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.
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.
Selected Podcast
Radiology’s Vital Role in Cancer Care
Featured Speaker:
To learn more about Dr. Park
Jinha M. Park, MD, Ph.D.
Dr. Park is an experienced radiologist, specializing in oncology and body imaging, and is also a laboratory scientist. Dr. Park graduated from the Keck School of Medicine at University of Southern California (USC) in 2001, where he received his M.D., as well as his Ph.D. in Pathobiology. He then completed an internship in Internal Medicine at Kasier Permanente, Los Angeles, and a residency in Radiology at the UCLA Medical Center.To learn more about Dr. Park
Transcription:
Radiology’s Vital Role in Cancer Care
Melanie Cole (Host): Radiology is one of the cornerstones of any hospital. It’s a key diagnostic branch of medicine essential for the initial diagnosis of many diseases and it has an important role in monitoring a patient’s treatment and predicting the outcome. Radiology is the specialty considered to be both the eyes and ears of medicine. My guest today is Dr. Jinha Park. He is an experienced radiologist specializing in oncology and body imaging at City of Hope. Welcome to the show, Dr. Park. Tell us a little bit about what is diagnostic imaging and radiology.
Dr. Jinha Park (Guest): Thank you for having me on the show, Melanie. The specialty of diagnostic radiology in medicine is as the consultants to referring clinicians who call upon us to initially diagnose and stage and all of the treatments of the patient especially in a cancer hospital like ours, where the screening mammograms need to be interpreted. Our specialty, we’re physicians who interpret the images and then render a report for the diagnostic purposes of a treatment plan or for surgeons to know where to go in the operating room and to better remove tumors or lymph nodes that are involved. We’re very essential for aiding our colleagues who are the treating physicians. That’s not to say that in our specialty we don’t have a treatment arm as well. There’s a branch called interventional radiology and nuclear medicine where we use injected tracers for treatment of patients as well.
Melanie: How is this important for patient care? I know interventional radiologists do work directly with patients. Tell us, what does the patient get from working with you?
Dr. Park: The patients get a very clear image of the body acquired by our staff. We have radiologic technologists who are trained in acquiring x-rays or ultrasound technologists who take the ultrasounds and we take the images. These also include CT, MRI, and including PET-CT as well. Our specialty is the one that’s tasked with looking through the images of the inside of the patient’s body to get a very clear picture of where a tumor’s primary location is and if it has spread. That would better aid the surgeon or the treating hematologist or oncologist to pick the right chemotherapy to assist the surgeon after they remove the tumor to make sure that all the different tumor deposits are cleared. We’re very essential for that initial staging. It’s called staging when we look at all the lymph nodes and the metastasized tumor, as well as follow the treatments to see if the tumor therapy is working, if it’s radiation therapy or if it’s oncology chemotherapy. Then we can follow the patient over time with serial scans or repeated scans. That will help us change the therapy if it’s not working, or know that if it’s not working, then we really have to take a completely different tack and approach. That’s where our goal is.
Melanie: Aside from diagnosis and looking at mammograms and CT scans and knowing what you’re looking at, how do you plan something like radiation therapy for an individual patient? How do you go about setting up how many they might need, how long it’s going to take?
Dr. Park: Radiation oncology is a separate specialty of medicine that branched away from diagnostic radiology in the early ‘70s. Originally, we had both diagnostic radiology and radiation therapy in one department in the hospital. Those colleagues now are mostly primarily involved with treating with external beam radiation or implanted metal that has radioactive seeds inside them, for example, prostate brachytherapy where the radiation oncologist put that into the prostate gland to treat prostate cancer. It’s essential that they know exactly where to place the radiation beam. When we look at a breast MRI, we’re looking for the involvement nodes under the armpit so we can tell the radiation oncologist, “You have to treat this much, it has extended beyond the breast.” Or, for example, if there is a patient who has a metastatic bone lesion in the spine, we’ll be able to look at the spine MRI and say, “It’s at these levels in the upper back or it also involves the lower back,” so they can plan accordingly and aim their beams at multiple levels or just a single level where the patient’s involvement is.
Melanie: Dr. Park, what are some of the more interesting imaging technologies currently available at City of Hope?
Dr. Park: Currently with MRI, we’re doing whole body scans, and I think that’s going to be very important in the days of personalized medicine. Now that we’ve sequenced the entire human genome, the oncologist will ask for biopsies to be analyzed, and now that we have the technology and the computing power, we can get every gene sequence and look at the mutation pattern. There are new biologic therapies in variance with chemotherapy that are very targeted to proteins that are altered in certain types of organs. Now, it’s going to be essential to know that if a patient has, for example, the BRCA-1 or the BRCA-2 breast cancer gene mutation, that there are other mutations like Li-Fraumeni or the p53 mutation, that there are family members who are higher risk of cancer, and so that we can do a whole body MRI and that we can look for small tumors that are just developing at an early time, much like we have seen in mammograms, or the gastroenterologist do colonoscopies to find cancer at an earlier level or size that we can prevent its spread. That’s really exciting to me and that’s an area that I’m actively working on at City of Hope. That’s a new technique that I think will be used more commonly to assist the efforts with personalized medicine to scan the entire genes of the cancer patient.
Melanie: That’s amazing and fascinating. If you’re scanning an entire body in an MRI, what kind of radiation does that expose us to?
Dr. Park: Well, MRI is a different form of image acquisition inside the body. We take advantage of hydrogen atoms in water and fat molecules. They spin in a certain frequency in a very high-powered magnet. When a patient is in there, the spin of that proton or the H of the hydrogen of H2O, when it aligns it with the magnet and it spins like a top. If you imagine a top on a table, it spins and then it falls down. When it falls down, that gives off FM radio wave, and the FM radio wave is what the computer is detecting. That’s the only radiation that’s involved in an MRI. It’s not like an X-ray where there is a chance of causing a gene mutation. The MRI is very safe and so that’s why it’s very exciting to be able to use that technology.
Melanie: Tell us a little bit about the newer developments in radiology, Dr. Park, like the PET-CT scan imaging system that does both at the same time, kind of.
Dr. Park: The PET-CT has been around for more than 10 years now. Part of that in the ‘80s and ‘90s, the PET technology was limited because we couldn’t see the anatomical features of the structures or organs, but to marry the PET scan with the CAT scan, now you can see exactly where the radioactive tracer will localize to a tumor deposit or a lymph node or a bone metastasis. The really exciting thing is getting a PET-MRI, which we don’t have quite yet, but we’re in the process of acquiring one in the next year. The PET-MRI fuses both technologies of very cancer-specific localization of radioactive tracer on the PET. It’s a very small, miniscule amount of radiation, but coupling that with the MRI which avoids the X-ray radiation. Those images are very explicit; MRI inherently has very good resolution. When you hear about a professional sport getting the MRI for an injury, you can delineate muscles, tendon, and ligament, and so imagine where we can marry those two technologies together. At City of Hope, we’re doing revolutionary research where we’re taking FDA-approved antibody biologic therapies, such as a drug called receptin, and we’re putting that radioactive tracer to do very tumor-specific imaging of a patient who may have that cancer gene mutation. We’re going to do some more research studies on PET-MRI with specific biologic tracers that can very specifically localize that tumor that have that cancer genetic mutation for which he or she can get that therapy. Personalized medicine is going to be here to stay, and that new tool is going to be very exciting for us at City of Hope.
Melanie: That is so interesting, Dr. Park. In just the last 30 seconds or minute, please give the listeners your best advice about why radiology is so important and its vital role in cancer care and why people should come to City of Hope for their care.
Dr. Park: Well, radiology is… we are so privileged to be able to be the physicians who look inside the body without using a scalpel to cut open and look for the abnormality. We’ve been trained to look for what’s normal and then what’s abnormal, and for screening, for surveillance, for re-staging, to see if a treatment is working or not, then we move on to a new one if it’s not. I think imaging is very, very important for a cancer patient’s care and to improve upon the clinical trials that we’re doing to see if there’s a new drug that’s working or not working so we can move to new drugs that are more effective. Radiology is so important and we have state-of-the-art equipment here to assist our colleagues in treating patients.
Melanie: That is so great. Thank you so much, Dr. Park. You are listening to City of Hope Radio. For more information, you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.
Radiology’s Vital Role in Cancer Care
Melanie Cole (Host): Radiology is one of the cornerstones of any hospital. It’s a key diagnostic branch of medicine essential for the initial diagnosis of many diseases and it has an important role in monitoring a patient’s treatment and predicting the outcome. Radiology is the specialty considered to be both the eyes and ears of medicine. My guest today is Dr. Jinha Park. He is an experienced radiologist specializing in oncology and body imaging at City of Hope. Welcome to the show, Dr. Park. Tell us a little bit about what is diagnostic imaging and radiology.
Dr. Jinha Park (Guest): Thank you for having me on the show, Melanie. The specialty of diagnostic radiology in medicine is as the consultants to referring clinicians who call upon us to initially diagnose and stage and all of the treatments of the patient especially in a cancer hospital like ours, where the screening mammograms need to be interpreted. Our specialty, we’re physicians who interpret the images and then render a report for the diagnostic purposes of a treatment plan or for surgeons to know where to go in the operating room and to better remove tumors or lymph nodes that are involved. We’re very essential for aiding our colleagues who are the treating physicians. That’s not to say that in our specialty we don’t have a treatment arm as well. There’s a branch called interventional radiology and nuclear medicine where we use injected tracers for treatment of patients as well.
Melanie: How is this important for patient care? I know interventional radiologists do work directly with patients. Tell us, what does the patient get from working with you?
Dr. Park: The patients get a very clear image of the body acquired by our staff. We have radiologic technologists who are trained in acquiring x-rays or ultrasound technologists who take the ultrasounds and we take the images. These also include CT, MRI, and including PET-CT as well. Our specialty is the one that’s tasked with looking through the images of the inside of the patient’s body to get a very clear picture of where a tumor’s primary location is and if it has spread. That would better aid the surgeon or the treating hematologist or oncologist to pick the right chemotherapy to assist the surgeon after they remove the tumor to make sure that all the different tumor deposits are cleared. We’re very essential for that initial staging. It’s called staging when we look at all the lymph nodes and the metastasized tumor, as well as follow the treatments to see if the tumor therapy is working, if it’s radiation therapy or if it’s oncology chemotherapy. Then we can follow the patient over time with serial scans or repeated scans. That will help us change the therapy if it’s not working, or know that if it’s not working, then we really have to take a completely different tack and approach. That’s where our goal is.
Melanie: Aside from diagnosis and looking at mammograms and CT scans and knowing what you’re looking at, how do you plan something like radiation therapy for an individual patient? How do you go about setting up how many they might need, how long it’s going to take?
Dr. Park: Radiation oncology is a separate specialty of medicine that branched away from diagnostic radiology in the early ‘70s. Originally, we had both diagnostic radiology and radiation therapy in one department in the hospital. Those colleagues now are mostly primarily involved with treating with external beam radiation or implanted metal that has radioactive seeds inside them, for example, prostate brachytherapy where the radiation oncologist put that into the prostate gland to treat prostate cancer. It’s essential that they know exactly where to place the radiation beam. When we look at a breast MRI, we’re looking for the involvement nodes under the armpit so we can tell the radiation oncologist, “You have to treat this much, it has extended beyond the breast.” Or, for example, if there is a patient who has a metastatic bone lesion in the spine, we’ll be able to look at the spine MRI and say, “It’s at these levels in the upper back or it also involves the lower back,” so they can plan accordingly and aim their beams at multiple levels or just a single level where the patient’s involvement is.
Melanie: Dr. Park, what are some of the more interesting imaging technologies currently available at City of Hope?
Dr. Park: Currently with MRI, we’re doing whole body scans, and I think that’s going to be very important in the days of personalized medicine. Now that we’ve sequenced the entire human genome, the oncologist will ask for biopsies to be analyzed, and now that we have the technology and the computing power, we can get every gene sequence and look at the mutation pattern. There are new biologic therapies in variance with chemotherapy that are very targeted to proteins that are altered in certain types of organs. Now, it’s going to be essential to know that if a patient has, for example, the BRCA-1 or the BRCA-2 breast cancer gene mutation, that there are other mutations like Li-Fraumeni or the p53 mutation, that there are family members who are higher risk of cancer, and so that we can do a whole body MRI and that we can look for small tumors that are just developing at an early time, much like we have seen in mammograms, or the gastroenterologist do colonoscopies to find cancer at an earlier level or size that we can prevent its spread. That’s really exciting to me and that’s an area that I’m actively working on at City of Hope. That’s a new technique that I think will be used more commonly to assist the efforts with personalized medicine to scan the entire genes of the cancer patient.
Melanie: That’s amazing and fascinating. If you’re scanning an entire body in an MRI, what kind of radiation does that expose us to?
Dr. Park: Well, MRI is a different form of image acquisition inside the body. We take advantage of hydrogen atoms in water and fat molecules. They spin in a certain frequency in a very high-powered magnet. When a patient is in there, the spin of that proton or the H of the hydrogen of H2O, when it aligns it with the magnet and it spins like a top. If you imagine a top on a table, it spins and then it falls down. When it falls down, that gives off FM radio wave, and the FM radio wave is what the computer is detecting. That’s the only radiation that’s involved in an MRI. It’s not like an X-ray where there is a chance of causing a gene mutation. The MRI is very safe and so that’s why it’s very exciting to be able to use that technology.
Melanie: Tell us a little bit about the newer developments in radiology, Dr. Park, like the PET-CT scan imaging system that does both at the same time, kind of.
Dr. Park: The PET-CT has been around for more than 10 years now. Part of that in the ‘80s and ‘90s, the PET technology was limited because we couldn’t see the anatomical features of the structures or organs, but to marry the PET scan with the CAT scan, now you can see exactly where the radioactive tracer will localize to a tumor deposit or a lymph node or a bone metastasis. The really exciting thing is getting a PET-MRI, which we don’t have quite yet, but we’re in the process of acquiring one in the next year. The PET-MRI fuses both technologies of very cancer-specific localization of radioactive tracer on the PET. It’s a very small, miniscule amount of radiation, but coupling that with the MRI which avoids the X-ray radiation. Those images are very explicit; MRI inherently has very good resolution. When you hear about a professional sport getting the MRI for an injury, you can delineate muscles, tendon, and ligament, and so imagine where we can marry those two technologies together. At City of Hope, we’re doing revolutionary research where we’re taking FDA-approved antibody biologic therapies, such as a drug called receptin, and we’re putting that radioactive tracer to do very tumor-specific imaging of a patient who may have that cancer gene mutation. We’re going to do some more research studies on PET-MRI with specific biologic tracers that can very specifically localize that tumor that have that cancer genetic mutation for which he or she can get that therapy. Personalized medicine is going to be here to stay, and that new tool is going to be very exciting for us at City of Hope.
Melanie: That is so interesting, Dr. Park. In just the last 30 seconds or minute, please give the listeners your best advice about why radiology is so important and its vital role in cancer care and why people should come to City of Hope for their care.
Dr. Park: Well, radiology is… we are so privileged to be able to be the physicians who look inside the body without using a scalpel to cut open and look for the abnormality. We’ve been trained to look for what’s normal and then what’s abnormal, and for screening, for surveillance, for re-staging, to see if a treatment is working or not, then we move on to a new one if it’s not. I think imaging is very, very important for a cancer patient’s care and to improve upon the clinical trials that we’re doing to see if there’s a new drug that’s working or not working so we can move to new drugs that are more effective. Radiology is so important and we have state-of-the-art equipment here to assist our colleagues in treating patients.
Melanie: That is so great. Thank you so much, Dr. Park. You are listening to City of Hope Radio. For more information, you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks so much for listening.