Carbon utilization and storage through rehabilitation of groundwater wells.

According to the Intergovernmental Panel on Climate Change (IPCC) of the United Nations (UN), rise in atmospheric concentration of carbon dioxide (CO 2 ) due to anthropogenic factors is considered as the primary driver for global climate change. With almost every major corporation around the world working towards their "net-zero goals", it is becoming increasingly important to have more technologies that can help reduce carbon footprint. Achieving sequestration of CO 2 in the subsurface through Carbon Capture Utilization and Storage (CCUS) technologies like CO 2 -Enhanced Oil Recovery, CO 2 -Enhanced Geothermal Systems, CO 2 -Enhanced Coal Bed Methane, etc. is well accepted. We introduce yet another attractive CCUS opportunity through well rehabilitation. Aqua Freed® and Aqua Gard® are well-known well rehabilitation and preventive well maintenance technologies that utilize (inject underground) liquid CO 2 for the purpose. The goal of this study was to quantify the storage capacity of Aqua Freed® and Aqua Gard®, and establish their CCUS credentials. Depending on the well being serviced, these technologies can inject up to 40 US tons of CO 2 per well. Based on field data collection and statistical modeling, we estimated that 82-96% (median 90%) of the injected CO 2 remains in the subsurface post injection. Overall, our results and analysis of the US market suggest that using CO 2 for well rehabilitation and maintenance has a storage potential of several megatonnes of CO 2 annually in the US alone.

18F-FDG PET/CT of transitional cell carcinoma.

OBJECTIVE: The objective of this article is to provide a practical illustrated review of PET/CT in the imaging evaluation of transitional cell carcinoma. CONCLUSION: Local evaluation of the primary tumor in patients with transitional cell carcinoma on PET is often limited by the obscuring effect of excreted FDG, but assessment of metabolic activity may still be possible through close correlation with CT images. PET/CT may also be helpful in the detection of disease outside the bladder at nodal or more distant sites and in the assessment of recurrent disease.

Gelatinous foam needle tract embolization during CT guided percutaneous transthoracic lung biopsy: A practical and cost effective approach in the community hospital setting.

Gelatinous foam (GelFoam, Pfizer, Inc, New York, NY) is a low cost, readily available material with a wide range of procedural applications. A novel implementation during computed tomography (CT) guided percutaneous lung biopsy to reduce the rates of pneumothorax leading to further intervention with chest tube placement. We present the imaging and outcome of a patient undergoing this procedure in a community hospital setting.

Endovascular Repair of Renal Artery Anastomotic Pseudoaneurysm Following Living Donor Kidney Transplant.

Renal artery anastomotic pseudoaneurysms, an uncommon complication of transplantation, may result in aneurysm rupture and loss of allograft. We report the case of 50-year-old female with back pain 3 weeks post renal transplantation. CT scan revealed transplant renal artery anastomotic pseudoaneurysm arising from anastomosis of two renal arteries joined together to form a single renal artery that was joined to the aorta. Successful endovascular treatment was achieved with covered stents, resulting in preserved renal function. Follow-up ultrasound at one-day post procedure and CT at 2 months revealed satisfactory renal perfusion with no pseudoaneurysm. Endovascular treatment of transplant renal artery pseudoaneurysms with covered stent and ostial flare balloon technology may be preferred in patients with extensive prior pelvic surgery, as illustrated in this case.

GI hemorrhage arising from splenic artery: intraprocedure cone-beam CT as problem-solving tool to aide in safe catheterization of offending vessel.

We present the case of a 67-year-old female with melena and hypotension who was found to have a bleeding splenic artery pseudoaneurysm subjacent to a large gastric ulcer on computed tomographic angiography. The lesion was angiographically occult on standard anteroposterior and oblique projections. The offending vessel was identified on intraprocedure cone-beam computed tomography (CT). This case illustrates the value of intraprocedure cone-beam CT as a problem-solving tool for the interventional radiologist.

PET/CT presentation of primary effusion lymphoma-like lymphoma unrelated to human herpes virus 8, a rare NHL subtype.

We present a 71-year-old female with human herpes virus 8 (HHV8)-unrelated primary effusion lymphoma (PEL)-like lymphoma. Dyspnea and pericardial effusion led to pericardiocentesis, diagnosing diffuse large B-cell lymphoma. She underwent positron emission tomography/computed tomography (PET/CT), which demonstrated hypermetabolic pericardial, pleural, and ascites fluid without lymphadenopathy elsewhere. Malignant fluid in the absence of lymphadenopathy is a hallmark of PEL. PEL is associated with immunodeficiency states such as acquired immunodeficiency syndrome (AIDS) and infectious agents such as HHV8. Our patient had no such history and had not received immunosuppressive chemotherapy. We present the PET/CT findings of this rare case of HHV8-unrelated PEL-like lymphoma.

Effect of iterative reconstruction algorithms on peripheral MDCT angiography virtual histology plaque volumes: have we been overestimating disease burden?

Our objective was to compare plaque volumes of multidetector computed tomographic images reconstructed using adaptive statistical iterative reconstruction (ASIR), model-based iterative reconstruction (MBIR), and filtered back projection (FBP). We reviewed 25 patients for a total of 50 extremities imaged on the same scanner. Calcified plaque FBP volume (3468.2 ± 2634.8 mm(3)) was higher than ASIR (2548.1 ± 2166.5 mm(3)). Calcified plaque FBP volume was higher than MBIR (mean=2345.7 ± 1935.4 mm(3)). Our findings suggest that traditional FBP methods overestimate disease compared to newer reconstruction methods.

Implementation and evaluation of a performance improvement intervention to address physician documentation deficiencies in abdominal ultrasound.

PURPOSE: For ultrasound reports to meet criteria for coding as abdomen complete (USABC), 8 elements are required: liver, bile ducts, gallbladder, spleen, kidneys, pancreas, inferior vena cava (IVC), and aorta. Failure to document all 8 results in coding as ultrasound abdomen limited. The purposes of our study were to identify deficiencies in documentation, implement a performance improvement intervention to address deficiencies, and evaluate the intervention. METHODS: In the first phase, 50 consecutive USABC reports performed as part of routine medical care were retrospectively analyzed for the presence or absence of the 8 elements required for USABC coding. Subsequently, education regarding current procedural terminology coding in abdominal ultrasound and standardized macros was provided to radiologists. In the second, postintervention phase, an additional 50 consecutive USABC reports were analyzed for the presence or absence of the 8 elements. RESULTS: In the first phase, none (0%) of 50 reports met criteria for USABC. The most commonly omitted elements were IVC (present in 2% of reports) and aorta (present in 6%). After intervention, there was an increase to 37 reports (74%) meeting criteria for USABC. The most commonly omitted elements were IVC (present in 76%) and aorta (present in 86%). Lack of 100% compliance was secondary to failure to update a macro and inaccurately scheduled studies (focused right lower quadrant/appendicitis study scheduled as USABC). CONCLUSIONS: We improved USABC documentation from 0% to 74%. Our compliance rate after intervention was similar to the 75.1% of previously published larger studies. Our study illustrates the efficacy of simple performance improvement interventions to improve abdominal ultrasound documentation.