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5.  Male urogenital disorders 
The British Journal of Radiology  2012;85(Spec Iss 1):S1-S2.
PMCID: PMC3746406  PMID: 23118098
6.  Olympic special feature editorial 
The British Journal of Radiology  2012;85(1016):1146-1147.
PMCID: PMC3587059  PMID: 22815413
7.  Fourth review of the UK national patient dose database 
The British Journal of Radiology  2012;85(1018):e957-e958.
PMCID: PMC3474019  PMID: 22972980
10.  The diagnostic value of FDG–PET cannot be judged by iliac bone marrow biopsy 
The British Journal of Radiology  2012;85(1016):1204-1205.
PMCID: PMC3587095  PMID: 22815418
11.  Cancer risks from diagnostic radiology: the impact of new epidemiological data 
The British Journal of Radiology  2012;85(1020):e1316-e1317.
PMCID: PMC3611740  PMID: 23175496
16.  Laterality of motor control and breathing 
The British Journal of Radiology  2012;85(1012):468.
PMCID: PMC3486670  PMID: 22457405
17.  Pre-existing oral contrast from lanthanum carbonate: a confounding factor in CT mesenteric angiography 
The British Journal of Radiology  2012;85(1012):e073-e075.
A 69-year-old male was referred from the renal unit to radiology for investigation of bleeding per rectum. A CT mesenteric angiogram was performed. However, it was noted on the pre-contrast images that the large bowel contained positive oral contrast media. The procedure was abandoned as it would have been difficult to see extravasation of intravenous contrast from a bleeding point in the large bowel. The initial belief was that either the patient had been given oral contrast by ward staff on the assumption that it would be needed, or had had a recent radiological study requiring contrast, which was still present. Neither was the case; it emerged that the patient was taking Fosrenol (Shire Pharmaceuticals, Wayne, PA), a lanthanum carbonate medication used in the treatment of hyperphosphataemia. Lanthanum is densely radio-opaque and appears as positive bowel contrast on CT and plain radiography studies. When considering radiological studies specifically requiring the absence of oral contrast, it is important to be aware of the patient's drug history to avoid non-diagnostic scans with the associated radiation exposure.
PMCID: PMC3486678  PMID: 22457410
19.  Three-dimensional airway lumen volumetry: comparison with bronchial wall area and parenchymal densitometry in assessment of airway obstruction in pulmonary emphysema 
The British Journal of Radiology  2012;85(1020):1525-1532.
The purpose of this study was to compare three-dimensional airway lumen volumetry with bronchial wall area and parenchymal densitometry in the assessment of airway obstruction in pulmonary emphysema.
56 patients, who were smokers, underwent CT examination and pulmonary function tests (PFTs). For quantitative assessments, the following parameters were computationally calculated: (1) percentage of voxels −950, −960 and −970 HU in the lung (%LAA−950, %LAA−960 and %LAA−970, respectively); (2) percentage of partial bronchi luminal volumes per total luminal volumes (LVmain, main and distal bronchial volume/total luminal volume; LVlobe, lobar and distal bronchial volume/total luminal volume); and (3) mean wall area percentages of segmental bronchi of the right apical and left apicoposterior segment (WA%seg) and of subsegmental bronchi (WA%sub) in the upper lobes. These parameters were correlated with PFTs and statistically compared between a chronic obstructive pulmonary disease (COPD) group [forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)<70] and a non-COPD group.
FEV1, maximum mid-expiratory flow rate and forced expiratory flow at 25% vital capacity had significant correlation with LVmain (r>0.53, p<0.0001), LVlobe (r>0.52, p<0.0001), WA%seg (|r|>0.29, p<0.05) and WA%sub (|r|>0.31, p<0.05). FEV1/FVC had significant correlation with all parameters (0.27<|r|<0.52, p<0.05). LVmain and LVlobe and WA%seg and WA%sub were significantly different between the two groups (LVmain and LVlobe; p<0.0001, WA%seg and WA%sub; p<0.05).
Bronchial luminal volumetric assessment better reflected the airflow limitation parameters.
Advances in knowledge
Bronchial luminal volumetric assessment can potentially be used to gauge airflow limitation in pulmonary emphysema.
PMCID: PMC3611709  PMID: 22932062
20.  Thin-section CT findings in Pseudomonas aeruginosa pulmonary infection 
The British Journal of Radiology  2012;85(1020):1533-1538.
The aim of this study was to assess clinical and pulmonary thin-section CT findings in patients with acute Pseudomonas aeruginosa (PA) pulmonary infection.
We retrospectively identified 44 patients with acute PA pneumonia who had undergone chest thin-section CT examinations between January 2004 and December 2010. We excluded nine patients with concurrent infections. The final study group comprised 35 patients (21 males, 14 females; age range 30–89 years, mean age 66.9 years) with PA pneumonia. The patients' clinical findings were assessed. Parenchymal abnormalities, enlarged lymph nodes and pleural effusion were evaluated on thin-section CT.
Underlying diseases included malignancy (n=13), a smoking habit (n=11) and cardiac disease (n=8). CT scans of all patients revealed abnormal findings, including ground-glass opacity (n=34), bronchial wall thickening (n=31), consolidation (n=23) and cavities (n=5). Pleural effusion was found in 15 patients.
PA pulmonary infection was observed in patients with underlying diseases such as malignancy or a smoking habit. The CT findings in patients with PA consisted mainly of ground-glass attenuation and bronchial wall thickening.
Advances in knowledge
The CT findings consisted mainly of ground-glass attenuation, bronchial wall thickening and cavities. These findings in patients with an underlying disease such as malignancy or a smoking habit may be suggestive of pneumonia caused by PA infection.
PMCID: PMC3611710  PMID: 22844034
21.  Evaluation of the trade-offs encountered in planning and treating locally advanced head and neck cancer: intensity-modulated radiation therapy vs dual-arc volumetric-modulated arc therapy 
The British Journal of Radiology  2012;85(1020):1539-1545.
The primary purpose of this study was to assess the practical trade-offs between intensity-modulated radiation therapy (IMRT) and dual-arc volumetric-modulated arc therapy (DA-VMAT) for locally advanced head and neck cancer (HNC).
For 15 locally advanced HNC data sets, nine-field step-and-shoot IMRT plans and two full-rotation DA-VMAT treatment plans were created in the Pinnacle3 v. 9.0 (Philips Medical Systems, Fitchburg, WI) treatment planning environment and then delivered on a Clinac iX (Varian Medical Systems, Palo Alto, CA) to a cylindrical detector array. The treatment planning goals were organised into four groups based on their importance: (1) spinal cord, brainstem, optical structures; (2) planning target volumes; (3) parotids, mandible, larynx and brachial plexus; and (4) normal tissues.
Compared with IMRT, DA-VMAT plans were of equal plan quality (p>0.05 for each group), able to be delivered in a shorter time (3.1 min vs 8.3 min, p<0.0001), delivered fewer monitor units (on average 28% fewer, p<0.0001) and produced similar delivery accuracy (p>0.05 at γ2%/2mm and γ3%/3mm). However, the VMAT plans took more planning time (28.9 min vs 7.7 min per cycle, p<0.0001) and required more data for a three-dimensional dose (20 times more, p<0.0001).
Nine-field step-and-shoot IMRT and DA-VMAT are both capable of meeting the majority of planning goals for locally advanced HNC. The main trade-offs between the techniques are shorter treatment time for DA-VMAT but longer planning time and the additional resources required for implementation of a new technology. Based on this study, our clinic has incorporated DA-VMAT for locally advanced HNC.
Advances in knowledge
DA-VMAT is a suitable alternative to IMRT for locally advanced HNC.
PMCID: PMC3611711  PMID: 22806619
22.  Incidence of symptomatic brain metastasis following radical radiotherapy for non-small cell lung cancer: is there a role for prophylactic cranial irradiation? 
The British Journal of Radiology  2012;85(1020):1546-1550.
Brain metastases following radical radiotherapy for non-small cell lung cancer (NSCLC) are a recognised phenomenon; however, the incidence of symptomatic brain metastasis is currently unknown. The aim of the study was to identify the number of patients, staged in accordance with National Institute for Health and Clinical Excellence (NICE) guidance, who developed symptomatic brain metastasis following radical radiotherapy. There are two aims: to evaluate NICE guidance; and to provide vital information on the likely benefit of prophylactic cranial irradiation (PCI) in reducing neurological symptoms from brain metastasis.
A retrospective review of 455 patients with NSCLC who had undergone radical radiotherapy in 2009 and 2010 was performed. Computer-based systems were used to identify patient and tumour demographics, the staging procedures performed and whether brain imaging had identified brain metastasis in the follow-up period.
The total number of patients with brain metastasis within 6 months was 3.7%. The proportion of brain metastasis within 6 months in Stage I, II and III NSCLC throughout both years was 2.8%, 1.0% and 5.7%, respectively. Within the follow-up period (median 16 months, range 6–30 months), the total number of patients who developed symptomatic brain metastasis was 7.9%.
Patients staged in accordance with NICE guidance, of whom only 7.7% underwent brain staging, have a minimal incidence of brain metastasis following radical radiotherapy. The number of patients developing symptoms from brain metastasis following radical radiotherapy may be less than the morbidity caused by PCI.
Advances in knowledge
This finding supports the NICE guidance and brings into question the potential benefit of PCI.
PMCID: PMC3611712  PMID: 22993386
23.  Imaging of scleroma in the head and neck 
The British Journal of Radiology  2012;85(1020):1551-1555.
We review the appearance of scleroma in the head and neck on imaging. Scleroma is a chronic granulomatous disease that primarily affects the nasal cavity, but the pharynx and larynx may also be involved. On imaging, nasal scleroma appears as bilateral or unilateral expanded homogeneous nasal masses that may exhibit hyperintense signal on T1 weighted images. Pharyngeal scleroma commonly narrows the pharyngeal lumen and may involve the soft and hard palate. Imaging is essential to detect the extent of subglottic stenosis in patients with laryngeal scleroma. Rarely, scleroma may involve the orbit or the middle ear. Imaging is essential for the early diagnosis of scleroma and for differentiating it from other granulomatous and neoplastic lesions. Also, imaging is important for treatment planning and follow-up of patients after therapy.
PMCID: PMC3611713  PMID: 22898154
24.  Battlefield radiology 
The British Journal of Radiology  2012;85(1020):1556-1565.
With the increasing tempo of military conflicts in the last decade, much has been learnt about imaging battlefield casualties in the acute setting. Ultrasound in the form of focused abdominal sonography in trauma (FAST) has proven invaluable in emergency triage of patients for immediate surgery. Multidetector CT allows accurate determination of battlefield trauma injuries. It permits the surgeons and anaesthetists to plan their interventions more thoroughly and to be made aware of clinically occult injuries. There are common injury patterns associated with blast injury, gunshot wounds and blunt trauma. While this body of knowledge is most applicable to the battlefield, there are parallels with peacetime radiology, particularly in terrorist attacks and industrial accidents. This pictorial review is based on the experiences of a UK radiologist deployed in Afghanistan in 2010.
PMCID: PMC3611714  PMID: 22806621
25.  The many faces of posterior reversible encephalopathy syndrome 
The British Journal of Radiology  2012;85(1020):1566-1575.
The classic imaging findings of posterior reversible encephalopathy syndrome (PRES) are of bilateral parietal and occipital subcortical vasogenic oedema, and are well established in the literature. As experience with PRES grows, varied and atypical presentations are being increasingly described. This pictorial review illustrates the variable presentations of PRES, including cases with atypical imaging findings. We illustrate cases of PRES with varying distributions of vasogenic oedema as well as cases with atypical imaging findings, such as variations of haemorrhage and restricted diffusion. Atypical imaging findings should not dissuade the diagnosis of PRES in the appropriate clinical situation, and knowledge of the varied appearance and atypical findings of PRES allows the radiologist to make this diagnosis.
PMCID: PMC3611715  PMID: 23175479

Results 1-25 (440)