Week 4: Smrithi Karthikeyan

If I could describe this week in one word, it would be 'segmentation'. On Monday, I got the full radiology experience by shadowing a few interventional cardiologists reading cardiac MRI scans. It was interesting to see how different physicians had different methodologies for reading scans; some prefer to be completely 'blinded' and not read any patient history beforehand, whereas others swore by it to make sure they were looking for the right disease pathologies during their first impression. It was interesting to see how 'manual' and qualitative radiology readings are. For example, when determining whether or not a patient has septal flattening (either due to pulmonary hypertension or volume overload), it is up to the radiologist to visually assess whether the septal wall appears to be flat (this was quite tricky to an untrained eye - especially when it was a mild case of flattening). When reading with multiple radiologists, it was interesting to see the number of times they disagreed with each other's readings. After this experience, I realized why there is a strong push for incorporating computer vision tools in radiology - systematizing diagnoses may lead to less variability between radiologists. This could lead to potentially more reliable radiology report findings. 

For the second half of this week, I started working on my two projects for the summer: mitral annulus calcification analysis from cardiac CT and aorta segmentation from cardiac MRI. For the mitral annulus calcification analysis project, I was surprised by how hard it is to distinguish between annulus and coronary artery calcification, especially in no-contrast scans. The end goal of my project is to analyze whether the gold standard volumetric calcium score from CT is similar to the calcium score generated from a cardiac Quantitative Susceptibility Map (QSM) calcification score. For my aorta segmentation project, I spent most of my time this week learning about the heart anatomy, 4D flow MRI, and the 3D slicer software. Over the next couple of weeks, I am looking forward to seeing a few open-heart surgeries and shadowing a few physicians in gynecology!

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