David G. Bragg

Gossypiboma--the problem of the retained surgical sponge.

Commonly used surgical sponges and appliances all have standardized, readily recognized opaque markers visible on radiographs. When these markers are identified on postoperative radiographs, they should be assumed to represent retained surgical sponges or appliances. With the rare exception of thoracotomy dressings, these marked materials are seldom, if ever, used as external bandaging materials. AP and lateral radiographs should provide an immediate answer as to the location of any retained surgical device. The early recognition of these retained surgical sponges should eliminate most complications related to their presence.

Methotrexate Therapy and Pulmonary Disease

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.

The Clinical and Radiographic Aspects of Radiation Osteitis

Patients with radiation osteitis were studied in regard to the protean manifestations of this entity as it affects the skeleton, with emphasis on distinguishing radiation osteitis from radiation osteogenic sarcoma, metastatic bony involvement, or simple changes of disuse. Bone fragmentation, resorption, and soft tissue calcification may mimic the appearance of a radiation-induced osteogenic sarcoma. In the absence of infectious or traumatic complications, an area of known radiation osteitis which suddenly changes in appearance, becomes symptomatic, or is associated with a mass lesion should be considered neoplastic.

Microwave Reflection and Transmission Measurements for Pulmonary Diagnosis and Monitoring

The potential of using low intensity penetrating microwave energy in diagnosis and monitoring of pulmonary diseases such as edema and emphysema has been investigated theoretically and in selected animal models. These diseases are characterized by changes in total lung water which modify the permittivity and conductivity of the lung tissue, and consequently affect the microwave reflection from or transmission through the lung. Both reflection and transmission measurement techniques have been examined. Animal experiments have indicated changes in microwave reflection with lung water changes. The diagnostic capabilities of transmission measurements have been evaluated experimentally on a phantom model, and theoretically on a planelayered tissue model.

A Microwave Method for Measuring Changes in Lung Water Content: Numerical Simulation

A numerical procedure to simulate several physiological and geometrical changes occurring during development of edema and to study their effects on the sensitivity of the microwave detection method is presented. The method of solution utilizes a model which consists of a two-dimensional cross section of a thorax. The model is based on an X-ray CAT scan taken with the microwave applicators in place. The electromagnetic boundary value problem is then solved numerically using the method of moments. Numerical results are presented to show the effects of several parameters, such as the uneven water distribution in the lung, the field distribution in the aperture of the microwave transmitter, and the location of the receiver on the sensitivity of the microwave detection method. Based on these results, several suggestions are made to help optimize the sensitivity of the microwave method of measuring changes in lung water content.

Roentgen manifestations of pulmonary nocardiosis.

Abstract Nocardia is an uncommon, opportunistic infecting organism. The radiographic appearance of pulmonary nocardiosis is most commonly cavitary or lobar infiltration. Particular attention is focused upon the acute necrotizing course of nocardiosis as experienced in 5 patients. Difficulty with laboratory diagnosis, the frequent use of steroid therapy, and the necessity of sulfonamide therapy require that clinicians and radiologists be aware of the disease process, especially in the clinical setting of malignant tumors and long-term adrenocorticosteroid therapy.

An Investigation of the Use of Microwave Radiation for Pulmonary Diagnostics

This communication describes a new technique in which penetrating microwave radiation is used for the diagnosis and monitoring of pathological cardiopulmonary conditions, such as pulmonary edema. Edema causes changes in the electromagnetic characteristics of the lung tissue, which in turn produces a change in the reflected and transmitted microwave radiation. Both the amplitude and phase changes of the microwave signals are measured.

The clinical, pathologic and radiographic spectrum of the intrathoracic lymphomas.

The malignant lymphomas have many similarities, both pathologically and radiographically. The several unique or unusual features of these neoplasms should be kept in mind to identify their radiographic patterns of presentation. The radiologist confronted with the responsibility of evaluating a person with a known lymphoma should design his study and bias his opinion based on a thorough knowledge of the type and clinical stage of the tumor, as well as the treatment status of the patient.

Current applications of imaging procedures in the patient with lung cancer

The primary role of imaging procedures in the patient with lung cancer should be focused on staging and follow-up challenges. The role of imaging procedures in the detection of the patient at risk for primary lung cancer remains limited and cannot be recommended at present. There is no significant difference between the yield of CT and MR in this patient group, with the possible exception of a more specific role for MR when questions are raised concerning hilar lymph node involvement and mediastinal compartmental invasion. The main role of cross-sectional imaging techniques should be in the avoidance of unnecessary surgical procedures, identifying the unresectable patient prior to exploratory thoracotomy. It should be emphasized that all radiographic abnormalities are non-specific and must be histologically verified before presuming that an abnormal lymph node or large adrenal gland contains metastatic lung cancer.

Advances in diagnostic radiology: problems and prospects.

The advances in diagnostic radiology are summarized under the headings of new techniques, new procedures and new programs. The most dramatic progress has occurred in the field of imaging technology, where computerized tomography (CT) has revolutionized the approach to brain imaging. Less obvious and secure is the position of body CT imaging, partly a result of technological deficiencies but also, as a result of imaging potential. Improved image amplification and angiographic techniques have made possible interventional radiographic procedures that hold great promise for the future. Radiologists with an interest in diagnostic oncology must play a dominant role in helping guide these new advances and direct the more appropriate application of conventional radiographic techniques in the diagnosis and followup of neoplastic diseases. Cancer 40:500–508, 1977.