Tag: Medical Imaging

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MiCUP… Runneth Over?

An interesting quotation from the Hebrew bible. Basically it means that I have sufficient for my needs and I am good with that. So, where am I going with this you ask? Well, let me introduce you to my program MiCUP – Medical imaging Collaborative Undergraduate Program. 


The goal of the program is to bring together students from the faculty of Arts and Sciences and my faculty (Medicine) to learn about medical research in the world of medical imaging. I have a sprinkling of students every term from various programs such as Research Opportunity Program, Independent Studies, Youth Study Program, and MiVIP. It is only a modest number of students BUT provides ample brain power to get some really cool research done. My cup certainly runneth over. 


Have a look below at the timelines from my two recent ROP students.


Great work Kevin and Sylvia!!!




See you in the blogosphere,


Pascal Tyrrell



Kevin Chen ROP F/W 2014

Sylvia Urbanik F/W 2014

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MRA Is More Cost-Effective than the Current Strategy for Testing > 70% Carotid Stenosis

ROP Research Forum March 5th, 2015 – Kevin Chen





Kevin Chen is a 2nd year research opportunity program student studying neuroscience and
physiology in the University of Toronto Life Sciences Program. His main goal is to get into
medical school and to enjoy the UofT experience as much as possible!

Kevin’s ROP project consisted
of cost effectiveness analysis modeling to explore whether MRA could be a
cost-effective measure in testing and treating patients with carotid stenosis.
Preliminary results showed that in a subset of the population at risk for
carotid stenosis (> 70 %), MRA was dominant over the current strategy of testing with
Doppler Ultrasound. By reducing MRA scan time and by tailoring MRA sequences we believe it possible to extend these findings to include a larger sub-population (> 50 %). More to follow…

Well done, Kevin!

See you in the blogosphere,

Pascal Tyrrell

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Research Opportunity Program: Cost Effectiveness and Imaging Carotid Stenosis

ROP Research Forum March 5th, 2015 – Sylvia Urbanik

Sylvia is a second year student studying cell and molecular biology. She is currently finishing up her Research Opportunity Program that spanned the fall and winter semesters, and also recently represented us at the March 5th ROP research forum along with her partner and predecessors.

 
Her project dealt with cost-effectiveness analysis techniques for diagnostic imaging modalities, with a specific focus on carotid artery stenosis. She explored the different types of analyses used in assessing cost effectiveness. She examined how factors such as sensitivity and specificity of diagnostic tests (imaging modalities in this case) can affect the analysis, and conducted literature searches in order to find these variables in order to incorporate them into a cost effectiveness model.​

Well done, Sylvia!

Stay tuned, next Kevin Chen will be modeling with TreeAge…

See you in the blogosphere,

Pascal Tyrrell

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Research Opportunity Program: Imaging Carotid Stenosis

ROP Research Forum March 5th, 2015 – Helena Lan

Helena is a second-year student pursuing a specialist in Pharmacology and Toxicology at the University of Toronto. Participating in ROP299 this past summer (see here) has opened many doors for her. She is currently assisting Pascal on a systematic review on research methodology and biostatistics in medical imaging, working as a research assistant for a medical education study, participating in the research abroad program at Karolinska Institutet this summer… and recently represented us at the March 5th, 2015 ROP research forum!

Helena examined the technical aspects and information provided by two major imaging modalities, MRI and ultrasound, for diagnosing carotid stenosis. She suggests that MRI holds great promise to serve as a cost effective test for carotid stenosis as well as a tool for assessing vessel health and plaque composition that would provide important information for patient management decisions.




Stay tuned, next Sylvia Urbanik will be talking about cost effectiveness…

See you in the blogosphere,

Pascal Tyrrell

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Research Opportunity Program: What Is Carotid Stenosis and How Are We Treating Affected Patients?

ROP Research Forum March 5th, 2015 – Alana Man

Alana Man is a second year University of Toronto student pursuing a specialist in Bioinformatics and Computational Biology and a major in Immunology. She was a Research Opportunity student last summer with MiVIP (see here) and recently represented us at the March 5th, 2015 ROP research forum.

Alana’s project focused on care for patients with carotid stenosis in Toronto, Ontario, Canada. She looked at the different factors contributing to access to diagnostic testing such as procedure costs, wait times, and the differences between available imaging modalities and explores whether MRI could be the diagnostic test of choice over DUS for people at increased risk of carotid stenosis.

Well done, Alana!




Stay tuned, next Helena Lan will be comparing MRI and DUS…




See you in the blogosphere,




Pascal Tyrrell

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MiWord of the Day Is… PET scan!

 

Peanuts. What a great story. The most popular and influential comic strip in history. Snoopy was my first stuffed animal growing up. He still lives with my parents. So what is a PET scan anyway? I don’t recall ever seeing the picture above in any of the Peanuts cartoon strips.





Positron emission tomography (PET) is somewhat of a special medical imaging modality in that it brings together two different technologies from different times. Let me explain. Back in the early 1930s, George Hevesy was a young Hungarian physicist who developed biologically safe and useful radioactive tracers that could be ingested or incorporated into the body in some way.  Physicians would then manually locate where these radioactive tracers had gone in the body by using a Geiger counter at first and then later using special cameras (Kuhl‘s photoscan) to produce a crude emission image. 



So, how do we get cool pictures like these ones?  Well we would have to wait another 25 years after the development of radioactive tracers by Hevesy for the start of construction of instruments able to not only detect these radioactive sources in the body but to produce tomographic pictures.


It won’t be until the mid 1970s that PET – as we know it today – would be born. Essentially, a patient receives a emissions scan (PET) and a CT (we talked about that here) or MRI (we talked about that here) scan at the same time. The two scans are then merged together thanks to highly specialized computers (see the pictures in the middle frames). Voila! PET. 



PET is both a medical and research tool. Most often used in clinical oncology (medical imaging of tumors and the search for metastases), it is also important in clinical diagnosis of certain diffuse brain diseases such Alzheimer’s disease and other types of dementia.


Relax your brain a little listening to Radioactive by Imagine Dragons and don’t forget the fun part (see the rules here), using PET scan in a sentence by the end of the day:

Serious: Hey Bob, did you know that much of the success of the PET scan is due to the development of the radiopharmaceutical FDG (deoxyglucose) that lead the way to the characterization of Parkinson’s and Huntington’s disease?

Less serious: I can’t believe they developed yet another PET scan. Wasn’t the CAT scan enough?

See you in the blogosphere,

Pascal Tyrrell








 

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Walk Like an Egyptian!

So, in my last post I talked a little about Mesopotamian medicine (see here). I am certain many of you were thinking: “What? Should he not be talking about ancient Egypt?”. Well, of course, you are right – kind of… 


Egypt rose under the pharaohs during the same period as the Mesopotamian kingdoms (from about 3000 BC). They were known for their crazy ambition and technological prowess. Their medicine was very similar to that of the Mesopotamians in that it was influenced strongly by superstition  and religious beliefs. They too had three types of healers: the swnu who practiced medicine, and, of course, the priests and the sorcerers…




One of the reasons that ancient Egyptian medicine had a greater influence on modern medicine was that they were very good at documenting and archiving their work. The Ebers papyrus (c. 1550 BC) was their principal medical document that measured over 20 meters long (it is a scroll after all) and is the oldest surviving medical book. 




The Egyptians believed we were all born healthy but were susceptible to disorders caused by demons or by intestinal putrefaction. So the importance of eating your fruits and veggies was started way long ago! They also compared our vascular network to that of the River Nile and its canals and, therefore, it was important to keep the flow free from obstructions (see here for another interesting comparison!). Though they did not appreciate vascular plaques (atheroma) at the time they had already started to  figure out the importance of a healthy vasculature. Cool! 










As with Mesopotamia, Egypt’s powerful governance created a good environment for organized medical practice. However, because both regimes were highly codified (implying many strict rules based on religion and superstition that did not allow for discussion and experimentation) it will not be until ancient Greece that the roots of modern medicine will take hold.




Dance around your living room (in private if you must) to Walk Like an Egyptian by The Bangles in order to decompress and…


… I’ll see you in the blogosphere.




Pascal Tyrrell

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The story behind Connectory…

So, you are reading our blog thinking Pascal is a nut – that much is clear – but what of all the students plugged into his group? Are they nuts too?


Well maybe, but today I am going to talk to you about the group of four (not the group of seven) who started small and grew to be Connectory. John, Maria, Natasha, and Roger met in a graduate course at the University of Toronto and decided to work together on a project about innovation. That’s when they met me, joined “the program”, and got busy! Starting any endeavour from scratch is no easy task. All four had never met before, all came from very different academic backgrounds, and though their initial project was for “credit” the rest was on their own time.


There were some rough times at first but with perseverance comes success and Connectory was born and is just finishing up its first project as a new start-up business. Wow! 


Essentially Connectory is a data management solutions software development consulting group that operates in the healthcare space. Check out their webpage here.


Ok, so what? Well this post is not only to congratulate these four on a job well done but also to encourage you to do the same. One thing is for sure: if you don’t try you will not succeed – ever. My programs are all about learning, trying new stuff, benefiting from your successes as well as your failures, and wait for it… giving back. Yup as Uncle Ben said in Spiderman: “With great power comes great responsibility“. 


Just wanted to share a good story from our group with you today.




Listen to Bulletproof by La Roux to get pumped and…


… I’ll see you in the blogosphere!




Pascal Tyrrell

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Happy Late New Year 2015!!!

The Moody Tree



Ok, so I may have taken a longer break than I should have. Where was I you ask? I was enjoying some R&R with my family. My kids are at great ages – 15, 11, and 6. Then, of course, when I got back to my desk – whammo! The deluge of work. This morning, as I sat on the GoTrain on the way into Toronto, I thought of you and happily sat down to write my first post of 2015.


First, a thank you for your readership. We are soon approaching our first anniversary (next month) and my programs (MiVIP and MiB) and this blog are chugging along famously… all because of you!



Chicago Bean

Next, a funny story to explain the picture above. When I attended the RSNA last December (see my post here on this event) I brought along my old film camera for fun as I enjoy photography and decided to reminisce a little. To your right is a picture of the Chicago skyline reflected on the “Bean“. See me?


I hadn’t developed film in so long that I almost ruined it – in my laundry room between all of my family’s clothes, the ironing board, buckets, detergents… Anyway, I also had with me my trusted digital for snaps and one evening I was invited to a function at my boss’ hotel and he said to me:”Let me know what you think of the Christmas lights on the trees in front the hotel on your way in”. Alan Moody is an uber-radiologist, the chair of our department, and loves imaging the carotid arteries. As our minds often operate on the same wave lengths, I took the picture and voila – the Moody Tree was born!


There is no end to the fun we have here in the Department of Medical Imaging…



Even though this is not a “MiWORD” post how about you wish a belated Happy New Year to someone you have not been in touch with yet? Send them a quick text or better yet, send them the link to this post and tell them to visit the Moody Tree next time they are in Chicago during the holidays…


See you in the blogosphere,




Pascal




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MiWord of the Day Is… Haptoglobin!

 

Just got back from the RSNA! Wow what a big conference – 56,000 people this year. McCormick place in Chicago, Illinois (where the conference is held) feels like an airport it is so big. 


Love Chicago. Great city. 


Of course, I had the pleasure of attending a bunch of great presentations and today I will introduce you to one of them. Tina Binesh Marvasti (say that 7 times fast!) presented on the topic of Haptoglobin. No, not Hobgoblin (not sure who that is? See here) or his infamous green predecessor (see here). 


So, what is Haptoglobin you ask? It is a serum protein that binds free hemoglobin – resulting from the breakdown of red blood cells – and functions to prevent loss of iron (contained in the heme group) through the kidneys and to protect tissues from the highly reactive heme groups. Essentially a housekeeping protein that helps to recycle hemoglobin as part of the red blood cell life cycle. Now what if your ability to clean-up free hemoglobin was impaired? Well, quite simply you would be putting at risk those sensitive tissues that come into contact with free hemoglobin. 




One important example of this is vessel walls affected by atheroma (AKA plaque). Sometimes these atheroma can bleed (called intraplaque hemorrhage or IPH) which worsens the whole situation. Typically, your body responds by sending the clean-up crew including the Hobgoblin (or haptoglobin, I always get these two confused). 











When people have the recessive genotype (Hp 2-2) of the Hp gene they produce less haptoglobin and therefore are at increased risk of damage from free hemoglobin (or more specifically the heme groups).



Tina and friends hypothesized the following: 













And she found that having the recessive Hp2-2 genotype was associated with a higher prevalence of IPH in a group of  80 patients (average age of 73 yrs). She also found that the IPH volume of Hp2-2 patients worsened over time.








So what is the take home? The Haptoglobin genotype is associated with IPH which is a biomarker of high risk vascular disease and could identify populations at higher risk of developing cardiovascular events.

 

Now for the fun part (see the rules here), using Haptoglobin in a sentence by the end of the day:

Serious: Hey Bob, did you know that a recessive haptoglobin genetype may contribute to an increased risk of cerebrovascular disease?

Less serious: My GP suggested that based on my recessive hobgoblin genotype I should consider a healthier lifestyle. Funny, I always figured Doc Ock to be the one to watch for…

OK, watch the Spider-man 2 trailer to decompress and I’ll see you in the blogosphere…

 
 
 
Pascal Tyrrell