Week 5: Their efforts were not in vein…

This week, I completed the SUV and texture analysis comparison between MRI and PET scans for six patients. The preliminary results suggest that there is no linear correlation between SUV of PET and MRI. However, there may be a linear correlation in histogram entropy between MRI and PET. Histogram entropy is a measure of the uncertainty in image values; the wider the histogram spread the bigger the entropy. This could indicate that MRI can pick with the increased textured near prostate cancer lesion that is observed in PET, however that difference is too small to be seen by human eyes. To further prove this hypothesis, we need to compare non-cancerous prostate between MRI and PET scans to see whether the linear correlation persists. Next week I plan to incorporate 12 patients’ data and see if any new correlation arises. I also plan to segment non-cancerous prostate from the images and observe the texture analysis correlation between that and cancerous prostate tissue.

One of the unforgettable and incredible experiences of this summer experience was watching an angioplasty, or unblocking of the major vein, in the leg and thigh. Due to a blood clot in the saphenous vein, the doctors put a clip above clot, to prevent it from spreading to other areas of the body and causing a heart attack or stroke. However, that clip allowed a build of clot below it until the patient’s entire left major vein was clotted and unusable. It took the interventional radiologist that I was shadowing, Dr. Anuh Malhotra about 30 minutes, to put a wire up through the entire vein to remove the clot. Because of the difficulty even starting the procedure, I could feel how discouraged everyone in the procedure room was, including myself. I suddenly realized that doctors can never leave in frustration in the middle of their work, which I do numerous times. Somehow, Dr. Malhotra was able to move the wire through the clip by moving it through the teeth. Then he used a machine called an Angiojet, to spray a chemical that breaks up the clots and makes them easier to remove. The Angiojet then used a pressured vacuum to suck the clotted blood. It took about four and a half hours to remove all the clot inside the patient’s left vein. I could feel myself getting tired and I wasn’t even doing anything productive. Dr. Malhotra used the wire to place a balloon under the clip and used just enough pressure to open the balloon so that the clip would pop open. He then placed stents around the location of the previous clip to give the vein added stability. This entire process took about an hour. I was shocked at the endurance and confidence of the people in the procedure room. Even though it was a difficult and high risk surgery, because they could have just burst the patient’s vein, it was done very smoothly. I realized that doctors not only have to be smart, but they also have to be mentally stable and keeping working even when things seem to go wrong. I was very inspired after the surgery and hope that I get to see more interventional radiology procedures before it is time to leave this summer program.