Dr. Alan Moody: Forecasting the Future of Radiology
Dr. Alan Moody, MBBS, FRCP
Senior Scientist, Physical Sciences, Schulich Heart Research Program, Sunnybrook Research Institute
Staff Physician, Medical Imaging, Sunnybrook Health Sciences Centre
Chair and Professor Institute of Medical Science, School of Graduate Studies, University of Toronto
Associate Professor, Department of Medical Biophysics, University of Toronto
By: Bowen Zhang
Sitting behind three large, sleek, vertically-oriented monitors in a neatly organized office on the 7th floor of Sunnybrook Health Science Centre, I had the unique opportunity to speak with Dr. Alan Moody, Chair of the Department of Medical Imaging at the University of Toronto, regarding the field of medical imaging and its future impact on healthcare. His journey in medical imaging began in 1986, as he earned his medical degree at the University of Oxford in the United Kingdom. After completing radiology residency training in London and a subsequent fellowship in Toronto, Dr. Moody became a senior lecturer at Leicester University. This was followed by a similar post at Nottingham University. With these experiences, in 1998, he became the Chair of Academic Radiology and Clinical Director of the Radiology Department at Queen’s Medical Centre in Nottingham. His prolific research profile and experience also contribute to him holding senior positions at various different academic and research institutions. These roles include Radiologist-In-Chief at the Sunnybrook Health Science Centre, Senior Scientist at Sunnybrook Research Institute and Chair of the Department of Medical Imaging at the University of Toronto.
“Medical imaging is at the heart of modern medicine,” said Dr. Moody. When referring to black-and-white cross-sectional images scrolling across the screen, Dr. Moody exudes passion for medicine and radiology. This is evident when he analyzes magnetic resonance images from an anonymized patient with late-stage atherosclerosis, “The marvellous thing about medical imaging is that we are able to diagnose and treat patients quickly and non-invasively. Here [in this image], bright spots indicate bleeding inside the plaque. Therefore, this suggests that the patient is highly susceptible of having a stroke.”
When asked about the contributing factors that led to his decision of specializing
in the field of diagnostic radiology, Dr. Moody reminisced, “I pursued radiology, because I trained at sites which were at the forefront of imaging innovations. At Atkinson Morley’s Hospital in London, I witnessed the creation of computed tomography (CT) and trained under pioneers of the field; Drs. Jamie Ambrose and Godfrey Hounsfield. While working at Royal Marsden Hospital, I had the great opportunity to be among one of the first teams to use magnetic resonance imaging in a clinical setting.”
Prior to the advent of CT in the 1970s, there was no method available to directly image the brain. Dr. Moody remarked, “We had very limited technologies. Plane X-ray films were used to highlight the bony skull. To identify potential maladies inside a patient’s brain, angiography would indicate the presence of a late-stage tumour if the vasculature was displaced. In air catholography, a lumbar puncture was performed to inject a large volume of air into the patient’s cerebrospinal fluid. The patient was subsequently maneuvered for the air to travel to the ventricles. Despite the procedure being crude, air catholography allowed us to observe the ventricles and discern growing tumours. Nevertheless, patients dreaded the procedure and complained about its side effects, such as terrible headaches.”
When describing the invention and conception of CT, Dr. Moody claims that CT imaging has changed the landscape of diagnostic medicine and is the workhorse of diagnostic radiology. The evolution of CT imaging is remarkable, as the world’s first CT scanner at Atkinson Morley’s Hospital would take over two minutes to make one tomographic image and hours to fully map out the brain. If the patient sneezed, the process would have to re-start. However, the modern multidetector CT acquires multiple sub-millimeter spatial resolution slices. Processing speeds are reduced from hour to milliseconds.
Aside from medical imaging, Dr. Moody also comments on the potential of big data in healthcare. Dr. Moody says, “Big data is changing the way we learn, train and educate others. The medical world is sitting on a ‘gold mine’ of research fodder, which consists of numerous patient diagnostic images. Currently, many of the clinical images are used just once. By working cooperatively, clinicians and researchers could use these images to identify trends, correlations, and get new insights into health and disease.” With this vision for the future, Dr. Moody and his team have started a project called Medical image Network Enterprise (MiNE). This is a platform and electronic repository of anonymized clinical imaging data that could be shared among physicians, researchers, and students. “The most difficult part is getting the ‘gold’ out, as these images belong to the patients. We have to ensure that the patients’ data are used securely and responsibly.”
In parallel to big data, the next technological revolution will be centered on artificial intelligence (AI) and machine learning. The waves of enthusiasm and optimism have successfully brought AI to the forefront of physicians’ imaginations. Dr. Moody regards that machines can potentially make medical diagnoses independently. He comments, “It’s not a question of if, it’s a question of when! AI and machine learning are on the horizon for medicine in general. Regardless of your speciality, if you access and use big data, you can expect AI to be part of your everyday practice. In radiology, we are in prime position to apply AI and machine learning techniques, as our content and medium are already digitized. By simultaneously enhancing workflow efficiency, patient care and throughput, these technologies offer a paradigm shift in how clinicians work.” Today, one of the biggest challenges faced by physicians is the task of sifting through large volumes of patient information and determining what is clinically relevant. With the advancement of AI technology, it will augment the ability of radiologists to find the crucial data they need in a concise, easily-digestible format.
Medical imaging is truly a vital element in modern-day clinical practice. It has and continues to evolve the way physicians diagnose and treat patients. Dr. Moody is among those excited by the opportunities to come, “I think the future for medical imaging is extremely bright; provided we seize the opportunity through research to help build the next generation of medical imaging innovations. This will allow us to play an ever-increasing role in patient management through diagnoses, treatments, and preventions.”