high specificities suggest that a “normal” (no osteopenia) X-ray is unlikely to have a significantly low BMD.
Magnetic resonance imaging in macromelia and macrodactyly
Authors: D'Costa H , Hunter J D , O'Sullivan G , O'Keefe D , Jenkins J P R , Hughes P M 
Published: July 2009

Abstract
We report five cases presenting with soft tissue and bone overgrowth that demonstrate the ability of MRI to establish a diagnosis in the absence of specific clinical features. Disorders included macrodystrophia lipomatosa, angiolipomatosis, Klippel–Trenaunay–Weber syndrome, blue rubber bleb naevus syndrome and one case of segmental limited hypertrophy. The MRI appearances, and other radiological features of these conditions are discussed. MRI is recommended in all cases of macrodystrophy when the clinical features and plain film findings are indeterminate.
Technetium-99m-HMPAO labelled leucocytes in the detection and monitoring of inflammatory bowel disease in children
Authors: Jewell F M , Davies A , Sandhu B , Duncan A , Grier D 
Published: July 2009

Abstract
This study was a retrospective evaluation of the use of technetium-99m hexamethylpropyleneamineoxime (HMPAO) labelled leucocytes in the investigation of suspected inflammatory bowel disease in children. The images were analysed in 35 children and the findings were compared with the results of endoscopy/biopsy, barium studies and antinuclear cytoplasm antibody (ANCA) serology. The sensitivity of the white cell scan was 83% and the specificity 81%. This compares well with other studies in adults and is superior to barium investigations. The technique is recommended as a first line investigation to detect inflammatory bowel disease with a resultant reduction in the use of endoscopy and barium imaging.
Effects of microwave tissue coagulation on the livers of normal rabbits: a comparison of findings of image analysis and histopathological examination
Authors: Kato T , Suto Y , Hamazoe R 
Published: July 2009

Abstract
The livers of normal rabbits were subjected to microwave tissue coagulation (MTC), and comparison was made of the subsequent time-course changes in tissue observed on MRI, CT and histopathological examination. 16 rabbits were used. MTC was performed with a 21 gauge needle electrode inserted into the liver at laparotomy. 1–2 h after thermal coagulation, a region with slightly lower attenuation than that of surrounding normal liver parenchyma was observed on CT, and no enhancement was detected. With MRI, change from high signal intensity to iso-signal intensity from the inner zone to the margin was found on T 2 weighted images (T 2WI), and heterogeneous high signal intensity was observed on T 2 weighted images (T 2WI). On Gd-DTPA enhanced MRI, no enhancement occurred. 1–4 weeks after coagulation, the cellular structure at the site of coagulation was lost on histological examination, and the tissue became necrotic. On CT, homogeneous water density was observed, and no enhancement was detected. With MRI, regions of iso- or slightly low signal intensity were observed on T 1WI, and regions of heterogeneous high to low signal intensity were seen on T2WI. After 1 week, a granulation layer consisting mainly of fibrous tissue developed, and a ring-shaped enhancement was observed in the low signal intensity region on T 1WI and in the high signal intensity region on T 2WI. The ring-shaped enhancement was also noted on CT. MRI appears to be useful for observation of time-course changes following MTC therapy because of its sensitivity in the detection of tissue changes.
Cross-calibration of a fan-beam X-ray densitometer with a pencil-beam system
Authors: Bouyoucef S E , Cullum I D , Ell P J 
Published: July 2009

Abstract
This study describes the cross-calibration of two Hologic bone densitometers, one using a fan-beam X-ray source (QDR4500/A) and the other a pencil-beam source (QDR1000/W). The QDR4500/A allows spine and hip measurements to be made at three principal speeds. Results from two spine phantoms and 154 patients showed no significant difference in the absolute values or precision between speeds. The middle speed (taking 1 min to scan an adult lumbar spine) was used for the comparison between the instruments. The two densitometers were compared using two spine phantoms and 182 patients. In vivo measurements were made of all lumbar spine, hip, forearm and whole body sites. Regression lines, constrained to pass through the origin, were calculated. Slopes for total bone mineral density (BMD) for each scan type ranged between 0.994 and 1.029, the best value being found for forearm (1.000). Scatter graphs of the individual points were generated and showed results slightly worse than would be expected from repeat measurements on a single machine (79–88% fell within the expected 2 SD range). A trend for the QDR4500/A to overestimate BMD at low values and underestimate it at high values was seen in the femoral neck. The trend was more significant in the lumbar spine. There was an overestimate of total hip BMD throughout the range. Slopes of the regression lines for area and bone mineral content (BMC) were used to improve cross-calibration between the systems on a site-to-site basis, after which the results improved to a level consistent with repeat measurements on a single machine (81–94% within 2 SD). At present only global, rather than site-specific, correction factors can be employed for the spine and hip and no overall improvement in cross-calibration was possible. We conclude that although global correction factors allow adequate cross-calibration to be achieved, improvements could be made by the use of scan-site-specific factors.
Acute subarachnoid haemorrhage: detection with magnetic resonance imaging
Authors: Chrysikopoulos H , Papanikolaou N , Pappas J , Papandreou A , Roussakis A , Vassilouthis J , Andreou J 
Published: July 2009

Abstract
The purpose of this study was the evaluation of fluid attenuated turbo inversion recovery (FLAT TIRE) MR pulse sequence for detecting acute subarachnoid hemorrhage (SAH). Seven patients with SAH were studied within 6 days of ictus. Six of them underwent both CT and MRI and one MRI only. Pulse sequences included T 1 spin echo (SE), PD and T 2 turbo spin echo (TSE) and FLAT TIRE (TR/TI/TE = 6500/1800/140–180). All studies were performed on a 0.5 T system (Gyroscan T5, Philips Medical Systems). Simulated acute SAH was also studied with MRI. The FLAT TIRE sequence was better than the SE and TSE in all seven cases and better than CT in two cases. In two cases MRI was equivalent to CT, and in another two MRI underestimated the extent of SAH. The simulated acute SAH could be detected easily with the FLAT TIRE sequence, with difficulty on the T 1 weighted images and not at all on the PD/T 2 weighted images. The specific FLAT TIRE sequence used seems promising for the detection of acute SAH.
Reference ranges of bone mineral density for women in southern England: the impact of local data on the diagnosis of osteoporosis
Authors: Petley G W , Cotton A M , Murrills A J , Taylor P A , Cooper C , Cawley M I D , Wilkin T J 
Published: July 2009

Abstract
The construction of reference ranges that accurately represent the population at large is essential for the correct identification of osteoporosis from bone mineral density (BMD) measurements. In this study, reference data supplied by the manufacturer of the Lunar DPX + bone densitometer were compared with data obtained locally. Lumbar spine, proximal femur and total body BMD measurements were made in an age-stratified random sample of 702 Southampton women aged 20 to 89 years. Relevant demographic and medical data were recorded for each subject using a questionnaire. Reference curves of BMD (mean ± SD) were plotted against age for each measurement site and were found to be higher than the manufacturer's reference values at all ages and sites. Exclusion of women with factors known to affect bone mass only served to increase this discrepancy. According to World Health Organisation definitions, osteoporosis may be identified from BMD values alone. Based upon neck of femur BMD values, 100 (14.8%) of the women in this study group were categorized as osteoporotic using local young normal reference data, compared with only 39 (5.8%) using the manufacturer's data. By normalizing for age distribution, these findings were extrapolated to the local population where it was predicted that 26.0% and 10.1% of females over 50 years of age would be classified as osteoporotic using the respective reference ranges. This study clearly illustrates how the numbers of women diagnosed as osteoporotic vary with the use of different reference populations.
MR imaging of fetal brain abnormalities using a HASTE sequence
Authors: Tsuchiya K , Katase S , Seki T , Mizutani Y , Hachiya J 
Published: July 2009

Abstract
HASTE (half-Fourier acquisition single-shot turbo spin echo) is a sequence that enables T 2 weighted magnetic resonance (MR) images to be obtained in a few seconds. The purpose of this study was to evaluate the usefulness of this sequence in the diagnosis of fetal cerebral abnormalities. Five fetuses suspected of having cerebral abnormalities on ultrasound examination were studied by MR imaging using the HASTE sequence in utero. We compared the images with post-natal MR images or computed tomography (CT) scans. In four fetuses, the abnormality was diagnosed correctly, and the diagnosis was almost correct in the remaining fetus. This sequence is useful because it provides images of diagnostic quality in a very short scanning time.
Performance characteristics of the Pantak DXT-300 kilovoltage X-ray treatment machine
Authors: Aukett R J , Thomas D W , Seaby A W , Gittins J T 
Published: July 2009

Abstract
The beam and performance characteristics of a new orthovoltage X-ray unit, the Pantak DXT-300 have been evaluated. Data were collated for four qualities: 3.27 mmAl, 7.15 mmAl, 1.65 mmCu and 3.51 mmCu half value layer (HVL) (SE = 0.04mm). Parameters which were investigated included beam quality, central axis depth dose, relative output, backscatter factors, field uniformity, peripheral dose and head leakage. The calibration procedure and the performance of the dosimetry system have also been described.
The clinical and radiological features of cholecystocolic fistulae
Authors: Hession P R , Rawlinson J , Hall J R , Keating J P , Guyer P B 
Published: July 2009

Abstract
The clinical and radiological features of seven patients presenting with cholecystocolic fistulae are reviewed. The majority of the patients were elderly (age range 43–85 years, mean 70.7 years) and there was a female preponderance (6:1). The condition usually has a benign clinical course. Diarrhoea was the most common presenting symptom and the typical clinical features of gallbladder disease were absent. Cholangitis occurred in only one patient. The time between onset of symptoms and diagnosis varied from 1 week to 2 years (mean 22 weeks). In only one patient was the diagnosis of biliary–intestinal fistula suspected on the basis of the plain abdominal radiograph (Case 5). A diagnosis of cholecystocolic fistula was established by barium enema (5 cases), endoscopic retrograde cholangiopancreatography (ERCP) (1 case) and diagnostic laparotomy (1 case). The only cause identified in this series was acute or chronic cholecystitis.
Concordance and precision of dual X-ray absorptiometry with a 10 s scan
Authors: Patel R , Seah M , Blake G M , Jefferies A L , Crane F M , Fogelman I 
Published: July 2009

AbstractDevelopment of dual energy X-ray absorptiometry (DXA) scanners with multidetector array technology has resulted in greatly shortened scanning times. The Hologic QDR-4500 includes an ultrafast (10 s) “turbo” scan mode recommended by the manufacturer for fast screening studies or as an aid to positioning the patient prior to scanning using the normal fast (30 s), medium (1 min) or high definition (2 min) modes. The suitability of the turbo mode for use in routine clinical studies was assessed by examining the concordance of bone mineral density (BMD) measurements obtained in this mode with measurements obtained using the three normal scanning modes. Studies in 151 female patients showed statistically significant discrepancies in four out of the six scan sites studied with systematic differences of 2.9% and 3.1% being observed for the posteroantenor (PA) spine and intertrochanteric region of the hip, respectively. In vivo precision for the 10 s scan found by performing duplicate measurements on 37 patients had a coefficient of variation of 1.3% for PA spine and 2.5% for femoral neck BMD. An investigation of the dependence of precision on body mass index (BMI) shows that the precision of spine and hip BMD was adversely affected with increasing BMI but the trend was statistically significant only in the spine. It was concluded that turbo mode scans are acceptable for routine clinical studies of the spine and hip but should not be used for longitudinal studies or patients with BMI greater than 30 kg m−2.
Risk factors and dose–effect relationship for osteoradionecrosis after hyperfractionated and conventionally fractionated radiotherapy for oral cancer
Authors: Niewald M , Barbie O , Schnabel K , Engel M , Schedler M , Nieder C , Berberich W 
Published: July 2009

Abstract
A high frequency of osteoradionecrosis after hyperfractionated radiotherapy (RT) of head and neck tumours led to a detailed analysis of risk factors in the dental, surgical, and radiotherapeutic areas 168 patients with oral cancer were analysed retrospectively. 19% of them had been irradiated primarily and 81% post-operatively. 116 patients received a total dose mostly ranging from 60 Gy to 70 Gy to the ICRU 29 reference point (daily single dose 2 Gy). 52 patients were treated hyperfractionally with two daily fractions of 1.2 Gy per day, 4 h minimum apart and a total dose 82.8 Gy. Dental findings could be evaluated in 126 patients. Factors were checked for prognostic significance for osteoradionecrosis (ORN). Dose dependency was computed using a PROBIT analysis. Dental status before radiotherapy was generally poor (mean 11/32 teeth present, of these 1 was dead, 2.4 carious, 2.4 loose, 0.3 destroyed). On average, six teeth (range 0–27 teeth) had to be extracted. In one-third of the patients bone surgery was necessary. ORN occurred in 8.6% of the patients treated conventionally but in 22.9% of those treated hyperfractionally (p = 0.029). Biologically effective dose (p = 0.032) and deep paradontitis (p = 0.034) proved to be significant risk factors for ORN. PROBIT analysis showed a steadily rising dose dependency of the ORN frequency after conventional radiotherapy. Using total doses up to 70 Gy the frequency of ORN was 8.6%. Dose escalation using hyperfractionation led to an intolerable ORN frequency (22.9%) where a short interfraction interval was a significant factor. The use of this dose fractionation was therefore discontinued in 1992.