The British journal of radiology (Br J Radiol )

Publisher: British Institute of Radiology; HighWire Press

Description

The British Journal of Radiology is the official peer reviewed journal of the British Institute of Radiology covering all clinical and technical aspects of diagnostic imaging, radiotherapy and radiobiology.

Impact factor 2.11

  • 5-year impact
    0.00
  • Cited half-life
    9.70
  • Immediacy index
    0.33
  • Eigenfactor
    0.01
  • Article influence
    0.63
  • Website
    British Journal of Radiology website
  • Other titles
    British journal of radiology (Online), The British journal of radiology, BJR
  • ISSN
    1748-880X
  • OCLC
    47629775
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Renal transplantation, first performed successfully in the 1950s, is the treatment of choice for most patients with end-stage renal failure. It confers longer-term survival and a better quality of life than both haemodialysis and peritoneal dialysis. The success of renal transplantation is dependent on the preservation of renal graft function and despite the many advances in surgical techniques, immunosuppressive regimens and supportive therapies, many challenges remain including post-operative ureteral obstruction. This complication can pose a risk to graft, and, occasionally, to patient survival. In this pictorial review, we describe the causes of ureteral obstruction following renal transplantation and illustrate the pivotal role of radiology in both diagnosing and managing these complications.
    The British journal of radiology 10/2014;
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    ABSTRACT: Objective: To compare and contrast three databases, that is, The International Centre for Nephrogenic Systemic Fibrosis Registry (ICNSFR), the Food and Drug Administration Adverse Event Reporting System (FAERS) and a legal data set, through pharmacovigilance and to evaluate international nephrogenic systemic fibrosis (NSF) safety efforts. Methods: The Research on Adverse Drug events And Reports methodology was used for assessment-the FAERS (through June 2009), ICNSFR and the legal data set (January 2002 to December 2010). Safety information was obtained from the European Medicines Agency, the Danish Medicine Agency and the Food and Drug Administration. Results: The FAERS encompassed the largest number (n = 1395) of NSF reports. The ICNSFR contained the most complete (n = 335, 100%) histopathological data. A total of 382 individual biopsy-proven, product-specific NSF cases were analysed from the legal data set. 76.2% (291/382) identified exposure to gadodiamide, of which 67.7% (197/291) were unconfounded. Additionally, 40.1% (153/382) of cases involved gadopentetate dimeglumine, of which 48.4% (74/153) were unconfounded, while gadoversetamide was identified in 7.3% (28/382) of which 28.6% (8/28) were unconfounded. Some cases involved gadobenate dimeglumine or gadoteridol, 5.8% (22/382), all of which were confounded. The mean number of exposures to gadolinium-based contrast agents (GBCAs) was gadodiamide (3), gadopentetate dimeglumine (5) and gadoversetamide (2). Of the 279 unconfounded cases, all involved a linear-structured GBCA. 205 (73.5%) were a non-ionic GBCA while 74 (26.5%) were an ionic GBCA. Conclusion: Clinical and legal databases exhibit unique characteristics that prove complementary in safety evaluations. Use of the legal data set allowed the identification of the most commonly implicated GBCA. Advances in knowledge: This article is the first to demonstrate explicitly the utility of a legal data set to pharmacovigilance research.
    The British journal of radiology 09/2014; 87:20140307.
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    ABSTRACT: Cultural humility model of cross cultural communication skills training in breast care A Jain, G Reddick, L Barr, V Reece, C Hill The Nightingale Centre and Genesis Prevention Centre, UHSM NHS Foundation Trust, UK Background: Breast screening uptake rates remain consistently low in minority ethnic women. Poor communication plays a significant part in this. To a large extent it relied on improving health professionals ‘Cultural Competence’. The ‘Cultural Humility’ model however is a dynamic process & reaches beyond ‘Cultural Competence’ and is a lifelong process of self-reflection and self-critique’’. Inculcate a shared breast team understanding of the cultural humility model: ii) Encouragement to become an active participant. iii) Use trainees feedback to develop future learning process. Methods: Cultural Humility model relies on actively engaging in an ongoing process of communication skills besides actively follow the patient. A range of non-verbal and verbal skills have been modelled & rehearsed in situations of increasing complexity with opportunities to reflect and develop greater self-awareness using role play, video playback & Interpersonal Process Recall. Design and Delivery: Groups of multi-disciplinary breast care health professionals have participated in five a one day ‘Enhanced Communication Skills’ courses based on Cultural Humility model. Selfreflection, observer & facilitator feedback have enabled participants to develop their skills of cultural humility. The programme encouraged groups to 27 Symposium Mammographicum Conference 2014 26 © 2014 The British Institute of Radiology © 2014 The British Institute of Radiology Symposium Mammographicum Conference 2014 POSTER PRESENTATIONS POSTER PRESENTATIONS explore and resolve their barriers to communication. The 5 courses so far have attracted very high ratings from participants with further developments planned to enhance user experience. References: 1. Fontes, LA (2008) Interviewing Clients across Cultures: a Practitioners Guide. Guilford Press. 2. Jain, AK (2010) NS Evidence – Ethnicity and Health. 3. Kagan, N (1980) influencing human interaction- Eighteen years with IPR. In A.K. Hess (Ed Psychotherapy supervision: Theory, research and practice. New York: Wiley. 4. De Maesschalck S, Willems S, De Maeseneer J, Deveugele M. (2010) Development and validation of EMP-3: an instrument to measure physician’s attitudes toward ethnic minority patients. Fam Med. 2010 Apr;42(4):262–7. 5. Tervalon M and Murray-Garcia, J (1998) Cultural humility versus Cultural Competence: a critical distinctio Journal of Health Care for the Poor and Underserved. Vol 9, No.2 117–125.
    The British journal of radiology 07/2014;
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    ABSTRACT: Objectives. Retrospective analysis of the clinical utility of (99m)Tc-DMSA SPECT for characterisation of suspected renal masses. Methods. 15 patients who had undergone (99m)Tc-DMSA SPECT were identified, 13 patients also had SPECT/CT. (99m)Tc-DMSA uptake in the renal lesion was characterised semiquantitatively. Other imaging tests, histology and clinical data were available for correlation. Results. (99m)Tc-DMSA was not taken up in all 5 renal masses with histological confirmation of malignancy (uptake 7-19% of normal renal tissue), in 2 further masses which were clinically likely to be malignant and in one indeterminate mass (lack of sufficiently long follow-up). No renal malignancy was identified in any of the 7 patients whose renal masses had normal (99m)Tc-DMSA uptake (41-130%). Conclusions. Although caution with regard to applying those results in clinical practice must be advised, due to the retrospective nature of this report and the small number of patients included, it seems that (99m)Tc-DMSA SPECT shows a clinically useful diagnostic accuracy for distinguishing true renal masses (which in many cases require surgery) from pseudomasses. Advances in knowledge: (99m)Tc-DMSA SPECT is a clinically useful adjunct test for characterisation of suspected renal masses.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objective: In breast diffusion weighted imaging (DWI), the apparent diffusion coefficient (ADC) is used to discriminate between malignant and benign lesions. As ADC estimates can be affected by the weighting factors, our goal was to determine the optimal pair of b-values for discriminating breast lesions at 3.0T. Methods: One hundred fifty-two women with 157 lesions (89 malignant and 68 benign) underwent breast MRI, including a DWI sequence sampling 6 b-values (50,200,400,600,800 and 1000 s/mm(2)). ADC values were computed from different pairs of b-values and compared to ADC obtained by fitting the 6 b-values using a mono-exponential diffusion model (ADCall). Cut-off ADC values were determined and diagnostic performance evaluated by receiver operating characteristic (ROC) analysis using Youden statistics. Mean ADCs were determined for normal tissue and lesions. Differences were evaluated by lesion and histological types. Results: Considering the cut-off values 1.46 and 1.49×10(-3)mm(2)/s, the pairs (50,1000) and (200,800) s/mm(2) showed the highest accuracy, 77.5% and 75.4% with areas under the curve (AUC) 84.4% and 84.2%, respectively. The best pair for ADC quantification was (50,1000) s/mm(2) with 38/49 true negative and 69/89 true positive cases; mean ADCs were 1.86±0.46, 1.77±0.37 and 1.15±0.46×10(-3)mm(2)/s for normal, benign and malignant lesions. There were no significant differences in these ADC values when compared to ADCall (Dif=0.0075×10(-3)mm(2)/s; CI 95%:[-0.0036;0.0186]; p=0.18). Conclusions: The diagnostic performance in differentiating malignant and benign lesions was most accurate for the b-value pair (50,1000) s/mm(2). Advances in knowledge: The best b-value pair for lesion discrimination and characterisation through ADC quantification was (50,1000) s/mm(2.)
    The British journal of radiology 05/2014;
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    ABSTRACT: Objectives; To compare the pulmonary thin-section CT findings in patients with seasonal influenza virus pneumonia with Streptococcus pneumoniae pneumonia. Methods; The study group included 30 patients (20 male, 10 female; age range 20-91 years, mean age 55.9) with seasonal influenza virus pneumonia, and 71 patients (47 male, 24 female; age range 27-92 years, mean age 67.5) with S. pneumoniae pneumonia. Results; The proportion of community-acquired infection was significantly higher in patients with influenza virus pneumonia than with S. pneumoniae pneumonia (P = 0.001). CT findings of ground-glass attenuation (P = 0.012) and crazy-paving appearance (P = 0.03) were significantly more frequent in patients with influenza virus pneumonia than with S. pneumoniae pneumonia. Conversely, consolidation (P < 0.001), mucoid impaction (P < 0.001), centrilobular nodules (P = 0.04) and pleural effusion (P = 0.003) were significantly more frequent in patients with S. pneumoniae pneumonia than those with influenza virus pneumonia. Conclusions; Pulmonary thin-section CT findings such as consolidation and mucoid impaction may be useful in distinguishing between seasonal influenza virus pneumonia and S. pneumoniae pneumonia. Advances in knowledge; 1. Distinguishing seasonal influenza virus pneumonia with Streptococcus pneumonia pneumonia is important. 2. The CT findings of GGA and crazy-paving appearance were more frequently found in patients with influenza virus pneumonia than for patients with Streptococcus pneumoniae pneumonia, while consolidation, mucoid impaction, centrilobular nodules and pleural effusion were more frequently found in patients with Streptococcus pneumoniae pneumonia.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objective: Radiation therapy treatment planning was performed to compare the dosimetric difference between volumetric-modulated arc radiotherapy (RapidArc) and 7-field intensity-modulated radiotherapy (7f-IMRT) in the de?nitive treatment of cervical cancer. Methods: 13 patients with cervical cancer were enrolled in this study. PTV50 and PTV60 were prescribed at a dose of 50 and 60 Gy in 28 fractions, respectively. Dose to PTV60 was delivered as a simultaneous integrated boost (SIB) to the pelvic lymph nodes. Due to the mechanical limitation of the multileaf collimator (MLC) in which the maximum displacement was limited to 15 cm, two types of RapidArcTM (Varian Medical Systems, Palo Alto, CA, version 10.0) with different jaw width restriction (15 and 20-23 cm) were investigated to evaluate their dosimetric differences. The RapidArc plan type with dosimetric superiority was then compared against the 7f-IMRT on the target coverage, organs at risk (OARs) sparing, monitor units (MUs), treatment time, and delivery accuracy to determine whether RapidArc is beneficial for the treatment of cervical cancer. Results: The 15 cm jaw width restriction had better performance compared to the restrictions that were longer than 15 cm in the sparing of the OARs. The 15 cm RapidArc spared the OARs of the bladder, rectum, small intestine, femoral heads and bones and improved treatment efficiency compared with 7f-IMRT. Both techniques delivered a high quality-assurance passing rate (>90%) according to the ?3mm,3% criterion. Conclusion: RapidArc with a 15 cm jaw width restriction spares the OARs and improves treatment efficiency in cervical cancer compared to 7f-IMRT. Advances in knowledge: This study describes the dosimetric superiority of RapidArc with a 15 cm jaw width restriction and explores the feasibility of using RapidArc for the definitive treatment of cervical cancer.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objectives To review knowledge of radiographers and examine possible sociodemographic and situational contributors to this knowledge Methods A questionnaire survey was devised and distributed to a cohort of 120 radiographers. Each questionnaire contained two sections. In the first section background data including sex, age, highest academic level, grade point average (GPA), length of time from graduation, work experience as a radiographer, and the status of previous refresher course(s) were collected. The second section contained 17 multiple-choice questions concerning X-ray imaging parameters and safety issues. Results The response rate was 63.8%. In univariate analytic model, higher academic degree (p<0.001), higher GPA (r2=0.11, p=0.001), academic workplace (p=0.04) and taking previous refresher course(s) (p=0.01) were significantly associated with higher knowledge score. In multivariate analytic model, however, higher academic degree (B=1.62, p=0.01), higher GPA (B=0.50, p=0.01), and taking previous refresher course(s) (B=-1.26, p=0.03) were independently associated with higher level of knowledge. Age, sex, length of time from graduation, and work experience were not associated with the respondents' knowledge score. Conclusion Academic background is a robust indicator of radiographer's professional knowledge. Refresher courses and regular knowledge assessments are highly recommended.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objective To evaluate if vascular and pulmonary parenchymal enhancement values in dual-energy (DE) pulmonary computed tomography angiography (CTPA) can suggest the diagnosis of pulmonary congestion. Methods DE CTPA images of 90 out of 1321 patients negative for pulmonary embolism showed signs of congestive heart failure. We measured dual-energy-derived pulmonary parenchymal (PBV), pulmonary arterial (PA), and left atrial (LA) enhancement values in those and 142 control patients. Enhancement values were compared between the populations and correlated with serum values of BNP and proBNP, where available. Results No significant difference of PBV but significant differences of mean PA and LA enhancement and individual enhancement differences [PA-LA] were found between the populations. [PA-LA] was higher in patients with elevated BNP and proBNP and was positively correlated with those values. ROC analysis revealed a moderate discriminatory power of [PA-LA] for the presence of cardiac biomarker elevations. Conclusion PBV in DE CTPA is not altered in patients with signs of congestive heart failure. However, differences in enhancement values in the pre- and post-pulmonary vessels were found in comparison with the control population. Those easy measurements may be a helpful tool in patients with dyspnea or chest pain negative for PE.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objectives To calculate and evaluate absolute quantitative myocardial perfusion maps from rest first-pass perfusion MRI. Methods 10 patients after revascularization of myocardial infarction underwent cardiac rest first-pass perfusion MRI. Additionally, perfusion examinations were performed in 12 healthy volunteers. Quantitative myocardial perfusion maps were calculated by using a deconvolution technique and results were compared to the findings of a sector-based quantification. Results Maps were typically calculated within 3 minutes per slice. For the volunteers myocardial blood flow values of the maps were 0.51 ± 0.16 ml/g/min while sector-based evaluation delivered 0.52 ± 0.15 ml/g/min. A t-test revealed no statistical difference between the two value sets. For the patients all perfusion defects visually detected in the dynamic perfusion series could be correctly reproduced in the maps. Conclusions Calculation of quantitative perfusion maps from myocardial perfusion MRI-examinations is feasible. The absolute quantitative maps provide additional information on the transmurality of perfusion defects compared to visual evaluation of the perfusion series and offer a convenient way to present MR perfusion imaging findings. Advances in knowledge Voxelwise analysis of myocardial perfusion helps clinicians to assess the degree of tissue damage and the resulting maps are a good tool to present findings to patients.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objective: To retrospectively evaluate the association of magnetic resonance imaging (MRI)findings with the local control of nasopharyngeal carcinoma (NPC) treated with radiation therapy and chemotherapy (chemoradiotherapy). Methods: Pretreatment MRI of 101 patients (78 men and 23women, 23-79 years of age) who had NPC treated with chemoradiotherapy were retrospectively reviewed to evaluate tumor involvement of nasopharyngeal anatomic subsites, tumor volume, and MRI appearance .Local control rates were evaluated with respect to these MRI findings. Results: Univariate analysis (using the Kaplan-Meier method) showed that invasion of the skull base as determined by MR imaging was a significant predictor of local control. In terms of clinical characteristics , T stage and pathological subtype were significant predictors of local control. Multivariate analysis (Cox regression model) of the radiologic findings and clinical characteristics revealed that invasion of the skull base (P =0.003) and pathological subtype (P <0.001) were independent prognostic factors for local control. Conclusion: Invasion of the skull base as determined by MRI predicts the likelihood of local failure and may be helpful in identifying a subset of patients with tumors at risk of local recurrence within 3 years after primary chemoradiotherapy. Advances in knowledge: It has now become common practice to use MRI for pretreatment evaluation of patients with NPC. The potential role for MRI findings in predicting local control and prognosis in patients with NPC have implications for treatment planning.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objectives: The aim of our study was to investigate the relationship between nasal irrigation techniques (NIT) and survival rate(SR), quality of life(QOL) of nasal sinusitis(NS). Methods: We studied data from 1134 NPC patients who received radical radiotherapy were randomly divided into three groups(A?B?C).A used nasal irrigator; a homemade NI connector combined with enemator for B;C used nasal sprayer. Clinical effects,5-years overall survival(OS),progression-free survival(PFS) were observed. Furthermore, QOL of NS was evaluated using SNOT-20. Results: The median follow-up time was 69 months. The 5-year OS and PFS were 80.5% and 73.2%, in the total group, There were no significant difference in OS,PFS, xerostomia and neck skin toxicity ? grade 3 among groups. No difference in among groups. The incidence of NS was highest in C. Conclusions: The symptoms of NS seriously affected the QOL period of 1 year. C were no improvement during the follow-up period, A and B in contrast after 1 year. Although the exact mechanism remains to be explored in NIT, our finding suggest NPC patients should nasal irrigate 2 years after radiotherapy. Advance in knowledge: Our study shows that nasal irrigator is necessary for NPC patients of the high QOL in the terms of nasal sinusitis.
    The British journal of radiology 05/2014;
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    ABSTRACT: Objectives: To measure the effect of the insertion of less difficult malignant cases on subsequent breast cancer detection by breast imaging radiologists. Methods: Two studies were undertaken. Study 1: eight radiologists read two sets of images each consisting of 40 mammographic cases. Set A contained four abnormal cases and Set B contained six abnormal cases including two priming cases (less difficult malignancies) placed at intervals of 3 and 5 subsequent cases before a subtle cancer. Study 2: 16 radiologists read a third condition of the same cases, known as Set C, containing six abnormal cases and two priming cases immediately preceding the subtle cancer cases. The readers were asked to localize malignancies and give confidence ratings on decisions. Results: Albeit not significant, a decrease in performance was observed in Set B when compared to Set A. There was a significant increase in ROC Az (z=-2.532, P=0.0114) and location sensitivity (z=-2.128, P=0.0333) between the first and second halves of Set A and a marginal improvement in JAFROC FOM (z=-1.89, P=0.0587) between first and second halves of Set B. In Study 2, Set C yielded no significant differences between the two halves of the study. Conclusion: Overall findings show no evidence that priming with lower difficulty malignant cases affects the detection of higher difficulty cancers; however, performance may decrease with priming. Advances in Knowledge: This research suggests that inserting additional malignant cases in screening mammography sets as an audit tool may potentially lead to a decrease in performance by experienced breast radiologists.
    The British journal of radiology 05/2014;
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    ABSTRACT: This article reviews recent developments in primary standards for the calibration of brachytherapy sources, with an emphasis on the currently most common photon-emitting radionuclides. The introduction discusses the need for reference dosimetry in brachytherapy in general. The following section focuses on the three main quantities, i.e. reference air kerma rate, air kerma strength and absorbed dose rate to water, which are currently used for the specification of brachytherapy photon sources and which can be realised with primary standards from first principles. An overview of different air kerma and absorbed dose standards, which have been independently developed by various national metrology institutes over the last two decades, is given in the next two sections. Other dosimetry techniques for brachytherapy will also be discussed. The review closes with an outlook on a possible transition from air kerma to absorbed dose to water based calibrations for brachytherapy sources in the future.
    The British journal of radiology 05/2014;
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    ABSTRACT: Inoperable endometrial cancer may be treated with curative aim using radical radiotherapy alone. The radiation techniques are external beam radiotherapy (EBRT) alone, EBRT plus brachytherapy, and brachytherapy alone. Recently, high-dose rate (HDR) brachytherapy has been used instead of low-dose rate (LDR) brachytherapy. Image-Guided Brachytherapy (IGBT) enables sufficient coverage of the tumour and reduction of dose to the organs at risk thus increasing the therapeutic ratio of treatment. Local control rates with three-dimensional brachytherapy appear better than with conventional techniques (about 90-100%, and 70-90%, respectively).
    The British journal of radiology 05/2014;