Seeing the Difference Imaging Can Make in Medicine

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Dr. Michael Koren joins Kevin Geddings to discuss the pivotal role imaging has played in diagnosis and understanding of various diseases. Dr. Koren notes that before the science of imaging, the only way to see what was going on inside the body was with a knife. They then discuss some of the newest applications of imaging and how the use of CT scans and amyloid PET scans can see inside the heart and arteries to see how a disease is progressing or the effectiveness of new medications.

They talk about the progress that has been made and how we are able to see what's happening, but note that access to these imaging technologies is not evenly available and that sometimes cost or insurance can get in the way of healthcare access. Dr. Koren then points out that clinical research may offer some patients a way for some patients to access these imaging technologies outside of the traditional healthcare system if they have risks or signs of diseases being studied.

Be a part of advancing science by participating in clinical research.

Have a question for Dr. Koren? Email him at [e-mail]

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Episode Transcript

Speaker 1 (00:00):
Welcome to the MedEvidence Monday Minute Radio
Show hosted by Kevin Gettings ofWSOS St Augustine Radio and
powered by Encore Research Group.
Each Monday morning, dr MichaelKoren calls in to bring you the
latest medical updates withinsightful discussions.
Medevidence is where we helpyou navigate the real truth
behind medical research, withboth a clinical and research

(00:20):
perspective.
So sit back, relax and getready to learn about the truth
behind the data in medicine andhealthcare.
This is MedEvidence.

Speaker 2 (00:30):
Speaking of special stuff, we've got Dr Michael
Koren live on the studio line.
He joins us every Mondaymorning.
We appreciate him taking timeout of his busy schedule.
Of course.
He is a medical doctor and acardiologist and a research
scientist.
He's also, of course, theleader of the team at Encore
Docs where they do leading-edgeclinical research all around our
part of Florida, including herein St Augustine.

(00:52):
Their office is in theWhetstone Building next door to
UF Flagler Hospital.
You can connect with them at904-730-0166, and we're going to
talk specifically this morningabout a study going on here in
St Augustine that you couldpotentially be a part of, and it
relates back to the notion ofimaging in medicine, Right, Dr
Corrin?

Speaker 3 (01:11):
That's right, kevin, good morning.
Good morning, how are you?

Speaker 2 (01:14):
We're doing well.
It's a good post-Jaguar victoryMonday, so we're all excited.

Speaker 3 (01:19):
Absolutely, absolutely.
Wasn't pretty, but we'll takeit right.

Speaker 2 (01:23):
Oh heck yeah, it's still a W.
So the world of imaging.
I guess this would be a goodtrivia question.
When was, like the first X-raygoing way back.

Speaker 3 (01:34):
It's interesting.
Well, the Nobel Prize wasactually awarded to Willem
Roentgen for developing thetechnology of X-rays back in the
1890s.
Wow, those were the first.
He was a German scientist and,of course, that led to a
revolution in medical imaging,which has gotten more and more

(01:56):
and more sophisticated.
And there have been other NobelPrizes that have been awarded.
For example, mri has been atechnology that's been awarded
the Nobel Prize as well.
Awarded, for example, mri hasbeen a technology that's been
awarded the Nobel Prize as well.
So, certainly, scientificbreakthroughs and understanding
of physics has led to incredibleimprovements in medical imaging
and we're beneficiaries of thattoday?

Speaker 2 (02:15):
Yeah, no, absolutely.
And obviously the progress thatwe see in all forms of
technology, I'm sure extends toimaging, right?
I mean, what science can do togive us a sense of what's going
on inside our bodies is prettyamazing.

Speaker 3 (02:28):
Absolutely Back in the old days.
If you're having pain in yourbelly, for example, or other
places, you had to take a knifeand cut in and take a look.
But nowadays, virtually allthose things get answered
through imaging.
So they're truly breakthroughs.
But with that there's someunevenness, unfortunately.
So some of these technologiesare widely available and others

(02:52):
are less widely availablebecause of cost considerations
or because of the fact that thespecifics of that imaging
technology may or may not beavailable to a particular
community.
And that's where research comesin.
So you mentioned, for example,the technology that we're using
in St Augustine in some of ourstudies.

(03:12):
Well, there are actually two.
One is a concept called CTangiography, which is a concept
where, instead of doing invasivehard cast, we can use a cast
stand technique to take a lookat whether or not you have
blockages in coronary arteries,and that's not that esoteric,

(03:33):
it's fairly widely available.
But sometimes, because ofinsurance reasons, people can't
get access to it or theirdoctors may not be comfortable
ordering it if they're not acardiologist, for example.
Or there's concerns about otherelements of whether or not it's
an appropriate test for a person, which of course we evaluate as

(03:53):
part of our research, and for,for example, if somebody was a
pregnant person, we wouldn'tnecessarily subject them to
x-rays, and that'd be oneexample of reason that you would
not want to get a particularstudy.
So that goes into our evaluation.
But another thing that we'vedone, for example, is what's
called an amyloid PET scan ofthe brain, and that's also an

(04:16):
expensive technology that maynot be available in all
communities.
And then, when you get intosome of the details, each of
these imaging modalities hasdifferent type of software that
analyzes the images.
So in the cardiac space, forexample, there's certain types
of software that do AIreconstructions of the arteries

(04:36):
to get more insights to thenature of the plaque, the actual
blockages of the arteries, andso all these different
technologies may or may not beavailable to people that are
seeing their regular physicians,but for particular studies and
projects we have access to themand people look at this as a
reason to get involved inresearch.

Speaker 2 (04:57):
Yeah, that's pretty amazing, and so you have an
opportunity out there toparticipate in this so who would
be the folks out there, Dr Korn, who should consider
participating in this particularstudy, which is going to take a
look at imaging as it relatesto blood vessels of the heart?

Speaker 3 (05:13):
Yeah, so the particular study that you're
alluding to is using a reallyinteresting new medication.
It's called the CETP inhibitor,which stands for cholesterol
ester transfer protein inhibitor, and the reason it's a unique
drug is that we have great waysof lowering LDL cholesterol, but

(05:37):
not such great ways of raisingHDL the good cholesterol and the
study that we're looking at forthis imaging technology
involves whether or not amedicine that raises HDL will
have a beneficial effect onplaques in the arteries.
Some people participate in thiskind of study a
placebo-controlled study so youdon't know exactly what you're

(05:57):
going to be getting.
But there's the opportunitythat you can actually have a
medicine that raises your HDLand then we would look to see
whether or not that has abeneficial effect on these
blockages.
But whether or not you get theactual medicine in the study,
you'll get the benefits of theimaging, and this is an
important point because there isa debate in medicine, and

(06:19):
particularly in cardiology, iswhen you get more aggressive at
treating cholesterol problems.
So, for example, if you'reseven years old and your
arteries are completely clean,there's not a great reason for
you to take high doses ofmedication to lower your
cholesterol.
On the other hand, if you're 50or 60 and you already have an

(06:39):
even amount of plaquing in yourarteries, well, there's a good
chance that you could have aheart attack at some point in
your life if you don't dosomething.
And so people like that, whomay or may not even know whether
or not they have plaque, wouldbenefit from these imaging
studies to see whether or notthey're at high risk and, in
turn, whether or not they shouldbe involved in some sort of
medical intervention.

Speaker 2 (06:58):
And I guess too, some of our listeners driving around
or listening to us at theoffice or whatever if they've
had a family history of heartdisease, that might be another
reason to consider participatingin a study that would be
focused on imaging.

Speaker 3 (07:10):
Absolutely, and that's a major concern of a lot
of our projects, not just thisimaging project.
You and I have talked aboutthis concept of lipoprotein
malign, which is a type of acholesterol problem that runs
strictly through your genetics.
So that's another example, butthere are many, many other
examples of diseases that havegenetic components, including,
as I mentioned, alzheimer'sdisease and many other things.

(07:32):
So if there is a geneticconcern, please let us know and
we'll evaluate you.
And one of the nice thingsactually, I had this
conversation right before I leftfor the weekend on Friday with
a lovely couple, all aboutlycoprotein, little a, and these
were very educated people whotold us about their family
history and it was a concerningfamily history and we offered to

(07:55):
actually screen all their kidsand we'll do that for free as
part of research because we havestudy grants to cover all those
expenses.
So it's a nice opportunity forpeople to learn more about their
genetics and what their risk is.

Speaker 2 (08:07):
What a great opportunity for our listeners
out there.
And, of course, a key itemthere is it's not going to cost
you anything.
There may be opportunities toparticipate in studies and gain
some compensation and also toget your expenses covered.
But we would encourage you toreach out to Encore Docs here in
St John's County in StAugustine to learn how you can
participate.
If anything that Dr Corm wastalking about this morning has

(08:29):
kind of piqued your interest andit should.
904-730-0166.
Let them know.
You heard about it here on WSOS.
I would appreciate that.
904-730-0166.
I know it's hard to remembertelephone numbers when you're
driving around, but remember thewebsite EncoreDocscom.
That's spelled with an E,encoredocscom.

(08:52):
And whether it's heart diseaseor cancer or just about anything
else impacting our health, drKoren's also very much involved
in a great resourcemedevidencecom.
Correct, dr Koren.

Speaker 3 (09:01):
That's right.
We're super excited about thegrowth of MedEvidence and we
call it the truth behind thedata, and unfortunately there's
so much information on theInternet that's just not
reliable, and MedEvents is oneof those places where you really
get to the truth of the matter,and one way to do that is by
actually showing that sometimesdoctors have differing opinions

(09:23):
or different perspectives, andby seeing how different, very
well-respected doctors talkabout an issue, you'll get a
true sense for what the truth is, and there's things that we
know for sure, there's thingsthat we don't know, and there's
something in the middle, andthat's where research comes in,
where we figure this out througha structured scientific program
, and that's an opportunity forall the listeners to get
involved with what we do whileyou're learning more about

(09:45):
medicine and keeping you andyour family healthy.

Speaker 2 (09:47):
Yeah, the website's really intuitive media presented
to you in a variety ofdifferent formats.
I would encourage you to checkit out, share it with your
friends and neighbors.
Medevidencecom the truth behindall this data out there.
Medevidencecom.
Dr Corrin, thank you for allyour time this morning.
We appreciate it.
We'll talk again next week,okay.

Speaker 3 (10:07):
Sounds great.
Kevin, have a great day.

Speaker 1 (10:08):
Thanks for joining the MedEvidence podcast.
To learn more, head over toMedEvidencecom or subscribe to
our podcast on your favoritepodcast platform.