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The article discusses the challenges and advancements in diagnosing and treating calcified coronary artery disease. Topics include recommendations for treating mild, moderate, and severe calcium lesions in the cardiac catheterization laboratory, physiological mechanisms associated with cholesterol, and pathophysiology of atherosclerosis.

The article offers a look at technological advancements in cardiac computed tomography (CT). Topics discussed include access to the cardiac catheterization laboratory, energy-integrating detectors, photon-counting detectors and spectral photon-counting CT, image reconstruction relative advances in artificial intelligence (AI) and deep learning, and CT-guided coronary risk stratification and cardiac preventative care.

The article explains the importance of assessing cardiac output for optimal vessel opacification in computed tomography for proper diagnoses. Topics discussed include different classifications of heart failure based on the sidedness and pumping abilities of the heart, determinants of cardiac output such as heartbeat, heart rate, preload, contractility and afterload, as well as Laplace's law of physiological wall stress and its effects on cardiac output.

The article discusses the background and clinical implications of coronary computed (CT) tomography angiography (CCTA) and CT-based fractional flow reserve (CT-FFR). Topics covered include the practice of CCTA and CT-FFR, samples of CCTA and CT-FFR protocols and case studies involving CCTA and CT-FFR. It also cited the clinical relevance of CCTA and CT-FFR and the clinical effect of the PLATFORM trial on CT-FFR.

The article discusses the history of cardiac computed tomography (CT) and outlines the effect of conventional invasive coronary physiology testing. Topics include design of heart's dynamic nature and early CT scanner, conventional coronary physiology testing, and clinical studies substantiating coronary physiology testing.

The article highlights similarities between electronic noise reduction in photon-counting computed tomography (CT) and noise filtration in devices used for cardiac rhythm management. Topics discussed include examples of cardiac implantable electronic devices, comparisons between cardiac implantable electronic devices (CIEDs) and photon-counting CT, and association between photon-counting CT binning and noise reduction.

The article points out the need to understand the role and practice of right heart catheterizations (RHC) in the evaluation of dyspnea, including its differential diagnoses and markers of cardiopulmonary functioning. Topics covered include the parameters defining oxygen delivery, the disease states that might be considered in the differential diagnosis and the benefits of exercise RHC protocols.

The article discusses the use of coronary physiology testing to assess angiographically indeterminate coronary artery occlusions for checking possible block flow of lesions and symptoms of ischemic heart disease. It states that the instantaneous wave-free technique gets pressure readings at a specific phase of diastole. Also noted is the enhancement of care at level 2-and level 3-designated cardiac catherization labs when coronary physiology testing and flow reserve indices are understood.

The article discusses the tasks of cardiac interventional radiologic technologists in implanting cardiac implantable electronic devices (CIED) for the patient's heart rhythm management. Topics covered include the conduct of infection control, prevention and follow-up care, and the matching of device performance to the patient's presenting electrophysiology, reporting of arrhythmias and estimating battery longevity. Also noted are these clinicians' specialized address of patient concerns.

The article focuses on percutaneous transluminal coronary angioplasty (PTCA) as an innovative treatment for coronary artery disease. Topics include the development of stents and image guidance systems for PTCA, the role played by radiologic technologists in cardiac interventional medical procedures, and the opportunities for improving the quality of cardiac catheterization laboratory (CCL).

Context Radiologic technologists are sometimes called on to resuscitate patients in cardiac emergencies. By understanding the dynamics of chest compressions during cardiopulmonary resuscitation (CPR) and the related risks for rib and sternal fractures, R.T.s will be better equipped to perform CPR. Objective To review the mechanics of CPR and its associated risks, as well as propose criteria for future studies of CPR-related injuries. Methods The author reviewed the literature to explain how CPR works, how often injuries occur during CPR and how these injuries have been studied in the past. Results Past investigations into CPR-related rib and sternal fractures are not consistent in research methodology and thus are not comparable. In addition, there is only 1 recent study that collected data on compression-induced injuries in survivors of cardiac arrest. Conclusion Consistent study protocols are needed to enhance interstudy comparability and improve resuscitative health care. Recently revised guidelines regarding chest compression during CPR invite new research on compression injuries. The author supports adoption of 5 criteria for future study protocols., Whether taking chest radiographs during cardiac events, assisting health care professionals who are providing advanced cardiac life support or acting as first responders initiating cardiopulmonary resuscitation (CPR), radiologic technologists need [...]

The article provides an overview of the chemistry of traditional contrast media. It examines the transition elements to benchmark the notion of energy stability via complete or half-filled orbital sub-levels for electrons. Also discussed are magnetic moments and paramagnetism, and the lanthanides, with a focus on elemental gadolinium.

The article discusses the chemistry's function in radiology. Topics covered include the effect of ionizing radiation on the human body, the radiopharmaceuticals used in medical imaging and radiation therapy, and the personal protection equipment used to assess and reduce occupational dose. Also discussed is the chemistry of the human body.

The article focuses on the uniqueness problem in x-ray computed tomography (CT) imaging and its effect in ensuring reliability and stability of image presentation. Topics include the five rules about the radon transform applied in deciphering uniqueness, the alternate approaches in describing the integration of a function in the plane, and the importance of the connection between the Radon and Fourier transforms in solving the uniqueness problem.

The article discusses the theories opposing Superman's x-ray vision including background radiation, and capability of emitted x-rays. It mentions the two methods of medical x-ray images including x-ray forward-scatter and x-ray backscatter imaging. Major advantage of backscatter x-ray imaging is its ability to distinguish objects with low atomic numbers. By emphasizing radiologic science education cellular basis of Superman's x-ray vision can be traced to Earth's yellow sun is also discussed.

The article discusses the contribution of Austrian mathematician Johann Radon to the computed tomography (CT) technique. It mentions that Radon's foundational paper in 1917 gave rise to the Radon transform, a mathematical construct that forms the basis of CT theory. Mathematics forms an important part of any scientific theory and mathematicians guide physicists and engineers to their theories and innovations; Radon's transform revolutionized the medical imaging earning him a pride of a place.

The article offers information on the 'Radon transform,' named after Johann Radon, which lies at the center of the theoretical underpinnings of computed tomography (CT) scanning in medicine. The 3 steps with respect to medical x-ray CT are discussed along with the history behind the introduction of medical x-ray CT scanner in diagnostic imaging. Different approaches to CT scanning by Sir Godfrey Hounsfield and Allan Cormack are discussed. Implications for CT in medicine, are also included.

Background Pain patterns associated with the facet and sacroiliac joints following lumbar total disc replacement correlate with biomechanical modeling observations, such as load transfer to the posterior spinal elements in total disc replacement with an artificial disc. When conventional treatment options are exhausted, spinal cord stimulation (SCS) offers clinically favorable outcomes to treat intractable pain. Objectives To contribute to the literature on neuroaugmentive techniques and on pain following disc replacement, and to highlight recent advances and forward-thinking concepts for nonsurgical intradiscal therapies. Results Three years of injection therapies and physical therapy did not significantly alleviate the patient's pain. A trial period of SCS rather than reoperation (fusion surgery) was elected. A constant-current multiple source SCS system was implanted. At 12-month follow-up for this system, the patient's pain had been reduced by more than 75%, and the patient reported improved quality of life, including a return of restful sleep. Conclusions SCS is a viable technique to control pain associated with artificial disc implant. [ABSTRACT FROM AUTHOR]

Background: Two studies, each consisting of large sample sets, were recently published on radiation exposure in percutaneous spinal cord stimulation (SCS) trialing procedures. A more rigorous use of statistical methods in the second study more accurately defined benchmark reference levels. Principally, one physician implanter-considered an advanced interventional pain physician-performed all such procedures to nullify inter-physician variability. However, the literature is sparse in articles comparing exposure levels of radiation in pain procedures conducted by novice and advanced interventionally trained physicians, and inferential statistical analysis is seldom included in radiation exposure studies., Objective: The aim of this study was to compare fluoroscopy times between novice and expert physician implanters performing SCS trialing procedures, and to the benchmarked reference level, using inferential statistical methods. As a secondary objective, the importance of statistical concepts in interpretive-imaging and image guidance studies for interventional pain procedures will be outlined., Design: An observational study., Setting: A non-university outpatient Interventional Pain Management practice in the United States., Methods: Fluoroscopy time (in seconds) was retrospectively studied in 18 SCS trialing procedures (with dual lead placement in the low thoracic spine) performed over a 3-month period. The procedures were categorized by physician experience: one novice physician implanter with n = 5 cases and one expert physician implanter with n = 13 cases. All procedures were conducted with the same fluoroscope operator and the same mobile C-arm fluoroscopy system. A two-tailed t-test was used to compare mean fluoroscopy times between physician categories. Left-tailed t-tests were used to compare mean fluoroscopy times for each physician category separately to the benchmark level (μ = 71.7 seconds). Incident air kerma (KERMA) was assessed by nonsimplistic modeling., Results: No statistical difference was found in mean fluoroscopy times for SCS trialing procedures between the novice- and expert-implanter, χnovice = 63.5 seconds and χexpert = 53.9 seconds. In the case of the novice implanter, although mean fluoroscopy time was lower than the benchmark reference level, χnovice = 63.5 seconds compared to μ = 71.7 seconds, this was not significantly relevant. In the case of the expert implanter, a statistically relevant reduction in mean fluoroscopy time was observed compared to the benchmark level, χexpert = 53.9 seconds versus μ = 71.7 seconds. KERMA ranged from 5.3 mGy to 9.1 mGy with a mean and standard deviation of 6.5 mGy and 1.5 mGy, respectively, in the novice implanter sample set. KERMA ranged from 2.6 mGy to 13.1 mGy with a mean and standard deviation of 5.8 mGy and 3.2 mGy, respectively, in the expert implanter sample set., Limitations: Given that reference levels for radiation exposure in SCS trialing procedures are established, combined with comparisons in fluoroscopy times based on physician experience, expanding the physician database will assist in data validation., Conclusion: Radiation exposure levels in SCS trialing procedures remain negligible. While no differences in fluoroscopy times for such procedures were detected based on physician experience, the expert implanter demonstrated the ability to use less fluoroscopy time than that of the benchmark reference level.

Background: Evidence of a paradigm shift towards epicranial neurostimulation treatment techniques aimed at the site of headache pain is beginning to populate the literature. This is most apparent by 2 recently published reports describing alternative approaches to peripheral nerve stimulation techniques for refractory migraine, including hemiplegic migraine., Objectives: To contribute to the emerging literature on epicranial-based neuroaugmentative approaches which target site-specific areas of distinct, but relatively diffuse, headache pain. Specifically, we describe the feasibility of a novel neurostimulation technique: occipital nerve stimulation, combined with bilateral subcutaneous electrical stimulation over the temporal region, to treat a patient dually diagnosed with "complicated migraine" and occipital neuralgia. Integral to this report, key stimulation programming data are also presented to better distinguish the role of this form of therapy in migraine, or other headache forms, from both the clinical and biomedical perspectives., Methods: Case presentation with literature review., Results: At 24-month follow-up, headache onset had been reduced by more than 50%, including cessation of neurologic deficits that accompanied the patient's migraines. No complications or adverse side effects are reported. The programming data reported here supports a proposed mechanism of action concerning stimulation of the auriculotemporal nerve distribution/anterior temporal region for management of refractory pain in migraine., Limitations: Case presentation provides only initial assessment of treatment safety, not conclusive evidence of treatment effectiveness. Future studies which consider "follow-the-path" epicranial approaches to peripheral nerve stimulation techniques for refractory headache pain are needed to better quantify outcomes and mechanisms of action., Conclusions: In the single case reported here, the feasibility of a novel neurostimulation technique (occipital nerve stimulation/bilateral subcutaneous temporal region stimulation) to treat headache is presented. At the 24-month follow-up, no complications (such as loss of coverage due to lead displacement or lead fracture or erosion) or adverse side effects were reported. Finally, inclusion of fundamental programming data in reports on neuroaugmentative approaches to headache care will complement initiatives in research from the clinical and biomedical communities involved in this field.

Background: The utilization of spinal cord stimulation (SCS) to treat intractable pain has increased substantially in recent years. Integral to this therapy, the fluoroscope assists with requisite mapping protocols during trialing procedures to identify topographical dermatomal representations of spinal segments, and its use demands measurements of radiation exposure. However, such data is not found in the literature., Purpose: The aim of this study was to report on radiation exposure during percutaneous SCS trialing procedures., Design: An observational study., Setting: A non-university out-patient Interventional Pain Management practice in the United States., Methods: Fluoroscopy time from 110 SCS trialing procedures performed in a non-university, outpatient setting was studied retrospectively. Summary statistics were reported for all procedures collectively, as well as for lead arrangement and location. The interventional spine team carried out all procedural cases with the same mobile C-arm fluoroscopy system. Incident air kerma was evaluated by simplistic modeling., Results: Mean total fluoroscopy time was 133.4 s with a standard deviation of 84.8 s, and the mean percentage of time allocated to pulsed fluoroscopy was 31.9%. Fluoroscopy time for the most common lead arrangement/location, neural canal dual leads/low-thoracic (n=87), ranged from 28.5 s to 387.4 s. Incident air kerma was 1.8-43.7 mGy., Limitations: A preliminary report with a sample size of 110., Conclusion: Various lead placement options are available to the spinal interventionalist to treat pain with SCS. Our data set provides first steps to obtain benchmark reference estimates on fluoroscopy times and radiation exposure during SCS trialing procedures/spinal segment mapping. Fluoroscopy times for such interventions may be considerable when compared to more commonly performed pain medicine procedures; however, skin injury is improbable.