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| the medical use of ionizing radiation as part of cancer treatment to control malignant cells |
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| Form of interventional radiology used to treat coronary in-stent restenosis |
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| Radiography can be used for; |
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–Coronary artery
–Ventricular
–Aortic
–Pulmonary
–Chest x-ray |
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| TIMI = Thrombolysis in Myocardial Infarction Grade 0 |
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•No antegrade flow
•No or minimal blush |
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| TIMI = Thrombolysis in Myocardial Infarction Grade 1 |
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•Penetration without perfusion
•Stain is present but fails to opacify the entire bed distal to the stenosis
•Blush persists on next injection |
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| TIMI = Thrombolysis in Myocardial Infarction Grade 2 |
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•Partial perfusion
•Dye opacifies the entire bed distal to the stenosis
•Strongly persists at end of washout
•Rate of filling is slower but is gone by next injection |
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| TIMI = Thrombolysis in Myocardial Infarction Grade 3 |
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•Complete perfusion
•Normal ground glass appearance of blush
•Dye persistent at end of washout |
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| Estimates the likelihood for intervention success and risk for abrupt vessel closure |
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| AHA Lesion Classification |
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| AHA Lesion Classification -Type A Lesions- |
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•Discrete lesions < 10 mm in length
•Concentric lesions
•Readily accessible
•Non-angulated segment (< 45-degrees)
•Smooth contours
•Little or no calcification
•Non-ostial location
•No major side branch involvement
•Absence of thrombus |
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| AHA Lesion Classification -Type B Lesions- |
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•Tubular and length between 10-20 mm
•Eccentric lesions
•Moderate tortuosity of proximal segment
•Moderate angulation of segments (between 45 and 90-degrees)
•Irregular contours
•Moderate to heavy calcification
•Ostial lesions
•Bifurcation lesions
•Presence of some thrombus |
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| AHA Lesion Classification -Type C Lesions- |
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•Diffuse lesions greater than 20 mm in length
•Excessive tortuosity or proximal segment
•Extremely angulated segments greater than 90-degrees
•Total occlusion for longer than 3 months
•Inability to protect major side branches
•Degenerated vein grafts with friable lesions |
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•Blood flow around occluded vessel lesions
•Accomplished by the smaller vessels
•Chronic process; not able to “restore flow” around acute occlusions
•Flow is antegrade or retrograde
•Determining factor of which vessels are protected or may be lost during PCI |
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| Determining factor of which vessels are protected or may be lost during PCI |
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| Which views are best for showing the proximal aspects of vessels as well as the circumflex? |
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| Which views are best for showing the distal aspects of vessels as well as the LAD? |
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| In the LAO, the RCA resembles |
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| In the RAO of the RCA, the conus artery points |
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| In the LAO of the RCA, the SA nodal artery points |
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| Maximum dose in any one year |
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| Cumulative dose over lifetime |
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| Risk of mortality from single CXR is about |
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| One PTCA procedure involves the equivalent of from ____________ CXR’s |
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| Principles of radiation protection |
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| TIME, DISTANCE , SHIELDING!!!! |
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| The intensity of the exposure declines by the inverse square of the distance from the primary beam |
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Inverse square law
–Examples:
•At 2 units of distance, the exposure has been cut to 25% (1 / 2^2)
•At 3 units of distance, the exposure has been cut to 11% (1 / 3^2) |
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| What are methods and equipment used to reduce radiation penetration into the human body? |
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–Lead aprons
–Thyroid collars
–Lead-lined eyewear
–Strategically placed lead shields
and drapes |
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| Dosimetry records are maintained by who? |
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| When ionizing radiation interacts with any material, such as crystals, the radiation deposits either all or part of the initial energy in that material. Some of the atoms in the material that absorbs that energy become ionized, producing free electrons and holes. |
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| Your TLD dosage is collected how often and in what units? |
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–Collected monthly
–mREM recorded on DD1141 |
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| Establishes provisions of minimum standards by the Federal government for the accreditation of education programs and certification of staff who perform radiologic procedures |
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| Radiation Safety & Protection Regulations |
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