Cancer screening with full-body MRI scans and a seminar on the field of radiology | Rajpaul Attariwala, M.D., Ph.D. (#61 rebroadcast)

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Jul 3, 2023

Raj Attariwala, a dual board-certified radiologist and nuclear medicine physician, joins to reveal how his engineering background led to groundbreaking MRI technology for cancer detection. He discusses the unmatched resolution of full-body scans and the critical topics of sensitivity, specificity, and the risks of false positives in cancer screening. The conversation also covers the evolution of imaging technologies from X-rays to MRIs, emphasizing the innovations aimed at enhancing diagnostic accuracy while mitigating radiation exposure risks.

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INSIGHT

Ultrasound Mechanics

Ultrasound uses high-frequency sound waves, not ionizing radiation, to create images.
It works like an echo, reflecting sound waves off tissue interfaces to determine depth.

ANECDOTE

Prenatal Ultrasound & Skill

Prenatal ultrasounds use sound waves, posing no radiation risk to the fetus.
The skill of the technician is crucial in ultrasound, more so than having the most advanced equipment.

INSIGHT

Mammography and Breast Density

Mammography is a low-attenuation X-ray that effectively penetrates fatty breast tissue.
Dense breast tissue, common in younger and some older women, limits mammogram effectiveness, necessitating additional imaging like ultrasound or MRI.

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In this episode, radiologist/engineer, Raj Attariwala, explains how he was able to apply his engineering background to create a unique MRI scanner that is capable of constructing whole-body images with a resolution that is unmatched in the industry. Peter and Raj discuss the implications of such a robust, radiation-free imaging tool on the early detection of cancer. They dive deep into cancer screening and define terms such as sensitivity and specificity that are necessary to really understand this complex space. They then describe the biggest risks involved in this type of screening (false positives) and how Raj's unique technology and process might drive down this risk substantially. But before that, they discuss all the common imaging technology from X-ray, to CT scan, to PET scans, to ultrasound, to MRI, and more. They touch on the history of each, how they work, the usefulness and limitations of each of them, as well as the varying risks involved such as radiation exposure. If you are interested in cancer screening and/or you've ever wondered how any radiology tool works, this episode is for you.

We discuss:

Raj's road from engineering to radiology [2:45];
How X-ray works, the risk of radiation exposure, and the varying amounts of radiation associated with the different imaging technologies [13:00];
Computed tomography scans (CT scans): The history of CT, how it works, and why we use contrast [22:45];
Ultrasound: Benefits and limitations, and a special use for the heart [36:00];
Detecting breast cancer with mammography: When is works, when you need more testing, and defining 'sensitivity' and 'specificity' [46:15];
Magnetic resonance imaging (MRI): How it works, defining terms, and looking at the most common types of MRI [59:00];
Brain aneurysms: Using MRI to find them and save lives [1:18:45];
Raj's unique MRI technology [1:25:15];
The risk of false positives in cancer detection, and how Raj's MRI can reduce the number of false positives (i.e., increase specificity) [1:38:45];
The unique software Raj created to pair with his MRI machine [1:46:15];
Comparing the radiation exposure of a whole-body PET-CT to Raj's equipment (DWIBS-MRI) [1:48:45];
How diffusion-weighted magnetic resonance imaging (DW-MRI) has revolutionized cancer screening [1:50:15];
Why a DW-MRI is still not a perfect test [1:54:15];
The potential for advancing MRI technology: Where does Raj think it could improve in the next 5-10 years? [1:58:00];/li>
Are there any commercially available scanners that can match the resolution of Raj's images? [2:01:00];
Machine learning: When and where might machine learning/AI impact the field of radiology? [2:03:45]; and
More.

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