Memorial Sloan-Kettering Cancer Center Presents High School Essay Contest Winner

Daniel Spindler wins "Radiology Giving Back to New York" contest

Memorial Sloan-Kettering Cancer Center's Department of Radiology, in conjunction with the New York Roentgen Society and the New York City Department of Education, was happy to celebrate our annual "Radiology Giving Back to New York" high school program, which took place on April 29th, 2011. The program introduces high school juniors from all five boroughs of New York City to the broad spectrum of careers in radiology. Every year New York City high school students join us for a day of activities, including a hands-on ultrasound workshop and interactive lectures from renowned radiologists as well as radiology nurses, technologists and administrators from MSKCC. To participate, students must enter an essay contest on the topic “How Has Radiology Improved Health Care”. Prizes are awarded and the 1st place-winning essay is published on the Elsevier homepage.

This year we are proud to present this year’s winning essay, by Daniel Spindler, from New Dorp High School in Staten Island, NY:

Rector Wilhelm Conrad Roentgen saw a barium platinocyanide screen glow when exposed to an unknown radiation from a cathode ray tube. He then experimented on his wife by placing her hand in front of a photographic plate and was able to see her bones. From this moment, medicine was destined to change (Chen 2004). Radiology has changed health care all over the world in almost every environment. Many people, such as Antoine-Henri Becquerel, Max Von Laue, and others, helped improve the x-ray, but without Roentgen’s initial discovery there is a good chance that we would still be using older forms of diagnosis and treatment. Radiology has helped improve health care in many ways, including medical research, treatment, and diagnosis (rtstudents.com 2010).

Guido Lanfranc was a surgeon that lived hundreds of years before Roentgen. He would check for skull fractures by having the person put a violin string between their teeth. If the sound was not clear, they were thought to have a fracture. Radiology has changed the diagnosis of fractures (Barrett 2002). Sprains were often treated as fractures because there was no way to be certain that there wasn't a true break. Now radiology has changed medical diagnosis not only for fractures, but for many other conditions as well. Using sound waves, ultrasound started being used for diagnosis in the 1950's. It can be used to diagnose problems with most internal organs, and it also takes a person's first picture, which can be used to diagnose limb, heart and spine abnormalities in fetuses (Woo 1998-2001). More recently, special techniques called PET, CT, and MRI scans have changed diagnosis. CT scans, or computerized tomography, sends x-rays through the body to detectors, and the information is interpreted by a computer that generates 2D or 3D images of bones and organs. PET stands for positron emission tomography, which traces radioactive materials to determine the metabolism or function of a part of the body. Lastly, MRI uses strong magnetic fields and radio pulses to generate images with a computer of any part of the body. It has the advantage of not exposing the person to radiation. The newest techniques for diagnosis combine PET and CT scans to determine whether someone has cancer or if it is getting worse. It can also tell the difference between dementia and Alzheimer's disease (NYU Diagnostic Imaging Center 2005). This combination of techniques has also proven useful for medical research.

Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) have not only contributed to clinical practice but also to medical research. MRI and the PET scan both help to see things that we previously could not see within both normal and diseased brains, particularly in the area of cerebral blood flow. This has been useful in research on strokes, tumors, nerve function and even the effects of cocaine (Journal of Cerebral Blood Flow 2011). Some of the most remarkable areas of modern radiology involve how patients are treated.

Radiology has also helped doctors find less invasive ways of making sure different body parts are functioning properly. Now Endoscopic Ultrasound and Fine Needle Aspiration are used together to diagnose and stage lung cancer (Silvestri 1996). Also Radiation Oncology has become an important tool in treating cancers. Doctors use chemotherapy and radiation together to help improve the effects of the radiation. Doctors can give patients radiation treatments for inoperable tumors to save lives that were previously untreatable. There are also new types of radiation treatments, such as stereotactic radiation, and partial radiation therapy. Stereotactic radiation uses focused beams targeting a tumor to deliver the radiation dose accurately so that it minimizes the exposure of radiation to noncancerous tissues. Partial radiation therapy minimizes the radiation by having a balloon inserted into organs and putting radioactive seeds in it for a few days. Another treatment uses focused ultrasound uses sound waves to create heat to treat cancer. It was not able to be used before MRI, because it needed to be carefully targeted. A new treatment is radioimmunotherapy, where antibodies to a tumor are joined to a radioactive substance that can treat the spread of cancer. This will even work on a metastasis that the doctor does not know about (New York Presbyterian 2008).

Radiology has greatly improved health care in many ways and will continue to help people in ways that we cannot possibly foresee. In the last 116 years, we have found so many uses for Radiology that it has become one of the most important areas in health care today. Many people would not be alive if it weren’t for Radiology. Radiology has helped doctors make more accurate diagnoses. It also helps with medical research since we now can study the reactions in the brain with MRI /PET scans. It will help us learn how drugs affect us and help us understand many diseases such as Alzheimer's disease. Patient treatment has changed, whether through radiation therapy or by assuring a doctor that there is a fracture instead of a sprain. All in all, without Radiology, health care would be a whole different experience. We might still be asking patients to bite down on violin strings, and people might have to be surgically split open to biopsy a small tumor. Radiology truly has been the force behind the changes in medicine.

Bibliography
America, Radiology Society of North. Procedures A to Z
Assmus, Alexi. Early History of X Rays. 1995
Barrett, Erwin and Jack Mingo. Doctors Killed George Washington. Berkeley, CA: Conari Press, 2002
Chen, Michael, Thomas Pope and David Ott. LANGE: Basic Radiology. New York: McGraw Hill Medical, 2004
Journal of Cerebral Blood Flow and Metabolism. 2011
Key Dates in Radiology History
NYU Department of Radiology: What is PET/CT? 2005
Radiation Oncology: Advances - NY Presbyterian. 2008
Robison, Robert. History of Radiation Therapy
Sanghvi, Harisinghani MG. "Modalities in Modern Radiology: A synopsis." J Postgrad Medicine (2010): 56:85-7
Silvestri, Gerard, et al. "Endoscopic Ultrasound With Fine-Needle Aspiration in the Diagnosis and Staging of Lung Cancer." The Annals of Thoracic Surgery (1996)
Society of Interventional Radiology: The History of Interventional Radiology
Woo, Joseph. A short History of the development of Ultrasound in Obstetrics and Gynecology . 2002

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