Professor of Medical Physics Mika Kortesniemi represents a profession that usually goes unnoticed by hospital patients. Medical physicists, who are responsible for radiation safety in hospitals, are expected to play a more substantial role in the future.
The RAPTOR (Resuscitation with Angiography, Percutaneous Techniques, and Operative Repair) suite in the Meilahti Tower Hospital is an impressive synthesis of operating theatre and imaging laboratory. Dedicated to the emergency treatment of trauma patients, the room is not only equipped for surgical operations, but also for imaging patients on the operating table without the need to move them, thanks to a sliding gantry CT scanner. The room also has devices for performing ultrasonographies and angiographies, the latter being used specifically to check blood vessels.
Because imaging produces radiation, a shielding structure is located next to the operating table. This shield can protect as many as 18 people when imaging is ongoing.
"We spent a long time designing it so that moving back and forth between the shield and the table could be done as quickly as possible," explains Professor of Medical Physics of the University of Helsinki. He was involved in designing the RAPTOR suite together with other medical physicists in Meilahti.
While the combination of hospitals and physicists may sound strange, the Meilahti hospitals alone employ some 40 medical physicists. Above all, their duties are related to the use and management of radiation, including defining safe radiation doses and ensuring equipment safety. Kortesniemi in his position as Professor of Medical Physics oversees their training.
From astronomy geek to medical specialist
The Meilahti hospital complex is huge: HUS Helsinki University Hospital serves some 40% of all Finns, and Meilahti is its largest cluster of hospitals. Kortesniemi moves through the winding corridors of the complex with the confidence that experience brings. He has worked there for much of his career, ever since embarking on training in medical physics in 1996.
This career choice was not self-evident.
"As a child, I was infinitely interested in space and knew all the planets before I could read. I first studied astronomy at the University, but career prospects looked fairly limited in that field," reminisces Kortesniemi.
A decisive turn of events happened when Kortesniemi was summoned to the office of Juhani Keinonen, then head of department.
"I was worried I would be reprimanded for something I had done. Instead, he asked whether I would be interested in medical physics. I had already taken a course in the discipline, and did well in it, so I guess my name came up when they were looking for prospective candidates," he thinks back.
That was to be his life's work. In 2002 he completed his doctoral thesis on boron neutron capture therapy, a new technical solution at the time using radiation to destroy cancer cells by targeting boron atoms injected into the patient.
Around the same time, however, Kortesniemi moved on to radiology to supervise and develop imaging services. His speciality is computed tomography, a diagnostic imaging technology using X-rays to produce detailed cross-sectional images of the human body.
Extensive education ensures radiation safety
is one of the longest among the healthcare professions. The basic requirement is a doctoral or licentiate degree in physics, supplemented by a five-year specialisation period in a hospital. One year of this programme can be spent doing research, meaning that in practice postgraduate studies and specialisation studies often overlap.
The training may seem long, but Kortesniemi justifies it by international standards and safety.
"Medical physicists have the ultimate responsibility for radiation safety not only during treatment, but throughout the hospital," he says.
The importance of imaging and AI will grow
Kortesniemi believes that medical physicists will play a more substantial role in the future.
"Imaging will increasingly contribute to medical examinations as the amount of available data grows and AI is used more and more in making analyses.
One CT scan image can contain 10,000 shades of grey: the human eye may be able to distinguish perhaps a hundred, but AI all of them. This refines analyses in an unprecedented manner."
AI is entering research at full speed: at the moment, HUS Helsinki University Hospital is testing ten analysis algorithms and another 16 are in the pipeline.
Kortesniemi has his concerns about this development.
"There is the danger that we rely too heavily on technology - very few people know how to do their laundry by hand when we have washing machines. In medicine, there are always variables that are difficult to convert into a format that would be understandable to a machine.
In future, medical research will, in fact, become increasingly multidisciplinary," assures Kortesniemi.
"Imaging already operates at the intersection of data science, physics, medicine and mathematics. Humans will be needed to manage the big picture in the future as well," he concludes.
