Anatomy of a good talk

I listened to a very interesting talk recently (via GoogleTech Talks--if the link is broken, search for Breakthroughs in Imaging Neurovascular diseases such as Multiple Sclerosis ...). Mark Haacke, the speaker, had some years ago developed Susceptibility Weighted Imaging (SWI)--an MR modality that uses the phase information in a signal to image iron deposits in the brain. His talk is interesting because there is a story, a narrative, built around this endeavour and his efforts to find important clinical applications. Indeed, he has linked his research to Paolo Zamboni's work with multiple sclerosis (MS). (There is a Facebook group advocating a Nobel prize for Zamboni so a significant impact is projected.)

For those of us in research it is always rewarding to witness--even from afar--the full lifecycle of an idea or concept. Haacke shows how he develops the method (it is really just another case of using parts of the signal that were being filtered out as noise); verifies (with Xray fluorescence--XRF) that what they are looking at is iron; looks for and finds iron deposits in the veins and brain tissue of patients with MS and other neurological diseases (which suggests that excess iron is a biomarker for these kinds of conditions); makes a case for the quantitative analysis of the venous system (the other half of the better explored arterial system); identifies new imaging applications such as the previously unseen microbleeds in patients with traumatic brain injury (TBI); presents temporal data to show the build-up of iron and finally links this aggregation with Zamboni's hypothesis that the narrowing or stenosis of veins (such as the internal jugular vein--IJV) that drain out of the brain, creates a reflux which subsequently results in the accumulation of iron.
It remains to be seen if multiple sclerosis and other neurodegenerative diseases have a vascular origin but at the very least, the evidence--presented in various ways in this talk--shows a strong cause.

Haacke ends by listing specific ways in which "technical people" can get involved. He suggests ways to quantify blood flow, develop biomarkers, track patients, develop databases and develop new sponsership models to fund all this work. It's a very complete talk in this sense and the right way to invite people with different kinds of expertise in.

The talk is pitched at a general audience but there is enough detail so that someone like me, who works in medical imaging and with MS datasets, can also benefit. I'm a street kid; there've been no mentors. And talks like this give a perspective I haven't been able to get anywhere else. But more pampered academics can also benefit. I've been reading a paper where the author dabbles in a whole lot of esoteric math but is unable to construct a biomarker that appeals to common sense. Well, having perspective is one way to compensate for a lack of common sense.

Offshoring work for medical diagnosis

A Wall Street Journal blog article headline states: India is benign for radiologists. It turns out that:

... reading such images relies heavily on what the two economists call “tacit knowledge.” Pattern-recognition software, which could make the work routine, doesn’t work very well in identifying malignancies and other problems,

The paper the blog refers to, was of course, talking about clinical diagnosis but one step removed from this is medical image analysis. Studies usually require databases (some very large) of subjects/cohorts who fit a common description. We might be quite far from full automatic diagnosis, but tasks can be broken down and piecemeal solutions can cetainly be outsourced. (I've been tempted more than once to go this route with the data I use or would use if only I could process them all.)

Suppose we want to build a database of twin brains or multiple sclerosis brains or whatever. Some of the tasks that are routine and could be outsourced are: registering the brains to a common template, segmenting specific sections of anatomy, representing the data in a certain way (in a representation space). Now with close supervision someone with basic training could easily do this. So the problem might be that there are not enough people who can supervise such work. And the people who can have not thought of setting up shop in India. Big pharma is interested in such studies so it could be a lucrative outsourcing venture if someone could put it all together.