I must mean UFO or Unidentified Flying Object? You remember the movie Close Encounters of the Thrid Kind? Spielberg’s massive hit in 1977 following his release of the original Jaws. Back in those days UFO sightings were often in the news (or tabloids anyway) and this movie hit the sweet spot. It even helped launch the toy “Simon” which as it turns out was very similar to the multicolored, note-playing alien saucers featured in the movie – coincidence?
So, what the heck is UBO? Well, as it turns out the human body exhibits a variety of anatomical details in the ever so important Magnetic Resonance Imaging (MRI) scan that we have all learned to love (see our series on MRI and Carotid Stenosis). The majority of patients have similar anatomical features on imaging but some fall outside these normative patterns. When radiologists come across findings that are difficult to interpret they will often refer to them as “Unidentified Bright Objects”. The challenge, of course, is that the radiologist needs to decide whether to label the anatomy in the image an “UBO” – essentially an image artifact – or “disease”.
This is where the rubber meets the road. Interpretation of MRI scans is work done by people, and, as with all jobs, the quality of performance varies. Therefore, the accuracy of the MRI exam is heavily dependent on the quality of the radiologists who interpret them. It is for this reason that the training a radiologist receives is crucial to his/her success. In addition, there is an important relationship that exists between the radiologist and the primary care physician as they have to balance indications of abnormality in MRI scans with the information provided by other techniques such as the clinical exam. A successful diagnosis relies on a good team effort.
Now for the fun part (see the rules here), using UBO in a sentence by the end of the day:
Serious: Went for my MRI today. Told me that the UBO on imaging was just an artifact. Nothing to worry about. Phew!
Less serious: Hey Bob, did you hear on the news the report of another UBO hovering over farmer John’s field last night? Or was that UFO? I always get those two mixed up…
Listen to UB  0’s Red Red Wine to decompress and…
…I’ll see you in the blogosphere.
Last Wednesday, my ROP students Kiersten and Indranil, and UofT medical student Eli Lechtman had the opportunity to interview the legendary (see here) Dr. Kim Tysdale – a general practitioner in Cambridge, Ontario.
Why do you ask? Well each year 50,000 Canadians suffer from a stroke with 26% due to carotid artery disease. Carotid artery stenosis is the narrowing of the carotid arteries due to plaque buildup (see atherosclerosis). These plaques can then rupture and create blood clots that travel up to the brain. In turn, these blood clots then get stuck in the brain’s smaller blood vessels, causing a stroke. So plaque = bad and ruptured plaque = worse!
What if we had a clue as to which plaque may rupture? Well, in turns out that the presence of intraplaque hemorrhage (IPH) can help us predict just that! IPH is bleeding within the plaques, which causes them to become more vulnerable (see vulnerable plaque). There is a 6 times greater risk of stroke in people with IPH! And…. a new medical imaging technique called MRIPH imaging allows for visualization of IPH. MRIPH is similar to traditional MRI but highlights the artery walls and looks at the arterial plaques.
While in Cambridge, Kiersten, Indranil, and Eli presented Dr. Tysdale with an overview of medical imaging techniques for the assessment of carotid artery stenosis with an emphasis on the new MRIPH technique. Informing physicians like Dr. Tysdale which of his patients are more at risk of having vulnerable plaques (by providing information on IPH) could result in patients receiving more appropriate and timely treatment – thereby reducing the number of strokes!
BTW, we had Dr Tysdale at “hello” (not sure what I am referring to? See here).
So what up with the eggs? Kiersten, Indranil, and Eli also had the chance to tour Dr. Tysdale’s beautiful country house and meet his lovely wife (and nurse!), Eva, who sent everyone home with fresh chicken eggs! Awesome.
Thank you Dr Tysdale for being such a great sport!
Here is their infographic of the trip (great job gang!). Enjoy!
|Kiersten Thomas and Indranil Balki – ROP Summer 2015
Stay tuned for more ROP adventures!