Walter J. Russell

Prolonged injection angiography for diagnosing intracranial cavernous hemangiomas.

A case of intracranial cavernous hemangioma displaying feeding arteries, tumor stains, and venous pools is presented. Tumors of this type may simulate avascular masses on angiography; however, when surgically excised, they bleed profusely. A correct preoperative diagnosis can help avoid unnecessary incisions. Prolonged injection angiography clearly depicts the tumors and their venous pools, which may be pathognomonic of cavernous hemangiomas.

Dose to the Active Bone Marrow, Gonads, and Skin from Roentgenography and Fluoroscopy

With use of phantom dosimetry, bone-marrow integral, gonadal, and skin doses were calculated for nearly all radiographic and fluoroscopic examinations conducted in the Department of Radiology of the Atomic Bomb Casualty Commission. The data are included in tabular form for reference purposes. These data are being used in a continuing investigation of the contribution of medical x ray to the total exposure experience of atomic bomb survivors. Results obtained in this study are compared with those published by other investigators.

Soft X-ray Dosimetry and RBE for Survival of Chinese Hamster V79 Cells

Dosimetry and biological effects of 40 and 50 keV low-energy X-rays generated by a SOFTEX Model CMBW-2 apparatus were studied. Doses were measured using a thin-window parallel-plate ionization chamber; beam quality was assessed using aluminum absorbers; exposure rates per unit current were determined according to the X-ray tube current and exposure times; and thermoluminescent (BeO chip) dosimeters were used to ascertain dose distributions in the irradiation field. The average correction factors for nonuniformity were calculated from the measured dose distributions. The means for ascertaining accurate exposures and doses using these methods are discussed. The dose-survival relationship of Chinese hamster V79 cells were assessed by irradiating them with 40 and 50 kV soft X-rays, 180 kV X-rays, and 60 Co gamma rays. Soft X-rays with three distinct effective energies were tested by changing the tube voltage kV and aluminium filter thicknesses; namely (1) 40 kV without filter, (2) 40 kV with a 0.2 mm thick aluminium filter and (3) 50 kV with a 0.7 mm thick aluminium filter. The effective energies obtained according to attenuation measurements using aluminium for these soft X-rays were 8.1, 11.7 and 18.5 kV, respectively. In this study the relative biological effectiveness (RBE) at 10 per cent survival compared with 60Co gamma rays ranged from 1.5 to 1.6. The RBE of 180 kV X-rays relative to 60Co gamma rays was 1.29. This study provided experimental data for the RBE of V79 cells in the intermediate energy range between hard and ultrasoft X-rays, data for which were previously reported by Goodhead and co-workers (1977, 1979, 1981).

The incidence of thoracic vertebral fractures in a Japanese population, Hiroshima and Nagasaki, 1958–1986

The incidence of thoracic vertebral fractures (TVF) in a Japanese population of 14,607 individuals from Hiroshima and Nagasaki was determined by sex, age, birth cohort, and exposure to atomic bomb radiation. The diagnosis of TVF was based on lateral chest radiographs made from 1 July 1958 to 28 February 1986. The subjects, who were born between 1880 through 1939, were categorized by sex into 10-year birth cohorts. TVF incidence increased by a factor of 1.7 in all birth cohorts with each 10-year increase in age in females, but did not increase with age in males. The incidence was significantly lower in the younger birth cohorts in both sexes. The incidence declined by a factor of 0.5 in males and 0.6 in females for each 10-year decrease in the year of birth. TVF incidence did not differ between the cities, and no correlation with atomic bomb radiation exposure was demonstrated.

Osteitis Condensans Ilii, Including Its Resolution

Abstract A series of 48 patients with osteitis condensans ilii and with roentgenograms spanning up to twenty years were observed for the degree of bone involvement and any other significant skeletal abnormalities. Interval changes on serial roentgenograms and any possible associated clinical findings were carefully noted. Low back pain was experienced by 26 patients, of whom 17 had other abnormalities such as narrowed intervertebral spaces and scoliosis which could also have been responsible for the symptoms. Osteitis condensans ilii definitely resolves with time in most cases.

Active Bone Marrow Distribution in the Adult

A study of active bone marrow distribution was made, and tables were compiled showing percentage and quantity of active marrow at specific locations. They will facilitate dose calculations for standard diagnostic and therapeutic radiological procedures, and are adaptable for possible use with an electronic computer.

Focal fatty infiltration of the liver mimicking a tumor: sonographic and CT features.

Focal fatty infiltration of the liver detected by ultrasonography (US) in this asymptomatic woman had unusual features. It appeared as a sharply marginated, spherical mass lesion on CT, with soft tissue attenuation values of 30 HU unenhanced and 50 HU with enhancement. This tumor-like zone completely resolved on follow-up US and CT, underscoring the need for follow-up examinations to exclude primary or metastatic tumors. Our review of the literature failed to reveal previous reports of features such as these.

Slow-growing lung cancer in a fixed population sample radiologic assessments

Radiographs generated during 20 years of biennial chest radiography of 107 patients with histologically proven lung cancers were reviewed for radiological evidence of slow‐growing lesions. Twenty‐nine of 37 solitary circumscribed peripheral masses which doubled in volume in five or more months prior to any therapy were considered slow growing. By these criteria, 7 (17%) of 41 squamous cell carcinomas were slow growing; whereas 22 (42%) of 52 adenocarcinomas grew slowly. There were no slow‐growing tumors among the 14 anaplastic carcinomas or cancers of other histological type. The mean doubling time for the seven squamous cell carcinomas was 5.7 months; that for the 22 adenocarcinomas was 13.1 months. The cancers of females tended to grow more slowly than did those of males. There was no appreciable difference between the mean age of the 29 patients with slow‐growing lesions and that of the remaining 78. Not only was the majority of cancer in the present study readily detectable by radiographic screening of the chest; patient survival correlated very well with the growth rates of the lesions, including those of seven resected tumors. The survivals of the seven patients with adenocarcinomas whose lesions were resected were no better than those of the remaining adenocarcinoma patients who had no surgical treatment. The results of this study proved that an appreciable percentage of lung cancers do develop slowly, especially adenocarcinomas.

Computed tomography of posterior longitudinal ligament ossification: its appearance and diagnostic value with special reference to thoracic lesions.

An earlier review of the lateral chest radiographs of 8,610 Hiroshima and Nagasaki Adult Health Study subjects revealed 48 persons with posterior longitudinal ligament ossification (PLLO) in the thoracic region. Seven additional PLLO cases detected outside that observation period brought the total to 55. Among them, 15 patients with neurological signs and/or the greatest degree of thoracic PLLO were selected for computed tomography (CT) of the spine in the present study. Computed tomography proved extremely valuable in identifying the location, shape, and severity of PLLO. In two cases, CT differentiated some lesions previously regarded to be PLLO as actually due to hypertrophie margins of vertebral bodies. Possible explanations are included for the development of the laminated or tandem type PLLO, and PLLO that is located laterally rather than in midline.

Estimation of Exposure Pattern and Bone Marrow and Gonadal Doses during Fluoroscopy

Abstract A technique using industrial type X-ray film to determine pattern of exposure and dose during fluoroscopy is described. Using bone marrow distribution tables previously compiled, a basic evaluation of the procedure was made, using a phantom, with the co-operation of ten radiologists in the community. Bone marrow dose and gonadal dose were calculated for each of the examinations and are included. The procedure proved practical and efficient in demonstrating differences in dose by examiner. With modification, it may be useful during patient examinations.