The British journal of radiology (Br J Radiol)

Publisher: British Institute of Radiology; HighWire Press, British Institute of Radiology

Journal 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.

Current impact factor: 2.03

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 2.026
2013 Impact Factor 1.533
2012 Impact Factor 1.217
2011 Impact Factor 1.314
2010 Impact Factor 2.062
2009 Impact Factor 2.105
2008 Impact Factor 2.366
2007 Impact Factor 1.773
2006 Impact Factor 1.279
2005 Impact Factor 1.394
2004 Impact Factor 1.232
2003 Impact Factor 1.089
2002 Impact Factor 0.925
2001 Impact Factor 0.959
2000 Impact Factor 0.951
1999 Impact Factor 1.067
1998 Impact Factor 0.867
1997 Impact Factor 0.811
1996 Impact Factor 0.794
1995 Impact Factor 0.675
1994 Impact Factor 0.766
1993 Impact Factor 0.694
1992 Impact Factor 0.671

Impact factor over time

Impact factor

Additional details

5-year impact 1.98
Cited half-life 9.20
Immediacy index 0.30
Eigenfactor 0.01
Article influence 0.67
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

Publisher details

British Institute of Radiology

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • On funder's repositories, institutional repository or subject-based repositories
    • Publisher's version/PDF can be used on non-commercial open access repositories
    • Published source must be acknowledged
    • Must link to publisher version
    • Authors retain copyright
    • Author copyright and source must be acknowledged with full citation and set statement (see policy)
    • Non-commercial use
    • Publisher last contacted on 20/06/2013
  • Classification

Publications in this journal

  • Jung Jae Park · Byung Kwan Park · Chan Kyo Kim
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    ABSTRACT: Adrenocortical adenoma is the most common adrenal tumour. This lesion is frequently encountered on cross-sectional imaging that has been performed for unrelated reasons. Adrenal adenoma manifests variously on computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography. The learning objectives of this review are to describe the imaging findings of adrenocortical adenoma, to compare the sensitivities of different imaging modalities for adenoma characterization, and to introduce differential diagnoses.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objective: To evaluate the usefulness of low-dose computed tomography (LDCT) for the diagnosis of acute lower respiratory infection (ALRI) in elderly patients in the emergency room (ER). Materials and methods: A total of 160 consecutive patients (mean age: 75.9 ± 9.2 years; range: 60-97 years), who were diagnosed to have ALRI by LDCT in the ER, were enrolled in this study. Initial chest radiograph (CR) and CT patterns of ALRI were analyzed, and clinical courses of patients were assessed. Results: Forty nine patients showed negative CR in whom main CT patterns were diffuse bronchial wall thickening (n=23), ground-glass opacity (n=6), mixed centrilobular nodules and ground-glass opacity (n=3), small consolidation (n=8), or consolidation in dependent lung (n=9), while other 111 patients with the main CT pattern of consolidation demonstrated pulmonary abnormality on CR. Pulmonary edema and pleural effusion were associated in 12.5% and 23.1% respectively. The rate of hospitalization, care in the intensive care unit, mortality and comorbidity were significantly higher in the CR(+)LDCT(+) group (88.3%, 36.1%, 18.2%, 59.5%) than in the CR(-)LDCT(+) group (55.1%, 8.2%, 2.0%, 38.8%; p ≤ 0.05). Conclusion: LDCT was useful for the early diagnosis of ALRI in elderly patients who showed negative initial CR. The patients with negative initial CR had main CT patterns of diffuse bronchial wall thickening, ground-glass opacity, centrilobular nodules, small consolidation, or consolidation in dependent lung on LDCT. Advances in knowledge: The use of LDCT may be considered for the early diagnosis of ALRI in elderly patients who have high comorbidity.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Purpose: To compare the trans-rectal (TR) spectral Doppler findings between benign prostatic hyperplasia (BPH) group and prostate cancer group. Material and methods: All the patients were assessed for adequate preparation and informed consent was obtained prior to the procedure. The control group (n=33) comprised of patients who were negative for malignancy on biopsy. Study group (n=22) were positive for malignancy and were also divided into three groups on the basis of Gleason score. Study parameters included mean values for Resistive index (RI); Pulsatality index (PI) and Systolic/Diastolic ratio (S/D) and Peak systolic velocity (PSV). These were separately measured for bilateral capsular and urethral branches and compared between groups. In patients with unilateral tumor, these were compared between tumor and non-tumor side. Finally, the parameters were compared with patient's age. Mann-Whitney U test was used to evaluate the statistical significance. Results: The mean values of RI, PI, S/D and PSV were found to be 0.84/1.03;1.8/1.99; 3.93/4.45 and 15.52/16.15 cm/sec respectively in control and study groups which were not statistically significant. In patients with unilateral malignancy (n=16), there was no significant difference from non-tumor side. Doppler parameters showed statistically significant relation with age. Mean of minimum RI was found to be 0.60 in patients < 60 years and 0.76 in patients > or equal to 60 years of age in the benign category [p value 0.014]. PI and S/D also showed significant difference in the benign category. Conclusion: TR Spectral Doppler parameters did not reveal any significant difference in patients with or without prostatic malignancy, irrespective of Gleason grade. Doppler parameters however, showed significant correlation with age and were lower in younger patients. Advances in Knowledge: TR spectral Doppler is unlikely to emerge as diagnostic and prognostic tool for carcinoma prostate.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: The purpose of this study was to evaluate if high mammographic density can be used as one of the selection criteria for Magnetic resonance imaging (MRI) in invasive lobular breast cancer (ILC). Methods: In our institute, high breast density has been used as one of the indications for performing MRI scan in patients with ILC. We divided the patients in two groups, one with MRI performed preoperatively and other without MRI. We compared their surgical procedures and analysed if surgical plan was altered after MRI. In case of alteration of plan, we analysed if the change was adequate by comparing post-operative histological findings. Results: Between 2011 and 2015, there were a total of 1601 breast cancers with 97 lobular cancers, out of which 36 had pre-operative MRI and 61 had no MRI scan. 12 (33.3%) had mastectomy following MRI, out of which 9 (25%) had change in surgical plan from conservation to mastectomy following MRI. There were no unnecessary mastectomies in the MRI group. However, utilisation of MRI in this cohort of patients did not reduce re-operation rate (19.3%). Lobular cancer in situ (LCIS) was identified in 60% of re-operations on post surgical histology. Patients in the 'No MRI' group had higher mastectomy rate 26(42.6%), which was again appropriate. Conclusion: High mammographic density is a useful risk stratification tool for selective MRI in ILC within a multi-disciplinary team meeting (MDTM) setting. Provided additional lesions identified on MRI are confirmed with biopsy, pre-operative MRI does not cause unnecessary mastectomies. Used in this selective manner, re-operation rates were not eliminated, albeit reduced when compared to literature. Advances in Knowledge: High mammographic breast density can be used as one of the selection criteria for pre-operative MRI in invasive lobular breast cancer without increase in inappropriate mastectomies with potential time and cost savings. In this cohort, re-excisions were not reduced markedly with preoperative MRI.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: To investigate the correlation between apparent diffusion coefficient (ADC) values and prognostic factors in invasive ductal carcinoma (IDC) patients. Methods: Forty-eight lesions belonging to 47 patients with histopathologically proven IDC were examined using conventional MR and diffusion-weighted imaging at a 3.0 Tesla system. All of the patients had modified radical mastectomies or breast-sparing surgery plus axillary lymph node dissection. The ADC values acquired from the ADC maps consisted of six different b values (0, 50, 100, 500, 1,000 and 1,500 s/mm(2)), and were compared with the patients' ages, tumor size, histologic grade of the lesions, tumor localization, lesions' distance to skin surface and nipples, the existence of axillary lymph node involvement, the number of involved axillary lymph nodes, estrogen/progesterone receptor status, peritumoral lymphovascular invasion status, and the existence of HER2 (c-erbB-2) overexpression. Results: A statistically significant relationship was found regarding axillary lymph node involvement (p = 0.027), and estrogen/progesterone receptor status (p = 0.013). No significant relationship was detected regarding other prognostic factors (p >0.05). Conclusions: Among various prognostic factors, ADC values were significantly correlated with only axillary lymph node positivity and estrogen/progesterone receptor status. Advances in knowledge: In the present study, the relationship between ADC values of IDC lesions that are acquired at a high magnetic field (3.0 Tesla) system by using multiple b values and some specific prognostic factors that were not evaluated before in the medical literature was investigated.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: Evaluation of potential dose savings by implementing adaptive statistical iterative reconstruction (ASiR) on a gemstone-based scintillator in a clinical 64-row whole-body computed tomography (WBCT) protocol after multiple trauma. Methods: Dose reports of 152 WBCT scans were analysed for two 64-row MDCT scanners (scanner A and B); the main scanning parameters were kept constant. ASiR and a gemstone-based scintillator were used in scanner B, and the noise index was adjusted (head: 5.2 vs. 6.0; thorax/abdomen: 29.0 vs. 46.0). The scan length, CT dose index (CTDI) and dose length product (DLP) were analysed. The estimated mean effective dose was calculated using normalized conversion factors. Student's t-test was used for statistics. Results: Both the mean CTDI [mGy] (scanner A: 53.8±2.0, 10.3±2.5, 14.4±3.7; scanner B: 48.7±2.2, 7.1±2.3, 9.1±3.6; p < 0.001, respectively) and the mean DLP [mGy x cm] (scanner A: 1318.9±167.8, 509.3±134.7, 848.8±254.0; scanner B: 1190.6±172.6, 354.6±128.3, 561.0±246.7; p < 0.001, respectively) for head, thorax, and abdomen were significantly reduced with scanner B. There was no relevant difference in scan length. The total mean effective dose [mSv] was significantly decreased using scanner B (24.4±6.0, 17.2±5.8; p < 0.001). Conclusions: The implementation of ASiR and a gemstone-based scintillator allows for significant dose savings in a clinical WBCT protocol. Advances in knowledge: Recent technical developments can significantly reduce radiation dose of WBCT in multiple trauma. Dose reductions of 10% - 34% can be achieved.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Oligodendrogliomas are glial tumours, predominantly occurring in adults. Their hallmark molecular feature is co-deletion of the 1p and 19q chromosome arms, which is not only of diagnostic, but also of prognostic and predictive relevance. On imaging these tumours characteristically show calcification and they have a cortical-subcortical location, most commonly in the frontal lobe. Due to their superficial location, there may be focal thinning or remodelling of the overlying skull. In contrast to other low-grade gliomas, minimal to moderate enhancement is commonly seen and perfusion may be moderately increased. This complicates differentiation from high-grade, anaplastic oligodendrogliomas, in which enhancement and increased perfusion are also common. New enhancement in a previously non-enhancing, untreated tumour however is suggestive of malignant transformation, as is high growth rate. MR spectroscopy may further aid in the differentiation between low and high-grade oligodendroglioma. A relatively common feature of recurrent disease is leptomeningeal dissemination, but extraneural spread is rare. Tumours with the 1p/19q co-deletion more commonly show heterogeneous signal intensity, particularly on T2 weighted imaging, calcifications, an indistinct margin, and mildly increased perfusion and metabolism than 1p/19q intact tumours. For the initial diagnosis of oligodendroglioma, MR imaging and CT are complementary: MR imaging is superior to CT in assessing tumour extent and cortical involvement, while CT is most sensitive to calcification. Advanced and functional imaging techniques may aid in grading and assessing the molecular genotype as well as in differentiating between tumour recurrence and radiation necrosis, but so far no unequivocal method or combination of methods is available.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: To investigate the CT features of reperfusion (presence/absence) in Non-Occlusive Mesenteric Ischemia (NOMI) and their prognostic value in an emergency setting. Methods: A revision was undertaken of imaging from 20 patients (16 males/4 females) with a dismissal summary of NOMI. All patients had previously undergone a minimum of one MDCT examination, and consequently underwent surgery (n=8), autopsy (n=2), angiography (n=1) or endoscopy (n=9). An evaluation of the CT scans was conducted to determine vessels, mesentery, bowel and peritoneal cavity features. A comparison between the average diameter of the SMA was carried out between NOMI and 30 controlled cases. Kappa, Kolmogorov-Smirnov and Fisher's exact tests were used for statistical analysis. Results: A mean SMA diameter significantly smaller than that of the controlled cases was found for NOMI patients (K-S test: D= 0.75, Prob=3.7E-08). Fisher's exact tests showed a strong connection between the presence of reperfusion and mesenteric fat stranding (p=0.026), bowel wall thickening (p=3.2E-05), and a high attenuation of the bowel wall on unenhanced CT images (p=2.8E-04). A reduction in mortality was significantly linked to the combination of normal mesenteric vessels and wall thickening (p= 0.034). Conclusions: Analysis of not only vessels findings, but mesentery and bowel CT features will support the identification of NOMI with or without a reperfusion event in an emergency setting. A strong correlation between some CT features and lower mortality exists. Advances in knowledge: CT features of NOMI with or without reperfusion are demonstrated. Correctly assessing the presence of reperfusion in NOMI, may allow better management of these conditions in the emergency setting.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Purpose: To describe the clinical, computed tomography (CT), and pathological findings of pediatric peripheral PNET (pPNET) to enhance the recognition of these rare tumors. Material and methods: The clinical, CT and pathologic findings of 18 pediatric patients with pPNET confirmed by biopsy or surgical pathology were retrospectively reviewed. Results: The age of these 18 pediatric pPNET patients ranged from 4 months to 15 years, with a mean age of 7.7 years. The lesion locations of these 18 pediatric pPNET patients were located in head and neck (n=4), chest (n=2), abdomen and pelvic cavity (n=6), spine (n=3), ilium (n=2) and femur (n=1). Immunohistochemical examination revealed Homer-Wright rosettes in 7 lesions, and 94.4% lesions showed consistent positive staining for CD99. On plain CT images, the majority of pPNET showed such lesions that were ill-defined (72.2%), irregular shaped (83.3%), heterogeneous (66.7%) or hypodense mass (94.4%); and together with osteolytic bone destruction when the lesion originated in the bone. Calcifications were found in three lesions. After contrast administration, all soft tissue masses were persistently enhanced heterogeneously with various cystic or necrotic regions, and 71.4% of them had linear enhancement. 94.4% of soft tissue masses showed a moderate degree of enhancement. Seven cases had lymph node metastasis at diagnosis. Conclusion: Pediatric pPNET can involve any part of the body, and a large, ill-defined, aggressive soft tissue mass and moderate heterogeneous enhancement with varying cystic regions and linear enhancement, with or without osteolytic bone destruction on CT images could suggest the diagnosis. Advances in knowledge: PNETs constitute a rare type of malignant neuroectodermal tumors that have chromosomal translocations identical to Ewing's sarcoma (ES), and the reports about radiological characteristics of this disease in children are insufficient. This study has described the clinical features, computed tomography (CT) and pathological findings in 18 pediatric patients diagnosed as pPNET in different locations, as a way to enhance the recognition of these tumors and help to differentiate from other types of pediatric malignant bone and soft tissue tumors.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Endometriosis is a gynecologic disease characterized by endometrial tissue outside the uterine cavity. Commonly it affects the pelvic organs. When endometrial nodules or plaques are localized in others sites than uterus or ovaries, it is termed extragenital endometriosis. Adequate preoperative assessment is essential for treatment planning. MRI is a non-invasive method with high spatial resolution that allows the multiplanar evaluation of genital and extragenital endometriosis. Herein we present a pictorial review of a variety of extragenital endometriosis cases all of which can be encountered in clinical practice.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objective: To evaluate T2 relaxation values (T2RVs) of knee joint cartilage after double-bundle anterior cruciate ligament reconstruction (DB-ACLR) in a six-month follow up and to correlate changes between T2RVs with meniscal status and clinical findings. Methods: Twenty-seven patients who underwent DB-ACLR and magnetic resonance (MR) imaging before and 6 months after surgery, and 27 control subjects were enrolled. We compared T2RVs of the control versus pre-operative MR and pre-operative versus post-operative MR using 28 sub-compartments, including superficial and deep layers. Correlations between T2RV changes with meniscal status and clinical data were examined. Results: The pre-operative T2RV was significantly higher than that of the control group in the medial tibia (posterior-superficial), posterior medial femur (superficial), and posterior lateral femur (superficial and deep). The post-operative T2RV was significantly higher than that of pre-operative in the posterior medial femur (superficial), medial tibia (anterior-deep and central-deep), lateral femur (anterior-deep, anterior-superficial, and central-superficial), and posterior medial femur (deep). Moderate positive correlations between pre-operative and post-operative T2RVchanges were found at the posterior medial femur (interval between injury and MR examination, and instability) and posterior lateral femur (Lysholm score) Conclusion: Patients with ACL injury followed by DB-ACLR presented short-term sub-compartment T2RV changes at the medial femur, lateral femur, and medial tibia. Meniscal status did not affected T2RV, however clinical findings influenced T2RV at the posterior grooves of medial and lateral femoral condyles. Advances in Knowledge: Patients submitted to double bundle anterior cruciate ligament reconstruction presented T2 relaxation value changes in both femoral and medial tibia condyles 6 month after the surgery, affecting not just the weight-bearing, but also less-weight-bearing area.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: This study evaluated the potential benefit of a split-parotid delineation approach on the parotid gland in treatment planning of NPC patients. Methods: 50 NPC patients with parapharyngeal space (PPS) and/or level IIa cervical node involvements were divided into 3 groups: PPS only, level IIa cervical node only and both. Two volumetric modulated arc therapy plans were computed. The first plan (control) was generated based on the routine treatment planning protocol, while the second plan (test) was computed with the split-parotid delineation approach, in which a line through the antero-lateral margin of the retromandibular vein was created that divided the parotid gland into antero-lateral and postero-medial sub-segments. For the test plan, the antero-lateral sub-segment was prescribed with a dose constraint of 25 Gy in the plan optimization. Dosimetric data of the parotid gland, target volumes and selected organs at risk (OARs) were compared between the control and test plans. Results: The mean dose to the antero-lateral sub-segment of the parotid gland in all 3 groups was kept below 25 Gy. The test plan demonstrated significantly lower mean parotid dose than control plan in entire gland and antero-lateral sub-segment in all 3 groups. The difference was the greatest in group 3. Conclusions: The split-parotid delineation approach significantly lowered the mean dose to the antero-lateral sub-segment and overall gland without greatly compromising the doses to target volumes and other OARs. The effect was more obvious for both PPS and level IIa cervical node involvements compared to either of them alone. Advances in knowledge: It is the first paper that based on the assumption that parotid gland stem cells were situated at the antero-lateral segment of the gland, and applied the split-parotid delineation approach on the parotid gland in treatment planning of NPC patients with parapharyngeal space and level IIa cervical node involvements, so that the function of the post-RT parotid gland might be better preserved.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Magnetic Resonance Imaging (MRI) has superior soft tissue definition compared to existing imaging modalities in radiation oncology; this has the added benefit of functional as well as anatomical imaging. This review aims to evaluate the current use of MRI for lung cancer and identify the potential of a MRI protocol for lung radiotherapy. Thirty relevant studies were identified. Improvements in MRI technology have overcome some of the initial limitations of utilising MRI for lung imaging. A number of commercially available and novel sequences have shown image quality to be adequate for detection of pulmonary nodules with the potential for tumour delineation. Quantifying tumour motion is also feasible and may be more representative than that seen on 4DCT. Functional MRI sequences have shown correlation with FDG-PET in identifying malignant involvement and treatment response. MRI can also be used as a measure of pulmonary function. While there are some limitations for the adoption of MRI in radiotherapy planning process for lung cancer, MRI has shown the potential to compete with both CT and PET for tumour delineation and motion definition with the added benefit of functional information. MRI is well placed to become a significant imaging modality in radiotherapy for lung cancer.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: To evaluate prospectively the performance of diffusion-weighted imaging (DWI) for detection of active lesions on MR-enterography (MRE) in children with inflammatory bowel disease (IBD). Material and methods: MRE of 48 children (mean age 13 years) with suspected or known IBD were blindly analyzed by two independent readers for the presence of active lesions. Two sets of imaging including DWI and gadolinium-enhanced imaging (GEI) were reviewed. A reader consensus was obtained. Gold standard was histopathological findings. In patient-level analysis and segment-level analysis, sensitivity and specificity were calculated for DWI and GEI, and compared using McNemar's test or logistic random-effects models. Results: At least one active lesion was confirmed in 42 children (87.5%). Sensitivity and specificity for detection of at least one lesion were respectively 88.1% (95%CI, 74.3-96.1), 83.3% (95%CI, 35.9-99.6) for DWI and 66.7% (95%CI, 50.4-80.4), 83.3% (95%CI, 35.9-99.6) for GEI. In segment-level analysis, sensitivity and specificity for detection of specific-segment lesions were respectively 62.5% (95%CI,48.1-75) and 97.1% (95%CI,93.5-98.7) for DWI and 45.7% (95%CI,30.8-61.3) and 98.2% (95%CI,95.3-99.4) for GEI. Sensitivity of DWI was significantly better than GEI per patient (p=0.004) and per segment (p=0.028). Conclusion: DWI demonstrates better performance than GEI for detection of active lesions in children with IBD. Advances in knowledge: Examination with no intravenous injection. DWI can replace T1weighted-images when pediatric patients are screened with MRE for IBD. Examination performed in free-breathing is better tolerated by children.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: To report clinical and dosimetric outcomes of a consecutive series of anal cancer patients treated with volumetric intensity-modulated arc-therapy (VMAT) concomitant to chemotherapy (CT). Methods: A cohort of 39 patients underwent VMAT employing a schedule consisting of 50.4 Gy/28 fractions to the gross tumor volume and 42 Gy/28 fractions to the elective nodal volumes for cT2N0 patients. Patients with cT3-T4/N0-N3 tumors were prescribed 54 Gy/30 fractions to the gross tumor volume and 50.4 Gy/30 fr to the gross nodal volumes if sized < 3 cm or 54 Gy/30 fr if > 3 cm. Elective nodal regions were given 45 Gy/30 fractions. CT was administered concurrently following Nigro's regimen. Primary endpoints was acute toxicity. Secondary were colostomy-free survival (CFS), disease-free (DFS), cancer-specific (CSS) and overall survival (OS). Dosimetric data are also provided. Results: Median follow up was 21 months. Maximum acute toxicities were: dermatologic - G3: 18%; GI-G3: 5%; GU-G3: 2%; anemia-G2: 7%; leukopenia-G3: 28%;G4:8%; neutropenia-G3:13%;G4:18%; thrombocytopenia- G3:11%;G4:2%. The actuarial 2-year CFS was 77.9% (95% CI: 54-90.4%). Actuarial 2-year OS and CSS were 85.2% (95% CI: 60.1-95.1%), while DFS was 75.1% (95% CI: 52.4.7-88.1%). Conclusions: Our clinical results support the use of VMAT as a safe and effective IMRT option in the combined modality treatment of anal cancer, with consistent dosimetry, mild toxicity and promising sphincter preservation and survival rates. Advances in knowledge: Intensity-modulated radiotherapy is a standard of care for anal cancer patients and VMAT is a robust technical solution in this setting.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: 10% of all hip fractures are occult on plain radiography, requiring further investigation to ascertain the diagnosis. MRI is presently the gold standard investigation, but frequently has disadvantages of time delay resulting in increased hospital stay and mortality. Our aim was to establish whether Multi Detector CT (MDCT) is an appropriate first line investigation of occult femoral neck fractures. Methods: From 2013 we elected to use MDCT as the first line investigation in patients believed to have an occult femoral neck fracture with negative plain films. These were reported by consultant musculoskeletal radiologists. We retrospectively analysed the data of consecutive patients presenting to University Hospital of Wales, over 30 months with a clinical suspicion of a hip fracture. Results: 1443 patients were admitted during the study period. 209 (14.5%) had negative plain films requiring further investigation to exclude an occult femoral neck fracture, of which 199 had a CT. 93 patients had no fracture and 20 had isolated greater trochanter fractures. None of these patients progressed to develop an intracapsular femoral neck fracture at 4 month follow up, although one patient sustained an extracapsular fracture following a high energy fall whilst admitted. 26 femoral neck fractures were diagnosed on CT, whilst the remaining 60 patients were diagnosed with other pelvic ring fractures. Conclusion: When interpreted by experienced radiologists MDCT have both sensitivity and specificity of 100%. Advances in knowledge: We recommend the use of MDCT as a safe and appropriate first line investigation for occult femoral neck fractures.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objective: The aim of this study was to compare sonoelastographic findings in the retina-choroid-sclera (RCS) complex and vitreous in glaucomatous and healthy eyes. Methods: For this cross-sectional comparative study, 20 patients with primary open-angle glaucoma (POAG) and 20 healthy volunteers were recruited. Ultrasound elastography measurements were taken with a sonographic scanner of the RCS complex, anterior vitreous (AV), posterior vitreous (PV), retrobulbar fat tissue (RFT), optic disc, and optic nerve in each eye. Results: The elasticity index of the RCS complex, RFT, optic disc, optic nerve, AV, and PV were similar in both groups (p > 0.05), though the AV/PV strain ratio in the group of patients with glaucoma was significantly higher (p = 0.04). Conclusions: Glaucoma increases the AV/PV strain ratio. In providing reproducible and consistent values, the real-time elastography technique may be helpful in elucidating the mechanisms of glaucoma in some aspects. Advances in knowledge: This study can help to evaluate the elasticity of retina-choroid-sclera (RCS) complex and vitreous in glaucomatous eyes with real-time elastography.
    No preview · Article · Feb 2016 · The British journal of radiology
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    ABSTRACT: Objectives: This investigation seeks to evaluate the prevalence and imaging characteristics of tracheal diverticula (TD) among patients with cystic fibrosis (CF). Methods: A total of 113 cystic fibrosis patients at our institution, with a median age of 29, had chest CT examinations between 2002 and 2014. These imaging studies were retrospectively reviewed to assess for presence and characteristics of TD, including quantity, size, and location. The severity of CF disease was assessed using the Bhalla CT scoring system and pulmonary function tests. Results: Of the 113 cases reviewed, 20 patients were found to have one or more TD (17.7%). Presence of TD was associated with more severe disease by imaging criteria, with Bhalla CT score of 13.9±4.3 in patients with TD and 11.5±4.3 in patients without TD. For the pulmonary function tests, FEV1 and FEV1 percent predicted demonstrated a trend towards worsening function in patients with TD, though the difference was not statistically significant. Conclusions: The prevalence of tracheal diverticula in our CF patient population based on chest CT exams was 17.7%. In addition, presence of TD was associated with more severe CF disease by imaging criteria. Advances in Knowledge: Tracheal diverticula appear to have a higher prevalence in cystic fibrosis patients compared to the general population, are associated with more severe cystic fibrosis pulmonary disease by CT criteria, and are frequently underreported by radiologists.
    No preview · Article · Feb 2016 · The British journal of radiology