Tuesday, October 20, 2020
Mitochondrial Health

#61 – Rajpaul Attariwala, M.D., Ph.D.: Most cancers screening with full-body MRI scans and a seminar on the sector of radiology

On this episode, radiologist/engineer, Raj Attariwala, explains how he was capable of apply his engineering background to create a singular MRI scanner that’s able to establishing whole-body photos with a decision that’s unmatched within the business. Peter and Raj focus on the implications of such a strong, radiation-free imaging device on the early detection of most cancers. They dive deep into most cancers screening and outline phrases reminiscent of sensitivity and specificity which are mandatory to essentially perceive this complicated area. They then describe the largest dangers concerned in this kind of screening (false positives) and the way Raj’s distinctive know-how and course of may drive down this threat considerably. However earlier than that, they focus on all of the frequent imaging know-how from X-ray, to CT scan, to PET scans, to ultrasound, to MRI, and extra. They contact on the historical past of every, how they work, the usefulness and limitations of every of them, in addition to the various dangers concerned reminiscent of radiation publicity. If you’re taken with most cancers screening and/otherwise you’ve ever questioned how any radiology device works, this episode is for you.

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We focus on:

  • Raj’s street from engineering to radiology [7:45];
  • How X-ray works, the chance of radiation publicity, and the various quantities of radiation related to the completely different imaging applied sciences [18:00];
  • Computed tomography scans (CT scans): The historical past of CT, the way it works, and why we use distinction [27:45];
  • Ultrasound: Advantages and limitations, and a particular use for the guts [40:45];
  • Detecting breast most cancers with mammography: When is works, once you want extra testing, and defining ‘sensitivity’ and ‘specificity’ [51:15];
  • Magnetic resonance imaging (MRI): The way it works, defining phrases, and the commonest kinds of MRI [1:03:45];
  • Mind aneurysms: Utilizing MRI to seek out them and save lives [1:23:45];
  • Raj’s distinctive MRI know-how [1:30:00];
  • The danger of false positives in most cancers detection, and the way Raj’s MRI can cut back the variety of false positives (i.e., enhance specificity) [1:43:40];
  • The distinctive software program Raj created to pair along with his MRI machine [1:51:15];
  • Evaluating the radiation publicity of a whole-body PET-CT to Raj’s gear (DWIBS-MRI) [1:53:40];
  • How diffusion-weighted magnetic resonance imaging (DW-MRI) has revolutionized most cancers screening [1:55:15];
  • Why a DW-MRI remains to be not an ideal check [1:59:00]; 
  • The potential for advancing MRI know-how: The place does Raj suppose it might enhance within the subsequent 5-10 years? [2:03:00];
  • Are there any commercially accessible scanners that may match the decision of Raj’s photos? [2:06:00];
  • Machine studying: When and the place may machine studying/AI impression the sector of radiology? [2:08:40]; and
  • Extra.

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Raj’s street from engineering to radiology [7:45]

How they met

  • Peter and Raj met by a mutual buddy that instructed Peter he needed to go and take a look at Raj’s fancy MRI machine
  • Peter flew to Raj’s clinic in Vancouver and acquired a full-body MRI in 2015 for the primary time

*See Peter’s instagram post showing video of the scan*

Determine 1. Peter going into Raj’s Prenuvo MRI machine.

Raj’s enterprise

  • AIM Medical Imaging is a non-public scanning firm which Raj began to have the ability to “play” along with his MRI know-how
  • His clinic known as Prenuvo which was began with a purpose to “put the facility of preventive medication right into a affected person’s fingers”

Raj’s street to radiology

  • Raj acquired a chemical engineering diploma
  • throughout that time period I spotted that I really just like the physique and physiology and the way that works
  • Then determined to get a grasp’s and PhD in biomedical engineering at Northwestern
  • Throughout that point, he and his crew constructed a robotic that might do keyhole surgery within the eye that wound up attracting lots of consideration from physicians from top-tier universities
  • The need to have the ability to converse the language of medical doctors, Raj determined to go to medical college

Med college

  • “Hated each minute of it”
  • Raj likes solutions to questions and shortly realized that there’s lots of issues within the physique, and physiology, and pathophysiology that we simply don’t totally perceive

“What I’d really begin to boil it all the way down to is that I’d really return to my engineering pathophysiology texts, and I’d really learn them and speak to the PhD guys, and they might really give me the theories on what they thought was occurring. While you really acquired that concept, it was nearly like planting a seed, and then you definately really understood how the whole tree would look.”

Know-how in medication

  • Raj’s past love was know-how so he determined to place these issues collectively 
  • Labored on a few of the very first surgical robotic machines ever constructed
  • However in that course of, Raj realized that the perfect place to concentrate on know-how in medication was radiology (imaging know-how)

Radiology 

  • Began in an space known as nuclear medicine, which is a small specialty inside radiology the place you’re really useful imaging, how issues work, how do issues change, what occurs over time
  • Actually favored nuclear medication as a result of it was displaying you what’s occurring when issues are regular after which when issues grow to be irregular (Raj significantly liked how the reply was black and white which is uncommon in medication)

Analogy

  • Radiology is like anatomy, a blueprint… the place you really see what’s occurring, you really see the modifications, and also you see the shapes of issues, and you utilize that very a lot as a blueprint for a constructing to truly see what it does
  • Whereas nuclear medication, as a substitute of the blueprint, you really know there’s all these folks carrying letters, transferring out and in of this constructing (We don’t actually know the place the constructing partitions are, however we all know that there should be one thing occurring there)
  • While you put the blueprint along with the motion inside the world of curiosity, you begin to notice “oh, these are postal staff carrying issues, and right here’s the geometry of the constructing. That energy actually is definitely fairly helpful.”

1 +1 = 3

  • The primary gadget to mix useful imaging with nuclear medication imaging was the positron-emission tomography-computed tomography (PET-CT)
  • These two separate modalities of useful imaging and anatomic imaging come collectively to truly make one thing higher than every half individually (i.e., 1+1=3)

Recommendation Peter acquired from radiology folks whereas in med college:

“Anytime you order a check, behind your thoughts you must be asking your self, ‘Would you like anatomical data, or useful data or each?’”

Determine 2. An instance of an anatomical picture of the mind with CT scan and with an MRI. Picture credit score: regencymedicalcentre.com

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Rajpaul Attariwala, M.D., Ph.D.

Raj is the Medical Director at AIM Medical Imaging in Vancouver.

Over the previous decade, he has been successfully creating a brand new method of doing MRI by fine-tuning the {hardware} and constructing distinctive software program to create a totally revolutionary product and course of by which to take a look at the physique utilizing the know-how of magnetic resonance.

He’s a twin board licensed Radiologist and Nuclear Drugs doctor licensed in each Canada and the US. He acquired his formal coaching at UBC with durations of specialised medical coaching at Memorial Sloan Kettering Most cancers Centre (New York), UCLA, and USC.

Raj accomplished a Ph.D. in biomedical engineering at Northwestern.

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