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The Peter Attia Drive

#61 - Rajpaul Attariwala, M.D., Ph.D.: Cancer screening with full-body MRI scans and a seminar on the field of radiology

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.77.3K Ratings

🗓️ 8 July 2019

⏱️ 133 minutes

🧾️ Download transcript

Summary

In this episode, radiologist/engineer, Raj Attariwala, explains how he was able to apply his engineering background to create a unique MRI scanner that is capable of constructing whole-body images with a resolution that is unmatched in the industry. Peter and Raj discuss the implications of such a robust, radiation-free imaging tool on the early detection of cancer. They dive deep into cancer screening and define terms such as sensitivity and specificity that are necessary to really understand this complex space. They then describe the biggest risks involved in this type of screening (false positives) and how Raj’s unique technology and process might drive down this risk substantially. But before that, they discuss all the common imaging technology from X-ray, to CT scan, to PET scans, to ultrasound, to MRI, and more. They touch on the history of each, how they work, the usefulness and limitations of each of them, as well as the varying risks involved such as radiation exposure. If you are interested in cancer screening and/or you’ve ever wondered how any radiology tool works, this episode is for you.

We discuss:

  • Raj’s road from engineering to radiology [7:45];
  • How X-ray works, the risk of radiation exposure, and the varying amounts of radiation associated with the different imaging technologies [18:00];
  • Computed tomography scans (CT scans): The history of CT, how it works, and why we use contrast [27:45];
  • Ultrasound: Benefits and limitations, and a special use for the heart [40:45];
  • Detecting breast cancer with mammography: When is works, when you need more testing, and defining ‘sensitivity’ and ‘specificity’ [51:15];
  • Magnetic resonance imaging (MRI): How it works, defining terms, and looking at the most common types of MRI [1:03:45];
  • Brain aneurysms: Using MRI to find them and save lives [1:23:45];
  • Raj’s unique MRI technology [1:30:00];
  • The risk of false positives in cancer detection, and how Raj’s MRI can reduce the number of false positives (i.e., increase specificity) [1:43:40];
  • The unique software Raj created to pair with his MRI machine [1:51:15];
  • Comparing the radiation exposure of a whole-body PET-CT to Raj’s equipment (DWIBS-MRI) [1:53:40];
  • How diffusion-weighted magnetic resonance imaging (DW-MRI) has revolutionized cancer screening [1:55:15];
  • Why a DW-MRI is still not a perfect test [1:59:00];
  • The potential for advancing MRI technology: Where does Raj think it could improve in the next 5-10 years? [2:03:00];
  • Are there any commercially available scanners that can match the resolution of Raj’s images? [2:06:00];
  • Machine learning: When and where might machine learning/AI impact the field of radiology? [2:08:40]; and
  • More.

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Transcript

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0:00.0

Hey everyone, welcome to the Peter Atia Drive. I'm your host, Peter Atia.

0:10.0

The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,

0:15.7

along with a few other obsessions along the way. I've spent the last several years working

0:19.6

with some of the most successful top performing individuals in the world, and this podcast

0:23.8

is my attempt to synthesize what I've learned along the way to help you live a higher quality

0:28.3

more fulfilling life. If you enjoy this podcast, you can find more information on today's

0:32.5

episode and other topics at peteratiamd.com.

0:41.6

Hey everybody, welcome to this week's episode of The Drive. I'd like to take a couple of

0:45.6

minutes to talk about why we don't run ads on this podcast and why instead we've chosen to

0:50.3

rely entirely on listener support. If you're listening to this, you probably already know,

0:55.0

but the two things I care most about professionally are how to live longer and how to live better.

1:01.1

I have a complete fascination and obsession with this topic. I practice it professionally,

1:06.0

and I've seen firsthand how access to information is basically all people need to make better

1:11.0

decisions and improve the quality of their lives. Curating and sharing this knowledge is not easy,

1:16.3

and even before starting the podcast, that became clear to me. The sheer volume of material

1:20.9

published in this space is overwhelming. I'm fortunate to have a great team that helps me

1:25.7

continue learning and sharing this information with you. To take one example, our show notes are

1:31.2

in a league of their own. In fact, we now have a full-time person that is dedicated to producing

1:35.9

those, and the feedback has mirrored this. So all of this raises a natural question. How will we

1:41.9

continue to fund the work necessary to support this? As you probably know, the tried and true way

1:47.4

to do this is to sell ads, but after a lot of contemplation, that model just doesn't feel right

1:53.3

to me for a few reasons. Now, the first and most important of these is trust. I'm not sure how you

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