Biomedical subjects
Publications and source records attributed to L Kalisher.
The evaluation of maxillofacial pathology was undertaken using xeroradiography. The edge enhancement and wide image latitude were shown to give additional information, especially in areas of bony overlap, such as the temporomandibular joint, without resorting to tomography. Other areas of possible utilization are also discussed, including sialography.
Sixty-four carcinomas were detected in 1,315 women examined by xeromammography in 1973. Seventeen carcinomas were occult and 14 were detected in women referred for clinically benign lesions. The remaining 33 carcinomas were diagnosed on the basis of both clinical and roentgenographic examination. There were three false-negatives. Two of these lesions were obscured by very dense fibrocystic disease. The third lesion was called benign due to an error in interpretation. There were eight false-positives; four of these demonstrated intraductal hyperplasia and asymmetry, which may be a precursor to frank malignant change. Xeromammography is suggested as a highly accurate means of detecting occult mammary carcinomas and clarifying the nature of clinically suspected lesions.
Xeroradiographic evaluation of the axillary lymph nodes permits differentiation of characteristic patterns, including normal nodes and those enlarged as the result of fatty infiltration, inflammation, metastases from a breast primary, or primary nodal disease such as lymphoma or hyperplasia. The author describes his experience with this technique in selected patients.
A simple, inexpensive local cooling system for thermal evaluation of breast disease is described. Skin temperature measured during a 10-minute cooling process averaged 1.2degrees C higher over 31 proved cancers and 0.6degrees C lower over 18 benign masses. Forty-nine masses averaged 1.7 cm in diameter and were 1.5 cm deep; 23 of 31 malignancies (74%), 16 of 18 benign growths (88%), and 46 of 52 "normals" (88%) would have been correctly diagnosed, while results for 10 of 22 women (45%) with asymmetrical diffuse non-malignant disease would have been falsely classified positive.
Male breast disease, although overshadowed by its female counterpart, is still a problem which often comes to the attention of the radiologist. The major importance of mammography is differentiating unilateral gynecomastia from cancer. We now recognize four xeroradiographic patterns of gynecomastia: (1) increased ducts only; (2) ductal hyperplasia mimicking adenosis; (3) small ducts with stromal proliferation; and (4) fatty replacement only. These reflect the duration of the process. Gynecomastic masses are central, smooth, and most important, extend from the nipple outward, usually bisecting the midplane. Ducts may be visible. Carcinoma is usually central, dense, with irregular spiculated margins and, unlike gynecomastia is rarely in the midplane of the nipple, although it can be retroareolar in location. There may be concomitant skin changes or lymphadenopathy seen on the xerogram and these never occur in gynecomastia. There are numerous etiologies for gynecomastia, and these have been discussed in detail. It is thought that the radiologist should be aware of the pathophysiology of male breast disease and understand its significance.
A total of 88 cases of normal and pathological conditions of the skull, brain and spinal cord was studied by skull series, pneumoencephalography, and air myelography. The roentgenographic images of these structures were recorded by conventional roentgenograms, xeroradiograms, and tomogrrams and compared with each other. In general the high resolution and wide recording latitude of xeroradiography produced a more pleasing, sharper image than that obtained by conventional roentgenography. However, the individual tomographic image was superior to xeroradiography.
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