Leaving the Dark Room - Rashi Ranjan

Updated: Jul 11, 2020

The door to room 5210 has a window 75 centimeters tall and 15 centimeters wide, and if you look through it, you’ll see... absolutely nothing. The world of diagnostic radiology is a dark one⁠—quite literally. But if you put your ear to the door, you’ll hear bickering, laughing, and a lot of clicking of computer mice. For the past two months, I have been immersed in an environment where everyone exudes a love for science, suggesting podcasts when someone felt uninspired but also sharing a pun or two to take a break. When my CIRM instructor Ms. Bhatt first asked me what word comes to mind when I think of regenerative medicine, I thought “potential,” which holds true when I think about my laboratory experience altogether. I spent my time analyzing T2 hyperintensity using specific MRI sequences to find the efficacy of CAR-T-cell-therapy-treated glioblastoma, but I found that my mentors cared equally that I understood the objective and significance of the work I was performing and how I was contributing to the Chaudhry Lab. Throughout the weeks, I’ve looked at multiple brain scans from many patients—each a three-digit-number I’ll never be able to attach to a name or face—and it’s easy to disassociate the person from the disease when squinting at a bright screen in a dark room to find any spot of hyperintensity. But at City of Hope, all the moving parts are on one campus. Every Friday morning, I walked across Beckman Research Institute to Helford Clinical Research Hospital for Tumor Board, where I would simply observe a group of neurosurgeons, radiologists, nurses, and students discuss a real patient’s real disease in their real brain. That experience made the work I did on a computer in the laboratory so much more meaningful and applicable. Learning to perform image segmentation was no easy feat; even after two months of studying a brain and identifying the different components, I can revisit a study I finished working on three hours ago and find something I missed. Even though I’m not a radiologist, I’ve learned the power of immunotherapy in an era of precision imaging. My work is contributing to a project that can automatically read an MRI and find the prevalence of disease to be able to conduct correlative tests to find the distribution of the tumor. This project intrigues me since CAR-T cell therapy is the embodiment of regenerative medicine, modifying the patient’s own white blood cells through a chimeric antigen to use the patient’s native immune response to target cancer. Each MRI sequence I study—T1, T1 post-contrast, T2, and T2 FLAIR—has its own strengths, and the key is to find which one (or ratio of) can tell us most about the effectiveness of treatment. By improving the diagnosis of patients with glioblastoma treated with CAR-T cell therapy, early detection, and patient stratification is possible to improve survivorship. Researching this treatment and its effects on the malignant grade IV gliomas has been fascinating—I walk in the door every day to a new type of tumor, a new patient, a new story, and I contribute to something that will change precision imaging. The uncertainty is unwavering, but I have the most compassionate, helpful mentors who have made me believe in my own capabilities: crafting the analytic eye of a radiologist, communicating to other researchers about my project and its significance, and chasing my scientific dreams at my dream job. Thank you to CIRM and City of Hope for giving me the opportunity to meet mentors who I can seek guidance from for a lifetime, to hear speakers from different backgrounds who have all found passions in research, and to attend workshops that teach me how to read scientific papers. I am leaving the dark room now, but I am walking on a bright and inspiring path that this internship has paved for the future.

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