Pulmonary nodule detection and characterization continue to improve with technological advancements. The noninvasive methods available for assisting in nodule detection and for characterizing nodules as benign, malignant, or indeterminate will be discussed. Evidence-based guidelines will be reviewed to help guide the appropriate management of pulmonary nodules.

Advances in multidetector technology have made dual-energy computed tomography (CT) imaging possible. Dual-energy CT imaging enables tissue characterization in addition to morphologic evaluation of imaged regions. This article reviews current and potential CT technology, technical and workflow considerations when performing dual-energy CT, and clinical applications in the thorax, with an emphasis on the knowledge gained so far.

Plasma levels of the endogenous opioid peptides beta-endorphin and [Met]enkephalin were estimated in 10 osteoarthritic patients during treatment with a sustained-release indomethacin preparation (Osmosin). Significant diurnal variation of beta-endorphin levels was evident both on and off treatment (p less than 0.05, respectively), but the therapy was nevertheless accompanied by decreased morning levels of this peptide; no such changes were recorded for [Met)enkephalin. Whilst the treatment was associated with a reduction of pain, particularly in the evening (p less than 0.02), no correlation was evident between pain and beta-endorphin levels, nor between the patients' perception of pain relief and changes in beta-endorphin levels. The results suggest either that prostaglandins may be involved in the synthesis/release of beta-endorphin, or that the alleviation of stress may in turn reduce the need for continued beta-endorphin production in these patients.

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Background: United States Preventative Task Force recommends annual lung cancer screening with low dose computed tomography (CT) in adults ages 55-80, who have a thirty pack year history of smoking and are currently smoking or quit within the past 15 years. Thirty percent of all lung cancers diagnosed in United States are due to occupational exposure, with a vast majority diagnosed in first responders. No occupational specific guidelines exist for lung cancer screening with low dose CT for first responders. Method: November 1, 2018-March 21, 2019 low dose lung CTs were performed on a 144 first responders. Age ranges from 40-76, Gender: 116 Males and 28 Females. The average years of exposure was 23 yrs. Patients were screened at various Simon Med Radiology locations in Arizona with various CT scanners. The CT dose index ranged (CTDI vol) ranged from 1.6-2.6mGy. No contrast was used. Result: 40 lung nodules identified: 1 anterior mediastinal mass, 2.1x1.5cm which was removed in a 42 yearold and found to be an epithelioid thymoma. Lung-RADS screening follow-up was used even though a lot of the patients did not meet age criteria. The remainder of the lung lesions classified as follows: Lung-