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.
Learn more about becoming a patient at City of Hope by visiting us online or by calling 800-826-HOPE (4673). City of Hope staff will explain what’s required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.
Donating blood and platelets saves lives. We all know this. Yet every summer, potential blood donors become distracted by vacations and schedule changes. As a result, blood donations fall dramatically across the nation, leaving hospitals frantically trying to bring in much-needed blood for their patients.
Earlier this week, the American Red Cross sent out an urgent appeal for blood, reporting that donations are down about 8 percent over the past 11 weeks. “The shortfall is significant enough that the Red Cross could experience an emergency situation in the coming weeks,” the organization said on its website.
Hospitals with trauma and emergency departments aren’t the only institutions that need blood. City of Hope patients need more than 37,000 units of blood and platelets each year. In comparison, City of Hope’s Michael Amini Transfusion Medicine Center brings in about 22,300 units of blood and platelets each year, not nearly enough to meet the hospital’s needs. » Continue Reading
To be a great cancer hospital, you need a great oncology program. Just ask City of Hope – and Becker’s Hospital Review.
The health care publishing industry stalwart, described as the “leading hospital magazine for hospital business news and analysis for hospital and health system executives,” recently selected City of Hope to its 2014 edition of “100 Hospitals and Health Systems With Great Oncology Programs.”
The inclusion on the list likely comes as no surprise to City of Hope patients and their families, but outside recognition of top quality is always welcome. In offering its list, Becker’s Hospital Review includes this important note: “Organizations cannot pay for inclusion on this list.”
That’s an important distinction, one that isn’t always true for many such lists. » Continue Reading
Diagnostic errors are far from uncommon. In fact, a recent study found that they affect about 12 million people, or 1 in 20 patients, in the U.S. each year.
With cancer, those errors in diagnosis can have a profound impact. A missed or delayed diagnosis can make the disease that much harder to treat, as the Agency for Healthcare Quality and Research recently noted in calling attention to the diagnostic errors research.
This means that patients who’ve been diagnosed with cancer shouldn’t always assume that either the diagnosis or their options are precisely what they’ve been told. Sometimes a cancer has progressed more than the diagnostic tests suggest; sometimes it’s progressed less. And sometimes the diagnosis is completely off-base.
Clayton S. Lau, M.D., associate clinical professor and an expert in testicular cancer surgery at City of Hope, explains the difference that second opinions can make in getting a proper cancer diagnosis and care. » Continue Reading
Eleven years ago, lymphoma patient Christine Pechera began the long road toward a cancer-free life.
She had been diagnosed with non-Hodgkin lymphoma and told by doctors elsewhere that her lifespan likely would be measured in months, not years. Refusing to give up, she came to City of Hope for a second opinion. There, she received her first encouraging words. She began treatment soon after watching the Tournament of Roses Parade in Pasadena, an event that she’d watched as a child and that she thought she might never see again.
After undergoing chemotherapy, radiation and an autologous stem cell transplant – a procedure using her own stem cells – Pechera returned to health, only to relapse in 2005.
She can still find the YouTube video pleading for help in the search for a matching bone marrow donor. Because she was Filipino, matches were hard to come by; her search was even featured on “Nightline,” highlighting the need for more diversity among donors. Finally, a man in Hong Kong – who never saw the video or “Nightline” – was identified as a match.
His stem cells – and the expertise of City of Hope’s lymphoma experts – saved Pechera’s life. The journey that began with a poor prognosis at another institution brought her back to the Rose Parade on January 1 of this year. This time, the former lymphoma patient rode on City of Hope’s float, paying tribute to the fact that the dream of being cancer-free can be within reach, even in some of the toughest cases. » Continue Reading
Brain surgery is not for the faint of heart. It takes courage, as well as curiosity and compassion. The truly great surgeons also have a desire to find new, and better ways, of healing the brain. Enter Behnam Badie, M.D., chief of neurosurgery at City of Hope.
Now a pioneer in brain tumor treatment, Badie entered medicine because of encouragement from his father. Healthy at the time, the family patriarch later succumbed to a brain tumor, the type of cancer in which his son now specializes.
Driven in part by that experience, Badie has since gone beyond the operating room. He wanted to help not just today’s patients, but also tomorrow’s patients. Through collaborations with other scientists and other clinicians, he knew he could conduct groundbreaking research that would help both. » Continue Reading
Elizabeth Budde, M.D., Ph.D., wants to encourage infighting. She aims to turn the immune system on itself — to the benefit of patients with acute myeloid leukemia, or AML.
AML arises when abnormal white blood cells grow out of control, amassing in the bone marrow and interfering with normal blood cell development. Blood stem cell transplants are the only hope of cure for most patients with AML; however, many patients eventually see their cancer return.
Budde wants to give patients with relapsed AML a fighting chance by giving them modified white blood cells that attack their malignant cousins.
Her work is garnering increased attention. Budde, an assistant professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope, has been chosen as The Jake Wetchler Foundation for Innovative Pediatric Cancer Research-Damon Runyon Cancer Research Foundation Clinical Investigator. The accompanying $450,000 grant will support her studies for the next three years.
Six, to date; more soon. Outpatient bone marrow transplants, that is.
Finding new ways to deliver quality care with the greatest benefit is a priority for a patient-centered institution like City of Hope. For example, not every bone marrow transplant patient needs to check into the hospital for treatment. In fact, some might even benefit from remaining outpatients.
City of Hope’s new day hospital is designed to address their needs.
Studies have shown that day hospitals can meet clinical standards for bone marrow transplants without compromising patient quality of care. They allow patients to be treated as outpatients rather than inpatients, which lets them go home after their treatment. The result can be greater patient satisfaction and an improved patient experience. » Continue Reading
The best measure of success in the fight against cancer is in lives saved and families intact, in extra days made special simply because they exist.
Yuman Fong, M.D., chair of the Department of Surgery at City of Hope, understands what precedes that special awareness. When cancer strikes, one minute a person may feel healthy and young, he says, and in the next, they’re wondering how many years they have left.
In those situations, expertise matters. Commitment to research, knowledge of new therapies, unrelenting dedication to quality and improvement all play a role in the best possible cancer care. City of Hope has those factors. But the best measure of cancer care is cancer outcomes – and City of Hope has those, too.
In cancer, expertise matters. So do survival rates, patient safety, patient services and many other factors. City of Hope understands this, as does U.S.News & World Report.
The magazine’s 2014-2015 list of best hospitals for cancer once again includes City of Hope, ranking the institution 12 out of 900 eligible for consideration. The annual rankings recognize the nation’s premier hospitals, and inclusion on the list is widely considered an indicator of quality care.
City of Hope’s ranking is three positions higher than last year’s ranking and marks the 11th year that City of Hope has made the “Best Hospitals” list for cancer treatment. The ranking – above the ranking of many other nationally known and considerably larger institutions – highlights the institution’s increasing reputation for high quality care and outcomes. » Continue Reading