`l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Image-Guided Surgery Products - Procedures and Techniques Gantry Tilt: 15 to 20 degrees angulation of the gantry to the canthomeatal line or tilting the patient's chin toward the chest ("tucked" position).
CT is usually the first test ordered when a sinus tumor is suspected. If you suffer from chronic sinusitis, hearing loss, or ear infections, your ENT may order a CT scan of the sinuses or temporal bones to visualize the area and obtain the information necessary to create a comprehensive and effective treatment plan. Tell your doctor if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking, and allergies. J Laryngol Otol. Copyright 2023 Radiological Society of North America, Inc. (RSNA). Two pulses of oral steroids produced a prolonged response that was again only temporary. The CT scan used in our office can detect a variety of things including nasal polyps, inflammation or infection of the sinuses, and fluid-filled sinuses. /G3 gs You may need to change into a gown for the procedure. The Radiology Assistant : CT contrast injection and protocols CT paranasal sinus (protocol). Surgical Navigation can be utilized for a number of different surgical procedures. Storz fiberoptic light cable, 3.5 mm x 230 cm. He appeared generally healthy on examination and had hyponasal speech. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{
The CT scanner is typically a large, donut-shaped machine with a short tunnel in the center. Mucosal thickening, polyps, and other sinus abnormalities can be seen in 40 percent of symptomatic adults; however, clinical correlation is needed to avoid overdiagnosis of sinusitis because of nonspecific CT findings. This loss of image quality can resemble the blurring seen on a photograph taken of a moving object. Having reliable and of ct sinus ct scan images below, the bowel surgery, but clear liquid after. Centrifugal frontal sinus dissection technique: addressing anterior and posterior frontoethmoidal air cells.
1. 70482- CT Orbits with and without contrast 4. Examples of appropriate cases listed by the academy include, but at not limited to: Distorted sinus anatomy of development, postoperative or traumatic origin, Extensive sinonasal polyposis: pathology involving the frontal, posterior ethmoid and sphenoid sinuses, Disease abutting the skull base, orbit, optic nerve or carotid artery, CSF rhinorrhea or conditions where there is a confirmed or suspected skull base defect. However in chronic rhinosinusitis, the lining will be thickened and the sinuses are outlined by grey soft . ct of sinuses with fusion - Oral and Maxillofacial Surgery - MedHelp Image 4: The electromagnetic field generator (EMG) is generally stored with the brace and bracket (shown in fig. Three aspects of direct coronal imaging of the paranasal . Women will need to remove bras containing metal underwire. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ With few exceptions, neck CT should be performed with intravenous contrast material . He recently developed intermittent left-sided epistaxis. 5 Common Findings to Look For in a Sinus CT Scan You also may have a metallic taste in your mouth. Figure 2A, 2B, 2C, 2D shows the steps of the FESS technique. Sinusitis is one of the most common conditions encountered by primary care physicians, accounting for approximately 25 million office visits annually1 and costing more than $2 billion annually in direct medical expenses.2,3 According to the National Ambulatory Medical Care Survey, sinusitis is the fifth most common medical diagnosis for which antibiotics are prescribed.4,5. PDF Optimization of Techniques in Screening CT of the Sinuses Because of the progression of his headaches, a maxillofacial and head CT scan was obtained, revealing acute sinusitis with frontal epidural abscess (Figure 2). If you are having sinusitis symptoms that don't respond to medication, contact CT Sinus Center at (203) 574-5997 for further workup to see if endoscopic sinus surgery is right for you. The Images should be loaded onto the base unit prior to the registration process and the appropriate exam selected. Check for errors and try again. PDF CT scanning protocol - Stryker Corporation What are the limitations of CT of the Sinuses? /Length 40>> stream This will pass. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ 7 0 obj 2). CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems. Our understanding and management of paranasal sinus infections have improved since the introduction of nasal endoscopy, CT scans, and MRI. MRI allows better differentiation of soft tissue structures within the sinuses. Commonly Used CPT Codes for CT | Harrison Imaging Centers . Neuro patties, x , x 1, x 3. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures, Radiation Therapy for Head and Neck Cancer, evaluate sinuses that are filled with fluid or thickened sinus. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ The CT scan data will be used as an interactive anatomy "road map" for Stealth device guided surgery. The radiologist will send an official report to the doctor who ordered the exam. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ The hand denotes child-specific content. Treon Plus: Infrared light based unit currently utilized at the VA in Iowa City. Image-Guided Surgery Products CT scans are minimally-invasive and can accurately help doctors diagnose nose and sinus issues. How the Test is Performed Sinus Surgery | Medtronic The CT paranasal sinus protocol serves as an examination for the assessment of the study of the mucosa and bone system of the sinonasal cavities. CT Navigation Setup for Image Guided Surgery-Sinus and Skull Base ADVERTISEMENT: Supporters see fewer/no ads.
After watching this. Next, the table will move quickly through the scanner to determine the correct starting position for the scans. The patient is a 45-year-old healthy white man with longstanding right-sided nasal obstruction associated with postnasal discharge and cheek pressure. See the CT Safety During Pregnancypage for more information. Findings on CT scan should be interpreted in conjunction with clinical and endoscopic findings because of high rates of false-positive findings. Illustrated by: Timothy McCulloch, MD, Copyright The University of Iowa. Image 5: The power station is secured to the bed with the EMG cord plugged in (shown here), along with the power cord and base unit connection cords (see fig. CT of the Neck: Image Analysis and Reporting in the - RadioGraphics Image 1: AxiEM System powerbox with cords for connecting to the base unit. from the hard palate to above the end of the frontal sinuses, bone kernel (e.g. 256 Slice CT - Updated 01-25-2022 Sinus: R/O Mass. Allergy induction protocol used to induce allergic rhinosinusitis in guinea pigs with intranasal (i.n.) Read More Created for people with ongoing healthcare needs but benefits everyone. The MRI showed extension of the neoplasm into the medial anterior maxilla and septum (Figure 4). Helical Position/Landmark: 2-3 cm (20-30 mm) above the vertex. However, the technologist will always be able to see, hear and speak with you through a built-in intercom system. All anatomic landmarks were found to be well defined in all three groups, with the exception of the ethmoid foramen (for identification of the ethmoid artery), which was indistinct or . the ct also deployed in the surgical system. <> The surgeon should ensure the desired patient, date of study, and anatomical location are obtained. Face/Sinus. A conventional x-ray exam directs a small amount of radiation through the body part under examination. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ 21151 Pomerantz Family Pavilion
CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Keep reading to know what we look for in a CT scan of the sinuses. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Neuroradiology CT Protocols N 1: Head CT without contrast N 1C: Pre- and post-contrast head CT N 2: Head CT angiography .
This unit has a variety of software packages available for Neurosurgery, Spine and Orthopedic procedures among others. Modern CT scanners can image large sections of the body in just a few seconds, and even faster in small children.
`l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ How the Test is Performed. Excellent test to evaluate for sinus disease including acute and chronic sinusitis, polyps, masses, postoperative evaluation. It is imperative that the correct patient, study from the desired date and the appropriate anatomical study are selected. Repairs to author landmarx protocol: sedo nor does ct sinus tumours or the advice. There is an x-ray tube and electronic x-ray detectors that are located opposite each other inside the ring, which is called the gantry. CT Protocols | Radiology Key Video-Telemedicine for Salivary Gland Swelling (Sialadenitis), The AAO-HNS currently maintains surgical navigation systems are deemed appropriate in "select cases to assist the surgeon in clarifying complex anatomy during sinus and skull base surgery.". These lines help ensure that you are in the correct position on the exam table. CT exams are generally painless, fast, and easy. A computed tomography (CT) scan of the sinus is an imaging test that uses x-rays to make detailed pictures of the air-filled spaces inside the face (sinuses).
After this treatment, his symptoms improved approximately 50 percent, and he received a limited CT scan of the sinuses.
2013;3(3):236-241. endstream Sinuses - Limited Indications o Anosmia, allergic sinusitis Sequences o Coronal sections without contrast Comments o Scans should be perpendicular to the hard palate. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ What are some common uses of the procedure? 2016;126(1):51-59. Peter M. Som, Hugh D. Curtin. The preferred initial procedure is a coronal CT image (13). Although air-fluid levels and complete opacification of a sinus are more specific for sinusitis, they are only seen in 60 percent of cases. The contents of this web site are for information purposes only, and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. The data were displayed at soft-tissue (450 H, 50 H), bone (4000 H, 1100 H), and intermediate (2500 H, 250 H) Metal objects, including jewelry, eyeglasses, dentures, and hairpins, may affect the CT images. 256 Slice CT - Updated 01-25-2022 Sinus: Head Boney Sinus (Flash Spiral) 256 Slice CT - Updated 01-25-2022 Sinus: Landmarx Sinus. Radiology department of the Rijnland Hospital in Leiderdorp, the Netherlands.
Women should always tell their doctor and x-ray or CT technologist if there is any chance they are pregnant. <> Learn more about our additional products for FESS and their potential benefits for you and your patients. Head CT Protocols - CTisus.com CT Scanning Stealth 7 (S7): Utilized in the main OR at UIHC. N 4: Sinus CT without contrast N 4C: Sinus CT with contrast N 5: Orbit CT without contrast N 5C: Orbit CT with contrast N 6: Mastoid CT without contrast N 6C: Mastoid CT with contrast N 7: Soft tissue neck CT with contrast . Radiologic Imaging in the Management of Sinusitis | AAFP
/XObject <>>> 2012;126(12):1224-1230. The Radiology Assistant : CT Protocols This unit has both electromagnetic and optical capabilities. Normally you cannot actually see the lining of the sinuses on a CT because it is so thin. `l\/ c+f>@@@@@V &x&p'@@@@@sb++ To use the navigation system, a computer tomography (CT) scan of the sinuses or the skull base of the patient is performed using a specific navigation protocol (in some cases the CT scan is saved into a DICOM format). Risk factors for complicated infections include prolonged tobacco use and chronic occupational exposure to wood dust, nickel, or chrome pigment. PDF Imaging Protocols c 800.595.9709 or (+1) 720.890 - Chattanooga Imaging 200 Hawkins Drive
However. This results in more detail. In neoplastic, inflammatory and infectious disorders, a CT scan of the paranasal sinuses is performed to demonstrate bony erosions, osteolytic lesions, and calcifications. Number along the monitor exactly where a soft tissue or the sinuses. Angle NO gantr y angle At the time the article was created Fabio Macori had no recorded disclosures. /Matrix [1 0 0 -1 0 792] Total amount of contrast. Sometimes a follow-up exam further evaluates a potential issue with more views or a special imaging technique.
DFOV: 25cm . Although the standards discussed herein reflect the University of Iowa's head and neck protocols, reliance on any information provided herein is solely at your own risk. q The x-rays used for CT scanning should have no immediate side effects. 2019; 46(4): 520-525. IV contrast manufacturers indicate mothers should not breastfeed their babies for 24-48 hours after contrast material is given. When the computer software reassembles the image slices, the result is a very detailed multidimensional view of the body's interior. The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well-equipped to deal with them. Acute Stroke - Brain. You may feel a need to urinate. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. Endoscopic sinus surgery with and without computer assisted navigation: A retrospective study. These multi-slice (multidetector) CT scanners obtain thinner slices in less time. What will I experience during and after the procedure? The patient is a 20-year-old healthy man with an upper respiratory tract infection that has lasted two weeks. Each IGS instrument should be registered and evaluated prior to utilization. CT imaging provides real-time imaging, making it a good tool for guiding. If contrast material is required, a nurse or technologistwill insert an intravenous(IV) line into a small vein in the patient's hand or arm. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ University of Iowa
This allows us to minimize radiation while providing a high tech three-dimensional image of the sinuses. What is a stealth ct of sinuses? | HealthTap Online Doctor In some protocols we always want to give the maximum dose of 150cc, like when you are looking for a pancreatic carcinoma or liver metastases. A CT scan of the face produces images that also show a patient's paranasal sinus cavities. It's also the most reliable imaging technique for . Straps and pillows may be used to help the patient maintain the correct position and to hold still during the exam. Siemens Definition AS 20 Protocols. Ramakrishnan VR, et al. Continues to cat scan sinus ct protocol was already in an enhancing mass, which offers better soft tissue windows. Stereotactic anatomical localization in complex sinus surgery: A systematic review and meta-analysis. This leads to the formation of posterosuperior attic pockets. (see below) Oxymetazoline HCL nasal spray, 0.05%. landmark ge ombl siemens breathing scouts ap and lateral parameter scan start below mandible end above frontal sinuses dfov 18 prep group ge siemens indication trauma / face pain oral prep scan 1. non-contrast recon 0.625mm or 1.25mm axial recon - bone algorithm 1.25mm axial recon - standard algorithm Brain (CTA) Brain (helical adult) CTA Carotid and Brain. The patient was started on a four-week course of broad-spectrum antibiotics in combination with an oral steroid pulse. The patient is a 37-year-old man who smokes. There are four pairs of sinuses, each connected to the nasal cavity by small openings. Some policies are stating that they won't allow the three codes to be billed together. You will lie on a narrow table that slides in and out of this short tunnel. When you enter the CT scanner, you may see special light lines projected onto your body. CT because of the universal sinus CT protocol, total saving was estimated as $142,162, which translated to $147,628 when adjusted for inflation. Then, the table will move slowly through the machine for the actual CT scan. This website does not provide cost information. CT is less sensitive to patient movement than MRI. It is usually performed as a non-contrast study. A total of 31 children and 84 adults were included in the analysis. Any motion, including breathing and body movements, can lead to artifactson the images. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ CT Sinus Cat Scan Quick Reference Guide for Physicians. The Preoperative Sinus CT: Avoiding a "CLOSE" Call with Surgical Accessed November 17, 2009. 5 0 obj A typical CT of the paranasal sinus may be as follows: Typical indications include the following: The purpose of a CT scan of the paranasal sinuses is to visualize the possible presence of inflammatory or newly formed tissue in the context of the paranasal cavities. It's also the most reliable imaging technique for determining if the sinuses are obstructed and the best imaging modality for sinusitis. Computerized Tomography (CT) Image Guided Sinus Procedures allows the surgeon to simultaneously visualize 4 different views on a monitor: the coronal, sagittal and axial CT scan images at the same time as the real time surgical endoscopic view. Navigation and non-navigation CT scan of the sinuses: comparison of the o Process images with bone algorithm. Follow-up exams are often the best way to see if treatment is working or if a problem needs attention. Air appears black. A prospective, randomized clinical study. FIND RELIEF. HRCT imaging of acquired cholesteatoma: a pictorial review `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Advances in diagnostic imaging techniques (e.g., computed tomographic [CT] scan and magnetic resonance imaging [MRI]) have enhanced the understanding and management of sinusitis. Like traditional x-rays, it produces multiple images or pictures of the inside of the body. After the ostiomeatal complex is accessed through the nostril with a rigid endoscope, the ostia and recesses are targeted, depending on the location and pattern of disease. 150 to 400 HU). RadiologyInfo.org is not a medical facility. His ears were clear by otoscopy, and his nasal examination revealed a right-sided septal deviation. The CT protocol itself is based on certain technical parameters, and the patient wouldn't notice any difference between Stealth CT protocol and standard CT protocol.
If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. These measure the amount of radiation being absorbed throughout your body.
For a CT scan of the sinuses, the patient is most commonly positioned lying flat on the back. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. It is the best imaging modality for sinusitis. The Preoperative Sinus CT: Avoiding a "CLOSE" Call with - PubMed `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ Nonetheless, mucocele may have a similar appearance to other benign . Patient undergoing computed tomography (CT) scan. The system is then used during the surgery to confirm the position of the surgeon's instruments at all times. CT Sinus Scan. The anatomy will certainly change with the progression of the procedure. 2013; 149(1):17-29. Interpreting findings seen at CT of the neck is challenging owing to the complex and nuanced anatomy of the neck, which contains multiple organ systems in a relatively small area. Surgical 3D Head. A CT scan generates images that can be reformatted in multiple planes. Laryngoscope. A radiologist, a doctor specially trained to supervise and interpret radiology exams, will analyze the images. 256 Slice CT - Updated 01-25-2022 Head: Temporal Bones. Otolaryngol Clin North Am. Image guidance provides surgeons with a more detailed view of intra-cranial and extra-cranial structures such as . To help ensure current and accurate information, we do not permit copying but encourage linking to this site. an optimal imaging protocol. This is where the technologist operates the scanner and monitors your exam in direct visual contact. Anterior ethmoid sinuses exhibit no mucosal disease. Depending on the type of CT scan, the machine may make several passes. NB: This article aims to frame a general concept of a CT protocol for the assessment of the paranasal sinuses. PDF Landmarx Sinus Ct Protocol - uploads.strikinglycdn.com Who interprets the results and how do I get them? When the ENT doctor orders a Landmark and 3D we will bill 76377 (3D) and 77011 (Landmarks). `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ 6 0 obj
A computed tomography (CT) scan of the sinus is an imaging test that uses x-rays to make detailed pictures of the air-filled spaces inside the face (sinuses). Figure 3A, 3B shows the CT appearance after FESS. The system displays the images on a computer monitor. . This study should be downloaded from the server or onto a CD to be taken to the OR. It can even generate three-dimensional images. x] xE Tell your doctor about all medications you are taking and if you have any allergies. Intra-Operative Use of Computer Aided Surgery, Sinus Surgery and Transnasal Skull Base Surgery, Otology, Neurotology, and Lateral Skull Base Surgery, Electromagnetic Compatibility for Cardiac Devices, California Transparency in Supply Chains Act, Information About Proposition 65 for California Customers, Digital Millennium Copyright Act (DMCA) Notification, Distorted sinus anatomy of development, postoperative, or traumatic origin, Pathology involving the frontal, posterior ethmoid and sphenoid sinuses, Disease abutting the skull base, orbit, optic nerve, or carotid artery, Cerebrospinal fluid rhinorrhea or conditions where there is a skull base defect, Benign and malignant sino-nasal neoplasms, Scanning and registration protocols that enable accuracy, StealthMerge ENT software that fuses different imaging modalities (CT, MRI) togetherfor improved visualization, Instruments that are designed and calibrated for use in image-guided surgery. With an updated browser, you will have a better Medtronic website experience. You may feel warm or flushed as the contrast is injected. An advanced navigation protocol for endoscopic transsphenoidal surgery. Created for people with ongoing healthcare needs but benefits everyone. Note: we are unable to answer specific questions or offer individual medical advice or opinions. Laryngoscope. CT scans in children should always be done with low-dose technique. You may lie on your back, or you may lie face-down with your chin raised. Fusion: Standalone, electromagnetic based ENT image guidance system. Web Privacy Policy | Nondiscrimination Statement. detect the presence of inflammatory diseases. endobj CT exams are fast and simple. Int Forum Allergy Rhinol. Unlike MRI, an implanted medical device of any kind will not prevent you from having a CT scan. Clinically and sinuses using landmarx protocol done without any general A CT scan may help detect sinusitis, evaluate sinuses filled with thickened sinus membranes, give additional information on tumors of the nasal cavity, diagnose inflammatory disorders, and plan for surgery by defining anatomy (12). Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes. To help answer those questions we have put together our protocols that we thought might prove useful. The most common reason referral for sub-specialty care is considered is failure of medical management for chronic or recurrent sinusitis. Ear, Nose & Throat Meta-analyses on commercial image-guided navigation systems suggest a reduction in major complications during endoscopic sinus surgery compared with non-image guided procedures. provide additional information about tumors of the nasal cavity and sinuses. If additional information is needed to determine the extent of soft tissue of the tumor, magnetic resonance imaging (MRI) may be helpful. Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the Radiological Society of North America (RSNA) and the American College of Radiology (ACR), comprising physicians with expertise in several radiologic areas. Weight > 90kg : 150cc. The paranasal sinusesare hollow, air-filled spaces located within the bones of the face and surrounding the nasal cavity, a system of air channels connecting the nose with the back of the throat. 8C (levels shown at left; . However, when symptoms are recurrent or refractory despite adequate treatment, further diagnostic evaluations may be indicated. PDF Ct Sinus Landmarx Protocol - uploads.strikinglycdn.com Citardi MJ, et al. SINUSES AND ORBITS CT FLANK FOR STONES 70486, 70450 CT Sinus and Head w/o contrast 74150, 72192 CT Abdomen and Pelvis w/o contrast 70486 CT . Some imaging tests and treatments have special pediatric considerations. Leave jewelry at home and wear loose, comfortable clothing. Scanning and registration protocols that enable accuracy StealthMerge ENT software that fuses different imaging modalities (CT, MRI) together for improved visualization Instruments that are designed and calibrated for use in image-guided surgery Benefits of image-guided surgery for ENT procedures Cpt 77011 | Medical Billing and Coding Forum - AAPC Masterson L, et al. CAT scan - sinus; Computed axial tomography scan - sinus; Computed tomography scan - sinus; CT scan - sinus. Sinonasal cancers are quite uncommon, with an annual incidence of less than 1:100,000 in the United States. The Department of Otolaryngology and the University of Iowa wish to acknowledge the support of those who share our goal in improving the care of patients we serve. Our studies are done in the axial plane and reconstructed in the coronal and sagittal planes. Image 2: AxiEM system power box with power cord and base unit cords attached. question. x@Qhm@0%\&'HD(qQCn,nG>ioR}lwlk~lo
x8v?f\[/v]d\m~yKl;~L~~ncOxpb,}0Ng|n}08OSD_@@@@@t2?~axNO|vw7}0sgAew-xW q>6>w7Wrn sm@@@@@g>GnG?'@uX
x[o~7|'l_/}@t_c_v@@@@@.5>O7ao/?FA?[c}R}qO?45}O,5G[?n{=]_T_Yo!ISK5h_|0x>h\_TAov/O}yiNn_)4X>y+OW? Vreugdenburg TD, et al. `l\/ c+f>@@@@@V &x&p'@@@@@MlP_TEc+ kr>R8 N+[LW{ CT-paranasal sinuses are a vital tool in the assessment of patients with CRS. The University of Iowa does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on this web site.
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