Week 5

This week I followed the routine as previous weeks shadowing Dr. Prince. I spent a few hours everyday in the reading room both at Cornell and Columbia going through patients diagnostic images such as MRI T1, T2 weighted, diffusion and, CT images observing physicians, fellows, and residents performing diagnostics. In addition I had the chance to go to multiple conferences. One was relatively a small group within radiology department of Columbia. They go through a few cases that they think is interesting in a sense that is different from general cases they deal with on a daily basis. This gives  residents and fellows a good chance to to read these cases in the presence of physicians as a part of their training. The second conference on liver was at 7 AM on Wednesday and in addition to physicians and fellows, surgeons and other specialties dealing with patients went through MRI procedure participate to go through several cases and discuss future directions. For instance, a patient was presented with malignant tumor in his liver that underwent hepatectomy but still had positive margins in the diagnostic images after surgery. The main discussion was either resection is necessary or radiation therapy is enough to suppress and control the lesion. In another case a 52-year-old female was presented with liver cancer. Her Alpha-FetoProtein (AFP)  showed rising values up to 952. Alpha-fetoprotein is a protein produced by liver with high levels during childhood but it decreases over time and abnormal increase of it in blood test can be a tumor marker. This patient was diagnosed with Hepato Cellular Carcinoma (HCC) which is a common type of liver cancer that can be caused by alcohol use or Hepatitis B or C. 

This week I also got to talk with several people regarding my project. I visited Imaging Data Evaluation & Analysis Laboratory (IDEAL) on 61st St. which is part of Weill department of radiology and talked with Dr. Amy Kuceyeski. This facility is essentially a dry lab with experts in signal and image processing to develop new algorithms and visualization techniques to improve clinical diagnostics. In addition, I visited Citigroup Biomedical Imaging Center on 72nd St. to meet with Dr. Jonathan Dyke. This facility has an MR scanner with physicists that develop theoretical and experimental models to take advantage of MRI non-invasiveness  in cancer diagnostics that can be replaced by more invasive techniques such as biopsy.