Insights into Prostate Cancer Research and Radiology with Jim Zhong
Episode Topic: In this episode of Skeleton Crew, we explore the world of interventional radiology, cancer treatment, and the pivotal role of medical imaging in modern healthcare. Our guest, Dr. Jim Zhong, a skilled interventional radiologist and researcher, shares valuable insights into advanced imaging techniques, and the integration of technology into patient care.
Lessons You’ll Learn: In this episode, you will get to know the importance of multidisciplinary collaboration in interventional radiology, where the experts work together to provide effective patient care. He discusses the evolution of procedures like Brachytherapy and Embolization, showcasing how imaging technologies have transformed treatment options. Here we delve into the impact of Hypoxia on tumor growth and its influence on radiation therapy resistance, offering a peek into the challenges and advancements in cancer treatment and more.
About Our Guests: Dr. Jim Zhong, is a seasoned interventional radiologist trainee at the University of Leeds and boldly leads the charge in harnessing the power of medical imaging for cutting-edge cancer treatments. With a deep interest in prostate cancer and a range of groundbreaking interventional procedures, Dr. Zhong’s journey stands as the ultimate showcase of blending research prowess, boundless innovation, and hands-on clinical finesse in modern radiology.
Topics Covered: Immerse yourself in the domain of interventional radiology, shedding light on the pivotal role of medical imaging in diagnosis and treatment. Dr. Zhong shares his unique experiences, ranging from complex procedures like portal vein embolization to innovative approaches in cancer treatment. Uncover the transformative power of multidisciplinary collaboration and gain insights into the future of radiology, where research and clinical practice intersect to provide optimal patient outcomes.
Our Guest: Dr. Jim Zhong, CRUK Clinical Research Fellow at the University of Leeds
Dr. Jim Zhong is a dedicated professional in interventional radiology and cancer research. He’s a CRUK Clinical Research Fellow at the University of Leeds, focusing on prostate cancer reirradiation techniques and personalized radiation treatment using imaging and biomarkers.
Jim’s educational journey started at The University of Edinburgh, where he earned his Bachelor of Medicine and Bachelor of Surgery (MBChB) degree. He further specialized in Interventional Radiology and Radiation Oncology at Columbia University. He also holds a Bachelor of Science (BSc) degree in Anatomy from the University of Leeds.
With a rich background that bridges academic and clinical experiences, Jim is committed to advancing medical knowledge and improving patient care. He’s actively engaged with professional committees like the Royal College of Radiologists, the British Society of Interventional Radiology, and more. His contributions to the medical field reflect his passion for innovative research and enhancing medical practices.
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[00:00:00] Jim Zhong
We look through the pictures, we give an opinion based on what we can see and also the clinical information, but we don’t actually extract the quantitative numbers behind the, you know, the pixels and the images and you can get a lot more from imaging. And with the advent of AI now, there is a lot of potential to use CT MRI data to characterize parts of diseases such as tumors, and in the future, hopefully, use that information to give patients more accurate treatments options and also personalize their treatment to improve their outcomes.
[00:00:40] Jen Callahan
Welcome to the Skeleton Crew. I’m your host, Jen Callahan, a technologist with ten-plus years experience. In each episode, we will explore the fast-paced, ever-changing, sometimes completely crazy field of radiology. We will speak to technologists from all different modalities about their careers and education. The educators and leaders who are shaping the field today and the business executives whose innovations are shaping the future of radiology. This episode is brought to you by X-raytechnicianschools.com. If you’re considering a career in X-ray, visit X-raytechnicianschools.com To explore schools and to get honest information on career paths, salaries, and degree options.
[00:01:28] Jen Callahan
Hey everybody. Welcome to another episode of The Skeleton Crew. Today I have with me a very exceptional gentleman. His name is Jim Zhong. He is a clinical research fellow from the University of Leeds, and he is specializing in the field of interventional radiology and oncological imaging. Jim, thanks for being with us here today.
[00:01:48] Jim Zhong
Thank you very much, Jen. Really happy to be here and thanks so much for the very kind introduction. Don’t think I’ve been described as exceptional much at the workplace. So really appreciate your gratitude.
[00:01:59] Jen Callahan
My pleasure. So first, let’s start. Can you tell me where the University of Leeds is?
[00:02:05] Jim Zhong
Yeah. So it’s a very good question. A lot of people in England probably don’t even know where Leeds is. So it’s one of the largest cities actually in the UK, I think by population is actually the second largest city and it sits in the northeast of England. So sort of middle of the country between London, which is in the south, and say Scotland in the north.
[00:02:23] Jen Callahan
So you’re currently a fellow, but you’re what we were talking before hand, that medical school is a little bit different in the UK than it is in the United States, but you started your, quote-unquote, residency in radiology and then you transition to your fellowship doing the research. Do you want to give us a little background?
[00:02:42] Jim Zhong
Yeah, of course. So in the UK, traditionally it’s a 5 or 6-year undergraduate degree. So I completed that and graduated in 2013 from the University of Edinburgh in Scotland. And then you have to do two years of internships called Foundation Years before you get your full doctor’s license. And then after that, you can apply and go into a radiology residency, which is five years in total, or if you do the interventional radiology track. You do three years of diagnostic radiology, followed by three years of dedicated interventional radiology training. So out of the six years I did, five years before going out of the program to do a three-year PhD, which is what I’m currently doing. And just in my last month of that, before I go into my final interventional radiology fellowship year from next month.
[00:03:35] Jen Callahan
You’re like. The end is in sight!
[00:03:38] Jim Zhong
Yes, the goalposts keep moving, though, unfortunately.
[00:03:41] Jen Callahan
I’m sure when you first entered into starting into radiology, maybe you weren’t exactly looking to do the Ph.D. route, you know, doing the fellowship and doing the research. So while you were within the radiology, what transitioned you to, change path and move on into the research area?
[00:03:59] Jim Zhong
Yeah, it wasn’t really until my third year of my residency where I had a research block. I had a bit more time to get involved with research, and I think that was when I realized that with all the imaging data available, we don’t really use the data as quantitative data. You know, we look at images like a bit of an art. We look through the pictures, we give an opinion based on what we can see and also the clinical information, but we don’t actually extract the quantitative numbers behind the, you know, the pixels and the images. And you can get a lot more from imaging. And with the advent of AI now, there is a lot of potential to use CT MRI data to characterize parts of diseases such as tumors, and in the future, hopefully, use that information to give patients more accurate treatments options and also personalize their treatment to improve their outcomes. So I saw the potential there and I thought actually this is something that’s quite exciting. I would like to get some more experience in that. And you know, with a Ph.D., it’s dedicated research training with very few clinical commitments. So you can really delve into that a bit more and get some of those useful skill sets hopefully that you can then apply to your interest area within radiology. So that was why I ended up considering doing a PhD.
[00:05:22] Jen Callahan
Right! Was there something that was within that happened during your IR residency that led you to that path?
[00:05:28] Jim Zhong
Yeah. So actually that was how I got into the research. I was doing some work with the interventional oncologists within Leeds who were studying lots of the effects of ablative treatments so you can insert probes into tumors now using image guidance such as CT or MRI or ultrasound, and you can burn, freeze, electrocute tumors to treat them and this is a different treatment option for solid organ tumors like liver tumors, kidney tumors. And you can stop patients from needing more invasive surgical procedures, which sometimes require longer hospitals stays. And so it’s less invasive way of treating these patients. So when I was studying these Interventional Oncology or IO treatment options, I thought, actually there’s a lot of potential here to understand how we can better target these tumors. But also with cancer, the more I learned about different cancer types, you realise that no two different tumors, even within the same organ, behave the same. There’s a lot of different physiology within that tumor and you can sometimes get that information from a scan. And so if we can understand and utilize that better, then we’ll be able to also offer patients the most appropriate treatment for them. And now there’s too many treatment options for patients. Sometimes it’s very difficult to know what is the best one that we can provide them. We’re obviously biased depending on what specialty we work in as a radiologist, as a surgeon, as an oncologist. Obviously, we always think, our tools are maybe the best and actually you should think about what the patient wants and give them all the options, and let them decide.
[00:07:08] Jen Callahan
So do you have a certain specialty of cancer that you’ve been researching?
[00:07:12] Jim Zhong
Yes. So during the Ph.D., the main focus has been in prostate cancer, which obviously is the most common cancer in men. So, you know, very widespread. And there are good treatment options for prostate cancer. But despite developments in areas such as radiotherapy, which is a very common treatment for prostate cancer, it can still come back. And so part of the Ph.D. is understanding why some prostate cancers come back, why some prostate cancers are perhaps more resistant to the radiation that we deliver, and also how you can treat the patients who have recurrent prostate cancer better, either with radiotherapy or with other tools. So that’s the main area I’ve been working in.
[00:07:52] Jen Callahan
Okay. So radiotherapy, I mean, I’m sure it’s the same exact thing, but radiation therapy where the patient’s going in lying down, there’s a specific area on the body that has been targeted. Correct? And where, not laser, but the radiation beam is being administered to.
[00:08:08] Jim Zhong
Yeah. So the way that you’ve described is what we call External Beam Radiotherapy, where the source of the radiation is from outside the patient. So the patient lies within the sort of machine that moves around them and delivers a high dose of radiotherapy to the tumor site. So all this is planned beforehand by the radiation oncologist to limit the radiation to the surrounding organs around the tumor and to mainly, accurately, deliver it to the tumor so you can reduce the side effects of radiotherapy. The other way you can also deliver radiation is inserting a high dose of radiation into the patient. So for the prostate, for example, you can do that by inserting a hollow tube into the prostate gland and then delivering either seeds or temporary radiation sources to the prostate. And that delivers like a high dose within the tumor itself. That’s called Brachytherapy.
[00:09:07] Jen Callahan
Brachytherapy. Okay. I was reading different things that you had published, and I have that written down Brachytherapy, question mark. Thank you for answering that without me having to ask. And it’s crazy. I mean, like you said, it’s the most common form of cancer that affects males. And one of your articles states 1 in 4 deaths for men. That’s crazy. I’m assuming. I mean, just with the prevalence of cancer amongst the world now that maybe those numbers for prostate cancer have grown in the past at least ten years or so, I would assume.
[00:09:37] Jim Zhong
Yeah. I think that from the Reese’s Cancer Research UK statistics, you know, 1 in 4 potentially even more men as we progress will develop prostate cancer. And again, another statistic I saw was, you know, 1 in 2 people will develop some form of cancer. You know, we are living longer and cancer is almost part of that ageing process at some point. And with imaging getting better, we’re also detecting lots of cancers much earlier and sometimes we don’t know what to do with those because there’s a risk of overtreatment as well. We know some cancers may be indolent and actually not cause patients any harm. For example, in prostate cancer, we now can stratify patients sort of risk based on how aggressive the cancer is. You know, we take a sample from the tumor and we can know how aggressive that cancer is likely to be. And so for the prostate, cancers are not very aggressive. They can probably be just observed and you can get a blood test to monitor your PSA or Prostate prostate-specific antigen level, which tells you the widespread that prostate cancer might be and you don’t need an invasive procedure that comes with the potential risks to the patient’s quality of life. So again, that’s something which, you know, we’re getting better at. So we’re not over-treating everyone that we diagnose that cancer in.
[00:10:58] Jen Callahan
Right? I don’t expect you to have this exact answer because I’m not saying that you’re a cancer specialist. You know, you’re doing your research and everything, but you’re talking about these. You don’t want to overtreat, but maybe give thoughts to my father who had had kidney cancer. And they did. You know, they actually sat and watched it for like a year and a half or so. I don’t think that they actually did a biopsy because of where it was located. He had other health complications that kind of deterred them. But it’s interesting that you say there are some body parts that you feel are maybe slower growing.
[00:11:29] Jim Zhong
Correct, with kidney cancer, you may not always biopsy these because we know that with small kidney tumors, with features that suggest, imaging appearances that suggest they’re not aggressive, you can watch and wait, particularly when they’re small. With kidney cancer, we go by size a lot of the time. And if you observe them over a number of years and they don’t
grow much, they’re growing maybe millimeters, then potentially we don’t need to treat those patients. However, if they grow significantly over 6 to 12 months, then that’s where you might want to consider doing a biopsy and then considering some treatment options. But for kidney cancers with small ones, now we don’t need to go in initially and treat them unless there’s anything worrying about how they appear. If they’re, for example, growing into other surrounding organs or they’ve spread anywhere else, that’s when you would want to give some treatment and we would pick up a lot more kidney cancers as well because more patients go for CT scans and we pick them up, incidentally, just, you know, from those because they don’t cause patients any symptoms necessarily.
[00:12:40] Jen Callahan
That’s exactly what happened. My dad received a routine CT scan for he had an aneurysm in his chest and they caught it at the very bottom of the CT scan. So exactly like you said, usually incidental findings.
[00:12:54] Jim Zhong
Yeah and obviously as radiologists, we get involved with reading these scans and the diagnosis aspect. But now with IR treatments, you can treat small kidney tumors. And it used to be that traditionally if you treated even small kidney tumors, some patients might end up with parts of their kidney or their entire kidney out. And that’s really drastic when you’re treating maybe a tumor that’s a couple of centimeters in size. So, you know, we’re picking up smaller tumors now. Less invasive options should definitely be the mainstay of that first-line treatment.
[00:13:26] Jen Callahan
So a little bit more that I was reading about the prostate cancer and stuff. So you talked about the Brachytherapy, but the hypoxia biomarkers. But I was reading further and it said, at least this is what I took from it and this is what I have in my notes. The less oxygen to I guess the area is, the more the tumor can grow. Did I get that right?
[00:13:46] Jim Zhong
Yeah. No, that’s really good. I think you’ve already summarized it for me.
[00:13:50] Jen Callahan
Okay. The lower the oxygen, the tumor could resist the ionizing radiation. Interesting, because I feel like usually you think like, at least for me, I’m thinking of, like, a fire. And the more oxygen you put to the fire, the bigger the fire is going to get. But this almost seems opposite of that, that holding back the oxygen, this is actually growing.
[00:14:09] Jim Zhong
Yeah. And with tumors that are hypoxic, which means that they are in a lower oxygen environment, they’re more resistant to radiation therapy. So if you deliver the same dose of radiation to two tumors and one is a lower oxygen state, then you don’t get as much damage from the radiation delivered because you need oxygen for the creation of oxygen free radicals. They’re called to actually, you know, cause the damage to the tissue. And if there’s a state of hypoxia, you don’t get as much of that therapeutic effect and some tumors in the body, we’ve realized, are just slightly more hypoxic than others. So head and neck tumors, prostate tumors, cervical tumors, you can get more hypoxic regions and environments. And so that makes it tricky potentially to effectively treat it with radiation therapy
So, you know, one way would either be to give patients a drug which helps improve that oxygenation and that hypoxia environment. Or you might need to give a bigger dose of radiotherapy to kill all the cancer cells effectively. But clearly, that carries potentially more side effects as well, because obviously you might treat surrounding areas and cause some radiation toxicity, but it’s something that we’re only really starting to try and understand and use in clinical practice because before it was more something we understood in the research area, but we didn’t really know how to change the way we treated hypoxic tumors. So that’s something interesting. I guess that might change in the future. Being able to do a diagnostic test to work out which tumors are hypoxic or not.
[00:15:49] Jen Callahan
Yeah, that would be definitely interesting to figure that out. But it seems like you kind of have a little baseline of certain areas that are more hypoxic than others, but that’ll only lead to more options for more treatments.
[00:16:01] Jim Zhong
I know, you know, I think I don’t know how you found it with working obviously in a different health care system, but in the UK, the research infrastructure within interventional radiology and I would say radiology isn’t as robust as some other specialties. So oncology is obviously a, historically, a very strong academic specialty. You’re always seeing them design clinical trials to research new drugs or treatment regimes. But you think of all the devices that we use in IR and we don’t really have much evidence for them. And I think part of my frustration was to try and allow trainees and future radiologists to
have some more research training because I think it’s really important to understand how to do at least good research or at least how to interpret clinical research papers so you can incorporate that learning into your practice. And otherwise, how are we going to push the specialty forwards, I guess, and know what’s best for patients if we, you know, aren’t up to date with things ourselves.
[00:17:00] Jen Callahan
Yeah. There’s always room for improvement, right? And from what not to say. Ever not leave from what you’ve learned. Mean that’s always there for your base. But there’s always more to build onto it, especially with all the different information that’s available that’s coming out.
[00:17:15] Jim Zhong
Exactly. If patients are going to struggle with the amount of options and information, I’m sure we are going to be relied on to try and filter that.
[00:17:23] Jen Callahan
So how do you feel with moving back in your last month and having that head back into the clinical aspect?
[00:17:31] Jim Zhong
The real world! I think I’m looking forward to definitely feeling a bit useful. Again, it’s been at times quite, I guess, lonely doing research, particularly during when things were all shut down with the height of the pandemic and you’re not really in the hospital, which is quite a nice social support network in some ways, being around other people and you’re working in your little silos. So definitely being back in the hospital, working the IR teams will be really nice, and feeling like I’m able to do, you know, the procedures and contribute to the clinical component will be something I’ve definitely missed during the PhD, but also the fear of knowing that I’m sure I’ve de-skilled a lot and there’ll be a lack of confidence I think, in the first couple of months back. But hopefully, it’ll be like riding a bike as people tell me.
[00:18:16] Jen Callahan
Remind me again. How long has it been since you’ve been out of the clinical role?
[00:18:20] Jim Zhong
I’ve been mainly doing research for the last three years. I still do usually every week some clinical work, so usually around prostate cancer, so prostate biopsies or Brachytherapy delivery, or some diagnostic radiology reporting, but nowhere near as much as the full-time clinical work that I was doing before the Ph.D. So I’ve been speaking to my training program director and they were usually having these support meetings for trainees coming back from extended periods of leave. But usually in radiology, it’s with, for example, patients or sorry, trainees coming back from maternity leave, and there’s definitely fewer coming back from doing extended time out with research. But it’s interesting to hear about how you lack that confidence. Perhaps you do retain a lot of the skill set and the knowledge, but it’s the confidence that takes a bit of a knock and, you know, needs a couple of months, I think, to get back up to speed with everything.
[00:19:16] Jen Callahan
Sure. Yeah, definitely. I mean, I was out on maternity leave three different times with my jobs and that was like 3 to 4 months. And I went back, you know, first, like day or two, I was kind of like, oh, took a little bit of time. But I mean, so I can only imagine three years with you doing that. You have an attending there, obviously. And then are there other doctors who are within their residency or their clinical training?
[00:19:40] Jim Zhong
Usually in the Angio Suites for the the list that we’re a part of, we may have a senior trainee and a more junior trainee who might be a first or second-year resident. And over the course of six months, the senior trainee might be expected to start most cases and also do some teaching and then work perhaps with the attending on the more complex cases. And then the junior trainee will have some basic competencies that they’ll try to learn and master during that placement, such as ultrasound-guided vascular access, being able to, you know, puncture arteries, get vascular access, and starting to get involved with the IR kit and getting used to some of the tools that we use. Because as you know, again, there’s so much so many different wires and catheters and kits that you use and it’s really hard to remember when you might use what. So thankfully, our attendings are very supportive and quite hands-on. So they all like to be at least in the room, even behind the control switch area, to be able to offer any verbal guidance if required. So, you know, it’s good educational training as well to have there.
[00:20:46] Jen Callahan
Yeah. So when you first started, did you feel comfortable being there with the attending and then also to the tech would be with you? Because I’m assuming that in the UK it’s the same as the US, that the IR tech is there to basically be a first assist to the doctor. How did you feel with your role between the two?
[00:21:06] Jim Zhong
Oh, that was great. I think that’s one of the parts of the job that I love most working in that multidisciplinary team. You know, we have at least one, sometimes two techs. We have at least two nurses in the room as well who are also assisting, depending on the type of case we might have other clinicians. So with the aortic stent graft cases, we normally have a vascular surgical resident or attending there. So it’s great camaraderie and being able to, you know, learn from each other. I’m definitely rely on the techs and the nurses so much remembering names of things and kit to use. They’ve helped me out of pickle many, many times. So it’s a good working environment from that aspect.
[00:21:45] Jen Callahan
So talking about being an interventional radiology, is there a certain procedure that you enjoy doing or that you did enjoy doing three years ago? I guess I should say, I mean.
[00:21:55] Jim Zhong
I really love about IR is the variety of types of procedures you can involve with, you know, we work in the vascular system. Them. We work in different organ systems and you learn a lot of transferable skills with different pieces of kit, different wires you can use. I think the first time that I was involved with a liver embolization case was probably one of the most memorable procedures. You know, it was something that I didn’t have much experience of, and we were doing a portal vein embolization for a patient who was going for a liver transplant. And this was a patient who potentially if I didn’t exist, they wouldn’t be able to have a liver transplant because basically they had cancer of the liver and we needed to block off the blood supply effectively to the parts of the liver that was going to get chopped off, but also that would allow the parts of liver that was left in the patient’s body to grow a bit. And that would give the patient some more time and they can potentially have a liver transplant. And it was a bit of a work of art, I remember because I don’t know if you’ve done these ports of embolizations in your center, but the attending that was doing it, he was using an embolic to block the portal veins and he just had this catheter.
[00:23:11] Jim Zhong
And I was watching the still image on the screen and he just, you know, was like spinning this around. Obviously, you can’t see what he’s doing because twiddling the wire and catheter with his fingers. But on the screen, you could see this little catheter and it was just rotating, filling all the veins perfectly with his embolic, which was mixed in with iodine. So it appears like black on the screen, just beautifully made a cast out of all these portal veins. And as he was pulling it all back into the main portal vein, it was just a beautiful work of art, literally, because obviously, the final Flourish grab was an image with, you know, all these portal veins filled with this embolic agent that I just thought, Wow, doesn’t that look so cool? And I would never be able to do that now. I’d probably embolize all the wrong blood vessels and no one would get a liver transplant. But yeah, hopefully something I can aspire to be.
[00:24:02] Jen Callahan
Did that take him a while to do?
[00:24:04] Jim Zhong
Actually, no. He was in and he got the cast in place, it probably took about a minute, but it felt like slow motion as he was doing it. Obviously, he’s so experienced, he just knows how to spin the catheter. So it engages all the correct portal vessels.
[00:24:18] Jen Callahan
Oh, wow, That’s cool. So how about some of the things that we discussed, like you said, like the brachytherapy with putting the container with the radio seeds? Is that something that your department at Leeds had done? So you’ve seen that before?
[00:24:33] Jim Zhong
So we do that with radiation oncologists because the radiation oncologist actually delivers the dose, the seeds or the radiation dose to the prostate, you know, as an example. But the radiologists’ role there is to review the ultrasound imaging because it’s done under ultrasound guidance. The tubes themselves are inserted through the perineum. So the patient is anesthetized. They have a transrectal ultrasound probe so we can visualize the prostate. And then through the perineum, we deliver lots of these tiny little hollow needles effectively, and then you deliver the dose down those needles. It’s all it’s all planned beforehand. So you know exactly the dose required to whatever part of the prostate gland.
And it’s all planned on the MRI that the patient has had before the procedure. So the technical component is quite quick. There’s a lot more time required to actually plan the dose so that you don’t treat too much around the bladder or around the rectum because obviously, that causes side effects. So it’s the hard work a lot of the time is actually in the preparation rather than the technical aspect of getting into the prostate, which is an established way, you know, transperineal approach. That’s how we do biopsies as well. Now the prostate. So we’re quite familiar with that technical approach.
[00:25:50] Jen Callahan
Yeah. Isn’t it why you’re sitting here like saying with all the different modalities that go into planning something like this, isn’t it kind of almost simplistic how it’s like you can’t do this without the many different modalities? You know, you said MRI, ultrasound. You’re doing this under X-ray guidance, which is in the interventional suite. So you have at least three different components underneath the radiology umbrella all working together to treat this person. I mean, it’s not simple at all, I’m sure, putting it all together, but it just all meshes together that you’re pulling different puzzle pieces together to make it treatment.
[00:26:24] Jim Zhong
I guess, again, shows the value of imaging now. Right, in modern health care, which I think people don’t realize how radiology is so central to a lot of patient management and even treatment now with options. And where would we be if we couldn’t see into the body with all these imaging tools? Right. It would just be blindly feeling around and then hoping that you can stick a needle in somewhere and get a tissue specimen and maybe go through about five different organs that you didn’t want to. Because I think when I was reading about how the first prostate biopsies were done and it would just be, you know, you’d do a digital rectal exam, try to find out where the prostate was and just blindly. Go in with a hollow bore tube and try to rip out a bit of prostate and probably rip out the rectum in the process. It’s like, Oh God, what a barbaric who thought to do this? Why did they think of doing this procedure?
[00:27:15] Jen Callahan
Yeah, barbaric for sure. But I mean, you figure some of the things that are being used might not have been developed at that time like CAT scan and MRI really weren’t made until the 80s. Oh, yeah. And they’ve just gotten better and better, obviously with technology and with like X-ray and ultrasound and everything with technology getting better. I mean, this type of procedure that you’re talking about could have happened back in the 60s.
[00:27:40] Jim Zhong
You know, you’ve suddenly made me realize one of your previous questions, Jen was a memorable case. And I think one case when I was in my first set of on-call shifts in the UK, we do overnight shifts where we covered the acute emergency department. And we had a patient who had come in with a road traffic accident and they were clearly bleeding internally because they needed blood transfusion.
Their blood pressure was in their boots and traditionally those patients, they would just get taken to the theatre, opened up, you see a big pool of blood and you just try to pack it and hope for the best. But, you know, with a CT scan, you take them through. It takes, well, less than a minute to acquire a full-volume CT. You identify the bleeding points and then they can go for an embolization procedure and you block off where you know they’re bleeding and think, gosh, you know, to think that even probably someplace in the world now with no access to imaging, they don’t have that option. But this is revolutionized how we manage trauma patients with imaging. Right. To make it more targeted, to treat bleeding. And you can just stabilize the patient within seconds of blocking that bleeding point.
[00:28:46] Jen Callahan
Right. Or, for instance, I work in a hybrid room with vascular or cardiac doctors. Same thing. You’re talking about trauma patients coming in. They might have a dissected aorta somewhere within the body, and sometimes the patient does have to be opened. But with the advancements that have been done, they do everything endovascular early. If they can, they’ll go up through the femoral artery and try to repair the dissection of the aorta that way without having to open the patient up. So it’s similar. I mean, probably 20 years ago that wasn’t the case. Like you said, hack them and hope for the best, or open it up and try to figure out where it’s coming from, which is crazy.
[00:29:26] Jim Zhong
Yeah. And then you think of the post-operative stay the risk of getting pneumonia while being on a ventilator. Yeah, it has lots of knock-on effects, doesn’t it, as well.
[00:29:37] Jen Callahan
So what are you looking forward to then for your last bit of your education journey?
[00:29:41] Jim Zhong
Jim So what’s been, I guess nice with a PhD in the last six months has been pulling everything together, getting the thesis all written and linking up all the small projects that you’ve done and sort of creating a story. And obviously, it feels like actually you’ve done some work. As a first year, I felt like I had no results, didn’t really know what I was doing. It was a new area of radiology and cancer I was learning about, so it’s nice to see things wrapping up and getting all pulled together and then definitely going back into full-time clinical practice, working with the team, working with patients. That was something I definitely missed during my time doing research and just feeling part of that patient pathway and, you know, seeing patients before and after they have procedures like tumor ablation, which is obviously something that quite passionate about from a research perspective as well. And there’s lots of new technologies coming through as well. And so hopefully in the future, having gained some experience with the research aspect, learnt how to be involved with clinical trials, we can start to actually translate some of these new technologies into clinical practice and use that to treat patients in a less invasive way. And yeah, it’ll be really exciting to combine the two going forward.
[00:30:53] Jen Callahan
That’s great. Well, wish you luck and the rest of your journey. Yeah.
[00:30:56] Jim Zhong
So hopefully a month ago PhD another 12 months of training, but who knows? I’m sure I’ll find some way to extend my training even longer, but hopefully. Hopefully not too long.
[00:31:06] Jen Callahan
A little bit further away.
[00:31:08] Jim Zhong
Yes, but. Thank you very much for having me and to talk through all these things. It’s been really fun.
[00:31:13] Jen Callahan
Yeah, it was an enlightening conversation and I learned lots of new stuff. So thank you for explaining all that. I really do wish you lots of luck finishing out your medicine and hope that you’re happy with what you do.
[00:31:23] Jim Zhong
Thank you. Yeah.
[00:31:24] Jen Callahan
All right everybody, this is Jim Zhong, making some waves in the world of interventional radiology and then also to oncological imaging. All right, maybe I’ll talk to you soon, Jim.
[00:31:34] Jim Zhong
Hope so Jen, thanks for your time.
[00:31:36] Jen Callahan
All right, everybody. Thanks so much for watching. We’ll see you soon. You’ve been listening to the Skeleton Crew brought to you by X-raytechnicianschools.com. Join us on the next episode to explore the present and the future of the rad tech career and the field of radiology.