DOI:10.1259/bjr/22544945

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

This paper describes the implementation of intensity modulated radiotherapy (IMRT) in a radiotherapy department. When preparing to set-up an IMRT programme, it is important to review departmental protocols with regard to immobilization, CT planning, treatment planning and verification. Any additional quality assurance steps also need to be fully understood. A new IMRT programme is most likely to be successful if it builds on established clinical experience with three-dimensional conformal radiotherapy (CRT). Training of radiographers, clinicians and physicists is critical, and both team-work and communication are vital to ensure a smooth transition from 3DCRT to IMRT delivery in the clinic.

DOI:10.1259/bjr/19737738

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

Pancreatic imaging with multidetector CT allows multiphase acquisition of thin slices in a single breath-hold and is especially valuable in obtaining isotropic three-dimensional reformations that improves our ability to provide accurate pre-operative vascular mapping. Advanced MR technology allows faster imaging of pancreas, thus facilitating MR cholangiopancreatography. Use of tissue-specific MR contrast agents, endoscopic ultrasound and PET in pancreatic imaging has evolved considerably. This review article discusses the role of CT, MR, endoscopic ultrasound and PET imaging in pancreas.

DOI:10.1259/bjr/16642775

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

Distinguishing between small benign malformations in the liver and early metastatic disease remains difficult. We identified a group of 115 patients with known or suspected malignant disease who had “indeterminate” small liver lesions and who underwent 2–16 CT examinations (median 5) over a follow up period of 6–60 months (median 16). The size, shape, edge, homogeneity and attenuation of each of these lesions was assessed. The lesions were classified by their behaviour on follow up CT as either stable (79%) or unstable (21%). The unstable lesions (n=62) included 37 that grew larger and 25 that became smaller or disappeared in patients undergoing anti-tumour therapy. Image features predictive of stable behaviour were small size and sharp edge. Heterogeneity and soft tissue attenuation were significantly associated with unstable behaviour, but these features were seen in only a small minority of cases. Shape had no predictive value. A logistic regression model was constructed based on size and edge to allow an estimate to be made of the likelihood of an individual lesion being unstable. In patients with known or suspected malignant disease, the majority of isolated small liver lesions found on CT are benign. Although size under 5 mm and a sharp margin are favourable features, this appearance does not exclude malignancy.

DOI:10.1259/bjr/99569888

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

The aim of this study is to quantify power Doppler assessment of therapeutic response in rheumatoid synovitis. 13 patients (6 male, 7 female) with rheumatoid arthritis, who had an acute exacerbation of small joint synovitis in the hands, were examined with quantitative power Doppler, before and after intravenous corticosteroid treatment. All patients were examined by a single radiologist, using an ATL HDI 5000 ultrasound machine (ATL, Boswell). The images were analysed using a specially developed software package (HDI Lab), which quantifies power Doppler signal. All patients improved clinically following treatment, which was reflected in functional disability scores, and in the C-reactive protein levels and erythrocyte sedimentation rate. In all cases, there was a significant decrease in synovial vascularity as measured by the mean amplitude of signal on quantitative power Doppler. Quantitative power Doppler may allow objective assessment of treatment in small joint synovitis.

DOI:10.1259/bjr/40466706

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

The aim of this study was to analyse and compare the chest radiographic and CT findings in patients with primary and secondary Sjögren's syndrome. We retrospectively evaluated the frequency of abnormality and findings of both the chest radiography (n=107) and CT (n=59) in patients with Sjögren's syndrome. Abnormal cases were classified into five patterns based on predominant CT findings. Chest radiographic and CT abnormalities were seen in 24 (22%) and in 34 (58%) patients, respectively. Most frequently observed abnormal findings were linear and reticular opacities on chest radiograph, and ground-glass opacity, interlobular septal thickening and intralobular interstitial thickening on CT in both primary and secondary Sjögren's syndrome. Centrilobular abnormalities were significantly more common in patients with primary Sjögren's syndrome (p=0.018). According to our CT classification, interstitial pneumonia (IP) pattern was the most common in patients with both primary and secondary Sjögren's syndrome. Bronchiolitis pattern was more common in patients with primary Sjögren's syndrome and lymphoproliferative disorder (LPD) pattern was only observed in primary Sjögren's syndrome. In conclusion, although the most frequently observed pattern in our CT classification was IP pattern in both primary and secondary Sjögren's syndrome, centrilobular abnormalities and LPD pattern were relatively characteristic in patients with primary Sjögren's syndrome.

DOI:10.1259/bjr/18937619

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

The study aimed to evaluate the Commission of the European Communities (CEC) quality criteria for paediatric lateral spine radiographs, and to use these to assess and compare the quality of film–screen and digital images. 286 paediatric lateral spine radiographs (89 film–screen and 197 digital) were independently analysed by two observers according to the CEC criteria. Based on fulfilment of criteria, images were assigned two scores, an image criteria score and a visual grading analysis score. Sensitivity values (S) on digital radiographs were recorded and correlated with image quality. Variability for assignment of scores between observers was lower for the image criteria than the visual grading analysis technique. Analysis of variance for fulfilment of criteria between techniques, and (for digital images) age and sensitivity values was calculated. Film–screen did significantly better (p<0.05) than digital imaging for Criterion 6 (visually sharp reproduction of the cortex and trabecular markings consistent with age), but significantly worse for Criterion 7 (reproduction of the adjacent soft tissues). There was a significant difference in meanSvalues for each age group when Criterion 6 was or was not met. Results show that although interpretation between two observers was ambiguous, the CEC criteria were able to detect differences in quality of film–screen and digital images. It is also possible to use them when optimizing targetSvalues.

DOI:10.1259/bjr/57437508

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

It has been shown that radiological manifestations of coronary artery sclerosis are an indirect measure of co-morbidity and predictive of survival. The aim of the present study is to evaluate the outcome and side effects after three-dimensional (3D) radiotherapy in patients with unresectable non-small cell lung cancer (NSCLC) stage I, II and IIIA, depending on coronary artery calcification, Karnofsky performance index (KI) and co-morbidity. Between 1993 and 1999, 89 patients with unresectable NSCLC were treated with 3D-radiotherapy. The median age was 66.6 years and median KI 80%. All patients had 3D-treatment planning, based on CT scans. The median total dose was 60 Gy in 2 Gy fractions five times a week. The mean follow-up period was 13.2 months and mean survival time 12.2 months. Significant prognostic factors for improved survival were KI and tumour stage. Patients with a KI<90% had a median survival of 6.5 months compared with 14 months, in patients with KI≥90% (p<0.001). NSCLC stage I+II showed a significantly longer median survival than patients with NSCLC stage IIIA (16.5 months versus 7 months,p<0.004). A significant correlation was seen between pack-years and coronary artery calcification (p60 years (p<0.007). Side effects,e.g.pneumonitis, did not correlate with coronary artery calcification but correlated with chronic obstructive lung disease in 19/89 patients. Conventional CT scans for 3D-treatment planning are able to detect coronary artery calcification. There is a significant correlation between age, KI, tobacco consumption and vascular calcification. Although there was a trend to worse overall survival, coronary artery calcification was not a significant predictor of progression-free and overall survival.

DOI:10.1259/bjr/97164438

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

A retrospective study has been undertaken in an attempt to identify physical parameters that could confidently be used to predict an enhanced risk of bladder morbidity following intracavitary brachytherapy. 366 women received brachytherapy as all, or part, of their treatment for cervical cancer at the Christie Hospital in 1990 and 1991, and of these, 60 patients developed identifiable bladder morbidity (graded on a scale of 1–4 using the Franco-Italian glossary). These were age and stage matched with 60 asymptomatic women who were also treated for cervical cancer by brachytherapy during the same time period. The sizes of applicators used in the two groups were noted and compared. The two groups were also compared with respect to the heights of the applicator set above the symphysis pubis, the degree of anteversion or retroversion of the applicator sets and where possible, the doses at the International Commission on Radiation Units and Measurements (ICRU) bladder reference point. Where CT scans of the applications were available, these were reviewed to see if any differences in the size, shape or location of the bladder were apparent. No significant difference was found between the two groups of patients for any of the parameters investigated. The physical factors investigated in this study cannot be used to reliably predict bladder complications. There was a significant correlation between bladder morbidity and morbidity in other pelvic sites.

DOI:10.1259/bjr/68756213

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY

摘要:

A computer program for checking photon external beam dose calculations is described. It provides a check of the treatment planning calculation by the use of machine data that are independent of that used in the initial calculation. Data required to specify any radiation beam are easily and rapidly set up and the program works for all the major manufacturers' machines. The user interface uses an interactive screen for machine data input and also for dose checking, where dose calculation is performed in real time as data are entered. The dose resulting from the planned field parameters is calculated and compared with the prescribed dose with a warning provided if the agreement is outside a set range (±5%). Its purpose is to act as a final quality assurance check to ensure that no significant errors occur in the monitor unit calculation.

DOI:10.1259/bjr/79169320

出版商:British Institute of Radiology    

年代:2003

数据来源: WILEY