Seventy-nine magnetic resonance (MR) studies of the knee were reviewed in an evaluation of the ability of MR imaging to demonstrate arthroscopically proved anterior cruciate ligament (ACL) tears. MR findings were also compared with the findings of two commonly applied clinical tests of ACL instability: the Lachman test and the anterior drawer test. The sensitivity of MR imaging was 94% (17 of 18), compared with 78% (14 of 18) for the anterior drawer test and 89% (16 of 18) for the Lachman test. The specificity was 100% for all three. Three MR criteria were applied: irregularity or a wavy contour of the anterior margin of the ligament, high-signal-intensity change within the substance of the ligament on T2-weighted images, and discontinuity of that substance. The sagittal T2-weighted image was especially helpful, producing an "arthrographic" effect, in which the anterior margin of the ACL is outlined by high-signal-intensity joint fluid. By demonstrating ACL and other extrameniscal lesions, MR imaging may help clarify the mechanisms of knee injury.

The Elekta Synergy is a radiotherapy treatment machine with integrated kilovoltage (kV) X-ray imaging system capable of producing cone beam CT (CBCT) images of the patient in the treatment position. The aim of this study is to assess the additional imaging dose. Cone beam CT dose index (CBDI) is introduced and measured inside standard CTDI phantoms for several sites (head: 100 kV, 38 mAs, lung: 120 kV, 152 mAs and pelvis: 130 kV, 456 mAs). The measured weighted doses were compared with thermoluminescent dosimeter (TLD) measurements at various locations in a Rando phantom and at patients' surfaces. The measured CBDIs in-air at the isocentre were 9.2 mGy 100 mAs(-1), 7.3 mGy 100 mAs(-1) and 5.3 mGy 100 mAs(-1) for 130 kV, 120 kV and 100 kV, respectively. The body phantom weighted CBDI were 5.5 mGy 100 mAs(-1) and 3.8 mGy 100 mAs(-1 )for 130 kV and 120 kV. The head phantom weighted CBDI was 4.3 mGy 100 mAs(-1) for 100 kV. The weighted doses for the Christie Hospital CBCT imaging techniques were 1.6 mGy, 6 mGy and 22 mGy for the head, lung and pelvis. The measured CBDIs were used to estimate the total effective dose for the Synergy system using the ImPACT CT Patient Dosimetry Calculator. Measured CBCT doses using the Christie Hospital protocols are low for head and lung scans whether compared with electronic portal imaging (EPI), commonly used for treatment verification, or single and multiple slice CT. For the pelvis, doses are similar to EPI but higher than CT. Repeated use of CBCT for treatment verification is likely and hence the total patient dose needs to be carefully considered. It is important to consider further development of low dose CBCT techniques to keep additional doses as low as reasonably practicable.

The "Radiovisiography" dental imaging unit (Trophy UK Ltd) is a digital system using an intensifying screen and charge-coupled device in an intra-oral sensor. This paper presents a description of the system and an assessment of the original model in terms of patient dose (relative to film systems), resolution (limiting resolution and modulation transfer function), distortion and image noise (amplitude). The system does offer the possibility of reduced patient exposure and minimal distortion, although resolution and latitude are inferior to standard dental film.

Knowledge of current practices amongst general dental practitioners (GDPs) is important in planning postgraduate and undergraduate teaching curricula and in ensuring the relevance of clinical research. A number of methods are available to dentists for the rapid production of intraoral radiographic images, including concentrated and monobath chemistry. No current data exists about the use of such 'rapid' systems in the UK. The aim of this study was to obtain this data, including the relative popularity of the different systems. A questionnaire on 'rapid' processing of radiographs was distributed to all 855 GDPs in four Family Health Services Authorities in North West England. Responses were received from 326 GDPs (38.1%). 29.4% of GDPs used some kind of 'rapid' system, with 'packet processed' films being the most popular. 6.1% of all GDPs used 'rapid' systems routinely, while the remainder used them for specific situations, typically emergencies and endodontics.

A number of products are available to dentists for the rapid production of intraoral radiographic films but there is little information on their relative merits. This study evaluated the performance of five "rapid" film processing products commonly used by British dentists in comparison with standard Kodak manual processing. Two Perspex contrast-detail test objects were made in order to investigate threshold contrast. Film speed, film gradient, limiting resolution and threshold contrast results are presented. Rapid processing systems possessed lower film speed when compared with Kodak Ektaspeed film and standard Kodak processing. The speed of E-speed film was found to be lower than that of D-speed film when used with Westone "Rapid X-ray" processing. Overall image quality was generally similar for all film/processing combinations evaluated, with the exception of Nix QP which gave markedly poorer image quality.