MRI can provide considerable additional information in the detection and characterization of ILC.

Leeds Test Object TOR[MAM] has been designed to supplement the current FAXIL mammography test object TOR[MAX]. It contains a range of details that have a more natural radiographic appearance and has been designed as a test that more closely approximates the image quality achieved in clinical mammography. Physical aspects of the design and implementation of TOR[MAM] are presented. The TOR[MAM] has been used in a preliminary physical evaluation of the comparative image qualities produced by conventional (screen-film) and photostimulable phosphor computed mammography and the results are discussed. TOR[MAX] results are also presented. The influence of digital image processing (enhancement) on the image quality of computed mammograms is also considered. The results presented indicate the sensitivity of TOR[MAM].

No abstract

Skeletal toxicity is known to occur with high doses of isotretinoin (greater than 2 mg/kg/day). We have attempted to evaluate the clinical significance and document the extent of musculoskeletal toxicity associated with a relatively low dose of isotretinoin (0.5 mg/kg/day) used in the treatment of severe acne. Radiographs of 120 patients were examined. Twelve per cent showed minor changes (four patients had spinal hyperostoses and 10 had calcaneal hyperostoses). None of the musculoskeletal changes we observed was clinically significant. Comparison with matched control X-rays showed 8% of the controls to have similar non-significant changes. Follow-up of 11 of the patients with abnormal X-rays showed minor deterioration in one patient, no change in four and improvement in six. Thus, doses of 0.5 mg/kg/day isotretinoin in such patients did not produce any significant long-term musculoskeletal changes. With increasing use of this beneficial drug in acne, radiologists and dermatologists should be aware of its skeletal toxicity.

Mammography is a branch of radiology which could benefit greatly from the assimilation of digital imaging technologies. Computerized enhancement techniques could be used to ensure optimum presentation of all clinical images. Beyond this it will facilitate powerful new clinical resources such as computer-assisted diagnosis, tele-mammography, plus digital image management and archiving. An essential precursor to all these advances is the availability of appropriate direct digital mammography (DDM) image-acquisition system(s) to capture high-quality breast X-ray image data at the outset. The only practical DDM image-acquisition system currently available is (photo-stimulable phosphor) computed radiography. Modern computed mammography (CM) uses similar radiation doses to the patient and produces equivalent, albeit different, image quality to screen-film mammography. Computed mammography offers superior rendition of the skin edge and sub-cutaneous tissue and dense parenchyma, while ensuring equivalent micro-calcification detectability. Meanwhile, a variety of new technical approaches to DDM are under active investigation and/or development which promise to supercede film-based mammography. These new (second generation) DDM technologies promise the radiologist superior image quality combined with significant dose savings compared with contemporary imaging systems. In this review we describe and compare the physical and clinical characteristics of CM and the various emerging DDM image-acquisition technologies.