Showing papers in "Radiology in 1973"

Definitive radiation therapy of carcinoma of the prostate. A report on 15 years of experience.

Abstract: The charts of 310 consecutive patients with localized prostatic carcinoma treated definitively with small-field external-beam irradiation were reviewed. The 5- and 10-year uncorrected actuarial survival rates for patients with disease limited to the prostate were 72 and 48%, respectively, compared to 48 and 30% in patients with palpable extracapsular extension. Patients for whom the interval between histological diagnosis and initiation of radiotherapy was less than one year had a significantly higher survival rate than those for whom this interval was longer. Severe symptoms which persisted beyond one year after treatment developed in 5%. Sexual potency was maintained in 70% of patients not hormonally manipulated following radiotherapy.

Evaluation of Receiver Operating Characteristic Curve Data in Terms of Information Theory, with Applications in Radiography

Abstract: A method is presented for quantitative evaluation of observer detection performance data based on elementary principles of information theory. The resulting index of detectability, average information content per observation, is compared with previously proposed measures of observer performance both on theoretical grounds and for the practical problem of evaluating radiographic screen-film systems.

Repair of potentially lethal radiation damage in vitro and in vivo.

Abstract: The repair of potentially lethal damage was studied in plateauphase cultures of human LICH cells in vitro and in NCTC-2472 mouse fibrosarcoma grown in vivo in both the ascites and solid forms. Solid tumors and old, slowly-growing ascites tumors repaired potentially lethal damage; the kinetics and amount of repair were similar to those found in plateau-phase cultures. Repair in vitro was associated with a change in the slope of the survival curve without an accompanying increase in the shoulder of the curve. The effects of repair of sublethal and potentially lethal damage were additive. Thus this repair is another factor which influences the response of tumors to fractionated irradiation.

Successful management of postbiopsy arteriovenous fistula with selective arterial embolization.

Abstract: Selective arterial embolization of autologous clot into a large post-biopsy renal arteriovenous fistula produced complete closure of the fistula and immediate cessation of hematuria. Repeat arteriography after five days demonstrated persistent occlusion of the fistula, while elsewhere the clot had virtually completely lysed. Although no angiographic evidence of infarction was noted, a small infarction was seen in the lower pole of the right kidney at autopsy one month later which might have been secondary to the injected thrombus.

Human coronary artery size during life. A cinearteriographic study.

Abstract: The diameters of large epicardial coronary arteries were measured by quantitative cinearteriography in 99 patients. Average coronary size was larger than normal in patients with lesions associated with left ventricular hypertrophy and∕or dilation. The size of the coronary arteries supplying the left ventricle was normal in patients with pure mitral stenosis and in those with the “floppy mitral valve syndrome” (when mitral regurgitation was slight or absent). The left coronary artery was larger than the right coronary artery in 83% of cases. Measurement of coronary artery size is a simple and useful extension of coronary arteriography.

Recurrence rates following radiation therapy of nodular and diffuse malignant lymphomas.

Abstract: Analysis of local recurrence rates after initial radiation therapy in 198 patients with nodular and diffuse lymphomas revealed an inverse relationship of recurrence rate to dose, except for patients with diffuse histiocytic lymphoma. At a dose of 4,400 rads, the recurrence rates for nodular lymphomas approached zero, while for diffuse lymphocytic and diffuse mixed lymphomas the recurrence rates were significantly higher, 15 and 12%, respectively. Recurrence rates between 21 and 37% were noted in patients with diffuse histiocytic lymphoma who received between 1,500 and 6,500 rads: however, no correlation between dose and rate of recurrence could be demonstrated. The implication of these observations for the treatment of non-Hodgkin's lymphomas is discussed.

Arteriographic Management of Hemorrhage Following Pelvic Fracture

Abstract: Nine patients with massive pelvic hemorrhage were evaluated angiographically. In each case the site of bleeding was identified by pelvic aortography and hemostasis was produced by intra-arterial techniques. Embolization with autologous clotted blood was employed in 8 cases and in one patient bleeding was controlled by proximally occluding the hypogastric artery with an inflated Fogarty catheter balloon.

Spontaneous Osteonecrosis of the Knee

Abstract: Six cases of spontaneous osteonecrosis of the medial femoral condyle were found during a 40-month period. While each patient presented with pain in the affected joint, it required two or more months for the characteristic flattening of the condyle and a condylar radiolucency with a surrounding sclerotic border to appear. 87mSr scintigrams showed increased uptake over the lesion. The patients ranged in age from 58 to 73 years. The condition may result in either complete resolution or considerable degenerative disease.

Anomalous Branches of the Internal Cartoid Artery

Abstract: Anomalous branches of the internal carotid artery are rarely demonstrated angiographically. Cases of the ascending pharyngeal, occipital, Vidian (pterygoid canal), and posterior inferior cerebellar arteries arising from the internal carotid artery are presented. A case of anomalous origin of the anterior cerebral artery from the internal carotid artery at the level of origin of the ophthalmic artery is also described. Brief embryological explanations of the vascular anomalies are given.

Cerebral arteritis: classification.

Abstract: A comprehensive classification of cerebral arteritis based primarily upon pathological studies is presented. The radiological findings of cerebral arteritis in general are considered, followed by descriptions of individual entities. Associated clinical and radiological manifestations of the various diseases are discussed, with emphasis upon distinguishing characteristics. Differential diagnosis is also considered.

Time-dose and tumor volume relationships in the irradiation of squamous cell carcinoma of the tonsillar fossa.

Abstract: Megavoltage irradiation was used in treating 129 patients with squamous cell carcinoma of the tonsillar fossa. The data were analyzed with time-dose scattergrams and by using the nominal standard dose (NSD) to correlate the probability of control of the primary lesion with dose and stage (tumor volume). All early lesions (T1) were controlled with 6,500 rads given in 6.5 weeks. For more advanced disease (T2), 7,000 rads in 7 weeks (or its equivalent) was required in order to obtain a high probability of local control. The largest lesions (T3 and T4) have been most effectively treated with doses of 7,500 rads in 8 weeks (or its equivalent). Complications have been correlated with dose and volume irradiated.

Angiographic demonstration of fenestrations of the intradural intracranial arteries.

Abstract: Fenestration or partial duplication of intracranial arteries is noted occasionally during anatomical dissection. Since the phenomenon is rarely described in the literature, the authors present 5 recently observed cases, with a brief explanation of the proposed embryology and potential clinical significance.

Carcinoma in the porcelain gallbladder.

Abstract: Two cases of carcinoma in porcelain gallbladders are presented, bringing the total number of cases recorded in the literature to 26. While the exact frequency with which these two diseases occur together is impossible to determine, the association is sufficiently common to warrant prophylactic cholecystectomy for porcelain gallbladder if the patient is a suitable surgical candidate.

The narrow lumbar spinal canal syndrome

Abstract: The narrow lumbar spinal canal syndrome is characterized by (a) constriction of the interpediculate and anteroposterior diameters of the bony canal, (b) thickening and vertical orientation of the laminae as well as thickening of the facets and pedicles, (c) difficult, often markedly uncomfortable lumbar puncture, (d) prominence of the defects caused by relatively small extradural lesions, with varying degrees of obstruction, and (e) sharp delineation of the nerve roots of the cauda equina. The “cauda equina syndrome” and intermittent neurogenic claudication may be observed. Thirty-three cases are reviewed, with emphasis on diagnostic criteria, myelographic appearance, and clinical aspects.

Methotrexate Therapy and Pulmonary Disease

Abstract: Eight instances of a rapidly progressive pulmonary illness manifested by cough, dyspenea, fever, and cyanosis have been seen in patients on maintenance methotrexate therapy for leukemia. The roentgenographic, findings include diffuse bilateral pulmonary infiltrates which typically are predominantly interstitial early in the course of the disease with the subsequent development of confluent alveolar densities. Despite the severity of the clinical and radiographic changes, the disease is usually self-limited. The syndrome simulates and must be differentiated from acute disseminated progressive infectious processes, particularly Pneumocystis carinii pneumonia.

Mental retardation following in utero exposure to the atomic bombs of Hiroshima and Nagasaki

Abstract: The prevalence of mental retardation in children tested at 17 years of age who had been exposed in utero to the atomic bombs of Hiroshima and Nagasaki was studied in relation to the most recent estimate of radiation dose received. Significant increases at doses greater than 50 rads in Hiroshima and 200 in Nagasaki were found, with the risk of mental retardation generally rising directly with increasing dose. The lower dose-effect in Hiroshima may have been due to irradiation by neutrons which were virtually absent in Nagasaki.

Placental migration demonstrated by ultrasonography. A hypothesis of dynamic placentation.

Abstract: Placental ultrasonography showed placenta previa in 14 patients. Follow-up examinations at 4- to 8-week intervals prior to delivery revealed that the placenta previa was no longer present. In terms of the cervix, the placenta had migrated toward the uterine fundus, probably due to a more rapid growth of the uterus. Early diagnosis of placenta previa should indicate re-examination near term, and should not necessarily indicate cesarean section; Stresses produced by differential growth rates at the placental-uterine interface may be relieved by a continuing process of dynamic placentation constantly renewing and reforming the sites of placental attachment throughout gestation.

Incidence and causes of local failure of irradiation in squamous cell carcinoma of the faucial arch, tonsillar fossa and base of the tongue.

Abstract: The incidence and causes of radiotherapeutic failures and surgical salvage were analyzed by anatomical sites, staging of the primary lesion, modalities of treatment, and clinical features in 554 patients with squamous cell carcinomas of the oropharynx treated with megavoltage irradiation from 1954 through 1967. Differences in the incidence of failures were found by T staging, depending on the anatomical site. The presence of a necrotic ulcer was correlated with poor results. Systematic causes of geographical misses or underdosed areas were found in certain techniques. Specific precautions are outlined.

Prosthetic hip angulation.

Abstract: The author describes a method by which the angle of anteversion of the Charnley-Muller total hip prosthesis may readily be obtained by measurements taken from the radiograph.

Imaging of Bone Metastases with 99mTc-Sn-EHDP (Diphosphonate), 18F, and Skeletal Radiography

Abstract: Skeletal scintigraphy employing a new technetium-labeled diphosphonate compound (99mTc-Sn-EHDP) was compared with fluorine-18 bone scanning and radiographic skeletal survey to determine its ability to detect metastatic lesions. Fluorine-18 scanning revealed only 56% of the lesions seen with 99mTc-Sn-EHDP while the latter detected all lesions seen with fluorine-18 scanning. In the 10 patients studied, only 1 of 60 metastases was missed with 99mTc-Sn-EHDP, while skeletal radiography failed to visualize 43 of the 60 lesions.

The Radiological Society of North America, Inc.

Abstract: A broad view is taken of the past, present, and future of the Radiological Society of North America. The Society's concerns are enumerated: concern with cooperation between radiologists and technologists and between radiologists and those in other branches of medicine and allied sciences; concern in providing leadership in the field of radiation measurements and protection; in support of research; in scientific education of radiologists. At the Scientific Assembly and Annual Meeting every year, the educational experience is four-pronged with its refresher courses, lectures, scientific exhibits, and technical exhibits.

Roentgen Visualization of Minute Pleural Effusion An Experimental Study to Determine the Minimum Amount of Pleural Fluid Visible on a Radiograph

Abstract: Varying amounts of saline and contrast material were injected into the pleural space of cadavers to determine the minimum amount of fluid detectable on lateral decubitus radiographs As the amount of fluid injected increased, a predictable stepladder increase in density was observed; however, as little as 5 ml of fluid was visible on properly exposed radiographs

The angioarchitecture of colonic diverticula. Significance in bleeding diverticulosis.

Abstract: The intramural distribution of the vasa recta of the colon and particularly their relationship to diverticula were investigated in a group of operative and postmortem specimens using intra-arterial barium-gelatin injections, followed by high resolution radiography, microdissections, and histologic sections. Detailed study demonstrated a large arterial branch arching immediately over the dome of the diverticulum. Multiple short branches are displaced intimately around the body and neck of the sac. A pathogenetic relationship between bleeding colonic diverticulosis and the distinctive angioarchitecture is strongly indicated.

A cesium-137 irradiator for small laboratory animals.

Abstract: A 137Cs internal irradiator for small animals is described. The irradiator is loaded with two opposing sources of 2,660 Ci each, yielding 1100 rads∕min. to a tightly-collimated 3-cm diameter field. The front faces of the sources are separated by 27 cm. Vertical uniformity of dose rate is ±1.4%; horizontal uniformity is ±4%. Leakage outside the defined beam is less than 1%. The absorbed dose rate is relatively independent of irradiated sample size. Dose rate to the skin is maintained at tumor dose rate. Beam alignment is accurately reproduced by a mechanical alignment pin. Irradiation time is controlled by an electronic logic package coupled to a punched card reader. Provision is made for hyperbaric and anoxic treatment conditions.

Left gastric artery embolization for control of gastric bleeding: a complication.

Abstract: A case is reported in which an autogenous blood clot was embolized into the left gastric artery in an attempt to control massive bleeding from a lesser curvature gastric ulcer. Postmortem examination revealed full-thickness necrosis of the gastric wall in the distribution of the left gastric artery. Factors which may have contributed to this complication are discussed.

Renal ultrasonography: an updated approach to the diagnosis of renal cyst.

Abstract: Ultrasonic B-scanning has proved to be accurate in determining whether a renal mass is solid or cystic. It is, therefore, an ideal technique by which to select those renal masses (cysts) which are suitable for percutaneous puncture for the purpose of diagnosis. When a definite cyst pattern is indicated by the ultrasonogram, percutaneous puncture is performed. A clear aspirate with negative cytology and normal LDH is considered diagnostic of benign renal cyst. If a solid mass is suggested by ultrasonography, renal angiography is performed. The results of such studies in 84 patients are discussed.

Roentgenographs: Assessment of Asymptomatic Renal Lesions

Abstract: A protocol for sequential investigation of asymptomatic space-occupying lesions of the kidney is described. The aim of this protocol is to establish the diagnosis at an acceptable confidence level with a minimum of cost in time, money, and risk to the patient. The sequential investigation utilizes screening procedures first, and then secondly, employes more definitive examinations capable of establishing the diagnosis. Past experience with space-occupying lesions of the kidney is analyzed and the frequency of occurrence of specific findings in various disease entities is tabulated to ascertain the baseline information for the magnitude and confidence-value of each of these criteria.

Cranial arteritis associated with herpes zoster. Case report with angiographic findings.

Abstract: Angiographic findings of unilateral angiitis in a case of herpes zoster ophthalmicus with contralateral hemiplegia are described. Herpes zoster is often associated with major CNS involvement and a vascular etiology was previously postulated. Recent pathological reports suggest that cerebral angiitis secondary to herpes virus infection may be more common than heretofore realized. Our findings suggest a means by which suspected cases can be more fully evaluated.

Pigmented villonodular synovitis of the temperomandibular joint.

Abstract: Two cases of pigmented villonodular synovitis of the temperomandibular joint are reported. The diagnosis was not considered originally in either case and this entity has never been previously reported in this location. Smooth destruction of adjacent bone was encountered in both cases. Differential diagnosis including carcinoma of the external auditory canal and middle ear as well as other, less likely possibilities, are discussed.