Radiology is one of the cornerstones of any hospital. It is a key diagnostic branch of medicine essential for the initial diagnosis of many diseases and has an important role in monitoring a patient’s treatment and predicting outcome. Radiology is the specialty considered to be both the “eyes” and “ears” of medicine.
But because radiologists are often behind the scenes, reading images of the inside of the human body and providing results to other doctors, many are unaware of their vital role in helping patients live longer and healthier lives.
Here Jinha Park, M.D., Ph.D., director of MRI and Radiology Research, discusses how radiology has enhanced diagnostics and cancer treatment, and how his role as a “doctor’s doctor” is helping to make huge headway in the fight against cancer.
What is diagnostic imaging and radiology?
Diagnostic imaging and radiology is that specialty of medicine that employs the use of imaging to both diagnose and treat disease visualized within the body. Most people are familiar with the imaging equipment we use, including X-ray machines, ultrasound, CT and MRI scanners, to scan inside the body. These enable us to make a diagnosis or follow treatment response, from which our clinical colleagues target medical or surgical treatment in patients.
In a sense, radiologists serve as expert consultants by aiding clinical colleagues in choosing the proper examination, interpreting the resulting medical images and in using test results in patient care. We are the interpreters of the “radar, sonar and satellite GPS-like systems” that help find and track the “bad guys” within the patient’s body.
Why is radiology important in patient care?
Radiology directly impacts almost every specialty of medicine. As it relates to cancer patient care, every specialist may need imaging inside a patient’s body at some point to see if a treatment is effective or not, and to determine if there is a change in a tumor’s size and/or if there is a new lesion or metastases.
Also, here at City of Hope, clinical trials are a crucial component to developing new, more effective treatments that save lives. If a patient isn’t responding effectively to a trial’s treatment, it is our job as radiologists to let our hematology and medical oncology colleagues know, so the treatment can be promptly changed.
In this way, we can move on from something that is not working to a therapy that is more effective, sooner.
What are some of the imaging technologies currently available at City of Hope?
We’ve all heard of X-ray machines that are used to take pictures of dense tissues such as bones and teeth. There are now a host of other imaging technologies available, including ultrasound, computed tomography (CT), nuclear medicine, positron emission tomography (PET) and magnetic resonance imaging (MRI) to diagnose diseases.
Some of the cutting-edge research I do here at City of Hope is to partner with our surgeons to use MRI technology to search for the smallest deposits of cancer. This image-guided surgical navigation allows surgeons to “look” inside of the body and see affected tissue before there are symptoms. Because the image-guided technology is so precise and accurate, surgeons can decide how best to get to a targeted area and avoid healthy tissue before an incision is ever made.
This precision medicine shortens operating times and allows for smaller incisions, which translates into speedier recoveries and better results for patients. It also means that patients with conditions considered "inoperable" in the past now have an option.
Our advanced imaging techniques at City of Hope are second-to-none. We really have the best methods available to help our colleagues.
What are some of the newer developments in radiology?
PET/CT is a newer imaging tool that combines two scan techniques in one exam: a PET scan and a CT scan. PET/CT is mainly used for diagnosis, staging or restaging malignant disease and evaluation of treatment response. The two procedures together provide information about the location, nature of and the extent of the tumor. In other words, it answers questions like: Where is the tumor, how big is it, is it malignant, benign or due to inflammatory change, and has the cancer spread?
However, it’s the merger of two fundamentally different scanner technologies, PET and MRI, that is forming a more accurate and dependable way to diagnose different cancers. MRI scans provide exquisite structural detail but little functional information, while PET scans – which follow a radioactive tracer in the body – can show body processes, but not structures very well. With this technology, radiologists can correlate the structure of a tumor by MRI with the functional information from PET, and understand what's happening inside a tumor.
The PET/MRI scanner has the potential to improve patient care by increasing understanding of the causes, effects and development of disease processes to better diagnose cancer.
Why did you choose this specialty? What inspires you to do the work you do?
I had initially planned on pursuing a career in hematology/oncology. One day during my rounds at LA County/USC Medical Center as a medical student, I encountered a patient about the age of my father. I learned he had a 10 cm liver cancer and apparently, he had no options other than a liver transplant. But the criteria indicated he couldn’t get one.
I did a lot of research and looked into alternative treatments and found that interventional radiologists could potentially help shrink the tumor by “parking” (inserting) a little catheter next to the tumor through a skin puncture about the size of the tip of a pen. This catheter could then infuse chemotherapy directly into the tumor instead of throughout the whole body. After the tumor shrank, he then went on to the lifesaving liver transplant.
While I didn’t ultimately pursue a career in interventional radiology, the experience influenced my path toward molecular imaging, which I hope to use for improving minimally invasive medical procedures. To be able to work in a lab to find a new method of targeting imaging probes to cancer deposits is so exciting to me.
Picture a procedure room where we will cure cancer without large surgical scars or side effects from chemotherapy, but through a small hole that you can place a Band-Aid on. All of these image-guided therapies are the future of medicine.
Do you have a question for Dr. Park? If so, post it below.
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