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by:Newland     2019-10-12
Dr.
Marco Essig starts the computer and selects MRI from the folder.
Click on the mouse, an image will appear on the screen, the color is mixed together
Pink, green, orange, blue and white
All of this comes together in the form of a human brain.
In this case, the brain belongs to a patient who arrived at the Winnipeg Health Science Center earlier the day after the seizure.
This case is a bit unusual.
Usually, patients with seizures will have a history of epilepsy.
The patient did not have this record, nor did he have a seizure.
But it doesn\'t take a long time for Essig to solve the mystery.
A careful review of the images reveals the root cause of the problem: malignant tumors in the left hemisphere of the brain.
A few years ago, using standard black and white MRI to locate the tumor was almost what the radiologist could do.
But things have changed.
Advances in MRI technology and technology mean that radiologists are now able to learn more about the patient\'s head.
To trained eyes, more
Color images made today using recently developed functional imaging techniques such as perfusion or MR spectra can provide critical insight into the nature of the tumor, it includes blood supply for the tumor, cell density, and the rate at which it may grow.
The MRI on the Essig screen shows this.
Each color in the image represents blood flow levels within the brain and tumor.
When he studied MRI, Essig could see the part of the tumor colored in a brighter color.
This suggests that these areas of the tumor receive a high level of blood flow.
This is a strong sign of very aggressive and very dangerous vicious growth.
This kind of information is invaluable to oncologists.
The more they know about the patient\'s tumor, the more chances they have to make a successful treatment plan, and in this case.
Winnipeg is good, it turns out-
Positioned to use new MRI techniques and techniques to diagnose and treat patients, especially those with cancer, stroke and degenerative brain disease.
One reason is that the city\'s largest hospital is now home to the surgical innovation center that opened last fall.
Although Winnipeg has some high
The technical gems are different.
Located on the second floor of the hsckleysen Institute of Advanced Medicine, the suite consists of four guest rooms.
In one room there is an \"during-Operation\" MRI mounted on a ceiling track.
It is located between two adjacent rooms.
One for catheter angiography and the other for neurosurgery
Next to the control room.
Using some of the latest hardware and software technologies, the kit\'s MRI is able to provide more detailed images than some of the other MRI\'s being used, giving radiologists a better understanding of important indicators, such as blood flow to the tumor.
But what makes the suite special?
This is the only hotel like this in Canada.
MRI can be moved along the track to either of the two operating rooms, scanning the patients as they undergo surgery, and therefore is called an \"during-surgery\" MRI.
The second reason is Essig itself.
Recently recruited from Germany to receive a double appointment from the department head of radiology at the University of Manitoba School of Medicine and the director of diagnostic imaging medicine at the Winnipeg health area, essig is a leading specialist in the field of MRI and neuroimaging.
Over the years, his research has helped advance the use of MRI techniques to better diagnose and treat brain, breast and prostate cancer.
His work has also enhanced the medical community\'s understanding of brain degeneration such as Alzheimer\'s disease.
His dual role means that he will be responsible for leading diagnostic imaging operations in the region and ensuring that students at the University of Manitoba are trained in the latest MRI techniques and techniques.
In addition, Essig will continue his research.
Currently, he is hosting an international team of radiologists who are working on a new protocol for the use of MRIs.
Once completed, these protocols will become a guide for radiologists around the world as they strive to advance the science of reading MRIs, which in turn will lead to better cancer treatment, stroke, infection, or degenerative brain disease here and elsewhere.
As Essig explains, MRIs is made by companies of different specifications.
This can lead to differences in data interpretation and quantification.
We all have different scanners.
One from GE, the other from Siemens, and the other from Phillips.
\"There are different areas of advantage,\" he said of the ongoing research . \".
\"For our patients, each tumor is very different and each patient has different treatment and results,\" he said . \".
\"We are currently working on a standardized process for obtaining and processing data so that we can get standardized results and then we can apply it to the needs of each patient. \"Radiology -
Diagnosis and treatment of diseases using imaging technology
Since the German physicist Conrad Renqin made the first X-
1890 seconds of light
Since then, progress has led to a better X.
The appearance of rays and other imaging techniques, including MRI (
Magnetic resonance imaging, CT (
CT scan, PET (
Electron emission tomography
, Ultrasound and, can lead to a long time
Term issues such as permanent loss of important functions such as seizures or speech.
Most types of chemotherapy can cause hair loss or extreme nausea.
Some types of chemotherapy can lead to a long period of time.
Long-term negative effects such as heart failure.
Radiation therapy also has its risks because it increases the likelihood that patients will develop cancer elsewhere in the body due to exposure to radiation.
Unfortunately, although biopsy is helpful, they do not always provide an accurate assessment of the biological composition of the tumor.
Tumors are often heterogeneous, which means that a single tumor can have many different types of cells.
\"For example, if you do a biopsy a few millimeters on the left, you will find
\"Tumor grade,\" said Essig.
\"If you do a few millimeters of biopsy on the right, you will findgrade tumour.
\"In other words, it is possible to diagnose a tumor as a low tumor.
Not high marks --
Grade, resulting in less aggressive treatment, or even a \"wait-and-see\" approach rather than a stronger treatment plan.
This is where the latest advances in MRI technology work.
When scientists find that the magnetic properties that produce detailed pictures can also be used to show differences in blood flow or other tissue features, key breakthroughs occur in 1990 seconds.
Developments since then include the latest developments in new functional imaging technologies such as dynamic enhanced sequence MRI or dynamic magnetic sensitivity-contrast MRI.
These new technologies give radiologists a deeper understanding of the nature of the tumor. \"(
New Technology)
\"This means that we can describe the type of tumor we found in patients,\" Essig said . \".
\"Thanks to the new technology, we now know more about genetics within the tumor.
They don\'t have homogeneous genes.
\"They are much more heterogeneous,\" Essig said . \"
\"They have aggressive parts and not aggressive parts.
We can now better judge whether this is malignant or benign, and we can better predict the grading of tumors and help guide the treatment, results and management of patients.
In addition to knowing more about tumors, new MRI techniques and techniques can benefit patients in other ways, Essig said.
A case study of patients undergoing blood tests with high prostate-specific antigen levels (PSA)
This is usually associated with the risk of prostate cancer.
Using perfusion MRI, radiologists can map prostate vessels (blood vessels)
Reveals areas where blood supply has increased, which often indicate cancer.
Using these enhanced images, the surgeon can aim at the point of failure while performing the biopsy procedure.
\"Before, the risk was that the surgeon would miss the tumor.
So what does he do?
He also had 30 biopsies . \"
\"I have seen nearly 100 patients biopsy from the prostate, which is almost close to complete resection.
\"With a new diagnostic imaging approach, the invasive nature of this procedure is much smaller, and usually only one biopsy sample is needed to confirm the tumor, not dozens,\" said Essig.
As is expected, a better diagnosis of the tumor will lead to better treatment.
\"In oncology, there is a golden rule that says the patient\'s outcome is very dependent on first-line treatment,\" Essig said . \".
\"Knowing where the malignant part of the tumor is from the very beginning, it is very important to develop an optimized treatment plan.
\"If the first treatment is ineffective, cancer will grow frequently during that time, which makes treatment more difficult.
In addition, patients are usually weakened by the side
The effect of ineffective treatment.
The new MRI technology is also of great help to the operating room.
Detailed images produced by functional techniques allow surgeons to remove cancer growth more precisely by helping them distinguish what is normal tissue and what is not.
For example, during surgery to remove the tumor, the surgeon may place the extracted tissue under a microscope in the operating room to ensure that they have removed all malignant growth.
But sometimes it is difficult to distinguish between normal and abnormal tissues.
\"The difference is so good that the human eye cannot tell the difference,\" Essig said . \".
The MRI of the new surgical innovation center is particularly useful in dealing with such situations, as during the procedure it can be moved to an adjacent operating room without interfering with the patient\'s determination that the malignant tissue has been removed.
\"During the procedure, they sometimes scan two or three times because they want to remove as many malignant tissues as possible,\" Essig said . \".
New MRI techniques can also be used to help patients with other brain injuries.
For example, a doctor can use MRIs to look at the head of a stroke patient to determine which parts of the brain are blocked by blood flow.
This allows surgeons to use advanced blood clots
Destruction treatment, including inserting a small device into the blood vessel to cut off the blockage.
New MRI techniques play an important role even after treatment, as they allow doctors to monitor the outcome and effectiveness of the treatment, including whether the patient has experienced any post-treatmentTreatment side
Effects such as attacks and headaches.
\"Our clinical partners want to know if the treatment is successful and they want to know if there are any side effects --
The effect of treatment, \"said Essig.
\"Patients may have new symptoms after treatment, and we will do some imaging to distinguish whether this is a temporary effect of treatment.
\"Part of Essig\'s role in the region is to ensure that new imaging technologies are implemented for the best interests of patients.
To this end, he began meeting with local experts from different disciplines such as oncology and neurology to discuss how perfusion MRI techniques can improve care.
An example of this collaboration is the weekly \"tumor rounds\", which provides an opportunity for Essig and delegates from the pathology, oncology and radiology departments to discuss the treatment process for new patients.
\"We discussed the next steps for these patients and how we can best treat their disease,\" he said . \".
\"We are all sitting on a boat, so we want to row together by sharing this information and finally getting feedback on whether our decision is correct or not.
\"Essig is responsible as chair of radiology at the University of Manitoba to ensure that students receive the best training.
To this end, he is working to launch a virtual anatomy and virtual pathology program that will use MRI images to help students better understand the anatomy of the human body and the development of the disease.
The idea is to give half of the students
An hour of lectures on a particular issue, and then have them browse the specially developed image dataset for detailed anatomical structures, for example, to locate the tumor in the case of a disease.
As long as there is the right software, slides from any scanner can be used to create data sets.
It turns out that Essig only had this software when teaching at Heidelberg University, and he is now working on importing this technology into Manitoba.
\"It was developed in a nearby town in partnership with a technical university.
\"I have spoken to them and they are willing to bring it over,\" he said . \" Virtual programs are fairly new, he added.
The training and clinical duties of Essig are closely related to his research.
\"This is the advantage of radiology --
Your field of research is so extensive.
You can make technical improvements.
You can improve the image quality.
\"You can study the correlation between imaging results and other laboratory results, clinical results, pathological results,\" he said . \".
In addition to his work as chair of the International Committee for the preparation of MRI protocols, Essig is already considering studies he would like to undertake with his Winnipeg research team, including radiologists and others at the University of Manitoba.
He believes that the use of imaging technology to advance opportunities in other medical fields, including testing the effectiveness of the latest treatment methods.
As Essig explains, functional MRIs can confirm whether treatment is effective by indicating, for example, whether blood flow is reduced in the most malignant part of the tumor tissue.
The question is: what is a significant decrease in blood flow?
\"Is it reduced by 20 per cent, 30 per cent or 40 per cent? \" asks Essig.
\"Unless we have a standardized measure, we can say that the blood supply of this patient is reduced by half, which effectively treats the tumor, we don\'t know. \" With well-
Oncologists will be able to determine more quickly whether the new treatment is appropriate for a specific patient.
It is also important that if it does not work, the doctor can change the route faster, rather than waiting for a few months on the road.
\"We have these tools, but the problem is that they are not standard practices yet, and that is what we have done,\" Essig said . \".
\"We are working hard, so we have a better understanding of the whole process.
Winnipeg is an ideal location for further development of this study, Essig said.
\"A lot of people ask, \'Why are you going to Winnipeg?
I told them it was because it allowed me to combine clinical and academic work in the best possible environment.
Joel Schlesinger is a writer in Winnipeg.
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