In 10 years, computed tomography coronary angiography (CTCA) has shifted from an investigational tool to clinical reality. Even though CT technologies are very advanced and widely available, a large body of evidence supporting the clinical role of CTCA is missing. The reason is that the speed of technological development has outpaced the ability of the scientific community to demonstrate the clinical utility of the technique. In addition, with each new CT generation, there is a further broadening of actual and potential applications. In this review we examine the state of the art on CTCA. In particular, we focus on issues concerning technological development, radiation dose, implementation, training and organisation.
A correlation between inflammation and cancer has been identified in the case of nasal cancer, however a specific connection between nasal inflammation and extramedullary nasal plasmacytoma (ENP), to the best of our knowledge, has not yet been determined. The present case report describes a patient affected by ENP, in who the tumor arose in the same area, from which a nasal polyp was previously surgically removed, five months after the polyp excision. The patient underwent surgical endoscopic tumor asportation without being treated with radio-chemotherapy. ENP was totally removed via surgery and no signs of recurrence were identified by endoscopy or magnetic resonance imaging during the last checkup 1 year after tumor asportation. It was hypothesized that in this elderly patient, who was exposed to viral infections and pollution for several years, ENP may be correlated to the inflammatory process that occurred after surgery, and this likely contributed to a neoplastic mutation in B-cells.
In IR procedures, in order to evaluate the effective dose, the importance of the double dosemeter has been recognised, one worn above and one under the apron. Over the last few decades several algorithms have been developed to combine the readings of the dosemeters, however currently there is no international consensus on which is the best one. In this work, eight irradiations, corresponding to typical interventional radiology procedures, were carried out in order to experimentally verify the accuracy of the algorithms. The patient was substituted by solid water-equivalent (RW3) layers, while effective dose to personnel was calculated by TLDs inside the Alderson Rando phantom. The results show that most of the algorithms, with a few exceptions, are too conservative, however there are many factors which can affect their accuracy, so it is impossible to achieve a high level of precision in the evaluation of the effective dose.
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