Clinical Immersion - Week VIII

Epilogue.

After all the endless days of working and restless shadowing of doctors at HSS, my time as a clinical intern came to an end yesterday after a final presentation of my work to Dr. Potter. In preparation for the meeting I spent several days gathering data on image resolution for 468 pictures, resulting in 468 data points that had been categorized based on several parameters impacting resolution (GSI type, keV voltage or image filter, and use of a specialized image formats). The control for the pictures was the old GSI format used by GE on creating the MRI pictures, with all other experimental ones being studied due to their possible increase in resolution level. Creating a neat comparison among all the data points was perhaps the most critical step to making sure that the presentation went smoothly; to accomplish this, I decided to first compare the keV voltages and the use of the specialized filter (in this case, hydroxylapatite on water) among all three GSI types in order to visually how different was the resolution based on the parameters that a user can actually alter. After this was accomplished, I sorted the data once again based on GSI type, a parameter that a user can no longer alter. In this way, the presentation could make the most sense to Drs. Potter, Meyer, and Greditzer.
The data plots supported that careful consideration should be given more to the GSI type than to the use of any particular keV value. However, what was clearest was the fact that certain image formats were particularly advantageous for highlighting microfeatures in the femoral condyles, and possibly being much better at quantifying trabeculae in upcoming studies. The two image formats, work in progress and current standard, seem to be much better at acquiring features in an image (high acquisition value) and establishing a much higher resolution (high avg resolution level). While it was expected that these formats were going to do better, it was still great to see that the program could now quantify just how much better these formats were at capturing the distinct small features of the trabecular architecture present in the femoral condyles.
While much work is still needed before critical research on trabecular microarchitecture using MDCT can take place, the first step is ensuring that the Potter laboratory will move forward with their collaboration with Dr. van der Meulen. So far, I have been informed that my data will be taken into consideration for future research and that the program I made will be taken into consideration for the analysis of more pictures. It has also been suggested that a formal meeting should take place between Dr. Potter, Dr. van der Meulen and I in order to discuss possibly continuing this project as some sort of collaboration.

With regards to my last adventures, it seems that transition was the last theme: from city to beach escapades to a visit to the Museum of the City of New York/Museo del Barrio, the weekend highlighted how people affect their environment and vice versa. On Sunday I had the chance to visit Montauk with Lauren Hapach, a three hour trip taking us all the way to the tip of Long Island where sandy white beaches and multi-million dollar houses are. The stark contrast between the city and the beach were a surprise in their own right. Tuesday was devoted to Uptown Bounce, an event that allowed free admission to two museums on the Upper East Side, both of which featured exhibitions on activism in New York City, dating all the way back to the 1600s. The most informative was the Museo del Barrio's exposition on the Young Lords movement of the 60s and 70s that occurred not too far away from where the museum stands. Eerie snapshots of times past and present struggles on the way to transition. My last day on the city featured a vist to Soho and Prospect Park in Brooklyn before heading back to the Upper East Side.

The clinical immersion experience felt daunting at times and it, necessarily or not, placed me on awkward scenarios where I was left only with my intellect and plenty of time to define the problem and find the solution. While it was not necessarily what I had envisioned in mind (so much coding...), it did provide an insight into what the future will be like after I graduate from Cornell. By keeping an open mind, a problem can become a growing experience that can diversify in multiple ways. That would my advice for the incoming first years (in addition to having fun exploring the city)

Thanks for reading,
Victor Aguilar