Feature: MSU Radiology Advances with Amazing Technology

'Any sufficiently advanced technology is indistinguishable from magic.' -- Arthur C. Clarke

'This is the most amazing technology we could have imagined.' -- Dr. Laura Symonds, MSU Assistant Professor of Psychiatry/Radiology

            Imagine watching a brain caught in the act of thinking. Imagine watching a heart beat, the valves opening and closing, the sponge-like muscle ka-thumping in the chest. Now, imagine no more. All of this is now possible at MSU's Dept. of Radiology, which enjoyed a marvelous 1998.

             A new, beyond state-of-the-art building was officially opened for business, instantly making it one of the premiere virtual radiology centers in the world. In addition, major upgrades on MSU's MRI facility will give health care professionals and scientists views of human anatomy that a few years ago they could only have imagined. Here are some early reviews:

            'This is the most amazing technology we could have imagined,' says Laura Symonds, an assistant professor with appointments in the Depts. of Radiology and Psychiatry.

             'The spectrum of things we can do now is greatly broadened,' says Mark DeLano, assistant professor of radiology and director of research.

But most pithy was James Potchen, radiology chairperson, who says: 'This is big stuff.'

THE 'LAST GREAT BLACK BOX

            When Potchen discusses the intricacies of the brain, he tends to offer more questions than answers. What does a deaf person think when he or she reads? How does one person's perception of reality differ from another's? How do different people see the same world? 'These are fascinating questions,' he says. 'The brain is the last great black box. We're looking for ways to get in there and figure out how it's wired.'

            They are literally getting into people's heads by using new and vastly improved methods of MRI, a diagnostic imaging technique that provides extremely detailed images of the body's soft tissues. By use of a powerful magnet which interacts with sophisticated radio waves, MRI gives health care professionals a wealth of information, all without the use of often-dangerous radiation.

            The new technique, called functional brain imaging, is giving doctors and scientists the ability to actually 'watch' a brain while it's thinking. 'In the past, we would take the brain out of a patient, cut it up and see what it looks like,' DeLano says. 'Of course, that's rather crude and,' he adds with a smile, 'it's difficult to help people while they're still alive.'

            The concept of 'brain watching' is rather simple. When a certain part of the brain is working harder, more blood flows to that part. 'That's what we call activation,' says DeLano, who also is physician director of the MRI Center. 'It's just like in the heart--if you call on it to work harder, it requires more blood flow. We simply take pictures of where the blood flow is different. To be able to do that in living humans is a nice treat.'

            This obviously opens up a whole new world not only for radiologists, but psychiatrists, psychologists and others who study the ways of the mind. Consider depression, the 'common cold of mental health problems,' which affects some 15 million Americans--about five percent of the population. Using this new technology, scientists can take a picture of a depressed person's brain and see how it differs from one not suffering from depression. 'Now,' says DeLano, 'you can have an objective measure of how things are working, rather than just subjective measures.

            'And, of course, we know what is or isn't working, steps can be taken to help the problem. If a person's brain is working differently--not processing information properly--can it be helped with drugs?' DeLano asks. 'Or maybe they can be helped with therapy.'

            Functional brain imaging could make a major impact in helping victims of stroke. Today, in most cases, the severity of damage from a stroke cannot be estimated until a patient manifests symptoms. By that time, it's usually too late to help. But imagine capturing an image of a stroke victim's brain within the first crucial minutes--actually seeing where blood is flowing, where it isn't, and what exactly is either damaged or about to be damaged. 'We can now detect it within minutes and that's the time that's most important because you can intervene, you can make some treatment decisions based on this,' DeLano says. 'If we can limit the extent of the stroke, improve blood supply to the areas that don't have the stroke yet, then we can really have some impact.'

            Another project DeLano and Co. have begun is what he calls 'brain mapping.' Essentially, what they're doing is an 'inventory' of the brain--figuring out what part of the brain is responsible for what function. Again, the potential is enormous. For example, if a person is to undergo surgery for removal of a brain tumor, this will give surgeons a better idea of what areas of the brain to avoid and what some of the potential risks are. 'This eliminates some of the guess work,' he says. 'Right now we have a pretty good idea based on the surface anatomy of the brain. But to see functional anatomy, to see exactly where things are happening, that's going to be a real useful thing.'

            Other people who stand to benefit from this new technology are those suffering from maladies such as Alzheimer's disease, attention deficit disorder and dyslexia. Symonds says much of the work in those areas has been theoretical, until now. 'We are perfectly poised to use this technology,' she says. 'We've done lot of experimental work. Now we're ready for the next step.'

THE HEART OF THE MATTER

            Heart disease is no small matter. Consider these numbers: It's the leading cause of death in the U.S., claiming more than 42 percent of the 2.3 million Americans who die every year. In 1997, a quarter of all health care expenditures--$260 billion--went toward the treatment of cardiovascular disease. Unfortunately, determining if someone is suffering from heart disease can sometimes be more dangerous than the disease itself. One of the more common ways of assessing heart function is to insert a catheter through the body and into the heart. This invasive procedure--known as a catheter angiogram--is fraught with danger as it involves injecting a dye into the body, a dye that can sometimes have adverse or even fatal reactions from patients.

             At MSU, work is underway to use MRI to capture the images of the heart in action. So far, so good, says DeLano. 'We've been getting some really remarkable images,' he says. 'It's sort of like an echo-cardiogram in which we can actually watch the heart move through the heart cycle.'

             Will MRI ever totally replace the standard coronary angiogram? MSU, in partnershp with the General Electric Corp., is on the verge of a new study to determine if MRI is a more effective way of imaging blood flow through the heart, which is also known as perfusion. 'For the past year, we've been determining the protocol--how to do the study,' DeLano says. 'Now that our technology is up to speed, we can get started and hopefully see a favorable comparison to the coronary angiogram.'

            Presently, the coronary angiogram and other imaging methods--including echocardiography and nuclear medicine--have an accuracy rate of around 80 percent. DeLano is hopeful MRI will not only show a greatly improved accuracy rate, but will be able to detect certain diseases which are currently undetectable through other methods. 'If we can get a better test that gives information on perfusion, how the heart contracts, on the viability of the muscle itself, whether or not a patient would benefit from bypass surgery, and so on, then we'd really have something,' DeLano says.