The British Journal of Radiology

Our medical research library holds 14 studies published in The British Journal of Radiology (1968–2023). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 7 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 3 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: Oxford University Press
• Published: 1928 to the present, England
• Language: English
• ISSN: 0007-1285 (print), 1748-880X (electronic)
• Merged from: British Journal of Radiology. B.I.R. Section
• Merged from: British Journal of Radiology. RöntgenSociety Section
• Continues: BJR Supplement
• Its record in the NLM Catalog

2020s

• The lung cancers: staging and response, CT, 18F-FDG PET/CT, MRI, DWI: review and new perspectives. C. Owens, S. Hindocha, R. Lee, et al. 2023;96(1148):20220339. Review PubMed · Publisher · Free full text

  Abstract

  Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer deaths in both sexes combined. Recent years have seen major advances in the diagnostic and treatment options for patients with non-small-cell lung cancer (NSCLC), including the routine use of 2-deoxy-2[18F]-fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in staging and response evaluation, minimally invasive endoscopic biopsy, targeted radiotherapy, minimally invasive surgery, and molecular and immunotherapies. In this review, the central roles of CT and 18F-FDG PET/CT in staging and response in both NSCLC and malignant pleural mesothelioma (MPM) are critically assessed. The Tumour Node Metastases (TNM-8) staging systems for NSCLC and MPM are presented with critical appraisal of the strengths and pitfalls of imaging. Overviews of the Response Evaluation Criteria in Solid Tumours (RECIST 1.1) for NSCLC and the modified RECIST criteria for MPM are provided, together with discussion of the benefits and limitations of these anatomical-based tools. Metabolic response assessment (not evaluated by RECIST 1.1) will be explored. We introduce the Positron Emission Tomography Response Criteria in Solid Tumours (PERCIST 1.0) to include its advantages and challenges. The limitations of both anatomical and metabolic assessment criteria when applied to NSCLC treated with immunotherapy and the important concept of pseudoprogression are addressed with reference to immune RECIST (iRECIST). Separate consideration is given to the diagnosis and follow up of solitary pulmonary nodules with reference to the British Thoracic Society guidelines and Fleischner guidelines and use of the Brock (CT-based) and Herder (addition of 18F-FDG PET/CT) models for assessing malignant potential. We discuss how these models inform decisions by the multidisciplinary team, including referral of suspicious nodules for non-surgical management in patients unsuitable for surgery. We briefly outline current lung screening systems being used in the UK, Europe and North America. Emerging roles for MRI in lung cancer imaging are reviewed. The use of whole-body MRI in diagnosing and staging NSCLC is discussed with reference to the recent multicentre Streamline L trial. The potential use of diffusion-weighted MRI to distinguish tumour from radiotherapy-induced lung toxicity is discussed. We briefly summarise the new PET-CT radiotracers being developed to evaluate specific aspects of cancer biology, other than glucose uptake. Finally, we describe how CT, MRI and 18F-FDG PET/CT are moving from primarily diagnostic tools for lung cancer towards having utility in prognostication and personalised medicine with the agency of artificial intelligence.

2010s

• 18F-FDG PET/CT in the management of patients with malignant pleural mesothelioma being considered for multimodality therapy: experience of a tertiary referral center. H.S. Elliott, U. Metser, M. de Perrot, et al. 2018;91(1086):20170814. PubMed · Publisher · Free full text

  Abstract

  Objective: To compare the N- and M-staging accuracy of PET vs CT, as per the American Joint Committee on Cancer (AJCC) eighth edition in patients with malignant pleural mesothelioma (MPM) being considered for multimodality therapy in a tertiary referral center. A secondary aim was to assess survival outcome of patients chosen for surgical management after PET.

  Methods: A retrospective, single institution comparison of PET and CT was performed in patients with histologically proven MPM being considered for multimodality therapy. Performance of each modality in identifying nodal category and presence or absence of distant metastases was abstracted from electronic patient records. The standard of reference was surgical histopathology for nodal stage and histopathology or clinical and imaging follow-up of >3 months for distant metastases.

  Results: There were 101 eligible patients with complete data sets; 82 males, 19 females with a mean age of 66.6 years (range: 39-85). Most patients (n = 68) had epithelioid histology. Surgery was performed in 61/101 patients (60.4%), most of whom had multimodality therapy. Nodal category was concordant to surgical histopathology in 38/60 patients (63.3%) on PET, compared to 27/60 (45%) on CT (p = 0.001). For detection of ≥N1 disease only, PET and CT correctly staged 15/37 patients (40.5%) and 8/37 (21.6%), respectively (p = 0.023). Distant metastases were identified uniquely on PET in eight patients and on CT only in one patient. Overall, PET and CT correctly identified 11/12 (91.6%) and 4/12 (33.3%) patients with distant metastases, respectively (p = 0.0391).

  Conclusion: PET identifies significantly more patients with nodal or distant metastatic disease than CT and may contribute to more appropriate selection of patients with MPM for surgery or multimodality therapy. Advances in knowledge: In patients with MPM, fludeoxyglucose-PET/CT detects significantly more patients with distant metastases than CT. PET/CT can help in the selection of patients with MPM who would benefit from surgery or multimodality therapy.

• Unilateral pulmonary artery pre-operative occlusion test: technical feasibility and safety prior to pneumonectomy or pleuropneumonectomy for malignancy. M. Shimohira, T. Hashizume, K. Ohta, et al. 2018;91(1083):20160775. PubMed · Publisher · Free full text

  Abstract

  Objective: The aim of the present study was to assess the technical feasibility and safety of the unilateral pulmonary artery occlusion (UPAO) test in pre-operative evaluation of pneumonectomy or pleuropneumonectomy for lung or pleural tumours.

  Methods: The UPAO test was performed on 91 patients who were scheduled to undergo or were being considered for pneumonectomy or pleuropneumonectomy between June 2003 and July 2016. There were 74 males and 17 females, with a median age of 65 years (range, 23-80). The technical success rate, procedure time and complication rate were evaluated. Technical success was defined as completion of the UPAO test.

  Results: The diagnoses of the 91 patients were as follows: lung cancer in 63, malignant pleural mesothelioma in 21, thymoma in 5, lung metastasis in 1 and lung carcinoid in 1. The UPAO test was performed successfully on 88 out of 91 patients (technical success rate: 97%). The median procedure time was 57 min (range, 34-120). Cardiac arrest due to migration of the balloon catheter to the pulmonary trunk occurred in 1 patient (complication rate: 1.1%).

  Conclusion: The UPAO test in pre-operative evaluation of pneumonectomy or pleuropneumonectomy for lung or pleural tumours appears to be technically feasible. However, it needs to be performed with care in order to avoid severe complications. Advances in knowledge: The UPAO test can be safely performed and is helpful in evaluating patients for pneumonectomy or pleuropneumonectomy.

• Radiological predictors of complete cytoreduction in 59 patients with peritoneal mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a UK referral centre. A. Chandramohan, A. Thrower, N. Shah, et al. 2017;90(1079):20170361. PubMed · Publisher · Free full text

  Abstract

  Objective: To assess the imaging features of peritoneal mesothelioma and identify key anatomical sites that aid patient selection for complete cytoreduction.

  Methods: Pre-operative imaging of 59 (32 males, 27 females) patients who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) for histologically proven peritoneal mesothelioma [36 malignant peritoneal mesothelioma, 23 cystic mesothelioma were reviewed. Imaging findings were correlated with surgical outcome. Best imaging predictors of complete cytoreduction, n = 22 and major tumour debulking, n = 12 were assessed.

  Results: Most patients (88.9%) had diffuse peritoneal disease with mean radiological peritoneal cancer index of 18 ± 12 (range 2-39). Disease in the lesser omentum (n = 10), porta hepatis (n = 8), perigastric area (n = 5), mesentery (n = 25), small bowel (n = 17), hydronephrosis (n = 1), concurrent pleural disease (n = 2), lymph nodes (n = 1) and abdominal wall disease (n = 4) was considered unfavourable. While 78.9% of patients who underwent complete cytoreduction had no disease at unfavourable sites, 75% of those who underwent MTD did have disease at these sites. There was significant difference in the radiological peritoneal cancer index, severity of upper abdominal disease, small bowel and mesenteric involvement between patients who underwent complete cytoreduction and MTD for malignant peritoneal mesothelioma. Complete cytoreduction was not achieved in the presence of a rind of soft tissue around the small bowel (p = 0.016) and was unlikely in the presence of large volume upper abdominal disease (p = 0.06).

  Conclusion: Involvement of key anatomical sites such as small bowel serosa and large volume upper abdominal disease reduced the likelihood of achieving complete cytoreduction in patients with malignant peritoneal mesothelioma. Advances in knowledge: Demonstration of small bowel disease and large volume upper abdominal disease on imaging in patients with malignant peritoneal mesothelioma can be used to identify patients who may not benefit from cytoreductive surgery.

• Focal pleural thickening mimicking pleural plaques on chest computed tomography: tips and tricks. K.M. Alfudhili, D.A. Lynch, F. Laurent, et al. 2016;89(1057):20150792. Review PubMed · Publisher · Free full text

  Abstract

  Diagnosis of pleural plaques (PPs) is commonly straightforward, especially when a typical appearance is observed in a context of previous asbestos exposure. Nevertheless, numerous causes of focal pleural thickening may be seen in routine practice. They may be related to normal structures, functional pleural thickening, previous tuberculosis, pleural metastasis, silicosis or other rarer conditions. An application of a rigorous technical approach as well as a familiarity with loco-regional anatomy and the knowledge of typical aspects of PP are required. Indeed, false-positive or false-negative results may engender psychological and medico-legal consequences or can delay diagnosis of malignant pleural involvement. Correct recognition of PPs is crucial, as they may also be an independent risk factor for mortality from lung cancer in asbestos-exposed workers particularly in either smokers or former/ex-smokers. Finally, the presence of PP(s) may help in considering asbestosis as a cause of interstitial lung disease predominating in the subpleural area of the lower lobes. The aim of this pictorial essay is to provide a brief reminder of the normal anatomy of the pleura and its surroundings as well as the various aspects of PPs. Afterwards, the common pitfalls encountered in PP diagnosis will be emphasized and practical clues to differentiate actual plaque and pseudoplaque will be concisely described.

• Coarse pleural calcification in a mesothelioma patient raises the possibility of a rare tumour subtype: osteoblastic sarcomatoid mesothelioma. A.M. Mortimer, J. Rowlands, P. Murphy. 2011;84(1001):e106-8. Case report PubMed · Publisher · Free full text

  Abstract

  It is often suggested that calcification seen in association with pleural thickening implies benign disease. However, we present a case of a patient presenting with coarse pleural calcification associated with a pleural effusion and thickening, which following biopsy was shown to represent osteoblastic sarcomatoid mesothelioma. We describe the imaging features associated with this and differentiate these findings from those seen with benign pleural calcification. Similarities are drawn to other rare cases described in the literature.

2000s

• Breast or chest? A diagnostic conundrum. J.C. Lee, S. Banerjee, D.M. King. 2005;78(929):471-2. Case report PubMed · Publisher

1990s

• Malignant mesothelioma of the tunica vaginalis: a case with an unusually indolent course following radical orchidectomy and radiotherapy. J.L. Harmse, A.T. Evans, P.M. Windsor. 1999;72(857):502-4. Case report PubMed · Publisher

  Abstract

  Malignant mesothelioma (malignant adenomatoid tumour) of the tunica vaginalis testis is a very rare neoplasm with highly aggressive biological behaviour. Treatment is difficult, and widespread local invasion and/or metastatic disease at presentation are associated with a poor prognosis. In this case report we describe for the first time a patient who, despite presenting with locally advanced disease, remains well 10 years after diagnosis and treatment with radical orchidectomy and high dose radiotherapy.

1980s

• Dynamic contrast enhancement of asbestos-related pulmonary pseudotumours. P.M. Taylor. 1988;61(731):1070-2. Case report PubMed · Publisher

  Summary

  This report described three men with asbestos-related pulmonary pseudotumour (round atelectasis), seen at the Department of Diagnostic Radiology, University of Manchester, and examined the effect of intravenous contrast on their computed tomography (CT) appearances, which had not previously been recorded. All three had a history of asbestos exposure and pleural thickening. Each had a homogeneous, well-defined soft-tissue mass 3 to 3.5 cm in diameter beside thickened pleura, with lung vessels curving towards the lesion. Sections were repeated with dynamic contrast enhancement using 100 ml meglumine iothalamate. Mean attenuation rose from 35 to 100 Hounsfield units (HU) in a 48-year-old electrician, from 35 to 92 HU in a 56-year-old man, and from 40 to 65 HU in a 73-year-old maintenance fitter. In the first patient, thoracotomy found very thick parietal pleura but no folded lung or palpable mass. In the second, needle biopsy showed cellular fibrosis without malignancy, and the lesion was unchanged over 6 years. The third did not undergo thoracotomy. The lesions met six of eight published CT criteria for rounded atelectasis. Adjacent pleural thickening did not enhance significantly. The author concluded that these lesions enhance with contrast despite their fibrous nature, so enhancement did not help distinguish them from bronchial carcinoma, although it did help separate pleural from pulmonary lesions. Differentiation from malignant disease should instead rely on the CT criteria of Doyle and Lawler.

  PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

• Radiation pneumonitis in a patient exposed to asbestos. R.F. Ashford, J. Maher, A. Drury, et al. 1981;54(637):74-7. Case report PubMed · Publisher

1970s

• Peritoneal mesothelioma with unusual metastases. W. Hofner. 1979;52(624):1002-4. Case report PubMed · Publisher

  Abstract

  Malignant peritoneal mesothelioma is rare. A case is reported with an unusual metastasis and an exceptionally long survival time. Radiographic, ultrasonic, scintigraphic and surgical findings are presented and the literature reviewed.

  PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

• Pulmonary disease caused by the inhalation of cosmetic talcum powder. I.P. Wells, P.A. Dubbins, W.F. Whimster. 1979;52(619):586-8. Case report PubMed · Publisher

1960s

• Multiple pleural plaques. II. H.C. Anton. 1968;41(485):341-8. PubMed · Publisher

  Abstract

  A total of 40 cases of multiple pleural plaques is now analysed. The incidence is given of predominantly calcified, and predominantly non-calcified plaques. In addition to the faint shadow sign of the non-calcified plaque, the importance of the profile opacity is stressed. This may be the only sign in some cases. The concept of classical asbestosis is regarded with misgivings, and a re-interpretation is suggested of the ground-glass appearance. The scope and limitations of radiology in lesions due to asbestos inhalation are discussed. Associated neoplasms are illustrated.

  PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

• Pleural reaction associated with asbestos exposure. T.F. Collins. 1968;41(489):655-61. PubMed · Publisher

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