Friday, 9 November 2018

Radiation in Medicine



Radiation is the transmission or traveling of the energy through space or a material medium in the form of waves or particles. Ultraviolet radiation from the Sun is the most familiar form of radiation that we know. Except for the UV radiation, there are some higher-energy kinds of radiation, collectively known as Ionizing Radiation (such as α, β, or γ radiation) that are present on Earth and we all are exposed to it in minute doses through rock, soil, space, and air. But exposure to the higher levels of such radiation is harmful and dangerous and thus, the exposure should be controlled. The use of radiation in the medical field has made a huge evolution. Today, about one-third of the entire medical specialties involve radiation or radioactivity, right from the diagnosis - to the treatment.
Radiation is used in both nuclear medicine and radiology, but the difference is:
  • In general radiology, the X-rays enters the body from the outside source through space and creates a fixed or still image of the body, while in Nuclear medicine; a small amount of radioactive material (radiotracers, or radiopharmaceuticals) is administered internally, via injection, swallowing or inhalation inside the body into the bloodstream. This radioactive material travels through the area to be examined and produces γ-rays which are detected by the computers to create images.
  • The traditional imaging systems of radiology (X-rays, Ultrasound, CT scans, MRI) creates only a fixed or still image of the body showing the anatomy or structure of the body, while the nuclear imaging techniques (PET, SPECT) show the physiological function of the area to be investigated by producing two-dimensional or three-dimensional images.
  • In addition, through Nuclear medicine imaging techniques, a specific organ or tissue can be examined such as brain, lungs, and heart, unlike in general radiology imaging procedures where it produces the image of the whole area such as the chest cavity or abdominal cavity.


Advantages:

  • Both of these medical imaging specialties are used to diagnose and determine the severity of the disease and are involved in their effective treatment.
  • These imaging procedures are non-invasive or have the minimal invasion, less risk, a shorter recovery time and are less painful than the surgical treatments.
  • It also improves the cancer diagnosis with early detection and also involves its effective treatment (known as radiation oncology).

Disadvantages:
As with all the medical procedures, radiation techniques also involve a level of risk but the benefits are significantly greater than any risk involved.  
  • Exposure to the radiation in such techniques carries with it a minute increase in the risk of developing cancer later in life, especially to the radiologists and physicians.
  • In nuclear medicine, there is a small level of risk associated with the radiotracers administered into the body such as allergic reactions which are very rare as the type of the radioactive materials used by the specialist, depends on the medical history of the patient.



Friday, 2 November 2018

Interventional Radiology in Cancer treatment


Worldwide, cancer has the second highest mortality rate of all the disease. It consists of a large group of diseases involving the abnormal growth of cells rapidly. Today, there are many types of cancer treatments available depending upon the type of cancer and its advancement. Some patients receive only one type of treatment but mostly, the patients receive a combination of the treatments.

The three major treatments and therapies of cancer include:
  • Surgical treatment: In this procedure, surgeons remove cancer from the body through the operation using anesthesia. The procedure is complicated and painful.  
  • Chemotherapy: It involves drugs to kill or retards the growth of the cancer cells in the body.
  •  Radiation therapy: It uses high radiation energy to kill cancer cells and shrink the tumors in the body. Among all the treatments, the radiation therapy has a minimal invasion in the body but the main disadvantage is that there is a limit to the amount or lifetime dose of radiation body can safely receive. Also, radiation may kill the nearby healthy cells.

Interventional radiology is a medical specialty in which the highly trained physicians and radiologists perform minimally invasive procedures for the diagnosis and treatment of the various diseases. In the cancer treatment, it has reduced the risk, complications, pain and recovery time for the patients by replacing surgery and chemotherapy. Due to these, it is increasingly occupying the major role in the care of patients.

The specialty includes imaging techniques such as X-rays, Ultrasound, MRI, CT-scan and various other instruments to diagnose and treat the patients non-surgically using the catheter placed inside the body.

Diagnosis of Cancer
The appropriate treatment requires definite timely diagnosis and the accurate staging of cancer. With the IR technology, it is now possible to perform biopsies for histologic confirmations of the tumors with less or minimal invasion to the surrounding structures. The direct visualization through the imaging techniques permits the highly accurate diagnosis with a low complication rate. In addition, the cross-sectional images produced helps to define the lesion location, accessibility, and suitability for biopsy.

Treatment of cancer
It includes a wide range of procedures, from placing catheters to the extremely advanced procedures such as radioembolization, radiofrequency, Ablative Techniques and other techniques to treat such as colorectal, breast, gallbladder, pancreas, esophageal, stomach, lungs, melanoma and sarcomas. All these procedures involve minimal invasion and reduced complication rate.

Side effects

IR techniques and procedures may reduce the side effects that are typically associated with the traditional procedures of cancer treatment that are surgery, chemotherapy and radiation therapy. But there may be side effects such as fatigue and pain. 

Friday, 26 October 2018

Cause of Cancer and its Diagnosis




Cancer is used to describe a large group of diseases which involves the rapid and abnormal growth of the cell and has the potential to spread or invade other parts of the body. Till now, over 100 types of cancers have been discovered. Cancer has the second highest mortality rate. Oncology is a branch of medicine that deals with the diagnosis, treatments, prevention and all other aspects of cancer and the practitioner is known as Oncologist. 

Some possible early signs of cancer include a lump, abnormal bleeding, prolonged cough, sudden weight loss and a change in bowel movements. The problems associated with these signs are that while these symptoms may indicate cancer, there is a possibility of other causes.

The factors that cause cancer include both, genetic mutations from environmental factors and due to the inherited genetics. The majority of cancers (90–95%) are due to environmental factors and the remaining 5–10% is hereditary. The common environmental factors associated with deaths from cancer are high body mass index (obesity), low fruit and vegetable intake, tobacco use, lack of physical activity, alcohol use, infections, radiations, stress, and the pollution. However, it is impossible to prove what caused particular cancer as they do not have specific fingerprints. For example, non-smokers may also develop lung cancer probably as a result of air pollution or radiation.
Imaging has a significant role in almost every aspect of high-quality cancer care by using Artificial Intelligence (AI). It is a process of producing scan or images of the body to find or detect tumors and other abnormalities, determine the extent, and evaluate the effectiveness of the treatment. It is also used for biopsy and surgical procedures. It is considered a cornerstone of cancer care. In early diagnosis, imaging enables to detect cancer at its primitive stage which is more likely to be treated successfully. There is no single imaging test that can accurately predict cancer but it needs a complete evaluation to be effective.

Some of the common types of imaging that are used for cancer care include:

  • X-Ray- produce images of internal tissues, bones, and organs on film using the electromagnetic energy beams.
  • CT Scan- a procedure that uses a combination of X-rays and computer technology to produce more detailed images.
  • Ultrasound (sonography) - uses high-frequency sound waves and a computer to create images, called sonograms, of blood vessels, tissues, and organs.
  • MRI (Magnetic Resonance Imaging) - can assess blood flow, detect tumors and diagnose many forms of cancer, evaluate infections, and assess injuries to bones and joints using the electromagnetic radiofrequencies.

Saturday, 20 October 2018

Artificial Intelligence for Radiology



Introduction: Artificial intelligence (AI) will bring changes to the professional life of radiologists, as well as changing many other aspects of our lives. Since the invention of electricity, the internet and, more recently, artificial intelligence, the technologies of general use have made it possible for societies to progress and improve their quality of life.
Artificial intelligence and machine learning tools have the potential to analyze large data sets and extract meaningful information to improve patient outcomes, a skill that is also useful in radiology and pathology.

The images obtained by the MRI machines, the computed tomography (CT) scanners, and the radiographs, as well as the biopsy samples, allow the doctors to see the internal functioning of the human body.

Factor Affecting
  • Abundance of data
  • Development of artificial neural networks 
  • Increased affordability of the hardware
  • The future of radiology augmented with Artificial Intelligence
Radiologists are not familiar with Artificial Intelligence, pioneering work in the perception of medical images in the 80s. We are experts in domains in medical imaging, medical physics, and radiation safety. But in the last 6 to 12 years, there have been substantial innovations in obtaining images from deep learning methods of image classification. Today's artificial neural networks have rates of accuracy that surpass those of human radiologists in narrow-based tasks, such as nodule detection The first step in formulating a strategy is to define our capabilities and identify the competitive forces that represent a threat. We are facing competition from other medical specialties who spend more time interacting with patients and who can choose to buy AI technologies. We also face competition from suppliers of equipment that make imaging devices, such as CT scanners.
General use cases, potential impact and implementation strategy
They can be divided into task-based categories:
  • Detection and prediction automation
  • Intelligence augmentation 
  • Precision diagnostics and big data
  • Radiological decision support systems

Friday, 5 October 2018

3rd World Congress on Radiology and Oncology: Pediatric Computed Tomography (CT)

3rd World Congress on Radiology and Oncology: Pediatric Computed Tomography (CT): Pediatric Computed Tomography (CT) Radiology and Oncology 2019 today announced an important milestone in computed tomog...

Pediatric Computed Tomography (CT)





Pediatric Computed Tomography (CT)

Radiology and Oncology 2019 today announced an important milestone in computed tomography (CT) scanning for the center in Abu Dhabi.

Pediatric computed tomography (CT) is a fast, painless diagnostic Process that uses special X-ray tools to produce complete photographs of your child’s blood vessels, bones, soft tissues, and internal organs. It may be used to help diagnose abdominal pain or evaluate injury after trauma.

What is Children's CT?

Most commonly known as a CT or CAT scan, is an indicative therapeutic test that, like conventional X-rays, generates multiple images or pictures of the core of the body.

The cross-sectional illustrations produced during a CT scan can be reformatted in various planes, and can even produce three-dimensional images. These photographs can be observed on a computer monitor, printed on film or transferred to a CD or DVD.

CT pictures of internal organs, delicate tissue and veins give more prominent part than regular X-rays, particularly of blood vessels acnes.

CT scan might be directed on babies, new-born children and young people.

Some common uses of the system

        CT is utilized to help analyze a wide assortment of circumstances because of torment or weakness.

        CT may also be performed to evaluate blood vessels throughout the body.

        CT is the most commonly used imaging method for evaluating the chest

      It is used to obtain very detailed pictures of the heart and blood vessels in children, even newborn infants.

       CT is well-suited for imaging diseases or impairment of vital organs in the stomach including the kidney, spleen and the liver.

        CT scans can help to detect sores or tumors in the pelvis and assess for masses in the urinary region

        CT is an added example of new medical technology to help doctors specifically to diagnose disease.

        Patients with heart disease require specific diagnoses, and they frequently want them quick.


Thursday, 27 September 2018

Cancer : Establishing metastasis




Human VRK1 Is an Early Response Gene and Its Loss Causes a Block in Cell Cycle Progression??


In mammalian cells, the regulatory proteins that control the cell cycle are necessary due to the requirements of living in a heterogeneous environment of cellular interactions and growth factors. VRK1 is a new serine-threonine kinase that phosphorylates several transcription factors and is associated with proliferation phenotypes.



Scientists have discovered that a protein called VRK1 could help cancer take root in new parts of the body. It was discovered that VRK1 is necessary for the mesenchymal to epithelial transition, which scientists suspect may be important for the establishment of metastases. The expression of the VRK1 gene is activated by the addition of serum to the cells deprived of food, which indicates that it is required for the exit of the G0 phase and the entry in G1; a response that parallels the re-expression of MYC, FOS and CCND1 genes (cyclin D1), suggesting that VRK1 is an early response gene. The expression of the VRK1 gene is also closed by serum extraction.

The promoter of the human VRK1 gene cloned in a luciferase reporter responds similarly to serum. In response to serum, the expression level of the VRK1 protein has a positive correlation with cell proliferation markers such as phosphorylated Rb or PCNA, and is inversely correlated with cell cycle inhibitors such as p27. Removal of VRK1 by siRNA results in a G1 block in cell division and in the loss of phosphorylated Rb, cyclin D1 and other proliferation markers. The elimination of VRK1 by siRNA induces a reduction of cell proliferation. VRK1 is colocalized with p63 in proliferating areas of squamous epithelium and identifies a subpopulation in the basal layer.

They observed that cells with high levels of VRK1 were more apt to form cell-to-cell connections and had lower levels of mesenchymal markers that are often present in cancer cells. On the contrary, the cells seemed to undergo the opposite transition, from mesenchymal to epithelial. The cells were much less likely to migrate. If high levels of VRK1 caused cancer cells to migrate more slowly, perhaps VRK1 was necessary to allow cells to colonize a new area of the body.

Significance


VRK1 is an immediate early response gene required for entry into G1, and due to its involvement in normal cell proliferation and division, it could be a new target for the development of inhibitors of cell proliferation. In addition, VRK1 may one day serve as a biomarker for aggressive cancers, which could inform oncologists as they decide on more advanced or conservative treatments.