Classroom: Perspectives on Medical Imaging
By Kathryn LoConte
Professor Keith Paulsen, Thayer School’s Robert A. Pritzker Professor of Biomedical Engineering and a radiology professor at Dartmouth Medical School, arrived in class fresh from the Advanced Imaging Lab at Dartmouth-Hitchcock Medical Center. As he walked into Rett’s Room at Thayer School, his ENGS 7: Contemporary and Historical Perspectives on Medical Imaging class was waiting. The 15 students were prepared for the last class of the term. Their task: present position papers on the uses — and potential abuses — of medical imaging.
A seminar for first-year students, the course reviews the development of modern radiographic imaging, the basic physical principles behind common approaches to imaging, including computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI), and the pros and cons of each technique. Students consider the broader picture behind bringing imaging into clinical use, such as animal testing, human trials, costs, and the training technicians require. Paulsen, lead investigator on several imaging technology research collaborations between Thayer and Dartmouth-Hitchcock Medical Center (see Engineering in Medicine), also invites students to probe ethical issues surrounding insights that medical images unlock.
So, one by one on this final day of class, students discussed how increasingly sophisticated imaging techniques can lead to earlier diagnoses of breast, lung, and other cancers, and early detection of conditions such as Alzheimer’s disease. One student reported on how imaging can be used in assisted reproduction to help with genetic screening of pre-implanted embryos — and then considered moral dilemmas arising from creating a baby to provide bone marrow to another family member. Another student discussed implications arising from the fact that imaging has revealed structural differences between the brains of people with schizophrenia and those without. Some people with structural pre-symptoms go on to develop schizophrenia, but some don’t. Should all these people be pretreated anyway? What about unnecessary procedures, costs, and potential stigmatization and discrimination? What about insurance companies using imaging to identify structural differences and then denying coverage?
“The overall goal is to expose students to the field of medical imaging and have them learn the basics, how the systems work, and some of their strengths and weaknesses,” says Paulsen.
“Medical imaging in general is rich with applications of engineering and physics because the instrumentation is technically complex,” he says. “Many of the body’s systems and functions can be modeled, controlled, and investigated using engineering principles and methods. The instrumentation that is used to deliver health care is also very technical and rapidly evolving. As a result, engineering is becoming an increasingly important field of study in both biomedical research and medical delivery at all levels of the health-care system.”
For more photos, visit our Engineering in Medicine set on Flickr.