Thursday, July 12, 2012

Joseph Miller Week 5

This week was particularly interesting.  On Monday I saw the usual rounds of patients, menningiomas, glioblastomas, acoustic neuromas, trigeminal naralgias, etc.  On Tuesday, however, I was up bright at early at 4:30am to make it to Columbia to participate in three radiosurgeries on the GammaKnife.  Like the Linac at NYP Cornell, the gamma knife requires a "halo" to be screwed into the patients head in order to minimize their motion.  Then we bring up the MRI and CT merged images to do contouring of the areas to be treated and critical areas that should be avoided.  It's an interesting team of neurosurgeons and physicists.

After the GammaKnife, I saw more patients and then attended Tumor Board to discuss the cases of 18 patients.  Nothing particularly new but I did over hear some chatter about why we don't do VEGF reporting anymore and what a loss one doctor felt that was to our diagnostic power.  The MRS angle is looking more and more interesting as well as a problem of presentation instead of justification.  I think many of the doctors would like to have this information except the spectroscopy outputs are not intuitive at all and it doesn't make for quick diagnostic power.

I've also begun working on a new ultrasound device for the propogation of gliodil or some other wafer chemo delivery deeper into the surrounding tissue of a ressected cavity.  I will spend all day tomorrow working on this.

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