bluuebunny/crossref_metadata_2025_split huggingface dataset:
The utility of the Philips SRI‐100 Real Time Portal Imaging Device in a case of postoperative irradiation for prevention of heterotopic bone formation following total hip replacement
Authors: KIFFER JOHN D , QUONG GEORGE , BERGMAN NEIL R , LAWLOR MARITA , SCHUMER WENDY , AITKEN LIBBY , WALLACE ANTHONY 
Published: March 2008

SUMMARYThe new Radiation Oncology Department at the Heidelberg Repatriation Hospital in Melbourne, Australia commenced operation in June 1992. As part of quality control the Philips SL‐15 linear accelerator was fitted with the Philips SRI‐100 Real Time Portal Imaging Device (RTPID), the first such apparatus in Australia. One of its major advantages over older systems is its ability to provide a permanent hard copy of the image of the field treated. The computer image can be immediately manipulated and enhanced on the screen (with respect to such qualities as brightness and contrast) prior to the printing of the hard copy. This is a significant improvement over the more cumbersome older port films that required developing time, without any pre‐assessment of the image quality. The utility of the Philips SRI‐100 RTPID is demonstrated in the case of a patient irradiated soon after total hip replacement, as prophylaxis against heterotopic bone formation (HBF). The rapidity and quality of image production is a major advantage in these patients where postoperative pain may result in positional change between film exposure and image production. Extremely accurate shielding block position is essential to shield the prosthesis (and allow bone ingrowth for fixation) whilst avoiding inadvertent shielding of the areas at risk for HBF. A review of the literature is provided.
Has lymphography a role in early stage testicular germ cell tumours?
Authors: Stephenson NJH , Sandeman TF , McKenzie AF 
Published: March 2008

SUMMARYA retrospective study was performed of 183 newly diagnosed seminoma cases and 73 newly diagnosed non‐seminomatous germ cell tumours (NSGCT) presenting from 1985 to 1989 to a tertiary referral cancer hospital. The purpose was to assess the contribution of bipedal lymphography (LG) to the management of these patients. As the main value of LG is in detecting small retroperitoneal lymph node (LN) metastases, analysis concentrated upon early stage disease, specifically N0 and N1a LN disease. Comparison between LG results, abdominopelvic computed tomography (APCT), final clinical stage and treatment outcome was performed. We found that with the LG and APCT criteria used (filling defects > 2 mm and LN diameter >20 mm, respectively), LG was much more sensitive in disease detection. However, with modem techniques APCT can reliably detect disease 10 mm or greater. In addition, tumour marker status, primary tumour vascular invasion status and initial clinical examination were each more important in staging NSGCT disease than LG alone. Thus, LG is now rarely used in our institution but we will have to monitor our excellent survival data to confirm that this change in policy is warranted.
Assessment of abdominal aortic aneurysm with magnetic resonance imaging
Authors: Sardelic F , Fletcher JP , Ho D , Simmons K 
Published: March 2008

SUMMARYPre‐operative imaging of abdominal aortic aneurysms (AAA) is important in determining suitability for operation and operative approach. Ultrasound imaging is an excellent screening modality but is relatively poor at identifying renal arteries and the extent of iliac involvement. Computed tomography scanning with intravenous contrast and arteriography are invasive modalities that are associated with a small risk. Magnetic resonance imaging (MRI) offers the potential of accurate anatomical definition without use of contrast agents and passage of an intra‐arterial catheter.Eight patients who had their AAA evaluated with MRI are reported. All had renal arteries accurately defined, intraaneurysmal thrombosis was well delineated, and iliac extension was correctly identified in four cases. The initial experience has been most encouraging and the authors consider that MRI may become the investigation of choice for pre‐operative AAA assessment.
Fast magnetic resonance imaging in spinal trauma
Authors: Silberstein M , McLean K 
Published: March 2008

SUMMARYIn a prospective comparison between fast magnetic resonance imaging (MRI) sequences and conventional spin‐echo in a series of 20 patients, gradient‐echo imaging was found to be inferior to spin‐echo, especially in the visualization of spinal cord oedema, and the use of a rapid spin‐echo sequence was limited by inferior visualization of haemorrhage. While the use of a combination of these two fast imaging techniques resulted in equivalent results to conventional spin‐echo, the increased imaging time suggests that fast MRI cannot, as yet, replace conventional spin‐echo techniques in acute spinal trauma.
Partial thickness supraspinatus tears: Diagnosis by magnetic resonance arthrography
Authors: Bradley YC , Chandnani VP , Gagliardi JA , Reeves T Quentin 
Published: March 2008

SUMMARYTwo patients, with clinical symptoms of advanced impingement syndrome, presented for radiologic evaluation. The magnetic resonance (MR) images of each patient were interpreted as representing a full thickness tear of the supraspinatus tendon. Magnetic resonance arthrography was performed on both patients to further determine the extent of the tear. Using this technique, both patients were diagnosed correctly as having partial thickness tears; one on the articular surface and the other on the bursal surface of the tendon. This information is useful in surgical planning and in patient outeome.
Infantile hepatic haemangioendothelioma
Authors: Wong DC , Masel JP 
Published: March 2008

SUMMARYThree cases of infantile hepatic haemangioendotheliomas are described. Two demonstrate the natural history of regression of this benign tumour with no associated complication. The last case demonstrates life‐threatening complications, which included cardiac failure, thrombocytopenia, disseminated intravascular coagulation and bleeding. Imaging modalities with plain films, ultrasound, computed tomography and angiograms are presented. Pathological findings in two of the cases are also described.
Risk of small field of view in lumbar spine computed tomography for assumed lumbar disc herniation: Beware contained ruptured aortic aneurysm
Authors: Marsman JWP 
Published: March 2008

SUMMARYAmong several other atypical clinical presentations, back and leg pain may ensue from a contained ruptured abdominal aortic aneurysm. The present case concerns a patient whose back and leg pain were primarily thought to be orthopaedic or neurologic in origin. Computed tomography with small field of view, performed for the detection of a possible lumbar disc herniation, only partially showed a paraspinal soft tissue mass. Subsequently, recognition of this mass as a contained ruptured aortic aneurysm was delayed. The literature is reviewed concerning comparable cases and it is concluded that computed tomograms performed for possible lumbar disc herniation should also be screened for paraspinal disease and consequently, the applied field of view should be large enough to include at least the paraspinal psoas regions.
The Hutson loop and prosthesis: Clinical uses in hepato‐biliary intervention
Authors: Cameron DC , Frazer CK 
Published: March 2008

SUMMARYA number of method of making a Roux‐en‐Y hepaticojejunostomy have been advocated to help the radiologist gain access to the biliary system. We have found markers and rings unsatisfactory and therefore designed and tested our own prosthesis. Reliable rapid access is easily achieved using this device with a much reduced radiation dose to both patient and radiologist. The prosthesis has been used for the past 3 years, and the last 23 patients are reviewed. Seven patients have required repeated interventions via the loop and we present the findings and our results.
Lower limb deep venous thrombosis: A critical view of ultrasound
Authors: Gibson RN 
Published: March 2008

SUMMARYThe replacement of venography with ultrasound in investigation of lower limb deep venous thrombosis (DVT) is a trend that generally has been appropriate. However, there is substantial variation in reported accuracies related to different clinical contexts, operator experience and sophistication of equipment. The best and most consistent results are for suspected acute femoropopliteal thrombosis, while there is variation in accuracy and diagnostic approach for below knee thrombosis. Potential exists for substantial diagnostic inaccuracy for suspected recurrent DVT, in surveillance of high‐risk patients and in patients with possible pulmonary embolism. The choice of ultrasound over contrast venography should take account of local expertise and accuracy, availability of resources, clinical indication for investigation and cost‐effectiveness.
How do we bring an acceptable level of radiotherapy services to a dispersed population?
Authors: Denham JW 
Published: March 2008

SUMMARYRadiotherapy referral data from four Australian States confirm that access difficulties contribute to low radiotherapy utilization rates. Access could be improved by the provision of further small treatment centres in moderately large rural or semi‐rural population centres. Such a policy, however, could endanger existing standards of radiotherapeutic care unless the potential pitfalls of such an approach are addressed prospectively.
The changing face of radiation oncology in Australia 1950–1995: A personal view
Authors: Bourne Robert G 
Published: March 2008

SUMMARYIn 1950, orthovoltage X‐rays were used to treat a wide spectrum of malignant disease but results were impaired by poor depth dose and significant reactions; radium and radon were used commonly and superficial X‐ray therapy was used for a large number of skin cancers as well as many benign skin conditions. Since megavoltage X‐ray therapy was introduced to Australia and with earlier diagnosis, high standards for qualification as a radiation oncologist set by the Royal Australasian College of Radiologists (RACR), improved imaging and tumour localization, improved beam characteristics, computerization and dosimetry, patients are now better treated with improved local control and less morbidity. Public facilities have been chronically underfunded by governments resulting in waiting lists for treatment, and free standing private practices are important in sharing the ever increasing workload consequent to the increasing and ageing population. The use of brachytherapy has fallen but is enjoying a resurgence of interest. Chemotherapy has emerged. Radiobiology has had some influence on radiation treatment. Health education has improved and the needs and expectations of patients better appreciated and helped. Cancer societies have made an important contribution. Statistical evaluation of treatment is better understood. Undergraduate training and academic positions remain insufficient. The formation of the Faculty of Radiation Oncology of the RACR has given fresh impetus to the specialty.
MRI of intraspinal nerve sheath tumours presenting with sciatica
Authors: Loke TKL , Ma HTG , Ward SC , Chan CS , Metreweli C 
Published: March 2008

SUMMARYThe magnetic resonance imaging (MRI) characteristics of 14 intraspinal nerve sheath tumours (NST) presenting with sciatica were reviewed. The group comprised seven schwannomas, six neurofibromas and one perineuroma. The tumours were either iso‐ or hypointense with respect to spinal cord on T1‐weighted (T1W) images; almost all tumours were hyperintense compared with spinal cord on T2‐weighted (T2W) images. The tumours were all detectable on unenhanced T1W images. Nine NST were scanned following Gadolinium‐Diethylenetriamine penta acetic acid (DTPA) injection and all showed intense enhancement. This aids differentiation from sequestrated disc fragments. Tumours were more likely to show homogeneous enhancement unless they were recurrent tumours. Rim enhancement occurs more commonly in schwannomas and this can be used to differentiate these from neurofibromas. However, on unenhanced images, schwannomas cannot be distinguished from neurofibromas. Four tumours occurred at T11‐T12. There was poor correlation of the site of the lesion with the clinical findings. MRI studies in patients with sciatica should include the lower thoracic region especially if no protruded disc was found in the lumbar region.
Radiological abnormalities in children born as a result of assisted conception
Authors: Leighton DM 
Published: March 2008

SUMMARYOver 15 000 children are born each year as a result of the various techniques of assisted conception. In 1991, there were 2083 live births in Australia and New Zealand as a result of these techniques. Radiological abnormalities relating to the increased rate of prematurity, a probable increase in the risk of congenital malformations and a number of cases of neural crest tumours seen in these infants will be presented.
Hypofractionated irradiation for inoperable non‐small cell lung cancer
Authors: Stevens MJ , Begbie SD 
Published: March 2008

SUMMARYA policy of palliative intent thoracic irradiation was prospectively evaluated in 38 consecutive patients referred for treatment of inoperable non‐small cell lung cancer at a single institution. A target dose of 1700cGy in two fractions 1 week apart was delivered. Characteristics of the treatment group revealed most (87%; 33/38) to be of good‐excellent performance status with minimal weight loss before irradiation. Although three patients (8%) had initial metastatic disease, ail had symptoms referable to the thorax with cough (71%), dyspnoea (55%), haemoptysis (39%), and chest wall pain (34%) being dominant. Following treatment, the relative risk of maintaining complete response with regard to each of these symptoms was 0.91, 0.40, 0.92 and 0.78, respectively. Overall 70% of patients maintained complete symptomatic response to time of death or last review. Uncorrected median survival was 35 weeks and was comparable to best international end‐results for either palliative intent or curative intent radiation schedules. We conclude that the radiation regimen employed is safe, efficacious and eminently resource conscious. Recognition of patient groups who overwhelmingly derive no benefit from conventional fractionation schedules will streamline access to radiotherapy services of patients suitable for radical treatment.
Ultrasound and computed tomography appearances of primary hepatic leiomyosarcoma
Authors: Gandhi MR , Wong DC , Wood DJ 
Published: March 2008

SUMMARYPrimary hepatic leiomyosarcoma is a rare condition. The ultrasound and computed tomography findings in a 73 year old female patient are described. Previous reports have concentrated on the histopathological features and clinical presentation of the condition.
Systemic lupus erythematosus serositis
Authors: Low VHS , Robins PD , Sweeney DJ 
Published: March 2008

SUMMARYThe imaging appearances of a case of systemic lupus erythematosus, which manifested initially as a serositis, is described. Barium small bowel study showed segments of spiculation with tethering, angulation, and obstruction. On computed tomography there was ascites and segments of asymmetrical thickening of small bowel wall were observed. Laparotomy revealed extensive patchy serosai and peritoneal plaques but biopsy of these lesions did not lead to a definitive diagnosis. The diagnosis was made on the basis of marked elevation of antinuclear and anti‐double stranded DNA antibodies.
Obturator hernia: Diagnosis through medical imaging
Authors: O'Connell G , Cole A 
Published: March 2008

SUMMARYA rare case of obturator hernia is presented in a patient with persistent small bowel obstruction. There was a paucity of specific signs and poor general health which caused a delay in diagnosis. Ultimately delayed films from a barium follow through showed barium‐filled bowel in the region of the right obturator foramen: A computed tomography scan then confirmed the diagnosis by demonstrating the barium‐filled small bowel herniating through the right obturator foramen. Other imaging modalities such as herniography, barium enemas and ultrasound have also been successfully employed to diagnose obturator hernias.
The 1994 Australian Radiology Workforce Committee Report
Authors: O'Donnell C , Stuckey J 
Published: March 2008

SUMMARYThe task assigned to the College Workforce Subcommittee by the RACR Federal Council is to define current radiologist and trainee numbers, analyse professional demographics, and attempt to forecast radiologist numbers and the medical demand for radiological services. The period of this forecast is for 7 years leading up to 2001. This time course has been chosen on the basis of a 2 year period before any recommendation by Council could be instituted by the Educational Board and 5 years before any change in trainee numbers would be reflected in radiologist numbers. By necessity, assumptions have been made in formulating the final calculations and recommendations; the most difficult being the designation of an ‘optimum’ number of radiologists for our population. This assignment is an ongoing review and prediction process. The results and conclusions should be compared and contrasted to previous reports, in particular the 1992 Manpower Study.
Radiology in Rwanda
Authors: Miller Philip , Pearn John , Marcollo Shane 
Published: March 2008

SUMMARYThis account documents some aspects of military radiology in the aftermath of the Rwandan Civil War of 1994. Following the genocidal conflict of April‐July 1994, all radiographic services ceased in Rwanda, a nation of some 7 500 000 people. As part of the United Nations Peacekeeping Force, UNAMIR II, the Australian Medical Support Force established and provided, on an ongoing basis, sophisticated medical, surgical and intensivist care for the sick and wounded United Nations personnel, of whom there were up to 7000 deployed in Rwanda; and, as part of its humanitarian outreach, emergency medical and surgical care for Rwandese civilians. The Australian contingent of 308 service personnel established the Australian Military Hospital (the ‘United Nations Hospital’) in the former Clinic Wing of the Kigali Central Hospital. From August 1994 the Radiology Department of the Australian Medical Support Force provided the first specialist X‐ray services as part of the re‐building of the stricken nation and, over the ensuing year, provided a diagnostic service for soldiers and civilians with both chronic and recent war wounds, trauma victims in the aftermath of the Civil War, sick and injured soldiers and Rwandese suffering from any of the full range of medical conditions encountered in tropical Africa.
The role of colour and duplex Doppler ultrasound in the assessment of thyroid nodules
Authors: Holden Andrew 
Published: March 2008

SUMMARYThe role of colour and duplex Doppler ultrasound in investigating nodular thyroid disease was evaluated. Fifty patients with solitary or dominant nodules were studied. All nodules were examined with colour Doppler with spectral analysis performed on vascular lesions. Pathological correlation was available for all nodules. The majority of thyroid nodules could be accurately categorized by their colour Doppler appearances. This was true for both solitary and dominant nodules. All neoplastic nodules (adenomas, carcinomas) contained intra‐nodular flow signals. The majority of the colloid nodules were either avascular or had halo flow signals only. A minority of colloid nodules were vascular. These nodules were large (> 2cm), had dominant halo vessels and cytological evidence of follicular cell hyperplasia. Although colour Doppler lacks absolute specificity in discriminating neoplastic and non‐neoplastic thyroid nodules, the data suggests the modality has considerable use in clinical practice. The spectral analysis data was time‐consuming to obtain and had less obvious clinical application.
Magnetic resonance angiography findings in the early post‐carotid endarterectomy period
Authors: Stuckey SL , Gilford EJ , Smith PJ , Kean M 
Published: March 2008

SUMMARYThis preliminary study was designed to investigate the ability of multiple axial volume three‐dimensional fourier transform (3DFT) time‐of‐flight (TOF) magnetic resonance angiography (MRA) to depict the carotid bifurcation in the early post‐carotid endarterectomy period. Five patients underwent intra‐operative digital subtraction angiography (DSA) and carotid MRA within 5 days of carotid endarterectomy.An axial volume fast imaging in steady‐state precession (FISP) gradient‐echo 3DFT TOF carotid MRA technique in this limited series appeared to display accurately the surgically significant abnormalities at the carotid bifurcation after endarterectomy. However, in normal or near‐normal intra‐operative DSA studies, overestimation of internal carotid artery stenoses was encountered. Postoperative MRA demonstrates potential as a useful non‐invasive investigation after carotid endarterectomy but should be interpreted with caution until larger studies become available.
Chaotic phasic pattern as sole ultrasound evidence of extensive post‐thrombotic change
Authors: Phillips GWL , Esler S 
Published: March 2008

SUMMARYWe report three cases of extensive post‐thrombotic change confirmed at ascending venography but which did not demonstrate the currently accepted duplex ultrasound criteria for post‐thrombotic change. We also document a new ultrasound finding which we describe as a chaotic phasic pattern of deep venous flow which was the only duplex evidence of post‐thrombotic change in two of the cases. We suggest that its routine inclusion in duplex ultrasound assessment of the deep veins should be considered.
Calibration of entrance dose measurement for an in vivo dosimetry programme
Authors: Ding W , Patterson W , Tremethick L , Joseph D 
Published: March 2008

SUMMARYAn increasing number of cancer treatment centres are using in vivo dosimetry as a quality assurance tool for verifying dosimetry as either the entrance or exit surface of the patient undergoing external beam radiotherapy. Equipment is usually limited to either thermoluminescent dosimeters (TLD) or semiconductor detectors such as p‐type diodes. The semiconductor detector is more popular than the TLD due to the major advantage of real time analysis of the actual dose delivered. If a discrepancy is observed between the calculated and the measured entrance dose, it is possible to eliminate several likely sources of errors by immediately verifying all treatment parameters. Five Scanditronix EDP‐10 p‐type diodes were investigated to determine their calibration and relevant correction factors for entrance dose measurements using a Victoreen White Water‐RW3 tissue equivalent phantom and a 6MV photon beam from a Varian Clinac 2100C linear accelerator. Correction factors were determined for individual diodes for the following parameters: source to surface distance (SSD), collimator size, wedge, plate (tray) and temperature. The directional dependence of diode response was also investigated. The SSD correction factor (CSSD) was found to increase by approximately 3% over the range of SSD from 80 to 130cm. The correction factor for collimator size (Cfield) also varied by approximately 3% between 5 × 5 and 40 × 40 cm2. The wedge correction factor (Cwedge) and plate correction factor (Cplate) were found to be a function of collimator size. Over the range of measurement, these factors varied by a maximum of 1 and 1.5%, respectively. The Cplate variation between the solid and the drilled plates under the same irradiation conditions was a maximum of 2.4%. The diode sensitivity demonstrated an increase with temperature. A maximum of 2.5% variation for the directional dependence of diode response was observed for angle of ± 60°. In conclusion, in vivo dosimetry is an important and reliable method for checking the dose delivered to the patient. Preclinical calibration and determination of the relevant correction factors for each diode are essential in order to achieve a high accuracy of dose delivered to the patient.