Title

KAIST 바이오및뇌공학과

정 용

yong@kaist.ac.kr

Debate

Doctor’s side

Engineer’s side

• I need.. • I want you to make.. • I want to apply to

• I found a great article. It would be great if you help me apply it to

• Well, it looks valid scientifically, but not that appealing (to physicians)

Courtesy of E. Kim, MD, PhD

• I want to create something new

• I want to validate it first. Wait for a while

• It has been done by someone else. Not interested in it. Why do not you just tell him/her to help you?

• Hey, something great has come to mind. What do you think?

Why Imaging?

What do we want to see with medical imaging?

Function

Pathology

What do we see with medical imaging?

Example of Alzheimer’s disease

Dynamic Model of Biomarkers of the AD’s Pathological Cascade

Normal

Abnormal

Clinical Deterioration

Cognitively Normal MCI Dementia

Aβ Amyloid

Brain Structures

Neuron Injury & Dysfunction

Clinical functions

ADL NP test Structural Imaging

Functional Imaging

Memory

Molecular Imaging

Threshold

1970’s onward Structural Imaging

(CT MRI)

1980’s onward Metabolism

(FDG-PET)

1990’s onward fMRI and

resting BOLD

2000’s onward Molecular Imaging

(Amyloid PET)

Atrophy

Hypometabolism

Activation and

Network change

Aβ Deposition

Modified from Jagust, 2009

삶과 죽음

심장사

뇌사

* 장기 이식

죽음의 종류

-1SD -2SD

건강 vs. 질병(disease)

What is health? • Without any disease? (utopia)

• Within 2SD? (average)

• Manage to live (process)

Health(건강) vs. Disease(질병)??

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

WHO Definition of Health

1) Disease

2) Environmental factor

3) Nutritional state

4) Stress

5) Aging

6) Genetic or Inherited factors

7) Life habit

8) Religion

9) Health policy and social welfare

Factors that influences on Health

Disease (질병)

Syndrome (증후군)

Disorder, illness (질환)

Disability(장애)..

Definition

• Etiologic diagnosis(원인적)

• Pathologic diagnosis(병리학적)

• Laboratory diagnosis(실험실적)

• Syndromic diagnosis(증후군적)

Diagnosis

--pathy (sick)

• Encephalopathy, neuropathy, myopathy

--itis (inflammation)

• Encephalitis, meningitis, neuritis, myositis

--oma (mass)

• Neuroma, menigioma

Terms

V: vascular (혈관성: 뇌경색, 뇌출혈 등)

I: infectious (감염성: 뇌염, 뇌수막염 등)

P: paroxysmal (돌발성: 간질, 편두통 등)

T: toxic and metabolic (독성, 대사성: 알코올, 간독성 등)

N: neoplastic (신생물: 뇌암)

T: traumatic (외상성: 교통사고 등)

D: degenerative (퇴행성: 알츠하이머병, 파킨슨병 등)

D: developmental (발달성, 유전성: 근이영양증 등)

D: demyelinating (탈수초성: 다발성 경화증 등)

Classification of Neurologic Disease

What people in medical imaging engineers (not technician) need are

• Understanding of the possibility and the limitation of each modality

• Understanding of the ambiguity of biological, clinical or social basis of disease

Take Home Messages