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Biomedical subjects

R H Gold

Publications and source records attributed to R H Gold.

At least 55 records · Page 3Linked to original sources
PubMed1989

Desmoplastic fibroma of bone: radiographic analysis.

Desmoplastic fibroma (DF) of bone is a rare, nonmetastasizing but locally aggressive tumor that has been discussed infrequently in the radiology literature. The radiographs from 107 previously published cases of DF and seven cases from the authors' institution were analyzed to better understand and define its radiographic characteristics. DF was most common in the mandible, pelvis, and femur. A geographic pattern of bone destruction, with a narrow zone of transition and nonsclerotic margins, was seen in 80 (96%) patients with intraosseous DF for whom radiographs were available (83 patients). Internal pseudotrabeculation was seen in 76 (91%). Although widening of the host bone due to gradual apposition of periosteal new bone was common, occurring in 74 (89%) patients, distinct periosteal new bone occurred in only two (2%) patients with DF of intraosseous origin. The cortex was breached in 23 (28%) patients. Three cases of DF arising in the periosteum were identified and were differentiated radiographically from desmoid tumors of intraosseous or soft-tissue origin.

Adult↗
PubMed1989

Mammographic screening in southern California: 2 1/2-year longitudinal survey of fees.

The American Cancer Society sponsored a community-wide low-cost mammographic screening project in March 1986. One of the major goals was to effect a decrease in mammographic screening fees. To evaluate the effectiveness of the project, a telephone survey of 58 facilities was conducted six times over 2 1/2 years, beginning January 1986 and at 6-month intervals thereafter. The number of facilities offering lower fees for screening than for consultative mammography increased from two with a mean fee of $50.00 in January 1986 to 16 with a mean fee of $68.71 in July 1988. The trend for differentiating screening and consultative examination fees occurred at both hospital- and office-based practices, but fees were significantly lower in the office-based practices. There was also a statistically significant increase in the number of facilities accepting self-referred patients between January 1986 (15.5% of facilities) and July 1988 (34.5%). At the time of the last survey, 60% of office-based practices were accepting self-referred patients.

California↗
PubMed1989

Mammographic film-processor temperature, development time, and chemistry: effect on dose, contrast, and noise.

Six different combinations of film-processor temperature (33.3 degrees C, 35 degrees C), development time (22 sec, 44 sec), and chemistry (Du Pont medium contrast developer [MCD] and Kodak rapid process [RP] developer) were each evaluated by separate analyses with Hurter and Driffield curves, test images of plastic step wedges, noise variance analysis, and phantom images; each combination also was evaluated clinically. Du Pont MCD chemistry produced greater contrast than did Kodak RP chemistry. A change in temperature from 33.3 degrees C (92 degrees F) to 35 degrees C (95 degrees F) had the least effect on dose and image contrast. Temperatures of 36.7 degrees C (98 degrees F) and 38.3 degrees C (101 degrees F) also were tested with extended processing. The speed increased for 36.7 degrees C but decreased at 38.3 degrees C. Base plus fog increased, but contrast decreased for these higher temperatures. Increasing development time had the greatest effect on decreasing the dose required for equivalent film darkening when imaging BR12 breast equivalent test objects; ion chamber measurements showed a 32% reduction in dose when the development time was increased from 22 to 44 sec. Although noise variance doubled in images processed with the extended development time, diagnostic capability was not compromised. Extending the processing time for mammographic films was an effective method of dose reduction, whereas varying the processing temperature and chemicals had less effect on contrast and dose.

Female↗
PubMed1989

Diagnosis of breast calcifications: comparison of contact, magnified, and television-enhanced images.

Matched contact and microfocal-spot-magnified images of 31 breasts, each containing a cluster of microcalcifications within a biopsy-proved benign (n = 21) or malignant (n = 10) lesion, were evaluated. Each matched set consisted of one image magnified 1.5 or 2.0 times by a microfocal spot; one contact film-screen mammogram; and one television-digitized, enhanced, and optically magnified contact film-screen mammogram. Three experienced mammographers and three senior diagnostic radiology residents with 2 weeks of training in mammography interpreted the calcifications. The average area under the receiver-operating-characteristic curve for the experienced mammographers was 0.60 for contact radiographs, 0.61 for the television-digitized images, and 0.69 for the microfocal-spot-magnified radiographs. The less experienced senior residents scored below a random choice, 0.44, for the television-digitized images; 0.51 for contact radiographs; and 0.69 for the microfocal-spot-magnified radiographs. We conclude that when evaluating microcalcifications, radiologists without extensive experience in mammography should not substitute television-digitized and enhanced contact mammograms for microfocal-spot-magnified mammograms; rigorous clinical evaluation is needed before this system is accepted for clinical use.

Analysis of Variance↗
PubMed1989

Initial clinical experience with computed radiography imaging in an emergency department.

In the emergency setting, dual imaging was performed in 42 examinations using conventional and computed radiography imaging (CRI) systems. Six specialists considered computed images to be preferable to conventional radiographs in 28% of observations, of equal quality in 50% of observations, and of lesser quality in 22% of observations, even though incorrect processing algorithms were used in 62% of the digital exams. Correct processing improved CRI image characteristics and increased its desirability over conventional studies, suggesting that digital imaging will have greater application in the emergency setting as processing features are simplified.

Emergency Service, Hospital↗
PubMed1989

Magnetic resonance imaging of the musculoskeletal system. An overview.

Several of the features of magnetic resonance imaging (MRI) are advantageous for diagnostic examination of the musculoskeletal system. For example, the excellent depiction of bone marrow makes it a very sensitive method for identifying trauma, tumor, ischemia and infection of the marrow space. In addition, the high-contrast discrimination of soft tissues and the ability to make thin-section images in any plane allows for the depiction of abnormalities involving the muscles, ligaments, tendons, and neurovascular structures. The major disadvantages are the nonspecificity of many of the findings, the high cost of examinations, and the limited number of available MRI units. MRI is most appropriately utilized when it can be expected to provide diagnostic information not available from less-expensive noninvasive diagnostic methods and when the results of the examination may significantly affect patient management. To get the most out of the examination, it should be performed and interpreted with knowledge of clinical findings and results of other imaging tests, especially plain roentgenograms. To date, MRI has proved to be most useful for the evaluation of the spine, shoulder, hip, and knee.

Bone Diseases↗
PubMed1989

Film-screen mammography: comparison of views.

The authors performed oblique, mediolateral, and cephalocaudal film-screen mammographic views for all 9,662 patients examined at the UCLA Medical Center from January 1, 1980 to December 31, 1985. In these patients, biopsies yielded 172 cancers; 87 were nonpalpable. There was a mammographic mass in 113, only calcifications in 38, and distortion or asymmetry of breast parenchyma in 12. We retrospectively determined how each view contributed to depiction of tumors: 125 cancers were seen on all views, 10 on none, 11 on the oblique only, 4 on the mediolateral only, and 3 on the cephalocaudal only. The remaining cancers were detected on various combinations of views. Cancers were missed in individual views because of overlying dense tissue or because the tumor was outside the area depicted in the film. Breast cancer screening is performed with two views of each breast. Oblique-cephalocaudal two-view mammograms showed 158 cancers; mediolateral-cephalocaudal two-view mammograms showed 151 cancers.

Breast Neoplasms↗
PubMed1988

Hemangiopericytoma of bone.

Primary hemangiopericytoma of bone is a rare malignant tumor. Forty-one cases from the literature were reviewed, and four additional cases are reported. The peak incidence is in fourth and fifth decades. The pelvis and lower extremities are the most common locations. The radiographic features are nonspecific, although angiography may aid in the diagnosis. Based on a limited number of evaluable cases, the prognosis seems to correlate with the histologic grade of the tumor. Late recurrence and distant metastases are common.

Adult↗
PubMed1988

Ultrasound breast examination of asymptomatic patients with normal but radiodense mammograms.

Of 1757 consecutive women patients examined with ultrasound (US) between 1983-1986, 796 patients were asymptomatic, had no masses on their mammograms, and were scanned with whole breast US because their breasts were radiodense on mammography. Combinations of automated and real-time hand-held equipment, ranging in frequency from 3.9 MHz to 10 MHz. were used. Of the 796 examinations, 71.5%(569) were normal, 23.5%(187) disclosed cysts, and 4.3%(40) revealed solid masses. Four masses were biopsied, yielding one malignancy, two fibroadenomas and one normal breast tissue. All but 4 of the remaining 36 asymptomatic women with solid masses had a follow-up period of at least 1 year. In the authors' opinion, this low yield of one breast cancer in 796 asymptomatic women implies that whole breast US is of little value (in terms of breast cancer detection) in breasts that are radiodense but otherwise negative on mammography.

Adolescent↗
PubMed1988

Ultrasound artifacts affecting the diagnosis of breast masses.

An investigation of the outcome of over 1600 breast ultrasound examinations revealed a number of scanning artifacts. Artifactual echoes in cysts resulted from inappropriate scanning factors, including focal zone placement, gain, TGC, and gray scale, and from partial volume effect. The absence of a sign suspicious for carcinoma, posterior shadowing to a solid mass, resulted from faulty focal zone placement, or from the mass resting on chest wall tissue. Pathology was sometimes simulated by postsurgical scars, ducts, and benign calcifications. Corrective procedures to alleviate the various scanning artifacts are recommended.

Breast↗
PubMed1988

Musculoskeletal infection of the extremities: evaluation with MR imaging.

Magnetic resonance (MR) imaging was performed in 17 patients, 11-84 years of age, referred for evaluation of possible osteomyelitis involving the appendicular skeleton. MR imaging permitted successful identification of osteomyelitis in ten patients (four acute, two subacute with Brodie abscess, two chronic, and two acute with septic arthritis) and of cellulitis in the absence of osteomyelitis in four patients, including one with a soft-tissue abscess. Active osteomyelitis was excluded in three patients. Both T1- and T2-weighted spin-echo sequences were needed to evaluate osteomyelitis. T2-weighted images were needed to identify foci of active infection. MR images provided more accurate and detailed information regarding the extent of involvement than did radionuclide bone scans, computed tomographic scans, or standard radiographs. It permitted the differentiation of septic arthritis or cellulitis from osteomyelitis. In this limited series, MR imaging was particularly useful for seeking foci of active infection in areas of chronic osteomyelitis complicated by surgical intervention or fracture.

Abscess↗
PubMed1988

Shoulder instability: evaluation with MR imaging.

Instability of the glenohumeral joint is a common cause of chronic shoulder pain and disability. One or more episodes of subluxation or dislocation may result in a tear, detachment, or attenuation of the glenoid labrum, stripping of the joint capsule from the scapula, or trauma to the tendons or muscles of the rotator cuff. A series of 27 shoulders examined with magnetic resonance (MR) imaging showed changes of glenohumeral instability, which were confirmed with open or arthroscopic surgery. MR imaging was capable of displaying common types of pathologic conditions resulting from instability, including labral trauma, capsular detachment, and retraction of the subscapularis muscle. MR imaging is a valuable diagnostic tool for the evaluation of glenohumeral instability.

Humans↗
PubMed1988

Shoulder impingement syndrome: MR findings in 53 shoulders.

The shoulder impingement syndrome refers to a condition in which the supraspinatus tendon and subacromial bursa are chronically entrapped between the humeral head inferiorly and either the anterior acromion itself, spurs of the anterior acromion or acromioclavicular joint, or the coracoacromial ligament superiorly. As a result, the space for the bursa and tendon is reduced, and repeated trauma to these structures leads to bursitis and rotator cuff injury. Although pain and limitation of motion are common early findings, the diagnosis is often delayed until a complete tear of the rotator cuff has occurred. In an attempt to determine if MR can be used to depict the abnormalities associated with impingement syndrome (subacromial bursitis, supraspinatus tendinitis, and rotator cuff tear), we reviewed 107 MR scans of painful shoulders. Changes consistent with impingement syndrome were found in 53 patients (50%), 32 of whom underwent subsequent arthrography or surgery. MR was found capable of depicting several soft-tissue and bony abnormalities that have been clinically described in impingement syndrome. In regions of inflammation, we found that the supraspinatus tendon and/or the subacromial bursa were compressed by spurs (25 shoulders), capsular hypertrophy of the acromioclavicular joint (six shoulders), and/or low-lying acromion (14 shoulders). While T1-weighted MR imaging was highly sensitive to abnormalities of the supraspinatus tendon, tendinitis could be differentiated from a small tear of the supraspinatus tendon only with T2-weighted imaging. Large, full-thickness tears, especially if chronic, produced characteristic MR findings on both T1- and T2-weighted images. We conclude that MR can be used to detect several abnormalities associated with the shoulder impingement syndrome.

Bursitis↗
PubMed1988

High frequency breast ultrasound. Hand-held versus automated units; examination for palpable mass versus screening.

Four hundred forty-five patients had one or more breast ultrasound examinations with equipment from six manufacturers, operating at 5, 7.5, or 10 MHz. Two hundred seven patients were examined by both automated and hand-held units. In revealing cysts and solid masses, the automated and hand-held units performed nearly identically. Of 198 patients who had screening mammograms, ultrasound evaluation revealed that 85 (43%) had cysts, while 32 (16%) had solid masses. Of the 207 patients who had diagnostic mammograms for a palpable mass, 63 (30.4%) had cysts, while an equal number had solid masses. Of 45 solid masses from both groups that were imaged and biopsied, all 15 that were malignant were palpable. No nonpalpable malignancies were found by ultrasound alone.

Adolescent↗