Human oncogenic viruses account for at least 12% of total cancer cases worldwide. Epstein–Barr virus (EBV) is the first identified human oncogenic virus and it alone causes ~200,000 cancer cases and ~1.8% of total cancer-related death annually. Over the past 40 years, increasing lines of evidence have supported a causal link between EBV infection and a subgroup of lung cancers (LCs). In this article, we review the current understanding of the EBV-LC association and the etiological role of EBV in lung carcinogenesis. We also discuss the clinical impact of the knowledge gained from previous research, challenges, and future directions in this field. Given the high clinical relevance of EBV-LC association, there is an urgent need for further investigation on this topic.
Human oncogenic viruses are a group of important pathogens that etiologically contribute to at least 12% of total cancer cases in the world. As an emerging class of non-linear regulatory RNA molecules, circular RNAs (circRNAs) have gained increasing attention as a crucial player in the regulation of signaling pathways involved in viral infection and oncogenesis. With the assistance of current circRNA enrichment and detection technologies, numerous novel virally-encoded circRNAs (vcircRNAs) have been identified in the human oncogenic viruses, initiating an exciting new era of vcircRNA research. In this review, we discuss the current understanding of the roles of vcircRNAs in the respective viral infection cycles and in virus-associated pathogenesis.
Low-dose computed tomography (LDCT) has been extensively validated for lung cancer screening in selected patient populations. Additionally, the use of gated cardiac CT to assess coronary artery calcium (CAC) burden has been validated to determine a patient's risk for major cardiovascular adverse events. This is typically performed by calculating an Agatston score based on density and overall burden of calcified plaque within the coronary arteries. Patients that qualify for LDCT for lung cancer screening commonly share major risk factors for coronary artery disease and would frequently benefit from an additional gated cardiac CT for the assessment of CAC. Given the widespread use of LDCT for lung cancer screening, we evaluated current literature regarding the use of non-gated chest CT, specifically LDCT, for the detection and grading of coronary artery calcifications. Additionally, given the evolving and increasing use of artificial intelligence (AI) in the interpretation of radiologic studies, current literature for the use of AI in CAC assessment was reviewed.
Objectives
The aim of this study was to identify factors and quality improvement strategies to improve coronary computed tomography angiography (CCTA) studies referred for fractional flow reserve derived from CT angiography (FFRCT) analysis.
Methods
Thirty randomly selected CCTAs were analyzed for quality control. A uniform CCTA protocol was implemented by an in-house steering committee, emphasizing the importance of adequate heart rate control and nitroglycerine usage. Sixty additional randomly selected CCTAs were evaluated for quality at multiple time points during intervention, and FFRCT acceptance rate was analyzed at the conclusion.
Results
Prior to the implementation of this quality improvement program, our overall institution-specific percent acceptance rate was 76.1% for FFRCT compared to the national average of >95%. Post-intervention, this was improved to an average acceptance rate of 90% for FFRCT analysis.
Conclusions
Establishment and strict adherence to CCTA imaging protocols with appropriate training and adequate buy-in of CT technologists and nurses is a viable way of improving the quality of imaging and subsequent patient care.
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