Dem Bones Dem Bones Dem Dry Bones

Happy Canadian Thanksgiving!!!

A traditional holiday – originating from the native peoples of the Americas – to celebrate the completion and bounty of the harvest.

This year I am off to Algonquin park for a canoe portage trip with the kids! I will take the time to appreciate some of the successes of our MiVIP program and this blog over the long weekend.

Thanks for being a part of it!

Listen to Dem Bones by the famous Delta Rhythm Boys

… and I’ll see you in the blogosphere.

Pascal Tyrrell

MiWord of the Day Is… CAT scan!

A what scan? I am actually a cat guy myself. Not to say I don’t love dogs but if I had to make a choice…


I just finished reading a fantastic book by David Dosa entitled “Making Rounds With Oscar”. The premise of the book is a story about an extraordinary cat but the subject matter is very serious –  dementia and end-of-life care in the elderly. Have a gander.


So what the heck is a cat scan and what does it have to do with medical imaging? 


CT scans – also referred to as computerized axial tomography (CAT) – are special X-ray tests that produce cross-sectional images of the body using X-rays and a computer. CT was developed independently by a British engineer named Sir Godfrey Hounsfield and Dr. Alan Cormack and were jointly awarded the Nobel Prize in 1979. Yes, more Nobel prize winners…






In a nutshell, x-ray computed tomography:


– uses data from several X-ray images of structures inside the body and converts them into 3D pictures – especially useful for soft tissues.


– emits a series of narrow beams through the human body, producing more detail than standard single beam X-rays.


– is able to distinguish tissues inside a solid organ. A CT scan is able to illustrate organ tear and organ injury quickly and so is often used for accident victims.


– is analyzed by radiologists.


Unfortunately, unlike MRI scans, a CT scan uses X-rays and therefore are a source of ionizing radiation.





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

Serious: Hey Bob, did you know that the recorded image of a CAT Scan is called a tomogram? 

Less serious: My GP suggested that howling at the moon at night is not normal behavior and he wants to send me for a CAT scan. What? No way, I’m allergic to cats…

OK, listen to Cat Stevens to decompress and I’ll see you in the blogosphere…


 
Pascal Tyrrell

MiWord of the day is… Atom!

MiWord, a post on Sunday?!!! Well, I have been very busy lately and fell behind on my blog so I am now playing a little catch-up…


I was waiting in Logan airport for my flight back from a presentation in Boston – what unbelievably crazy traffic in that city – and I was texting my kids with my laptop open and my tablet next to me on the seat when I thought: I feel a little like Jimmy Neutron! I enjoyed watching that show with my kids. Lots of fun. Anyway, that idea of crazy science and the internal structure of the atom as displayed on Jimmy’s t-shirt may be the premise for a great kids show but it also led to the development of MRIWhat?!!! You say. 


MRI is an imaging technique. Maybe so, but it is particular in that it does not use any classic photographic equipment (film or lenses) or use x-rays as Roentgen did. It simply numerically measures how hydrogen nuclei absorb and release energy in response to particular frequencies. Need a refresher on the structure of an atom? See this post.


Don’t get it? OK, how about you think of this process as a crazy huge tuning fork. If you were to flick a tuning fork of a certain frequency (pitch) other tuning forks of the same frequency close by will pick up energy from the humming tuning fork and emit a sound in turn. Cool.


The nucleus of an atom can absorb energy and then relax by emitting energy in a similar way. Different atoms (or the same atom in different environments) will have different relaxation rates allowing for the identification of the composition of molecules. Ya, maybe a little complicated.





MRI measures how hydrogen nuclei absorb and release energy. Dependent on the location and the environment of the hydrogen atoms the MRI process is able to provide knowledge about the placement of hydrogen atoms in the body and in turn knowledge about the anatomy.





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

Serious: Hey Bob, did you know that the atom is the smallest unit that defines the chemical elements and their isotopes?

Less serious: I thought that splitting atoms would produce a large explosion but when I tried using my mom’s perfume “atomizer” it just produced a fine spray and nice smell…




Ok that was a little intense for a Sunday. Watch and listen to Symphony of Science (very cool BBC production) to decompress and I’ll see you in the blogosphere…




Pascal Tyrrell

MiWord of the Day Is… Cinemaradiology!

Yes, it is Halloween today and my kids could barely contain themselves getting ready for school. I suspect today will not be very productive as they count down the minutes before heading out to terrorize my neighbors.


Anyway, how about this for a scary thought: cinemaradiology! In the late 1800’s John MacIntyre at the Gasgow Royal Infirmary experimented with producing X-ray motion pictures. What!!!? He tried exposing film by passing it between the screen of the fluoroscope and the x-ray tube and by simply filming the fluoroscopic screen. This latter method was very difficult because, as all of you budding radiologists know, the images viewed on the fluoroscope screen were dim and of poor resolution at the time.


For years researchers worked on perfecting cinemaradiology. However, during those early years of discovery they lost interest when they realized that sharper images were possible when BOTH patients and investigators were exposed together AND that excessive radiation was a bad thing – duh! 


It would only be many many years later that fluoroscope screen technology would be improved to allow for brighter and higher resolution images (and without frying the patient and everyone around!). 

Fluoroscopy is a study of moving body structures – similar to an x-ray “movie.”  A continuous x-ray beam is passed through the body part being examined, and is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. As an imaging tool, Fluoroscopy is used in many types of examinations and procedures.

To my knowledge, no actors from the cinemaradiology era ever became successful stars in Hollywood…


No need to use the MiWord of the day in a sentence today (see rules here) as I realize you are busy getting ready for Halloween and need a break!


Decompress listening to the classic song Thriller by the King of Pop Michael Jackson and I’ll see you in the blogosphere…






Pascal Tyrrell

 

What Cluster Are You From?

This week and I had the pleasure of presenting to the Division of Rheumatology Research Rounds – University of Toronto. They were a fantastic audience who asked questions and appeared to be very engaged. Shout out to the Rheumatology gang!


So, I was asked to talk about a statistical methodology called Cluster Analysis. I thought I would start a short series on the topic for you guys. Don’t worry I will keep the stats to a minimum as I always do!


Complex information can always be best recognized as patterns. The first picture below on the left certainly helps you realize that it is not a simple task to know someone at a glance.





Now, I guess it doesn’t help that many of you have never met me either! However, you can appreciate that things get a little easier when the same portrait is presented in the usual manner – upright! 












This is an interesting example where the information is identical, however, our ability to intuitively recognize a pattern (me!) appears to be restricted to situations that we are familiar with.








This intuition often fails miserably when abstract magnitudes (numbers!) are involved. I am certain most of us can relate to that. 


The good news is that with the advent of crazy powerful personal computers we can benefit from complex and resource intensive mathematical procedures to help us make sense of large scary looking data sets.




So, when would you use this kind of methodology you ask? I’ll tell you…


1 – Detection of subgroups/ clusters of entities (ie: items, subjects, users…) within your data set.


2 – Discovery of useful, possibly unexpected, patterns in data.




OK, time for some homework. Try to think of times when you could apply this kind of analysis. 


I’ll start you off with an example that you can relate to. Every time you go to YouTube and search for your favorite movie trailer you get a long list of other items on the right that YouTube thinks may be of interest to you. How do you think they do that? By taking into account things like keywords, popularity, and user browser history (and many, many more variables) and using cluster analysis of course! You and your interests belong to a cluster. Cool!


In this series, we will delve into this fun world of working with patterns in data. 




Now that you have peace of mind, listen to The Grapes of Wrath






See you in the blogosphere,


Pascal Tyrrell



MiWord of the Day Is… Cuckoo!

One of my favorite more serious films is One Flew Over the Cuckoo’s Nest. What does Jack Nicholson’s portrayal of a bad guy hoping for easy served time in a mental institution have to do with medical imaging? Well it all starts with the lobotomy. Not to spoil the story, suffice it to say that the movie broaches the topic of lobotomies and how ridiculous they were. Lobotomy was a form of neurosurgery that involved damaging the prefrontal cortex in order to “calm” certain mentally ill patients. Needless to say the procedure was controversial from the beginning (1935 to the early 1970’s) but the author of the discovery, Egas Moniz, was awarded the Nobel Prize in 1949. Maybe not the most sound of decisions by the committee. However, for the time, it was considered progress in a very challenging area of medicine – mental illness. 


OK, medical imaging? Well as it turns out Moniz (do not confuse with St-Moriz, ahhh skiing…) is also known for developing cerebral angiography – a technique allowing the visualization of blood vessels in and around the brain. 



Moniz was interested in finding a non-toxic substance that would be eliminated from the body, but would not be diluted by the flow of blood before the x-ray could be taken. Another requirement is that the substance could not cause an emboli or clot as this would be a bad thing. Moniz played with salts of iodine and bromine and settled on iodine because of its greater radiographic density. And voila, birth of iodinated radiocontrast agents still in use today. Cool.




Supposedly it took him 9 patients to perfect his angiogram technique. Don’t ask about the first 8…

Moral of the story is: lobotomy bad and cerebral angiography good.



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

 
Serious: Hey Bob, when I was visiting my aunt in Australia I spied a little bronze cuckoo in her backyard! This could be my “big year“…


Less serious: Someone won a Nobel Prize for developing the lobotomy? Are you cuckoo?
 
 
Listen to Los Lobos (not short for lobotomy but “the wolves” in Spanish) singing La Bamba to decompress and…
 
… I’ll see you in the blogosphere,
 
 
Pascal Tyrrell

Another successful diagnosis thanks to the x-ray…

For more info see Free Birds

Happy Canadian Thanksgiving!!!

A traditional holiday – originating from the native peoples of the Americas – to celebrate the completion and bounty of the harvest. Well, no harvest for me but I will take the time to appreciate some of the successes of our MiVIP program and this blog over the long weekend.


Thanks for being a part of it!


See you in the blogosphere,

Pascal Tyrrell

Starting a new research project? Think Zorro!

Well, OK maybe think Zotero. The Mask of Zorro was such a great movie I could not resist. Having said that, when starting a new research project it may be helpful for you to think of yourself as Zorro. It may give you that extra zip required to get you through the inevitable research project doldrums…


So what is this Zotero thing anyway? Well Zotero is an open source reference management software that can act as your personal research assistant – helping you to organize and cite the numerous articles that you will be reviewing.


I was talking to Ori the other day – who is in the Radiation Therapy program at the Michener Institute – and he is in the process of planning a research project. As it turns out he has been a member of the MiVIP family since the beginning so he is well aware of my earlier posts that will help him along:


1- Thoughts on how to become a researcher


2- What is in a research question?


3- What makes up a good research question with the F.I.N.E.R. series.




Now how about the reference management software thing? Well, I give you an easy, fun, and instructional e-learning module to help you along. Our group has just finished our first kick at the can (so to speak) and so I invite you to have a look. Here is the link:


MiEducation Zotero e-learning module


Tell us what you think by posting comments and suggestions to this post.




Maybe listen to Ylvis in What Does the Zorro Say? while you go through the module. Fox in spanish is zorro…

 
… and I’ll see you in the blogosphere.
 
 
Pascal Tyrrell




The Adventures of Alana the Newbie Researcher

Timeline of my ROP experience

Stroke. Atherosclerosis. Carotid stenosis. MRI. Endarterectomy. To some people, these words are, well, just words. But for others, these few phrases could change the course of their lives. During my time in the Research Opportunity Program at the Department of Medical Imaging, I was able to learn all about carotid disease and the current status of carotid imaging modalities. As an added bonus, I did quite a bit of research on the impact that stenosis has on patient care and how new and exciting advances in medical imaging could affect it.



Over the course of four months, I went from being a huge research newbie to becoming an experienced research … trainee. I was introduced to the world of journal article writing, starting from doing elementary literary research all the way to drafting and writing a review article, which was completed entirely from the comfort of my beloved computer. With the help of Doctor Eli Lechtman and my ROP partner Helena Lan (if you haven’t seen her post on her experience you should check it out), we were able to put together 2 review articles that complement one another and will hopefully pose as a good foundation for future research.



Now, you must be thinking, “wow, this sounds like an extremely exciting summer; how could it possibly be better?” Well, my dear readers, it gets even better. One of the greatest things about being a part of this department is the community. The people here are all friendly, wonderful, and welcoming. From having an outing at Centre Island to letting us operate an uItrasound machine (thanks Modele!), I really felt like I was a part of “the gang.” What’s more, it was nice to have someone remember my name when I arrived in the morning, especially when I’m used to being my nameless self in the vast sea of students of our first year lectures (Convocation Hall, anyone?).



When I first sat down to write this post, I couldn’t decide what would be the best way to describe my time doing my ROP. And that’s when it hit me: it was an adventure! I may not have explored unknown lands or survived any near-death experiences, but there was not one day that went by where I wasn’t learning something new. Each day was a new experience, an opportunity to understand something I probably haven’t even heard of before. It still surprises me right now, as I’m writing this post, how much I have learned throughout this program, and the fact that I was able to experience something like this. I would have never thought I could write a review article and do the things I’ve done in only my first year of university. All in all, this was a great experience, and I encourage everyone to try out something like this!



Thanks for reading this, y’all! And if you just scrolled to the bottom of this post and thought “tl;dr,” you can still check out my infographic timeline (there’s pretty pictures)! Also I’d like to give a shoutout to my awesome Professor, Dr. Pascal Tyrrell (check out his latest post), as well as all the lovely members of the Medical Imaging department at U of T for making my ROP experience the way it turned out to be.



Remember to make every day an adventure,



Alana Man 🙂

Helena Lan: Summer 2014 ROP

Helena Lan Summer 2014 ROP

What is research like? If you had asked me this
question several months ago, I would have answered, “You wear a lab coat and
goggles while mixing chemicals or observing organisms. Hopefully something
interesting will happen, so that you get to publish your findings!” Well, after
participating in the Research Opportunity Program (ROP) at the University of
Toronto, I discovered that medical imaging research is more than just
pipetting, and is all the more exciting!

 
So what kind of research is conducted in the medical imaging world? For my ROP, the objective of my project was to evaluate the roles of the non-invasive imaging modalities for diagnosing carotid stenosis. Hence, I engaged in online literature research of the various imaging techniques for assessing this disease. In this process, I also learned to use Zotero to manage all my references, which provides an easy way to generate a bibliography (when the software doesn’t crash every time you open it). After gathering all the pertinent information, I then put together a review article suggesting how a change in the current imaging approach could potentially improve clinical outcome. Who knew a report could be compiled without doing the lab grunt work?     
 
Wait, so this is all a radiologist does? Sitting in front of a computer and typing all day? Of course not! During our time at Sunnybrook Hospital, we got the chance to chat with a radiologist and discovered that she could decide whether patients should be released after taking a look at their diagnostic images. Pretty powerful, eh? That’s not all. We also found out how radiologists identified any abnormalities in patients, as we had the opportunity to work with the VesselMass software which allowed for the delineation of the lumen and vessel wall of arteries on MRI images. Oh, and did I mention we observed an MRI and an ultrasound examination of the carotid arteries, and even got to perform an ultrasound scan ourselves. Super cool!
 
Still craving for more of my ROP experience? Check out my timeline infographic! You will find all the things I learned and all the fun I had there. Last but not least, I’d like to shout out a big THANK YOU to Prof. Pascal Tyrrell and Dr. Eli Lechtman, who guided us every step of the
way. Also, I’m very grateful to Dr. Alan Moody for including us in his research program at Sunnybrook, as well as other members of the VBIRG group who gave us the chance to
participate in various activities. My summer would not have been this fun and meaningful without all of your help!
 
Have fun researching,


Helena Lan