bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of a provincial radiation oncology service: The first year report and its implications for future developments
Authors: Byram David , Joseph David , Bulmer Margaret 
Published: March 2008

SUMMARYThis study compares the actual first year's workload of a new radiation oncology department with that predicted, and assesses the impact of the differences, and their implications for future similar developments. The treatment records and diaries for the Geelong Hospital Radiation Oncology Department were reviewed after the first 12 months of operation (opened in June 1992). Statistics relating to the number of patients seen, number treated, diagnosis, etc., were evaluated and compared to the original estimates based upon population statistics and likely referral rates. Nine hundred and seven new patients were seen in this period, and from them 718 courses of treatment were initiated. One hundred and eighty‐nine cases (20% of referrals) were seen but not treated. A further 102 treatment courses (14% of total) were initiated upon patients who had previously been irradiated. Forty‐six per cent of patients were managed by 10 fractions or fewer, and a further 23% by 25 or more fractions. Eighty per cent of patients were managed by one or two fields. Electrons were used in only 14% of cases. Further calculations suggested a further possible 441 cases of referral could be expected, based upon current population statistics. Referral rates for radiation oncology are highly dependent on a number of factors. As a result, estimates of referrals and hence the size of a department required for a given population vary widely. Our data support these concepts, and the concept that referral is also strongly dependent upon the distance patients need to travel. In considering the development of units outside of major cities it is suggested that referrals are likely to be on the high side of estimates and a minimum two‐machine unit is essential to cover the given workload.
The role of imaging in renal and extra‐renal rhabdoid tumours
Authors: Roebuck Derek J 
Published: March 2008

SUMMARYRhabdoid tumour of the kidney is an uncommon malignancy with a poor prognosis that usually occurs in childhood. Certain imaging features may help distinguish this lesion from the much more common Wilmstumour ‘. Extra‐renal rhabdoid tumours appear to have no specific imaging characteristics.
Splenic irradiation in HIV‐related thrombocytopenia
Authors: Leung John T , Kuan Richard 
Published: March 2008

SUMMARYSplenic irradiation has been used in patients with HIV‐related thrombocytopenia. This retrospective review deals with four patients treated with low dose splenic irradiation. All patients had an increase in platelet count and tolerated the treatment without side effects. However, the treatment response lasted for several months only.
Radiotherapy for melanotic freckles
Authors: Christie David RH , Tiver Kenneth W 
Published: March 2008

SUMMARYFive patients who received radiotherapy (RT) for 7 melanotic freckles (MF, also known as Hutchinson's freckles, lentigo maligna) were reviewed 8 to 37 months after their treatment by RT. Local control and a favourable cosmetic result occurred in all patients. Treatment toxicity was minimal. Few reports about the use of RT for MF exist. Many other treatments including observation alone have been associated with high rates of recurrence, and in some cases conversion to invasive melanoma has occurred. RT appears to be a safe and effective treatment for this condition, providing that doses equivalent to 44 Gy in 11 fractions or more are given.
Imaging findings in rabies
Authors: Sing Tom MYS , Soo Mark YS 
Published: March 2008

SUMMARYA 10 year old Vietnamese girl presented with clinical features of an acute encephalitic process. A cerebral angiogram performed to rule out vasculitis showed narrowing at the supraclinoid internal carotid and terminal basilar arteries. A diagnosis of rabies was established at autopsy. Although the major blood vessels and basal meninges were normal it was possible that transient arterial spasm induced by the viral infection was responsible for the angiographic appearance. Other imaging findings in our patient are described with a brief review of the literature. This is only the second case of rabies reported in Australia.1,2Rabies is a rare disease in the Australian community. Recently one patient with atypical clinical presentation was confirmed to have the disease only at autopsy. In the clinical work‐up, various radiological examinations were performed and a range of interesting features were encountered including an abnormal cerebral angiogram. The purpose of this paper is to report on these unusual features and to review those documented in the literature.
Magnetic resonance imaging features of an epidural spinal haemangioma
Authors: Gupta Sanjay , Kumar Sunil , Banerji Deepu , Pandey Rakesh , Gujral Ratni 
Published: March 2008

SUMMARYIsolated spinal epidural haemangioma without vertebral involvement is rare. We report a case of an epidural capillary haemangioma in the thoracic region and present the magnetic resonance findings, including contrast‐enhanced features.
Hallervorden‐Spatz disease
Authors: Boyacigil Süreyya , Tokoǧlu Figen , Paşaoǧlu Eşref , Ardiç Selim , Çomoǧlu Selçuk , Saka Mustafa , Öztürk Şerefnur 
Published: March 2008

SUMMARYIn a 22 year old man with dominant extrapyramidal signs, dystonia and mental deterioration, magnetic resonance imaging revealed marked overall low signal from the globus pallidus on each side, with central zones of high signal on T2‐weighted spin echo sequences. There was also a strikingly low signal in the zona reticularis of the substantia nigra, consistent with Hallervorden‐Spatz disease.
Assessment of an online radiology reporting system
Authors: Gormly KL , Langlois S Le P 
Published: March 2008

SUMMARYThis study was designed to assess the efficiency of radiology reporting in the Royal Adelaide Hospital Department of Radiology, which introduced online reporting in November 1994. Seventeen radiologists were monitored without their knowledge, and recordings were made of the times between report dictation and report typing, and the time that the report waited on computer for verification. The total median values for verification time for 9/17 radiologists were less than 12 h and for 14/17 were less than 24 h. On average, reports were available from all reporting areas within 24 h. However, some reports waited up to 13 and 14 days to be verified and to be available on computer for treating clinicians. This report demonstrates that on average rapid reporting is occurring, however some areas need to be considered further to maximize efficiency.
Ultrasonography of breast hamartomas
Authors: Black J , Metcalf C , Wylie EJ 
Published: March 2008

SUMMARYThe authors present the breast ultrasound findings of nine women with mammographic abnormalities typical of breast hamartomas. Two of the mammographically detected hamartomas could not be identified at breast ultrasound. Six hamartomas were well‐circumscribed masses of heterogeneous echogenicity with no posterior acoustic shadowing. One lesion was a well‐defined hypo‐echoic mass with no posterior shadowing. We conclude that many mammographically and clinically detected hamartomas can be clearly identified at breast ultrasound. The breast sonographer should be aware of the spectrum of appearances that may occur. When a breast abnormality has the characteristic mammographic appearances of a hamartoma, it may be counterproductive to perform an additional breast ultrasound.
Synovial sarcoma: An unexpected ultrasound finding in a post‐partum patient
Authors: Acton CM , Morrison WA , Slavin JL 
Published: March 2008

SUMMARYA 20‐year‐old patient presented after an uneventful pregnancy and delivery with an asymptomatic soft‐tissue mass behind her knee with the clinical features of a ganglion or Baker's cyst. An ultrasound scan demonstrated a well‐defined but solid mass with prominent vascularity. The mass was noted to increase in size prior to surgery. The pathological diagnosis was that of a synovial sarcoma grade 2, a rare malignant mesenchymal neoplasm with a serious prognosis.
A review of the radiological features of intracranial meningiomas
Authors: Kizana E , Lee R , Young N , Dorsch NWC , Soo YS 
Published: March 2008

SUMMARYTo evaluate the role of radiological imaging of meningiomas in confirming the diagnosis and as a neuroanatomical aid to surgical planning, 115 patients with surgically excised meningiomas between 1990 and 1993 were studied. Computed tomography (CT), magnetic resonance imaging (MRI) (on a 0.5T unit) and angiography were reviewed, and compared with histopathology (when available). Seventy‐eight CT, 89 MRI and 85 angiographic studies were reviewed, and correlated with histopathology in 67 cases. In 48 cases, the surgical specimens could not be pathologically classified. The most common lesion sites were the cerebral convexities, falx and sphenoidal ridges. True demarcation of cleavage planes was seen on 73% of MRI and 10% of CT studies. Computed tomography showed hyperostosis in 27% and MRI in 7% of studies. Tumours enhanced strongly with contrast in 98% of CT scans. On MRI there were variable signal intensities on different sequences, and no correlation between signal intensities and histological subtype was found. Oedema was present in 59% of CT and 66% of MRI studies, and was most pronounced in lesions > 3 cm in diameter. Tumour calcification was seen in 62% of CT and 8% of MRI studies. Vascular abnormalities were seen on 65% of MRI, 21% of CT and 84% of angiogram studies. Angiographic tumour vascularity did not correlate with histologic subtype. All three imaging modalities have management roles: CT for bony changes and calcification, MRI for multiplanar and vessel anatomy imaging, and angiography for vessel delineation and embolization if required.
Magnetic resonance imaging of tuberculous spinal infection
Authors: Loke TKL , Ma HTG , Chan CS 
Published: March 2008

SUMMARYThe magnetic resonance imaging (MRI) characteristics of 15 cases of tuberculous (TB) spinal infection were reviewed. The commonest site was the lumbar spine (53.3%), often with three or more contiguous vertebrae involved (47%). Destruction of the vertebral body and the presence of paraspinal soft‐tissue masses were noted in 73.3%. Posterior element abnormalities, which is a significant finding, were seen in 40%, a slightly lower incidence rate than in other reported series. Epidural disease (53.3%) and disc abnormalities (73%) were more frequent than was realized. The role of intravenous contrast is discussed. Intravenous gadolinium is useful because it increases diagnostic confidence by characterizing and delineating the disease process, detects reactivation in old and healed TB, helps in treatment management and may prove valuable in monitoring therapy. Magnetic resonance imaging should be considered to be the imaging modality of choice for patients with suspected tuberculous spinal infection.
Significance of short tau inversion recovery magnetic resonance sequence in the management of skeletal injuries
Authors: Van Gelderen WFC , Al‐Hindawi M , Gale RS , Steward AH , Archibald CG 
Published: March 2008

SUMMARYThe conventional radiographs and urgent short tau inversion recovery (STIR) magnetic resonance image (MRI) examinations of 27 consecutive patients with occult bony injuries were prospectively analysed over a 12 month period. A STIR MRI study was undertaken where the plain films were normal (n=15) or inconclusive (n=12) and where the patients’clinical setting was highly suggestive of an underlying bony injury. In six patients, MRI only revealed soft‐tissue injuries or joint effusions and did not demonstrate any bony injury but in the remainder fractures or bone contusions were shown to be present.The MRI studies were performed on a 0.2 Tesla lower field strength unit and the examinations were expeditiously performed, inexpensive, and done on a priority basis between electively booked patients. Radio‐isotope studies were not available and hence were not included in the study protocol.Apart from demonstrating the value of STIR MRI (without additional T1‐weighted sequences in most patients), the purpose of this study was to highlight the alteration in management in 18/27 patients (66%) and the significant alteration in management in six of these patients.
Extensive basal cell carcinoma treated with the mould radiotherapy technique
Authors: Leung John T 
Published: March 2008

SUMMARYSuperficial extensive basal cell carcinoma of the head and neck region can be difficult to treat because of the large area of skin involved, and the changing contour of the head and neck region. A patient with basal cell carcinoma involving the upper chest and neck treated with mould radiotherapy is presented.
Haemangioma of the oesophagus: CT demonstration
Authors: Dumbleton Siobhan A , Warshauer David M , Koruda Mark J , Woosley John T 
Published: March 2008

SUMMARYA case of haemangioma of the oesophagus is presented. The computed tomographic findings of an intramural mass with marked enhancement following intravenous contrast enable the diagnosis to be suggested pre‐operatively.
‘Duplication’ of the clavicle or ossification in coracoclavicular ligament
Authors: Schubert F 
Published: March 2008

SUMMARYA case is presented in which plain films revealed a short band of ossification adjacent to the inferior aspect of the lateral part of the clavicle. CT findings indicated that the ossification was situated in the coracoclavicular ligament and was not a manifestation of clavicular‘duplication’.
Computed tomography intravenous cholangiography
Authors: Nascimento Sherry , Murray Wynne , Wilson Peter 
Published: March 2008

SUMMARYIndications for direct visualization of the bile ducts include bile duct dilatation demonstrated by ultrasound or CT scanning, where the cause of the bile duct dilatation is uncertain or where the anatomy of bile duct obstruction needs further clarification. Another indication is right upper quadrant pain, particularly in a post‐cholecystectomy patient, where choledocholithiasis is suspected. A possible new indication is pre‐operative evaluation prior to laparoscopic cholecystectomy. The bile ducts are usually studied by endoscopic retrograde cholangiopancreatography (ERCP), or, less commonly, trans‐hepatic cholangiography. The old technique of intravenous cholangiography has fallen into disrepute because of inconsistent bile‐duct opacification. The advent of spiral CT scanning has renewed interest in intravenous cholangiography. The CT technique is very sensitive to the contrast agent in the bile ducts, and angiographic and three‐dimensional reconstructions of the biliary tree can readily be obtained using the CT intravenous cholangiogram technique (CT IVC). Seven patients have been studied using this CT IVC technique, between February 1995 and June 1996, and are the subject of the present report. Eight further studies have since been performed. The results suggest that CT IVC could replace ERCP as the primary means of direct cholangiography, where pancreatic duct visualization is not required.
Sucralfate cream in the management of moist desquamation during radiotherapy
Authors: Delaney Geoffrey , Fisher Richard , Hook Carolyn , Barton Michael 
Published: March 2008

SUMMARYRandomized trials have shown that sucralfate is effective in the management of acute radiation reactions such as oesophagitis, mucositis and proctitis. However, at the time of commencement of the present trial, it had never been used in the management of moist desquamation of the skin. The purpose of the present study was to assess the value of sucralfate cream in the management of moist desquamation during radiotherapy. Patients who developed moist desquamation during radiation were eligible. Patients were stratified by site of radiotherapy into three groups: (i) the head and neck; (ii) the breast; and (iii) other sites. Patients were randomized to receive 10% sucralfate in sorbolene cream or sorbolene alone. Patients' pain and skin healing were assessed by using linear analogue self‐assessment (LASA) scales and by serial measurement of the desquamated area. Due to poor patient accrual, the trial was terminated after 2 years and 39 patients. No statistically significant difference was found between the two arms in either time from randomization to healing or improvement in pain score. Twenty patients in the sucralfate arm took a geometric mean of 14.8 days to heal whereas 19 patients receiving sorbolene alone took a geometric mean of 14.2 days. The ratio of mean times to healing, 1.043, is not statistically different from 1 (P= 0.86; 95% CI = 0.65,1.67). A total of 75% of the patients reported pain relief on application of either cream. Mean LASA scores for pain for each day after randomization were compared by treatment arm and there was no statistically significant difference (P= 0.32). The present trial was unable to show a difference in terms of time to healing or pain relief in the treatment of moist desquamation. The small number of patients in the trial gave a wide confidence interval for treatment difference, implying that an important effect of sucralfate has not been excluded. Given the poor accrual in the present, single‐institution study, future studies may need to be multi‐institutional and we encourage other centres to perform randomized trials in the management of moist desquamation.
Perforated diverticulum of the ascending colon: Pre‐operative diagnosis by ultrasound
Authors: Khaleghian R , King AR 
Published: March 2008

SUMMARYA case of acute perforation of a diverticulum of the ascending colon is presented. The ultrasound features that helped in making a pre‐operative diagnosis are discussed. This rare surgical emergency and the similar clinical entities of perforated caecal or transverse colon diverticula are often clinically misdiagnosed as more common conditions such as acute appendicitis, acute cholecystitis or perforated ulcer. Awareness of this entity will help radiologists in making a correct pre‐operative diagnosis.
Radiation dose in computed tomography of the pelvis: Comparison of helical and axial scanning
Authors: Pitman Alex G , Budd Ray S , McKenzie Allan F 
Published: March 2008

SUMMARYAn anthropomorphic Rando phantom was used to compare radiation doses sustained during helical and conventional axial CT of the pelvis. The values obtained with the Rando phantom were validated against cadaveric phantoms, and show good agreement. For the authors’particular CT unit, helical scanning was found to deliver a lower radiation dose than conventional axial scanning. This was most prominent at 1.0‐s tube rotation times (average dose ratio 1.24). For realistic scanning parameters and exposure factors, the ratio of radiation dose to pelvic organs can be expected to lie in the range of 40‐100 mGy. The whole‐body effective dose (ED) depends on selection of scanning parameters and patient anatomy. In a favourable case scenario, the ED for CT scanning of the pelvis in a male can be expected to be between 10 and 20 mSv if the scrotum is not included in the radiation field, while the ED in a female will be −20 mSv. An examination of scatter radiation fall‐off curves from a single slice shows that the spread of scatter radiation is only marginally affected by slice thickness. A total of 10‐12 cm of human soft tissue acts as a good barrier against internal scattered radiation. The use of such scatter fall‐off curves, together with manufacturers’dosimetry specifications, allows a fast estimate of absorbed dose.
Phaeochromocytoma with central nervous system manifestations
Authors: Eclavea Anthony , Gagliardi Joseph A , Jezior Jim , Burton Brad , Donahue John P 
Published: March 2008

SUMMARYA 35‐year‐old Samoan male presented with intermittent headaches and hypertensive episodes for several months. A subsequent left adrenal gland phaeochromocytoma was discovered and surgically excised. An MRI of his brain demonstrated periventricular, basal ganglia, and centrum semi‐ovale infarction. We suggest that catecholamine excess and neuropeptide Y may contribute to intracerebral haemorrhage and infarcts associated with phaeochromo‐cytomas. Additionally, our surgical approach in removing the phaeochromocytoma is discussed.
Detection of renal arteries with fast spin‐echo magnetic resonance imaging
Authors: Tello Richard , Mitchell Peter J , Witte David J , Thomson Kenneth R 
Published: March 2008

SUMMARYWith the increasing use of non‐invasive imaging with MR and volumetric CT to evaluate renal arteries, the ability to accurately detect the number and state of native renal arteries becomes critical if conventional angiography is to be supplanted in these settings. The present study evaluated the utility of a fast spin‐echo (FSE) T2‐weighted sequence to detect the number and course of renal arteries and their ostia compared to conventional angiography. Ten patients underwent conventional catheter angiography either for renal artery stenosis evaluation or as potential renal donors. Each patient then had an MR study of the renal arteries and kidneys with FSE MR (TR = 4000 ms, TE = 102 ms, eight‐echo train length, 5‐mm‐thick interleaved 128 phase encodes, superior and inferior saturation pulses, number of excitations (NEX) = 4, on a 1.5‐T superconducting magnet (GE, Milwaukee, Wl, USA). Images were reviewed by two‘blinded’radiologists and renal arteries were counted and their ostia were evaluated. Results were compared with angiography and inter‐ and intra‐observer statistics were calculated. All 10 patients underwent MR successfully, nine for renal artery stenosis (RAS) evaluation and one was a renal donor. A total of 24 renal arteries were imaged in 19 kidneys. Fast spin‐echo MR is 95% accurate (95%CI: 88‐100%) in detection of renal arteries, with no statistical difference between FSE MR and catheter angiography (McNemar P= 0.0). Inter‐ and intra‐observer statistics demonstrate good‐to‐excellent agreement in renal artery detection (kappa: 0.63‐0.90). In one case of RAS evaluation an incidental adrenal mass was detected as the aetiology of the patient's hypertension. Fast spin‐echo MR can be a useful adjunct as part of the imaging for renal arteries with MRI.
Huge adrenal haemangioma
Authors: Hisham AN , Samad SA , Sharifah NA 
Published: March 2008

SUMMARYAdrenal tumours are either functioning or non‐functioning. Non‐functioning adrenal tumours are generally asymptomatic and usually of enormous proportions at the time of presentation. A case is presented here of a patient with a huge right adrenal haemangioma which was successfully treated surgically. This unusual tumour was 25 cm in diameter, was well encapsulated and weighed 4 kg. The literature pertaining to this interesting case is reviewed.
Fluid‐fluid levels in a simple bone cyst on magnetic resonance imaging
Authors: Maas EJ , Craig JG , Swisher PK , Amin MB , Marcus N 
Published: March 2008

SUMMARYAn unusual case is presented here of simple bone cyst (SBC) with fluid‐fluid levels on MR and cementum‐like substance on microscopy in an atypical location in the distal femur. Fluid‐fluid levels are commonly described in the literature within aneurysmal bone cysts, giant cell tumour, chondroblastomas and telangiectatic osteosarcomas, but a literature review revealed only one reported case with multiple fluid levels occurring in a simple bone cyst on MRI. A cementum‐like matrix is diagnostic of SBC and is seen in ± 10% of cases.
Foetal intracardiac transfusion for the treatment of severe anaemia due to human parvovirus B‐19 infection
Authors: Goodear M , Hayward C , Crowther C 
Published: March 2008

SUMMARYIntra‐uterine parvovirus infection may result in severe foetal anaemia and death. Ultrasound diagnosis of foetal parvovirus is presented, together with ultrasound‐guided foetal transfusion to treat the anaemia.