Dave Borczuk Internship

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Dave Borczuk Internship

  1. 1. A Summer Filled With Lymph Nodes Massachusetts General Hospital Molecular Imaging Department Boston, MA David Borczuk October 15, 2009
  2. 2. Mentors <ul><li>Dr. Sanjay Saini </li></ul><ul><ul><ul><li>Professor of Radiology, Harvard Medical School </li></ul></ul></ul><ul><li>Mukesh Harisinghani, M.D </li></ul><ul><ul><ul><li>Associate Professor of Radiology, Harvard Medical School Assistant Radiologist, Dept. of Abdominal Imaging  </li></ul></ul></ul>
  3. 3. Mentors <ul><li>Veena Iyer </li></ul><ul><ul><li>Research fellow who assisted me in my research. </li></ul></ul>
  4. 4. A Typical Workday: <ul><li>Catch the 9:48 AM commuter rail </li></ul><ul><li>Arrive at North Station at 10:30 AM </li></ul><ul><li>Start work </li></ul><ul><li>Lunch at 1:00 PM </li></ul><ul><li>Take train back home at 3:00 PM </li></ul>
  5. 5. Project 1 : Transitional Cell Carcinoma (TCC) <ul><li>Cancer of bladder or ureter lining. </li></ul><ul><li>Ages 50-70 y/o </li></ul><ul><li>Initial complaints: </li></ul><ul><ul><li>Hematuria (blood in urine) </li></ul></ul><ul><ul><li>Abdominal Pain </li></ul></ul><ul><li>Metastasis to lymph nodes </li></ul>
  6. 6. Transverse Pelvic/Abdominal CT http://emedicine.medscape.com/article/381323-overview Transitional Tumor
  7. 7. The Problem <ul><li>Tests can be negative or positive </li></ul><ul><li>Sometimes, tests can be wrong </li></ul><ul><ul><li>False Positives </li></ul></ul><ul><ul><li>False Negatives </li></ul></ul><ul><li>Goal : To test for false negatives </li></ul><ul><ul><li>Increase in node size in f/u CT = potential indication of TCC </li></ul></ul>
  8. 8. A Sample Spreadsheet
  9. 9. Project 2: Periportal Lymphadenopathy <ul><li>Periportal Lymph Node Enlargement </li></ul><ul><li>Causes </li></ul><ul><ul><li>Cancer </li></ul></ul><ul><ul><li>Cirrhosis of liver </li></ul></ul><ul><ul><li>Excessive alcohol consumption </li></ul></ul><ul><ul><li>Hepatitis (HCV and HBV) </li></ul></ul><ul><ul><li>AIDS </li></ul></ul><ul><ul><li>UNKNOWN? </li></ul></ul><ul><li>Goal: To explain this “unknown” cause! </li></ul>
  10. 10. Project 2: Periportal Lymphadenopathy <ul><li>2005-2007 patients with enlarged periportal lymph nodes </li></ul><ul><li>Noted if patient had any causes </li></ul><ul><li>No causes = included in study </li></ul>
  11. 11. Sample Spreadsheet
  12. 12. Conclusions <ul><li>Abstract to be presented 2010 </li></ul><ul><li>About 50-70 patients out of 700 had unexplained periportal lymph node enlargement. </li></ul><ul><li>Around 20 patients with negative TCC images were actually positive. </li></ul>
  13. 13. What I learned <ul><li>A vast amount of medical vocabulary and jargon. </li></ul><ul><li>Background of many types of cancers. </li></ul><ul><li>Ability to work with medical software. </li></ul><ul><ul><li>CAS (digital patient record system). </li></ul></ul><ul><li>How to read some types of CT and MRI images. </li></ul>

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