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2009

Grants and Awards

RSNA
RESEARCH & EDUCATION
FOUNDATION

FUNDING RADIOLOGY’S FUTURE®

Improving patient care by supporting


research and education in radiology and
related scientific disciplines through
funding grants and awards to individuals
and institutions that will advance radiologic
research, education, and practice.
 
 
Dear Colleague,

Our commitment to radiology research and education is stronger than ever. This year, the Foundation is celebrating its 25th
anniversary and the successful completion of a $15 million campaign. Through the generous support of our corporate,
private practice, and individual donors, we will be able to continue funding grant programs for the next 25 years.

We know that getting the first grant can be the hardest, and we are proud of our 25-year history of providing these critical
grants to launch successful academic careers. To date, the Foundation has awarded over $29 million for radiologic
research and education. The results are impressive—grant recipients have planted our seed money and turned it into over
$900 million in additional funding and countless improvements in patient care.

On behalf of the RSNA Research & Education Foundation, I would like to congratulate this year’s grant recipients. We look
forward to your discoveries in the years ahead. I would also like to give special thanks to our Vanguard companies for their
support. With the backing of the entire community we will keep radiology at the forefront of medicine.

Sincerely,

Jack E. Price
Chair, Board of Trustees
RSNA Research & Education Foundation

Bayer HealthCare Canon U.S.A.


Agfa HealthCare Pharmaceuticals

Bracco Diagnostics

Covidien Fujifilm Medical Systems


Carestream Health
Cook Medical

Siemens Healthcare USA


Philips Healthcare
GE Healthcare Hitachi Medical Systems

Toshiba America Medical


Systems Varian Medical Systems

RSNA R&E Foundation

Vanguard Companies

 
Research Grant Programs
Research Scholar Grant ............................................................................................................. 3–6
To provide protected research time to junior faculty members who have completed the
conventional resident/fellowship training program(s). The grant prepares research-oriented
faculty to obtain larger grants from other sources, such as the National Institutes of Health
(NIH), and to be able to establish their own fully funded research program. $75,000
annually for 2 years ($150,000 total) to be used as salary support for the scholar.

Research Seed Grant .................................................................................................................. 6–7


To enable investigators to gain experience in defining objectives and testing hypotheses in
preparation for major grant applications to corporations, foundations, and governmental
agencies. The grant is intended to support the preliminary or pilot phase of scientific
projects, not to supplement major funding already secured. Up to $40,000 for a 1-year
“Survey data reveal the extraordinary project.
success—measured in subsequent
dollars—of investigators with RSNA Research Resident/Fellow Grant ......................................................................................... 8–14
R&E Foundation-funded research To support trainees who are pursuing careers in academic medicine by allowing recipients
early in their careers. Many of the to devote 50% of their time to an approved research project under the guidance of a
topics these creative and inquisitive scientific advisor/sponsor. The grant provides investigators an opportunity to gain further
investigators soon translate into insight into scientific investigation and to develop competence in research techniques and
clinical application and dissemination. methods. $30,000 for a 1-year resident project or $50,000 for a 1-year fellow project to be
There is no better investment in used for salary and/or non-personnel research expenses.
the future of radiologic practice
anywhere in the world.”
Research Medical Student Grant ........................................................................................14–27
To make radiology research opportunities possible for medical students and to encourage
Gary J. Becker, MD
them early in their medical careers to consider academic radiology as an option for their
2009 President, RSNA; Executive
future. Students are expected to complete a 3-month, full-time research project under the
Director, American Board of
guidance of a scientific advisor. $3,000 for a 3-month research project to be matched by
Radiology
the sponsoring department ($6,000 total) as a stipend for the medical student.

Education Grant Programs


Education Scholar Grant ........................................................................................................28–32
To provide funding opportunities for individuals with an active interest in radiologic
education. Any area of education related to the radiologic sciences is eligible for Education
Scholar Grant support. Up to $75,000 annually for up to 2 years ($150,000 maximum) for
salary support and/or other project costs.

RSNA/AUR/APDR/SCARD Radiology Education Research


Development Grant ........................................................................................................................ 33
To encourage innovation and improvement in health sciences education by providing
research opportunities to individuals in pursuit of advancing the science of radiology
education. This program will help build a critical mass of radiology education researchers
and promote the careers of persons advancing the science of radiology education. Up to
$10,000 for a 1-year project to help cover the costs of research materials, research
“We have to continue working on assistant support, and limited primary investigator salary support.
advancing radiology science and
research to sustain our specialty
and compete with others. RSNA
R&E Foundation grants played a
critical role in my career, acting as a
springboard to get NIH funding. The
Recognition Awards
work I have done with my grants has
advanced contrast medium delivery Roentgen Resident/Fellow Research Award ..................................................... 34–36
technology and improved diagnostic To recognize and encourage residents and fellows who have played an active role in
quality of the images we interpret in radiologic research during the past year. Participating North American residency programs
our daily clinical practice.” receive an award plaque with room for the name of each year’s recipient. The Foundation
provides a personalized award for the department to present to the selected resident or
Kyongtae Ty Bae, MD, PhD fellow.
1996 Research Resident Grant
Recipient; 1999 Research Seed
Outstanding Researcher/Educator Awards ....................................................... 37–38
Grant Recipient; Member of
To annually recognize and honor one senior individual in each category who has made
Research Study Section
original and significant contributions to the field of radiology or radiologic sciences
throughout a career of research or teaching and education. Awardees are honored at the
opening session of the RSNA Scientific Assembly and Annual Meeting.

2  
Grant Research Scholar
Prostate Specific Membrane Antigen (PSMA) PET
Imaging for Detection of Metastatic Prostate Cancer
and Solid Tumor Neovasculature
Metastatic prostate cancer diagnostic imaging using traditional anatomic modalities including CT, MRI,
and ultrasound, as well as [18F]-FDG PET metabolic imaging, is limited. PSMA is a protein highly
restricted to prostate cancer. PSMA is also found to be specifically expressed on the neovasculature
of many solid tumors but, interestingly, not in prostate tumor neovasculature. ProstaScint®, a
radiolabeled monoclonal antibody binding to the intracellular domain of PSMA, was developed to
detect prostate cancer lymph node metastases but has limited accuracy due to antibody targeting
characteristics. Tumor vascular imaging in a number of solid tumors with another PSMA monoclonal
antibody, J591, has been recently demonstrated.

Intact monoclonal antibodies-based tumor detection is limited because of their low permeability in
Steve Y. Cho, MD
solid tumors and slow clearance from the circulating blood pool. Smaller molecular weight-based
Radiology radiotracers are more optimal for tumor detection because of their higher permeability into solid
Division of Nuclear Medicine/PET tumors and improved blood clearance in comparison to intact antibodies. [18F]-DCFBC is a novel,
The Johns Hopkins University low-molecular-weight radiotracer targeting the more accessible extracellular domain of PSMA.
School of Medicine Preclinical mouse prostate cancer tumor model imaging studies of [18F]-DCFBC demonstrate that this
new ligand has high uptake in PSMA-expressing prostate cancer cells. [18F]-DCFBC is a clinically
Bracco Diagnostics/RSNA practical PET imaging agent with superior pharmacodynamic and pharmacokinetic characteristics that
Research Scholar Grant warrants further evaluation in clinical trials.

[18F]-DCFBC PET images will be compared to conventional imaging methods and bone scan to
localize tumors in patients with advanced metastatic prostate cancer. Radiation dosimetry and
biodistribution of [18F]-DCFBC will be determined by PET imaging in patients with metastatic prostate
cancer to calculate whole-body and organ-specific radiation dosimetry.

We will also evaluate the potential of [18F]-DCFBC PET to specifically target neovasculature in solid
tumors, excluding prostate cancer. Tumor neovasculature PSMA expression will be obtained by tissue
immunohistochemistry and compared to [18F]-DCFBC PET findings.

Direct Imaging and Quantification of Cortical Bone on


a Clinical 3 T MR Scanner
Imaging of bone has been of fundamental importance to the practice of radiology. Plain radiographs
and CT provide images of high spatial resolution, and bone density is readily measurable with DEXA
and CT. However, the images and measurements very largely reflect the mineral content of bone, not
the organic matrix or bone water that occupy a larger volume and have important mechanical and
biological properties.

There has been considerable interest in assessing the organic matrix and water in bone with magnetic
resonance (MR) imaging. But bone has a very short T2, producing no signal with all clinical pulse
sequences. Ultrashort echo time (UTE) sequences with TEs 100-1000 times shorter than these
available on clinical scanners allow direct visualization of cortical bone. The objective of this proposal
is to develop qualitative and quantitative techniques to image and quantify cortical bone on a 3 T
Jiang Du, PhD clinical scanner.
Radiology
The research plan includes three parts: 1) Developing UTE imaging sequences. Technical issues
University of California, San Diego
including eddy currents, gradient non-linearity, and long T2 suppression will be addressed. 2)
Developing quantitative techniques. A saturation recovery technique will be used for T1 measurement
Agfa HealthCare/RSNA
and multiecho techniques for T2* measurement. Reference standards will allow bone water to be
Research Scholar Grant estimated. Bone bulk susceptibility will be estimated using a novel UTE spectroscopic imaging
(UTESI) technique. 3) Applying UTE imaging and quantitative techniques to normal volunteers and
two groups of patients (osteoporosis and osteomalacia). Volunteer data will be correlated with age,
sex, and weight and will serve as a control group. Patient population data will be compared to the
control group.

After the proposed project period, we will have developed UTE sequences for the first quantitative
evaluation of cortical bone in normal volunteers and patients. The noninvasive characterization of
cortical bone could be revolutionary if it proves to have a specific MR signature.
3  
Prostatic Artery Embolization as a Primary Treatment
for Benign Prostatic Hyperplasia
A third of men aged 50 years and over will develop bladder outlet obstruction/irritation from benign
prostatic hyperplasia (BPH), and a quarter will require surgical intervention. The surgical standard,
transurethral resection of the prostate, requires a 5-day hospital stay and has >50% incidence of
complications (eg, urethral stricture, urinary incontinence, impotence) leading many to search for
alternative, minimally invasive options. Selective embolization of the prostatic artery has been reported
as a safe and effective treatment for prostate bleeding after TURP or biopsy. Along these lines, we
generated preliminary results in six dogs with BPH and demonstrated a 40% reduction in prostate
volume at 1 month following embolization with microspheres, with subjectively better results, but
greater initial urinary retention, using a bilateral embolization technique.

Specific aims:
1. To determine 6-month safety of prostate embolization in a canine model; Salomao Faintuch, MD
2. To assess short/mid-term effects of prostate embolization for BPH on gland volume and Radiology
perfusion, urethral obstruction, and histology; Beth Israel Deaconess
3. To refine the technique by optimizing embolization particle size and assessing the need for
Medical Center
bilateral versus unilateral embolization.
Harvard Medical School
Dogs with BPH will undergo selective bilateral embolization of the prostatic arteries with 100-300µm,
300-500µm or 500-700µm (n=6, each) microspheres. Animals will be monitored clinically for 1 month GE Healthcare/RSNA
after embolization for infectious, ischemic, or other complications. Retrograde urethrocystography and Research Scholar Grant
dynamic contrast-enhanced MRI will be obtained prior to embolization and after 1 month for
quantitative and qualitative analysis of urethral stenosis, prostate volume, and enhancement. After 1
month, prostates will be excised for radiologic-pathologic correlation and microscopic analysis (particle
distribution, necrosis, inflammation). Unilateral versus bilateral embolization with the ideal particle size
will be compared (n=6, each), with a 6-month follow-up (results of Phase I).

This is a potential revolutionary treatment analogous to uterine artery embolization that has the ability
to evolve into treatment for prostate cancer (radioembolization-Y90, chemo/hormonal embolization).

Evaluation of Magnetic Nanoparticle Enhanced


Magnetic Resonance Imaging in Clinical Autoimmune
Diabetes
Type I diabetes mellitus (DM) is an irreversible, chronic disease causing disproportionately high per-
capita healthcare expense (~5 fold greater than non-diabetics), secondary to both long-term glycemic
management and occasional devastating acute and chronic complications. Although it is well
established that DM results from autoimmune destruction of the insulin producing beta cells of the
pancreatic islets, a true understanding of its immunopathogenesis in humans has remained elusive.
Previous techniques used to quantify insulitis (to measure the degree of inflammation and islet
destruction) and beta cell mass (BCM—a measure to gauge the amount of residual beta cells) are
invasive and impractical for most human studies. Imaging may therefore play an important role in
quantifying insulitis and BCM. Radionuclide attempts have shown initial promising results in animal
models of diabetes, without successful translation into human clinical trials. As novel
Alexander R. Guimaraes, MD, PhD
immunomodulatory therapies evolve in order to prevent beta cell destruction, a noninvasive, accurate
means of visualizing and quantifying BCM and insulitis becomes critical. Recently, we developed a
Radiology
technique based on the properties of magnetic resonance imaging (MRI) enhanced with magnetic Massachusetts General Hospital
nanoparticles (MNP) to allow indirect quantification and visualization of insulitis in animal models of
DM. We validated this MNP-MRI technique by correlating our findings with the standard invasive Bayer HealthCare
techniques used to study diabetes, including histology and flow cytometry of the pancreas and Pharmaceuticals/RSNA
pancreatic inflammatory infiltrate samples. Initial translation of this technique has resulted in a trial to Research Scholar Grant
study insulitis in humans, funded by the NIAID (PI Mathis/Weissleder). Twelve patients with early
onset diabetes have been enrolled with encouraging results. We are now poised to translate and
optimize this technology and apply it to an extended human clinical trial.

4  
Chronological Analysis of Tumor Size, Volume, and
CT Attenuation Coefficient in Women with
Adenocarcinoma of the Lung Treated with Erlotinib
Lung cancer is a leading cause of cancer death in the United States and worldwide. One of the recent
breakthroughs in lung cancer treatment was the discovery of the somatic activating mutations of the
EGFR tyrosine kinase domain in non-small cell lung cancer, which is associated with a dramatic
clinical response to EGFR inhibitors such as gefitinib and erlotinib. Erlotinib is particularly effective in
women with adenocarcinoma. However, most patients with initial responses to erlotinib treatment
eventually relapse due to acquired resistance to erlotinib.

The purpose of this proposal is to analyze chronological changes in tumor size and volume in women
with adenocarcinoma of the lung treated with erlotinib, and to determine if the tumor size change rate
and the tumor volume change rate precede the actual increase in tumor size and volume due to
Mizuki Nishino, MD
relapse. If a perceptible tumor size change rate and tumor volume change rate precede the increase
Radiology in tumor size and volume, oncologists can switch to another therapeutic agent before relapse in order
Brigham and Women's Hospital to prolong disease-free survival.
Dana-Farber Cancer Institute
The study will be performed using data collected in a Phase II prospective clinical trial of erlotinib in
Agfa HealthCare/RSNA women with previously untreated advanced adenocarcinoma of the lung at Dana-Farber/Harvard
Research Scholar Grant Cancer Center, which has enrolled 84 subjects. Data include chest CTs performed every 8 weeks and
EGFR mutation analysis. Size, volume, and CT attenuation will be measured using a semiautomatic
image-processing program. Rate of tumor size and volume changes will be calculated and will be
correlated with clinical outcome and genetic analysis results.

The long-term goal is to determine the imaging parameters that most efficiently predict acquired
resistance to erlotinib by correlating the imaging parameters with the genomic characterization of the
tumor, in order to optimize the therapeutic benefit of erlotinib and contribute to the prolongation of
survival in lung cancer patients.

Hyposmia, Septohippocampal Cholinergic


Denervation, and Amyloidopathy in Mild Cognitive
Impairment
Alzheimer’s disease (AD) is the most common form of dementia, accounting for over 50% of cases of
age-related dementia in the over 65 population. Amyloid misprocessing/deposition and cholinergic
neuron degeneration are key aspects of AD pathogenesis. In addition, substantial reductions in
neuronal nicotinic Acetyl Choline receptors (nAChRs) in the cortex of AD patients have been
documented on post mortem specimens.

Given the recent emergence of potential disease modifying anti-amyloid treatments there is a
compelling need for biomarkers that can identify subclinical/very early disease. Identification of
amyloidopathy is possible using PET imaging, however, the cost of this technology is prohibitive for
screening large populations.
Myria Petrou, MA, MBChB
Radiology Olfactory disturbances commonly precede clinical manifestations in a number of neurodegenerative
University of Michigan Health disorders including AD. There are reports of selective olfactory abnormalities in subjects with mild
System cognitive impairment (MCI) who convert to fulminant AD; pathophysiological mechanisms underlying
the hyposmia do however remain unclear.
Covidien/RSNA
Research Scholar Grant We propose evaluating the potential of an AD-selective smell identification test as an early screening
test for AD. For this purpose, we intend to study well-characterized subjects with mild cognitive
impairment (MCI) with a clinical olfactory test and amyloid PET imaging assessment. We will also go
on to explore mechanisms underlying the hyposmia in MCI subjects, specifically that degeneration of
septo-hippocampal cholinergic projections occurs early in AD and may provide an explanation for the
selective deficits in odor identification. We will use well established methodology for imaging of
cholinergic pathways using Acetylcholinesterase (AChE) PET with [11C]PMP. We also propose to
investigate the specific role of synaptic nicotinic cholinergic receptors in amyloidopathy-related
hyposmia using [18F]XTRA, a novel Acetylcholine Receptor (nAChR) PET radioligand.

Improved insights in pathobiological mechanisms of hyposmia in AD will not only allow early screening
of at risk subjects but may also provide novel therapeutical targets in patients with very early disease.

5  
Creation of a Model for Predicting Response to
Chemoradiation in Head and Neck Squamous Cell
Carcinoma
Chemoradiation of head and neck squamous cell carcinoma (HNSCC) is challenging due to frequent
local or regional failures. Our objective is to develop a prediction model using pre-therapy
demographic, pathologic, and MRI parameters to identify HNSCC patients who respond poorly to
chemoradiation. Our long-term goal is application of the model prospectively in a multicenter clinical
trial to identify poor responders who may benefit from escalated radiation doses, which are now
feasible and safer due to advances in targeted radiation delivery, and can improve disease-free
survival.

Among the factors influencing tumor response, we will study tumor cellularity as a key predictor.
Diffusion weighted MR imaging (DWI) is a molecular imaging technique measuring apparent diffusion
Ashok Srinivasan, MD
coefficient (ADC), which is considered a surrogate marker for tumor cellularity. The proposed study is
part of an ongoing trial at the University of Michigan involving serial MRIs in HNSCC patients
Radiology
(baseline, during third week of therapy and at 3 months) to study the utility of serial ADC values in University of Michigan
assessing tumor response. Patients undergo standard-of-care chemoradiation and therapeutic Health System
response is assessed after 3 months. As an additional step to this trial, we propose to use only the
baseline MRI data to construct a prediction model that will provide information on the utility of pre- Carestream Health/RSNA
therapy scans alone in predicting response. Research Scholar Grant    
 
Our specific aims are (1) building a prediction model using age, pathological grade, tumor volume,
nodal status, whole tumor mean ADC, and fractional tumor volume below an ADC threshold as
parameters influencing tumor response to chemoradiation, and (2) assessing the value of adding
“fractional tumor volume below an ADC threshold” to “whole tumor mean ADC” in predicting
therapeutic response.

Developing noninvasive imaging parameters that identify poor responders to chemoradiation is


important since therapy can then be individualized to increase chances of treatment response.

Quantification of Tumor Angiogenesis Using


Grant
Research Seed

Diffusion and Perfusion Weighted MR Derived


Parameters Correlated with Vascular Endothelial
Growth Factor (VEGF) Expression and Microvessel
Density in Renal Cell Carcinoma
There is up-regulation of vascular endothelial growth factor (VEGF) in renal cell carcinoma (RCC) and
this VEGF expression has been shown to be an important prognostic marker. Furthermore, new
experimental drugs which target angiogenic tumor pathways in the treatment of metastatic RCC are
being designed, tested and have been recently introduced in the clinical practice. The aim of this
project is to correlate quantitative MR markers of tumor angiogenesis with VEGF expression and
microvessel density (MVD) in RCC. We hypothesize that VEGF expression and MVD measured with
pathology is strongly associated with imaging parameters of angiogenesis measured with diffusion Hersh Chandarana, MD
(using intravoxel incoherent motion [IVIM] model) and perfusion-weighted MRI (PWI). Radiology
New York University
We will prospectively enroll 30 patients with RCC prior to undergoing surgical treatment (total or partial School of Medicine
nephrectomy). Imaging will be performed within 60 days of the surgery at 1.5 or 3.0 T utilizing diffusion
weighted imaging (DWI) with multiple b values, and PWI with high temporal resolution. DWI data will Toshiba America Medical
be processed to extract the IVIM parameters (perfusion fraction fp and pseudodiffusivity Dp). A two- Systems/RSNA
compartment adiabatic tissue homogeneity (ATHs) model will be used to analyze the PWI data and to Research Seed Grant
generate perfusion parameters (including tumor blood volume and tumor blood flow). Quantitative MR
parameters will be correlated with lesion size and differentiation, MVD, and VEGF expression obtained
at histopathology. If validated, MRI could be used as a non invasive biomarker of angiogenesis, and
could be used for predicting and monitoring response to targeted anti-VEGF and tyrosine kinase
inhibitor drugs which are currently under investigation in RCC. Future work will be oriented towards the
prospective use of MRI biomarkers of angiogenesis in prediction and monitoring of RCC response to
anti-VEGF treatments.

6  
Exploiting Angiogenic Rebound with Ionizing
Radiation
Vascular endothelial growth factor receptor (VEGFR) inhibitors represent a promising class of anti-
neoplastic agents and early investigations of combined VEGFR blockade and ionizing radiation
suggest impressive clinical activity. However, several critical questions remain. VEGFR inhibitors may
lead to compensatory increases in circulating pro-angiogenic and decreases in circulating anti-
angiogenic molecules. We hypothesize that these “rebound” phenomena may drive brisk
angiogenesis and tumor cell proliferation with inhibitor discontinuation. We further hypothesize that
ionizing radiation may be uniquely efficacious during this rebound phase.

To rigorously test these hypotheses, we will use a human pancreatic cancer xenograft model. We will
quantify changes in the plasma angiogenic proteome with continuous and discontinuous VEGFR
inhibition. Combined regimens of VEGFR inhibitors and ionizing radiation will be examined to test for
Kevin Kozak, MD, PhD potential deleterious effects of cyclic VEGFR inhibitor monotherapy and for enhanced tumor
Human Oncology radiosensitivity during angiogenic rebound.
University of Wisconsin School of
These studies will meaningfully address three central clinical questions. First, they will assess the
Medicine and Public Health
consequences of VEGFR discontinuation and clarify the merits of continuous versus cyclic anti-
angiogenic therapy. Second, these studies will provide insights into the potential value of VEGFR
Philips Healthcare/RSNA inhibitor continuation even in the face of apparent clinical resistance. Finally, through the identification
Research Seed Grant of a novel interaction between anti-angiogenic and radiation therapies, these studies will quantitatively
examine the potential for exploitation of angiogenic rebound with ionizing radiation.

Answers to these questions will provide the foundation for hypothesis-testing in humans in the setting
of translational and Phase I clinical trials. Moreover, continued refinement of our model of angiogenic
rebound will permit follow-on preclinical evaluation of potentially useful technologies including, for
example, [18F]-fluorothymidine positron emission tomography to track rebound endothelial and tumor
cell proliferation. The proposed project will be the first step in an integrated “bench-to-bedside-and-
back” effort to optimize anti-angiogenic therapy.

Real-Time MRI Evaluation of the Upper Airway in


Patients with Obstructive Sleep Apnea with EEG
Correlation
Obstructive sleep apnea (OSA) is a common and frequently undiagnosed condition where there is
recurrent upper airway collapse during sleep. Patients experience repetitive, brief awakenings
resulting in fragmented sleep which causes fatigue and excessive daytime sleepiness. Consequences
of OSA are numerous but include serious cardiovascular and neurovascular diseases.

OSA treatments are poorly tolerated, ineffective and/or invasive. Patients who can not tolerate
conventional positive airway pressure therapy can undergo “Phase 1” oral-maxillofacial surgeries to
enlarge the upper airway and reduce collapsibility.

Failure rates are as high as 60% and poor surgical outcomes have been attributed to inaccurate pre-
Lewis Shin, MD
operative localization and characterization of airway collapse. Most pre-surgical evaluation is
Diagnostic Radiology performed while the patient is awake or under a pharmacologically induced sleep. As a result, airway
Stanford University collapse that occurs during natural sleep is not always reflected in these exams.

Hitachi Medical Systems/RSNA We hypothesize that pre-surgical MR imaging with EEG correlation under natural sleep will more
Research Seed Grant accurately identify site(s) of airway collapse, thereby improving surgical planning and clinical
outcomes. We will scan 20 subjects who will undergo “Phase 1” OSA surgery.

Before and after review of MRI/EEG data, we will evaluate the OSA surgeon for changes in: 1)
assessment of characterization of airway collapse; 2) surgical plan; and 3) prediction of successful
correction. Surgeon's impression of MRI/EEG usefulness will be investigated. To evaluate for
improved clinical outcomes, we will compare polysomnography and sleepiness scale questionnaire
results with data from matched controls. Appropriate statistical analysis will be performed to determine
significance.

Dramatic improvements in clinical efficacy may result in a new paradigm for pre-OSA surgical
evaluation. Long-term goals would include: optimizing (shortening) scan protocol for clinical practice;
evaluating other existing therapies (dental appliances, radiofrequency ablation, Phase 2 surgery) and
emerging treatments to advance improvement strategies; and computational modeling with this data
to lay groundwork for developing innovative, minimally invasive treatments.

7  
Grant
Research Resident/Fellow
Molecular and Bioinformatic Identification of
Epithelial Ovarian Cancer Stem Cells
Stem cells organize and populate the body through a hierarchy of proliferation and differentiation,
while retaining the capacity to continuously self-renew. The insight that this physiologic order mirrors
the deranged orderliness of a developing malignancy led to the cancer stem cell (CSC) hypothesis,
which proposes that each tumor consists of a heterogeneous population of cells at various stages of
differentiation, but all derived from the same small CSC pool; that purging tumors of this CSC pool will
be sufficient to undermine their accumulated bulk and recurrence risk. Originally conclusively
demonstrated for AML, this elemental population has since begun to be described in solid tumors,
most prominently in breast cancer.

Epithelial ovarian cancer (EOC) is the leading cause of death among gynecological cancers, with
14,000 deaths annually. While EOC is thought to arise from the ovarian surface epithelium,
pathogenesis is poorly understood. Therapy options are similarly limited, especially with radiotherapy Robert Chin, MD, PhD
hobbled by toxicity. This study proposes to build on our previous monoclonal antibody library work, in Radiation Oncology
which we identified a potential negative marker for EOC stem cells. Aim 1 seeks to exploit this foothold
Stanford University Medical Center
by use of genetic array, single cell expression array, and bioinformatics to rapidly expand the list of
potential markers. These markers will then be screened against published datasets linked to clinical
Philips Healthcare/RSNA
outcomes data to screen for clinical significance. Aim 2 seeks to validate the efficacy of these markers
both in vivo by their ability to fractionate ever purer populations of CSCs and in vitro by induction of Research Resident Grant
either differentiation or killing of tumorigenic spheroids. Potentially therapeutic antibodies will be
evaluated in murine xenograft models.

The CSC hypothesis has far reaching implications for both scientific understanding and therapy. An
identified CSC population permits more specific screening for vulnerable molecular pathways and
immunologic targets amenable to radioimmunologic therapy.

Increasing Spatial Resolution and Depth of Optical


Fluorescent Imaging Using Microbubble Ultrasound
Contrast Agents
Optical imaging is the most sensitive molecular imaging tool that can capture molecular and cellular
processes in real time. Its major limitations are poor spatial resolution (~1cm3) and limited penetration
(2–3cm) due to extremely high scattering and absorption by tissues. The high scattering results in poor
spatial resolution because of the inability to accurately localize the exact origin or path of the detected
photon.

It is well known that ultrasound (US) modulates photons passing through its focal zone because the
US wave moves optical scatterers/absorbers to affect the light differently during the US compression
and rarefaction phases. This technique, called acousto-optic imaging (AOI), can accurately localize the
detected US-modulated photons since the location of the US focal zone is known in the 2D space. AOI
can potentially improve optical imaging resolution to nearly that of US resolution (few mm3). Since the
Mohammad Eghtedari, MD, PhD
detected optical signal is dominated by near field photons, modulated photons detected from greater Diagnostic Radiology
depth improve imaging of deeper tissues. The major challenge in AOI is the recognition of the few University of California, San Diego
modulated photons leading to poor signal-to-noise ratio (SNR) that decreases further with depth. We
showed in preliminary studies that microbubbles not only increase photon modulation amplitude Bracco Diagnostics/RSNA
because of their greater oscillation in an US field, but also generate harmonic modulation that Research Resident Grant
improves sensitivity and specificity of the detected modulation. Since it is known that US can also
modulate fluorescent signal, we plan to test whether microbubbles will also improve fluorescent SNR
to improve spatial resolution and depth of optical fluorescent imaging.

We propose to engineer a custom AOI system to image fluorescent-labeled targets within turbid
media, produce and optimize fluorescent-labeled microbubbles to be employed as contrast agents for
AOI, and determine the improvement in maximum depth of imaging and spatial resolution when
fluorophores are used without, with and when attached to microbubbles.

8  
Molecular Imaging of the Inflammatory Enzyme
Myeloperoxidase in Murine Cerebral Ischemia
Inflammation has been shown to correlate with adverse stroke outcome but the specific underlying
molecular mechanisms and their impact on stroke outcome remain poorly understood.
Myeloperoxidase (MPO) activity has been widely used as a pathological marker for inflammation in
animal models of stroke in biochemical and histopathological analyses. However, traditional methods
of investigation that require sacrificing the animals limit serial and longitudinal investigations that
would greatly facilitate pathobiological and pharmacological investigations, and often require
excessively large numbers of animals to achieve sufficient statistical power to confirm a therapeutic
benefit. The emergence of molecular imaging methods can largely overcome these obstacles.

We propose to use Gd-bis-5-HT-DTPA (MPO-Gd), a highly sensitive and specific molecular imaging
reporter of MPO activity developed in our laboratory, to study the role of inflammation in mouse
models of cerebral ischemia. We will evaluate the role of MPO in infarct propagation by serially
Reza Forghani, MD, PhD
examining MPO activity and infarct volume on MPO-Gd enhanced MRIs with and without treatment
Radiology
with the specific MPO inhibitor 4-aminobenzoic acid hydrazide. In addition, we will perform a similar
Center for Molecular Imaging evaluation on MPO knock-out mice for comparison. We will then correlate the findings with
Center for Systems Biology biochemical and histopathological analyses to confirm our imaging observations and validate MPO
Massachusetts General Hospital molecular imaging as a tool for noninvasive in vivo investigation of inflammation.

RSNA Research Fellow Grant These investigations could provide the basis for novel therapies to improve stroke outcome in
conjunction with an imaging paradigm for assessing the effectiveness of such interventions in
diseases with an inflammatory component in animals and potentially in human diagnostic imaging.

Using Micro-CT to Define the Role of Endothelial


Cells in the Response of Primary Lung Cancers to
Radiation Therapy
Despite aggressive treatment with radiation therapy, lung cancer remains the leading cause of cancer
death in the United States. Efforts to improve the efficacy of radiation therapy are hindered by
uncertainties in its mechanism of cell death and in identifying its precise cellular targets. The role of
the vasculature in the response of carcinomas to radiation therapy is controversial. Furthermore, the
mechanism of cell death in the vasculature after radiation therapy is unclear, and the role of p53 in
mediating these processes is debated.

We aim to resolve this important controversy using sophisticated genetically engineered mouse
models of lung cancer combined with state-of-the-art small animal imaging techniques. Using Cre-lox
technology we will delete Bax specifically in endothelial cells and determine whether endothelial cell
A. Paiman Ghafoori, MD
apoptosis regulates the response of primary lung tumors to radiation therapy. We will also clarify the
Radiation Oncology role of the p53 gene in mediating apoptosis in endothelial cells and in the response of primary lung
Duke University Medical Center tumors to radiation therapy by deleting p53 specifically in endothelial cells. Microcomputed
tomography will be used to follow primary lung tumors in mice and assess the effect of these genetic
Fujifilm Medical Systems/RSNA alterations on the response of tumors to radiation therapy.
Research Resident Grant
We postulate that lung cancers with endothelial cells that lack p53 will be more sensitive to radiation
therapy and that lung cancers with endothelial cells unable to undergo apoptosis will be more
resistant. These studies will enhance our understanding of lung tumor biology and will lay the
foundation for new treatment approaches to cure patients with lung cancer.

9  
Adenosine Induced Stress Myocardial Perfusion
Imaging Using Dual Source Cardiac Computed
Tomography
The current workup of symptomatic coronary artery disease (CAD) usually includes noninvasive
imaging. Nuclear myocardial perfusion imaging (MPI) provides reliable information on the functional
significance of coronary stenosis, yielding important management and prognostic information.
However, it cannot assess coronary anatomy, thereby necessitating invasive coronary angiography
(ICA) in many patients.

Advances in cardiac CT have enabled noninvasive assessment of coronary stenosis with excellent
diagnostic accuracy. Recent studies have demonstrated that cardiac CT can assess myocardial
function including perfusion and regional wall motion. In a preliminary study of 27 patients, we
demonstrated that dual-source CT can identify adenosine stress-induced myocardial perfusion defects
in patients with suspected CAD with a diagnostic accuracy at least equal to MPI, with similar radiation Brian Ghoshhajra, MD
dose, while simultaneously assessing coronary anatomy. Radiology
Cardiac CT/MR/PET Program
In this observational study, we will investigate 50 patients who have undergone recent MPI and are Massachusetts General Hospital
scheduled for ICA. Using a DSCT, we will perform adenosine stress retrospective CT (QCT) followed
by rest prospective CT (CTA). Images will be analyzed to assess myocardial perfusion reserve and Siemens Healthcare/RSNA
angiographic evidence of stenosis. We will determine the sensitivity and specificity of QCT on a per- Research Fellow Grant
patient and per-vessel basis for the diagnosis of significant CAD, compared to MPI, using ICA as a
reference.

Aim 1: Determine the feasibility and accuracy of QCT to detect myocardial perfusion defects in a
symptomatic population as compared to MPI. Hypothesis: The accuracy of QCT for the detection of
hemodynamically significant coronary stenosis is equivalent or better than MPI, using ICA as the
reference standard.

Aim 2: Determine the incremental value of CTA in conjunction with QCT for the detection of significant
coronary stenosis as compared to MPI. Hypothesis: Incorporation of CTA data with QCT data allows
significantly greater accuracy for the detection of hemodynamically significant coronary stenosis than
MPI, using ICA as the reference standard.

Targeted Radioiodinated Nanoparticles for the


Treatment of High Grade Glioma
Utilizing biopanning techniques with bacteriophage, we have recently demonstrated that among
screened phage-displayed peptides, the HVGGSSV peptide binds with high sensitivity and specificity
to irradiated xenograft glioma tumors. When bound to near infrared imaging agents, this peptide
selectively binds to responding irradiated tumors differentiating responding from non-responding
tumors.

We propose that radioiodination of the HVGGSSV peptide/phage, an HVGGSSV-decorated liposome,


labeled nanoalbumin or other biocompatible and biodegradable vector systems could be used to
deliver targeted radioactive iodine NP vectors for the treatment of high grade glioma. We will study the
biodistribution and pharmacokinetics of these systems to determine the optimal NP vector system for
the treatment of high grade glioma.
Jerry Jaboin MD, PhD
Aim 1: To determine the mechanism by which the HVGGSSV binds to irradiated tumor
Radiation Oncology
microvasculature. We hypothesize that the HVGGSSV peptide binds to a radiation-inducible antigen
Vanderbilt University
on tumor vascular endothelium. Utilizing affinity purification techniques and PDZ domain arrays, we
will identify proteins bound by our peptide.
Medical Center

Aim 2: To conjugate radioactive iodine directly to the HVGGSSV peptide and bacteriophage. We Philips Healthcare/RSNA
hypothesize that radioactive iodine bound to our polyvalent peptide will retain its tumor specificity. We Research Resident Grant
will directly conjugate the HVGGSSV peptide and phage to radioactive iodine and optimize conditions
to achieve tumor-specific targeting. We will also evaluate pharmacokinetics of the radioiodinated
peptide and phage to determine the best candidate for studies of therapeutic response in xenograft
models of glioma.

Aim 3: To conjugate radioactive iodine to nanoalbumin and liposome vectors. We hypothesize that
radioactive iodine bound to HVGGSSV-decorated liposomal and nanoalbumin vectors can retain
tumor specificity and deliver the nanoparticles to irradiated tumors. To form targeted radioiodinated
nanovectors, we will conjugate radioactive iodine to HVGGSSV-decorated liposome and nanoalbumin
vectors. We will determine the ability of these nanoparticles to bind to irradiated tumors and alter
tumor growth kinetics in vivo.

10  
An Investigation of EphB1 as a Mediator of the AT
Phenotype
Ataxia telangiectasia (AT) syndrome is a rare, autosomal dominant condition characterized by ionizing
radiation sensitivity, lymphoid abnormalities, and ataxia with cerebellar degeneration. The molecular
response to ionizing radiation via ATM (the gene that is mutated in AT) is mediated by a variety of
receptor tyrosine kinases. The mechanism of cerebellar degeneration is not completely established,
although it has been hypothesized to include defective DNA damage repair.

Our work with candidate gene analysis in AT cell lines has suggested that the receptor tyrosine kinase
EphB1 is regulated by ATM. EphB1 is a member of the Eph/Ephrin family of ligands and cell
membrane receptor tyrosine kinases, which play an important role in regulating neural development,
cell sorting and synapse formation.

Christopher Lominska, MD We propose to further characterize the ATM/EphB1 interaction with regard to the response to
Radiation Medicine radiation and the neurological phenotype. Cell culture studies will be performed to confirm regulation
of EphB1 by ATM. The effect of EphB1 inhibition on the response to radiation in human cell lines will
Georgetown University
be evaluated. We will further characterize the anatomy of the cerebellum in transgenic EphB1 mice.
Medical Center
Additionally, we will study EphB1 expression and cerebellar anatomy in AT human brain tissue.
RSNA Presidents Circle The project will increase our understanding of downstream signaling in the ATM pathway, as well as
Research Resident Grant investigating the role of EphB1 in radiation response and development of the cerebellum.

Mechanism of Anti-tumor Immunity Induced by


Radiotherapy and Irradiated Autologous Tumor
Vaccination
Emerging evidence suggests that radiotherapy, although traditionally considered immunosuppressive,
may boost anti-tumor immunity. We therefore hypothesize that radiotherapy can be combined with
immunotherapy for therapeutic advantage. Our preliminary data indicate that mice vaccinated with
irradiated autologous tumor cells become resistant to future challenge with that tumor. Similar results
are not seen in mice receiving heat-inactivated or lysed tumor cell vaccines.

We propose to examine the interaction between radiotherapy (XRT) and irradiated autologous tumor
vaccines (IATV). Mice with established tumors will be split into five treatment groups: placebo vs IATV
vs XRT vs IATVĺXRT vs XRTĺIATV. Isobolographic interpretation of tumor growth will determine
synergy or antagonism of modalities.
Arta Monjazeb, MD, PhD
Radiation Oncology We will also investigate the underlying immune mechanisms of these therapies. Naïve mice will
Wake Forest University receive adoptive transfer of immunocytes from vaccinated mice. Transference of tumor resistance
Health Sciences would confirm an immune mediated mechanism.

Philips Healthcare/RSNA Mice vaccinated against S-180 will be challenged with CT-26 and vice versa. Lack of cross resistance
Research Resident Grant would indicate a tumor specific immune response. Tumor infiltrating immunocytes from mice in the
aforementioned treatment groups will be analyzed by flow cytometry to determine the types of
immune cells involved in tumor resistance. To determine which are obligatory for tumor resistance,
treated mice will be depleted of individual cell types and then challenged with tumor. Antigen and
cytokine expression changes of irradiated tumor cells will be examined in vivo and in vitro.

In light of the growing importance of immunotherapy in cancer treatment, understanding the effects of
radiotherapy on the immune system and how to combine these modalities has significant therapeutic
implications.

11  
High-Resolution RNA-Based Targeted PET Imaging
Agents for Prostate Cancer
Despite advances in screening approaches for prostate cancer (PC), it is anticipated that 28,000 men
will die of the disease this year in the United States alone. This highlights a need for safer and more
effective imaging technologies for staging and monitoring of PC in these patients.

ProstaScint® is the only FDA-approved targeted-imaging agent for PC. However, its clinical utility is
limited by low specificity and sensitivity. Therefore, we propose the development of a novel imaging
tool for PC that overcomes these limitations.

This imaging agent will comprise a biological targeting moiety (an RNA aptamer) and an imaging
moiety (a chelator) that is conjugated to the aptamer via a molecular linker. The RNA aptamer binds
with high affinity and specificity to an antigen (PSMA) expressed on the surface of PC cells. The
aptamer will be conjugated to a chelator housing a positron emitting radionuclide for use in high- William Rockey, MD, PhD
resolution positron emission tomography (PET). Radiation Oncology
University of Iowa Hospitals and
We hypothesize that by optimizing the imaging and targeting moieties of the imaging agent we will
Clinics
enhance binding to its target and improve the overall stability of the radionuclide complex. In specific
aim 1, we will test various chelators and linkers used to conjugate the chelator to the RNA aptamer. In
specific aim 2, we propose the development of structural homologs and multimers of existing PSMA- Bracco Diagnostics/RSNA
specific aptamers to increase the aptamers’ stability and functionality. Finally, in specific aim 3, we test Research Resident Grant
the binding affinity and specificity of the resulting optimized agents in PSMA-positive PC cell lines. In
summary, we predict that this work will lead to a highly specific PET-based imaging agent that may
substantially improve the management of PC. The work proposed herein will also contribute to the
advancement of methodologies that can be applied to engineer targeted imaging agents for other
human diseases.

A Novel CT-based Biomarker for Predicting Therapy


Response in Hepatocellular Carcinoma by Selective
Quantification of Non-necrotic Tumor Components
Rapid developments in imaging techniques and advent of newer chemotherapeutic agents for
treatment of hepatocellular carcinoma (HCC) have highlighted the limitations of Response Evaluation
Criteria in Solid Tumors (RECIST). Estimation of total tumor volume has shown to be more effective
than RECIST but proves tedious for manual segmentations and poses problems for incorporation in
workflow. Moreover, some targeted chemotherapeutic agents may cause more tumor necrosis
compared to another. This may lead to false positive enlargement of the total tumor size on imaging,
which results in overestimation of an otherwise regressed or stable disease, as progressive according
to existing RECIST or total tumor volumetry criteria. Revisions in tumor response assessment criteria
on imaging are therefore needed.
Anand Singh, MD
Our hypothesis is that estimation of interval change in soft tissue volumes in a treated HCC by
segmenting and excluding necrotic portions on baseline and post-treatment MDCT datasets is Radiology (3-D Imaging)
possible through automation and can be a better predictor of therapy response than RECIST. This Massachusetts General Hospital
project will involve retrospective collection of baseline and post-treatment MDCT datasets of patients
with advanced HCC who were treated with the same drug protocol. Siemens Healthcare/RSNA
Research Fellow Grant
Interval change in non-necrotic volume between CTs obtained at different time point by manual and
automated method will be estimated, followed by maximum one-dimensional tumor measurements
(RECIST). RECIST measurements and interval change in non-necrotic volume will be obtained by
manual and proposed automated method and correlated with patient’s overall and progression-free
disease survival. The inter-method and intra-method agreements will also be evaluated by manual and
the proposed automated method.

After successful testing of our hypothesis, this method may have significant impact in clinical oncology
for therapy response assessment on wider latitude where similar principles for automations can be
applied to other organ tumors.

12  
In Vivo MRI Assessment of Erythropoietin Treatment
on the Migration of Iron Oxide-labeled Neuronal Stem
Cells in a Rat Stroke Model
Stroke-related mortality in the Western world is second only to that related to heart disease. Current
treatment options are of limited benefit. Imaging can play a pivotal role in providing the means for
delineating in vivo molecular mechanisms of the reparative process and site-directed therapy and by
offering early prognostic information. Partial success has been achieved in reversing stroke-induced
deficits with stem cell administration in experimental animals. The conditions required by stem cells to
migrate to peri-infarct tissue and to differentiate into neuronal cells is not yet understood.

Erythropoietin (EPO) promotes angiogenesis in the ischemic boundary region and facilitates migration
of neuroblasts to this area. We hypothesize that co-administration of neural stem cells (NSC) and
EPO will result in improved migration of NSC (primary endpoint), decreased size of infarcted tissue,
M. Reza Taheri, MD, PhD
and better functional outcome in a rat stroke model (secondary endpoints). NSC labeled with iron
Radiology oxide particles with/without the co-administration of EPO will be transplanted into the corpus callosum
University of Washington after temporary middle cerebral artery occlusion (MCAO) in a rat. The size of the area of
infarct/ischemia as well as the in vivo rate of migration of NSC will be measured multiple times with
GE Healthcare/RSNA MRI during the 3 weeks after MCAO. Evolution of the imaging findings will be correlated to changes in
Research Fellow Grant neurologic deficits.

This project will provide new information about the in vivo role of EPO on migration of NSC to peri-
infarct tissue and about the importance of this process in post-stroke recovery. This project will allow
me to hone my understanding of the pathophysiology of stroke as well as the role of stem cells and
imaging in this process. I intend to build on this project and systematically explore the in vivo
mechanism of migration and differentiation of stem cells.

Identification of Anti-Neoplastic FADD Kinase


Inhibitors Utilizing a Molecular Imaging-Based High
Throughput Screen
Despite advances in our understanding of the derangements in genes and signal transduction
pathways associated with neoplastic initiation and progression, there has been minimal impact on
survival for many types of cancer. For instance, the 5-year overall survival for lung cancer over the
past 15 years remains poor, with mortality in the range of 70–90% for locally advanced disease.
Previous work has identified that Fas-associated death domain (FADD) overexpression and
phosphorylated FADD (p-FADD) serve as prognostic biomarkers in a number of human malignancies
including lung cancer, where they are associated with higher proliferation and poor survival.
Furthermore, increased p-FADD expression correlated with elevated NF-kB activation. These results
suggest a relationship between FADD phosphorylation and NF-kB activation, a hallmark of therapy-
resistant cancers. I hypothesize that inhibiting FADD phosphorylation may sensitize cancer cells to
Terence Williams, MD, PhD
chemotherapeutic agents. To aid in identification of FADD kinase inhibitors, I will utilize a previously
Radiation Oncology generated pan-FADD kinase reporter (FKR), which non-invasively senses FADD-kinase activity in
University of Michigan real-time through bioluminescent imaging.

Toshiba America Medical In aim 1, the sensitivity and specificity of FKR will be characterized. In aim 2, a high-throughput screen
Systems/RSNA will be performed to identify compounds that target FADD phosphorylation from a diverse set of
Research Resident Grant compound libraries. Utilizing secondary screens, the toxic and less sensitive lead molecules will be
eliminated. Their relative efficacy will be evaluated by quantifying IC50 of the top lead compounds.
Finally, the specificity of candidate molecules in inhibiting FADD kinases will be investigated using
western blotting and protein kinase arrays.

The long-term goals are to identify compounds which inhibit FADD kinase activity and which can be
tested in pre-clinical models, perhaps in combination with other chemotherapies to determine whether
inhibition of FADD phosphorylation sensitizes cells to chemotherapeutics. Ultimately, these
compounds may benefit the treatment of tumors that are resistant to conventional therapies.

13  
Ultra-High Resolution Clinical Imaging of the Human
Medial Temporal Lobe with 7 T MRI
My research goal for neuroradiology fellowship is to investigate the medial temporal lobe at ultra-high
resolution with high-field magnetic resonance imaging. I will develop a novel methodology for in vivo
imaging of human hippocampal microanatomy using 7 Tesla MRI, employing both structural imaging
and diffusion tensor imaging with tractography for microanatomic functional correlation.

In order to obtain maximum resolution under controlled conditions, this protocol will be applied to
postmortem specimens of normal brains as well as brains from Alzheimer patients. We then plan to
apply this imaging procedure to patients with clinically defined Alzheimer disease and mild cognitive
impairment to facilitate the diagnosis of Alzheimer pathology before dementia ensues. Additionally, we
will scan epilepsy patients with possible medial temporal sclerosis to identify with greater accuracy
earlier signs of hippocampal derangement.
Michael Zeineh, MD, PhD
Radiology
Stanford University

RSNA Research Fellow Grant

Investigating the Role of the Gradient Index in


Research Medical Student Grant
Predicting Side Effects from Gamma Knife
Radiosurgery in the Treatment of Meningiomas
During the development of radiosurgery treatment plans, clinicians use several different approaches to
choose the best plan, clinical expertise being the most important factor. Several measures are in use
clinically, such as the conformality index, to help clinicians objectively assess the merits of different
treatment plans. Recently, Paddick and Lippitz suggested that the gradient index, a measure of the
dose falloff outside the tumor volume, might be an effective approach for choosing among plans with
similar conformity.

The goal of this project is to investigate whether clinicians can use the gradient index (GI) in addition
to other dosing parameters to develop treatment plans that will lead to fewer side effects post-gamma
knife radiosurgery (GKRS) for the treatment of meningiomas, one of the most common brain tumors.
Ehsan Balagamwala, BA
Specifically, we are interested in studying whether the gradient index is correlated with the frequency
and occurrence of side effects post-GKRS treatment in these patients. We are also interested in
Radiation Oncology
studying whether treatment plans with lower isodose volumes have the same effect on tumor volume Cleveland Clinic Foundation
reduction but lead to fewer side effects.
RSNA
These studies are novel as they will use patient follow-up data to study the efficacy of the gradient Research Medical Student Grant
index and will close the gap between the theoretical benefit of the gradient index and its clinical
benefit. Our study has the potential of having tremendous impact in the treatment planning process. If
the GI is found to be correlated with the occurrence of fewer side effects, clinicians can supplement
their expertise by using this simple and objective calculation to assess the quality of treatment plans
leading to significantly fewer side effects and better overall outcomes.

14  
Evaluation of MR-Visible ThermaSphere®
Microspheres for Simultaneous Chemoembolization
and Thermal Ablation
Evaluate the efficacy of transarterial chemoembolization with different MR-visible ThermaSphere®
formulations that simultaneously provide thermal ablation and doxorubicin release when exposed to
an external alternating magnetic field on tumor kill in vitro and in the rabbit Vx-2 liver tumor model.
Tumor kill efficacy will be compared to four optimized microsphere formulations including 1) Bland
ChemoSpheres®, 2) Doxorubicin Loaded ChemoSpheres®, 3) Bland ThermaSpheres® and 4)
Doxorubicin Loaded ThermaSpheres®.

It is our hypothesis for this study that control and efficacy can be achieved by localizing, combining,
and synchronizing the heat delivery and doxorubicin release. We further hypothesize that such a
delivery can be achieved using the appropriate combination of micron- and nano-scale materials and
Brad Barnett, BS
energy-based remote activation of these materials.
Radiology
The Johns Hopkins University The rationale for this approach is three-fold: First, localizing heat and chemotherapeutic delivery
School of Medicine provides tissue-sparing control of both agents. Further, synchronizing the delivery of the two agents
can potentially enhance the tumoricidal effects of each agent, increasing the therapeutic benefits
RSNA through potentiation or synergy. Finally, potential benefit arises from the remote activation and control
Research Medical Student Grant of dose and rate by adjusting the heat level with AMF power. In this proposal it is only the initial
hypothesis that will be tested. An understanding of the mechanism will be the subject of future efforts.

Improving Specificity and Sensitivity of a Computer-


Aided Detection Algorithm for Intracranial Aneurysms
Early detection of intracranial aneurysms is important for prevention of the morbidity and mortality that
result from aneurysm rupture. Detection rates of small intracranial aneurysms (3 mm–7 mm) with
MRA are low, with sensitivities for trained neuroradiologists of 60%–70%. We have designed a
computer-aided-detection (CAD) algorithm designed to detect small intracranial aneurysms on MRA
images. The goal of this project is to enhance the sensitivity and specificity of this algorithm through
detailed analysis of output data and identification of “typical” false-negative and false-positive results.

Using available clinical reports and consultation with the scientific advisor, I will analyze 200 MRA
patient datasets with angiographically confirmed aneurysms and 500 MRA patient datasets with
angiographically confirmed absence of aneurysms establishing “ground truth” for presence or absence
of aneurysms. I will then manually delineate a region of interest (ROI) containing each aneurysm.
Waleed Brinjikji, BS Each segment of the intracranial vasculature will be assigned a unique number to allow for automated
Radiology analysis of vessel location. The ROI will be compared to the results of the CAD algorithm to identify
Mayo Clinic false-negative and false-positive CAD outcomes on a location-by-location basis. We will assess the
characteristics of false-negative and false-positive cases, including: 1) aneurysm location; 2)
aneurysm neck and dome size; 3) diameter of branch vessels near “false-positive” aneurysm neck;
RSNA
and 4) degree of imaging artifact in parent artery. The dataset generated will then be used by the
Research Medical Student Grant computer scientist group to identify specific, reproducible, and problematic arterial locations or
aneurysm types that lead to erroneous CAD outputs. This enhanced understanding of the CAD
algorithm will lead to improvements in the algorithm itself, with the long-term goal of optimizing
accuracy.

15  
Evaluation of the Coagulation State in Relation to
Transarterial Chemoembolization for Hepatocellular
Carcinoma
Transarterial chemoembolization (TACE) is an effective treatment for patients with unresectable
hepatocellular carcinoma (HCC). Incidences of both hypercoagulability and bleeding disorders have
been reported following TACE for HCC, though these findings are complicated by the baseline
hypercoagulable state of malignancy and the transient prothrombotic state observed following other
embolization procedures. Therefore, it is unclear what net effect TACE has on coagulability in the
setting of HCC and whether certain patients may be more at risk of complications due to bleeding or
clotting.

We propose to obtain serial longitudinal peri- and intra-procedural measurements of coagulation and
hyperfibrinolysis markers for this investigation including: thrombin-antithrombin (TAT) complex,
Jacob Brown, BA
prothrombin fragment 1 and 2 (F1.2), platelet factor 4 (PF4), plasmin-2-antiplasmin (PAP) complex,
and D-dimer. Samples will be obtained at intervals before and within the first 24 hours after
Radiology
transarterial chemobolization. We hope to determine if clotting and/or bleeding risk is high enough to Georgetown University & National
warrant special precautions for some patients undergoing this procedure. Institutes of Health MD/PhD
Partnership Program

RSNA
Research Medical Student Grant

Detecting Complicated Plaque in the Coronary


Arteries using Magnetic Resonance Intraplaque
Hemorrhage (MRIPH) Technique in a Porcine Model of
Diabetes-Induced Accelerated Atherosclerosis
Atherosclerosis is a complicated disease process that is implicated in a number of conditions including
coronary artery disease (CAD). Despite much research, its pathogenesis is not yet fully elucidated;
therefore, good animal models are required in order to learn more about the disease process.

Using magnetic resonance intraplaque hemorrhage (MRIPH), we propose to visualize the progression
of coronary artery atherosclerosis in a previously established porcine model of diabetes-induced
accelerated atherosclerosis. Six pigs (8–12 weeks of age) will be randomly allocated to one of two
groups: diabetic-hyperlipidemic (D-HL) (n=4) and nondiabetic-normolipidemic (N-NL)(n=2). In the D-
HL group, the diabetic pigs will receive an intravenous injection of streptozotocin (a b-cell cytotoxin) to Helen Cheung, BSc
induce diabetes and a high-cholesterol (15%), high-fat (15% lard) diet to induce hyperlipidemia. The Radiology
N-HL group will not receive streptozotocin and will be on a regular diet. Both groups will receive an University of Toronto
MRIPH scan every 5 weeks for 20 weeks and blood work (cholesterol, lipids, fasting blood glucose)
every week for 20 weeks. The animals will be sacrificed at 20 weeks and the left anterior descending RSNA
and right coronary arteries will be dissected. The tissue will be analyzed for histological characteristics Research Medical Student Grant
(evidence of complicated plaque) and the lumen stenosis will be measured. A trained, blinded
observer will interpret the MRIPH images. Imaging results will be correlated with blood work and
histological data.

We hypothesize that diabetic, fat-fed pigs will be more likely to have a positive MRIPH than the non-
diabetic, normolipemic group and that there will be an increase in the prevalence and the size of the
MRIPH signal with increased progression of the disease.

The goal of this project is to develop the use of imaging to follow disease progression in animal
models and to determine the usefulness of the MRIPH technique in detecting complicated plaque in
the coronary arteries.

16  
Correlation Between Tumor Perfusion Measurements
and Tumor Growth Delay with Radiation Therapy in
an Autochthonous Prostate Cancer Murine Model
Today’s radiation therapy treatments offer unprecedented radiation delivery flexibilities and if
oncologists knew which tumor sub-volumes are radioresistant and which sub-volumes are radio-
sensitive, dose could be prescribed on the basis of biologic target volumes. Prior to implementing this
tumor or normal tissue functional imaging for radiotherapy, we have to overcome two hurdles. First,
we need to find an imaging modality that yields information relevant to radiation sensitivity. Second,
such information needs to be translated quantitatively into an increase or decrease in radiation dose
for the intended response (enhanced tumor kill or reduced normal tissue damage). CT-perfusion
(CTP) and power doppler ultrasound (PDUS) imaging of tumors are two promising techniques for
imaging biologic responses to radiation. The use of image-guided animal irradiation experiments can
be an effective pre-clinical assay for novel radiotherapy targeting.
Michael Connolly, BMSc
Radiation Oncology Our study represents the first known attempt at radiotherapy delivered to intact prostate in an
Schulich School of Medicine & autochthonous prostate cancer animal model with image guidance. Using a murine model of prostate
Dentistry, The University of Western cancer, the tumor growth delays (time to reach 5x pre-radiation volume) will be derived from the
Ontario weekly micro-CT scans following radiation, and we seek growth delays’ correlation with the level of
tumor perfusion from pre-treatment micro-CT and micro-US scans.
RSNA
Research Medical Student Grant The changes in tumor blood flow and volume will be monitored weekly after irradiation by micro-CT
and every other day by micro-US. The micro-PDUS data will be cross-correlated with the micro-CTP
data (that we considered to be the gold standard) to see how well measurements with one modality
can be predicted based on measurements with the other modality.

I will be responsible for the micro-US scans as well as the cross-correlation of data between micro-
CTP and micro-USPD scans. The supervisor will be responsible for overseeing the entire project,
including micro-CT perfusion scans and the radiation therapy.

Retrospective Review of Extra Hippocampal White


Matter Abnormality in Patients with Hippocampal
Sclerosis, Using Diffusion Tensor Imaging: Three
Automated Post Processing Methods
Detection of white matter abnormality by visual inspection has played an instrumental role in
identification and diagnosis of brain pathology. High resolution scanning and increased computational
power provide an overwhelming quantity of data for analysis. Minute anatomical abnormalities
detected are at a level not visually apparent. Therein lies the motivation for an algorithm that can
detect these changes and distinguish the pathological change. To this end, the diffusion tensor
magnetic resonance imaging (DT-MRI or DTI) technique has arisen, to characterize white matter
connectivity as a means of inferring pathological change at the neural tract level.
Cristian Coroian, BS MRI has been particularly successful in demonstrating hippocampal pathology in patients with MTLE.
Radiology Approximately 1% of the world’s population suffers from epilepsy and current surgical treatments
University of California, Los Angeles leaves 10%–30% of patients with persistent disease. Studies have shown putative extra-hippocampal
David Geffen School of Medicine changes may be of importance. Currently, DTI has improved detection of hippocampal pathology with
significant diffusivity and fractional anisotropy parameter changes. Furthermore, detected whole brain
Fujifilm Medical Systems/RSNA parameter changes suggest that in conjunction with a detection algorithm, DTI can yield a more
Research Medical Student Grant effective diagnostic study. There are multiple methods that can be employed to programmatically
detect anatomical changes.

We propose to perform a blind retrospective study to analyze pre-surgical DTI imaging of patients who
became seizure-free or not seizure-free post-surgically. Three methods will be utilized to research
optimal detection of minute abnormal anatomical change. Correlation will be made between identified
regions of white matter and neuropsychological testing, electro-encephalographic data, and post-
surgical seizure frequency. Consequently false positive and negative rates can be quantified to
optimize the choice of method with corresponding threshold values. Automatically detecting minute
white matter abnormalities will supplement visual diagnosis and improve pre-surgical planning and
patient's post-surgical outcome.

17  
Comparison of Quantification Techniques for Long T2
Components in Patellar Articular Cartilage at 3 T:
Multi-Echo Spin Echo (ME-SE), 2D Spiral Chopped
Magnetization Preparation (2D-SCMP) and T2
Preparation with Ultrashort Echo Time (UTE)
Acquisition
Osteoarthritis (OA) is the most common type of arthritis, affecting an estimated 20.7 million adults and
costing nearly $60 billion per year in the United States alone (Buckwalter JA, et al. ADDR 58 [2006]
150-67). Conventional imaging modalities capture later stages of OA in the form of tissue loss, which
is too late for preventative treatment. In contrast, noninvasive MR evaluation has proven effective in
characterizing both morphologic change in articular cartilage as well as biochemical change reflecting
Eric Diaz, BS
infrastructural degradation. Specifically, T2 values (an intrinsic MR tissue characteristic) have been
shown to reflect collagen integrity within articular cartilage, offering a noninvasive means of detecting Radiology
the earliest structural changes in the degenerative cascade (Gray ML, et al. J MSK Neuron Interact University of California School of
2004; 4(4):365-68, Dijkgraaf LC, et al., J Oral MF Surg 1995;53(10):1182-92). Articular cartilage has a Medicine, San Diego
known zonal variation in T2 relaxation times that ranges from 1 msec in the deepest layers to 40 msec
in the more superficial layers, the former definitely representing a technical challenge for conventional RSNA
MR evaluation. Research Medical Student Grant

We propose to test the feasibility of two novel pulse sequences for T2 quantification, the 2D-SCMP
and T2 Preparation UTE acquisition, against the standard clinical reference (ME-SE). All pulse
sequences will be tested first in phantoms and subsequently in cadaveric patellar specimens.
Cadaveric patellae will be sectioned into 3 mm axial slices using a high-precision saw. MR imaging
data will be collected with a home grown finger coil on a GE Signa Hdx 3.0T clinical scanner. For the
phantoms, calculated T2 values from each technique will be compared with known T2 phantom
values. For the patellar slices, T2 relaxation times will be processed off-line using a Matlab subroutine.
In addition, to determine if the novel sequences are sensitive to articular cartilage degeneration, the
cadaveric patellae will be subsequently analyzed by biochemical assay and immuno-histochemical
evaluation. Sequence efficiency will be assessed by duration of scan time.

Development of a Decision-Analytic Model to


Estimate Long-Term Outcomes of Cryoablation and
Radiofrequency Ablation for Renal Cancer
A rise in the incidental detection of renal tumors by diagnostic imaging has contributed to an
increase in the incidence of renal cell carcinoma (RCC). Despite improved detection rates, mortality
rates from RCC have not improved, suggesting that current RCC surgical treatment paradigms
require reexamination. Determining conditions under which ablative therapies are effective will
improve the quality of patient care significantly and prevent the unnecessary use of invasive and
costly surgical procedures.

The use of ablative therapies in RCC treatment is of considerable interest as they are less invasive
and expensive than the standard surgical treatment, nephron-sparing surgery (NSS). However, they
may be associated with higher local recurrence rates. Our group's preliminary work suggests that
Rebecca Hartman, BA
radiofrequency ablation (RFA) is preferred to surgery under most assumptions. Now, building upon
the group’s current decision model, we will assess and compare the long-term outcomes of
Institute of Technology Assessment
percutaneous imaging-guided radiofrequency ablation, cryoablation, laparoscopic, and open NSS Massachussetts General Hospital
for the treatment of small RCC in a refined, updated decision-analytic model.
Rebecca is enrolled at the
To accomplish this, we will first collect data by performing a systematic review of the literature on University of Pennsylvania
RFA, cryoablation, and laparoscopic and open nephron-sparing surgery (NSS) for renal tumors. We School of Medicine
also will perform a systematic review on renal tumor growth/behavior and recurrence, and use the
SEER cancer registry to obtain relevant outcomes data. RSNA
Research Medical Student Grant
The cumulative data elicited will provide insight into the current performance status of
radiofrequency ablation, cryoablation, and laparoscopic and open NSS for treating renal tumors, and
will be used to build an updated decision-analytic model that will estimate the life expectancy and
lifetime costs consequent to each strategy.

The long-term effectiveness, cost, and cost-effectiveness of each strategy will be compared.

18  
64Cu-ATSM Uptake In Vitro and Ex Vivo in Cervical
Cancer
The objective of this research is to evaluate 64Cu-ATSM uptake in cervical cancer cell lines and in
tumor explants from biopsy specimens of patients with newly diagnosed cervical cancer. This is an
exploratory study to demonstrate the feasibility of this technique in anticipation of developing further
translational research. This is especially important in light of the soon to be activated American
College of Radiology Imaging Network study (ACRIN 6682), (Phase II Trial of 64Cu-ATSM PET/CT in
Cervical Cancer). Cervical cancer ranks among the top three cancer diagnoses in women worldwide.

In the United States, the SEER Cancer Statistics Review identified cervical cancer as the third leading
cause of average years of life lost per person dying of cancer for all races and both sexes. About one-
third of cervical cancer patients develop recurrent disease, with the majority of these recurrences
detected within the first 2 years after completion of therapy. Proven predictors of disease recurrence
Wesley Haynes, BS include tumor stage, lymph node status, and tumor hypoxia. Copper (II)-diacetyl-bis (N4-
Radiation Oncology methylthiosemicarbazone), Cu-ATSM, labeled with a positron emitting isotope of copper has been
Washington University School of shown, in vitro and in vivo, to be selective for hypoxic tissue. In silico studies have explored the
mechanism of its hypoxia selectivity, and clinical studies with this agent have shown noninvasive
Medicine
imaging data that are predictive of cervical cancer patients’ response to conventional therapy. Tumor
hypoxia is an important prognostic factor in cervical cancer and predicts for decreased overall and
RSNA disease-free survival. In part, this is because hypoxic tumors are resistant to radiation and
Research Medical Student Grant chemotherapy.

Efficacy of Targeted Molecular Therapies Combined


with Irradiation on Skin Squamous Cell Carcinomas
Skin cancers are the most common cancer in the United States, of which squamous cell carcinomas
(SCCs) are the second most common type. Loss of transforming growth factor beta (TGFb) signaling
mediators, Smad2 and Smad4, are among the most common alterations seen in skin SCCs.
Keratinocyte-specific Smad2 knockout mice were more susceptible to skin carcinogenesis via
transcriptional upregulation of Snail subsequently downregulating Ecadherin leading to epithelial-to-
mesenchymal transition. Keratinocyte-specific Smad4 knockout mice developed spontaneous SCCs
mediated by increased TGFb and Smad3 resulting in increased inflammation and genomic instability.
Further, both Smad2 and Smad4 knockouts developed increased angiogenesis compared to
chemically induced tumors in wildtype mice mediated by hepatocyte growth factor (HGF) and vascular
endothelial growth factor (VEGF), respectively. Radiation therapy is commonly used in the treatment
of skin SCCs of the head and neck or as adjuvant treatment with a salvage rate of <50% for patients
Kristina Hoot, PhD with positive lymph nodes.
Radiation Oncology
Oregon Health & Science University Our preliminary data indicate that molecular targeting of the HGF receptor, c-met, reduces
angiogenesis in Smad2-deficient skin to that of wildtype skin. However, the effects of molecular
targets on Smad2- and Smad4-knockout tumor growth and metastasis have not been assessed.
Canon U.S.A./RSNA
Further, the radiosensitivity of Smad2- and Smad4-deficient cells and tumors have not been fully
Research Medical Student Grant characterized. We aim to address whether irradiation with molecular targeted therapy to the HGF
receptor, cMet, or to VEGF is capable of increasing the therapeutic efficacy of irradiation alone.

19  
Development of Magnetic Resonance Imaging-Visible
Embolic Agents
Transcatheter arterial chemoembolization (TACE) is a minimially invasive procedure and the current
standard treatment for unresectable hepatocellular carcinoma. Chemotherapeutics and embolic
materials such as polyvinal alcohol (PVA) particles are injected locally to produce a combination of
cytotoxic and ischemic effects to induce tumor necrosis. However, difficulty in assessing embolization
endpoint sometimes leads to incomplete treatment, liver damage, or non-target embolization, which
can decrease treatment response rate or increase mortality and morbidity. To overcome this limitation,
we aim to devise and validate MR contrast agent-modified PVA particles (CA-PVA) that can be
visualized intra- and post-procedurally.

Commercially available PVA particles 300–700 µm in size used clinically will be modified with Gd(III)
complexes. Building on previous work in PVA modification done at Northwestern, a new chemical
modification strategy will be used to improve the loading of Gd(III) per particle and maximize MR Hsiang-Hua Hung, BASc, MASc
signal. The synthesized CA-PVA will be validated and the imaging parameters optimized using in vitro Radiology
and ex vivo model systems on a clinical MR scanner. Specifically, CA-PVA will be imaged in capillary Northwestern University
tubes, agarose phantoms, rabbit liver tissues, and a dynamic flow model mimicking human arteries.
Feinberg School of Medicine
The long-term goals of this work include validation of CA-PVA using in vivo rabbit tumor models to
monitor real-time delivery and in vivo fate of the embolic material, and eventual clinical translation of
RSNA
CA-PVA to help optimize TACE protocols to improve success rate. Research Medical Student Grant

Comparison of CT Perfusion and MR Perfusion


Derived Cortical Grey Matter CBF in Cognitively
Impaired and Unimpaired Multiple Sclerosis Patients
Quantitative MRP derived CBF correlates with CTP derived values in MS patients. A similar reduction
of cortical grey matter CBF is expected for each modality in patients with and without cognitive
impairment. Our primary objective is to compare measured CTP and MRP derived cortical CBF.
Secondarily, we will analyze whether the correlation is maintained in the presence of cognitive
impairment. The single center pilot study will evaluate 44 MS patients; 22 with cognitive impairment
and 22 without. Patients will be matched for disease duration, age, sex, and their EDSS scores. I will
use my learned expertise to assist with image analysis and compiling research data.

MRP will be performed on a Philips 3 T with a quadrature coil to ensure compatibility with our current
in-house software applications. To allow for direct comparison of the different image sequences, the
Marcus Jansen, BSC
volumetric T1 and T2/PD weighted images will be coregistered with the DSC images. These images
will then be analyzed in a stepwise sequence. CTP will be performed on a 64-slice VCT (GE, Radiology
Lightspeed VCT). The calculation of CBF, CBV, BBB PS maps from the acquired CT perfusion data University of Ottawa
will be performed on a GE advantage workstation (ADW4.2) with the CT perfusion software.
Philips Healthcare/RSNA
No prior study has evaluated the correlation between CTP and quantitative MRP-derived cortical CBF. Research Medical Student Grant
Validating this association provides an opportunity for MS patient follow-up using either modality. It is
secondarily anticipated that perfusion parameters may provide an important correlation with impaired
neurocognition and that this may be used as a surrogate marker of disease activity.

 
20  
 
The Correlation of Tumor Perfusion with Clinical
Outcomes during Chemoembolization of Hepatocellular
Carcinoma
Transcatheter arterial chemoembolization (TACE) is an established treatment for non-resectable
hepatocellular carcinoma. However, optimal angiographic endpoints of the procedure have not been
established. Transcatheter intraarterial perfusion (TRIP) magnetic resonance (MR) imaging offers an
objective method to quantify intraprocedural tumor perfusion change. This study will test the
hypothesis that intraprocedural tumor perfusion change, as detected and quantified by TRIP-MR
imaging, correlates with clinical outcomes of TACE on non-resectable hepatocellular carcinomas.

We will recruit 100 consecutive patients with non-resectable hepatocellular carcinoma patients who
are scheduled for TACE using MR monitoring. TACE will be performed in a combined
MR/interventional radiology (MR-IR) suite that allows intra-procedural monitoring. Using TRIP-MR, we
Brian Jin, BA will measure the immediate pre-procedural and post-procedural perfusion by calculating the forward
Radiology volume transfer constant (Ktrans). Pre-procedural, post-procedural, and interval change in Ktrans will
Northwestern University be separately correlated with clinical outcomes immediately after the procedure, and at 1, 3, and 6
months follow-up.
Brian is enrolled at Albert Einstein
College of Medicine Clinical outcomes will consist of a) MR response b) functional MR response as indicated by diffusion
weighted MR c) toxicity levels , and d) survival. We expect that baseline and interval reductions in
RSNA TRIP-MR detected perfusion levels during TACE can predict future clinical outcomes. If so, then
Research Medical Student Grant TRIP-MR could be used as a prognostic biomarker during therapy and be used to establish an
endpoint for TACE. It could also potentially help stratify which patients should receive TACE or
another therapy.

Anatomopathological Correlation of Diffusion Tensor


Imaging in Epilepsy Patients with Focal Cortical
Dysplasia
Focal cortical dysplasia (FCD) is the most common cause of pediatric intractable epilepsy. For the
30% of epilepsy patients who cannot be treated with medication, surgical resection is an effective
therapy. However, subtle forms of cortical dysplasia may be difficult to define on MRI. Pilot studies
have suggested that diffusion tensor imaging (DTI) may improve recognition of FCD in epilepsy
surgery patients, but the correspondence between imaging anatomy and pathology remains unclear.
The purpose of this study is to relate changes in imaging parameters apparent diffusion coefficent
(ADC) and fractional anisotropy (FA) with histopathological changes in patients with focal cortical
dysplasia. Further insight into this relationship should enhance the utility of DTI in directing the
management of epilepsy patients.
Jennifer Kung, BA
ADC and FA measurements will be made in 25 cases of surgically proven FCD between 2003 and
Radiology 2008 in whom DTI was a component of presurgical evaluation. Values will be obtained in the region of
University of California, Los Angeles FCD as well as in the surrounding tissue and in the contralateral equivalent region. Histopathological
David Geffen School of Medicine studies of the resected tissue will be performed using Kluber Barrera myelin stain, GFAP, MAP2,
NeuN, Vimentin, Ki67, CD68 and HE stains. Statistical analysis will be performed to explore
RSNA relationships between DTI values and pathology results. The presence of dyslamination, balloon cells,
Research Medical Student Grant dysmorphic neurons, degree of gliosis, ectopic neurons, and polymicrogyria will be assessed and
compared to the clinical features including seizure frequency, EEG pattern, and post surgical
outcome.

We hypothesize that increased ADC will be associated the decreased myelin protein. In DTI, FA
reflects the density and orientation of dendrites, neurons, and axons, and we expect to see this
correspondence on a histopathological level.

21  
Radiologic and Microarray (Radiogenomic) Analysis
of Gastric Adenocarcinoma: A Novel Classification of
Tumor Subtypes and Prognosis
Carcinogenesis is marked by a progression through a series of accumulated genetic aberrations and
mutations. With the development of microarray, the simultaneous evaluation of thousands of genes
and their individual expression patterns is now possible. Nonetheless, the clinical utility of such genetic
profiling is currently limited due to cost and limited availability. Therefore, a method of translating some
of these molecular insights into a clinically useful framework is needed.

In this project, we hope to correlate genetic profiles of gastric cancer with phenotypic features on CT
and then use this information to generate gastric cancer subtypes and identify novel prognostic factors
using radiogenomic data. Gastric adenocarcinoma tissue from deceased patients who also have
accessible imaging studies at UCLA will be collected from the UCLA Pathology Department. Medical
Valentin Lance, BS
records will be examined for pertinent patient data, including demographics, oncologic history,
pathologic examination of gastric lesion, disease interventions (eg, chemotherapy, radiation therapy,
Radiology
gastric resection), and length of survival after initial diagnosis of gastric adenocarcinoma. The tissue University of California, Los Angeles
samples will undergo microarray gene expression analysis after extraction of RNA using RNAeasy
Mini Kit (Qiagen, Valencia, Calif, USA) according to manufacturer’s protocol. T-test will be used to RSNA
identify differences in mean gene expression levels between comparing groups. Diagnostic CT scans Research Medical Student Grant
will be reviewed by two board-certified radiologists and several traits will be closely examined and
scored, including tumor diameter, distribution, presence of enhancement after intravenous contrast,
tumor margins, and presence or absence of lymph node involvement or distant metastases. Finally,
radiogenomic analysis correlating gene expression data and phenotypic CT image data will be
performed.

Improved Isotropic 3D FSE Methods for Imaging the


Knee
Conventional MR imaging of the knee utilizes two-dimensional fast spin-echo (FSE) acquisitions that
require imaging at anisotropic resolutions and gaps between excitation slices. These highly anisotropic
methods introduce the risk of partial volume artifacts and prevent reformatting of image data in
different planes. Three-dimensional volumetric acquisitions at isotropic resolutions overcome these
problems, and may increase detection accuracy of pathology in joints imperceptible using 2D
methods. A newly developed 3D FSE sequence with extended echo train (3D-FSE-Cube) is currently
under investigation for use in diagnostic joint evaluation at 3 T. However, optimal pulse sequence
parameters for producing the highest quality images have yet to be determined. To ascertain these
values for a particular joint, 10 healthy subjects will receive knee MRIs at 3 T. The imaging parameters
repetition time (TR), receiver bandwidth, echo train length and parallel imaging factor will be
systematically altered for each subject while maintaining a constant scan time of 5 minutes and
isotropic spatial resolution of 0.6 mm. Qualitative measures for blurring and detail and quantitative Charles Li, BS
measures for signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for different tissues will be Radiology
calculated. Parameter combinations maximizing SNR, CNR, and detail while minimizing blurring will Lucas Center for MR Spectroscopy
be considered optimal. The optimized 3D acquisition can then be further evaluated with respect to and Imaging
traditional 2D FSE sequences, pre-optimized 3D-FSE-Cube sequences or arthroscopy for detection
Stanford University
sensitivity of joint pathology.
Charles is enrolled at the
University of California, San Diego
School of Medicine

RSNA
Research Medical Student Grant
 

22  
Evaluation of the Effect of Spleen Irradiation on the
Extent of Ischemic Stroke in a Rat Model
Stroke is the leading cause of long-term neurological disability in adults and the third leading cause of
death in the United States. Currently, the only FDA-approved treatment for stroke is tissue
plasminogen activator (tPA), which has a narrow therapeutic window (~3 hours) and limited success.
The goal of our research is to reduce the impact of this devastating disease by applying a novel
approach: temporary radiation-induced splenectomy (radiologic splenectomy).

The spleen is an organ with multiple functions; aside from storing red blood cells, it is also a part of
the immune system and contributes to the inflammatory response seen in stroke. Our hypothesis
states that temporary radiation-induced suppression of the spleen may promote neuroprotection by
interrupting the splenic inflammatory responses after an ischemic or hemorrhagic stroke. The
translation of radiologic splenectomy into clinical application will be straightforward as spleen
Ted Ling, MS, BS irradiation with relatively low doses is already often used in the palliative treatment of hematological
Radiation Oncology malignancies. This experiment will explore the response of the spleen to radiation as it pertains to
James M. Slater MD Proton stroke progression. Twenty aged Sprague–Dawley male rats will be divided into one control and three
experimental groups testing different times of splenic radiation after the initiation of focal cerebral
Treatment and Research Center
ischemia using the intraluminal thread occlusion of the middle cerebral artery (MCAO). Each animal
Loma Linda University
will be followed for a period of 7 days after which it will be euthanized for histological analysis. The
following data will be collected and analyzed at 1, 2, and 7 days after MCAO: (1) venous blood cell
Ted is enrolled at Saint Louis counts (2) infarct size (DWI) (3) brain cell morphology and lesion size (hematoxylin-eosin [H&E]
University School of Medicine staining) (4) standardized neurological score. If this study is successful, the benefit would be
enormous for the millions of people newly affected by ischemic stroke each year in our aging society.
RSNA
Research Medical Student Grant

Evaluation of 18F-FDG PET/CT in Monitoring Tumor


Ablation Efficacy of Irreversible Electroporation (IRE)
in Rabbit VX2 Liver Tumor
Primary liver cancer is the fifth most common cancer and the third leading cause of cancer-related
deaths worldwide. Recently, irreversible electroporation (IRE) has emerged as a promising minimally
invasive method to ablate liver cancer. Our preliminary studies have demonstrated that IRE can be
used to cause cell death of aggressive rabbit VX2 tumor of the liver. However, the effectiveness of
different imaging modalities in monitoring tumor response to irreversible electroporation has not been
investigated. Therefore, in this study, we will evaluate 18F-FDG PET/CT and CT alone in monitoring
tumor ablation efficacy of irreversible electroporation.

Previous studies have shown that 18F-FDG PET/CT performed after treatment provides additional,
earlier, and more accurate information about treatment efficacy compared to CT alone. This technique
Christina Ma, BS
has been accepted in the diagnosis, staging, and follow-up of non-small cell lung cancer, lymphoma,
Radiology colorectal and esophageal cancer, melanoma, head and neck cancers, and breast cancer. In this
University of Southern California proposal, we hypothesize that 18-FDG PET/CT is an effective method in monitoring tumor response
Keck School of Medicine to irreversible electroporation. Given the appropriate results, we propose to translate our findings into
a practical treatment and follow-up method for liver cancer patients.
RSNA
Research Medical Student Grant Ten rabbits will have VX2 tumors implanted into the left lobe of the liver and will be subjected to
ultrasound-guided IRE of the implanted tumors. Pre-procedure, immediately post-procedure (within 24
hours), and post-op (in 14 days) follow-up CT alone and PET/CT imaging will be performed using
Siemens microPET scanner to evaluate radiologic changes. PET/CT data will be compared to CT
alone data to assess which modality is more effective in monitoring the IRE-ablation of VX2 tumor.
Ablated tissues will be collected and investigated for immunohistological evaluation using H&E and
TUNEL assay.

23  
Post-Thrombotic Syndrome: Outcomes of Imaging-
Guided Endovascular Intervention
Established Post-Thrombotic Syndrome (PTS) is considered a debilitating, lifelong condition that
impairs quality of life and has no consistently effective treatments. To date, there is no study that
systematically evaluates the effectiveness of novel imaging-guided endovascular interventions for
PTS. The purpose of our study will be to 1) describe the effectiveness of imaging-guided endovascular
interventions for the management of established PTS in patients with deep vein thrombosis (DVT);
and 2) identify patient factors that predict favorable outcomes. A retrospective analysis of clinic
records and imaging studies of patients diagnosed with PTS who have received an endovascular
intervention (stent placement in the iliac vein or endovenous thermal ablation) at our institution
between 2003 and 2008 will be performed.

Patients will be retrospectively categorized as having exhibited complete response, partial response,
or no response to therapy based upon their physicians’ overall assessments at follow-up visits. The Lina Nayak, BA
presence of symptoms (pain, cramps, heaviness, pruritus, paresthesia) and signs (edema, skin Radiology
induration, hyperpigmentation, venous ectasia, redness, pain during calf compression) of PTS at Washington University
presentation and at interval follow-up will also be recorded and used to retrospectively to estimate a
Medical School
Villalta score (a standardized assessment for PTS).
Mallinckrodt Institute of Radiology
The proportion of patients exhibiting complete, partial, and no response will be described. The mean
Villalta score and severity category will be calculated and compared for the pre-treatment and post- RSNA
treatment data. The following baseline patient factors will be noted: presence or absence of venous Research Medical Student Grant
thrombosis of the common femoral or iliac vein, presence or absence of femoropoliteal vein patency,
and presence or absence of previous ipsilateral venous thrombosis, body mass index, age, and sex.
Analysis will be performed to determine if there is a statistically significant improvement in PTS
severity after intervention and if any patient factors correlate with a statistically significant improvement
in PTS severity.

Impact of Radiation Dose on Tumor Downstaging,


Pathological Complete Response Rate, and Overall
Survival Rates in Advanced Stage Rectal Cancer
In 2008, colorectal cancer was the third most lethal cancer in both men and women in the United
States. Several studies have demonstrated the efficacy of pre-operative 5FU-based
radiochemotherapy in rectal cancer. The main advantages of pre-operative compared to post-
operative radiotherapy include the possibility of reduction in tumor size, increased chances of surgical
resection with negative margins, and reduced toxicity. However, the impact of radiation dose
fractionation on pathologic outcomes in rectal cancer remains unclear. To begin answering these
questions, we propose to evaluate the impact of long-course (five-week duration) pre-operative
radiochemotherapy on tumor downstaging, pathologic complete response rate (pCR), and overall
survival rates in advanced stage rectal cancer.
Chirag Patel, MSE
The proposed project will retrospectively analyze pre- and post-operative rectal cancer pathology
Radiation Oncology
slides from two cohorts of patients receiving pre-operative radiochemotherapy. One cohort received
capecitabine + 45 Gy (in five weeks, 1.8 Gy/morning) while the other cohort received capecitabine + The University of Texas
52.5 Gy (in five weeks, 1.8 Gy/morning with additional 1.5 Gy/afternoon in the last pre-operative MD Anderson Cancer Center
week). We will quantify tumor downstaging, pCR, and overall survival rates. We hope to determine
whether concomitant boost radiotherapy is superior to traditional fractionation methods for pre- RSNA
operative radiochemotherapy in advanced stage rectal carcinoma. Research Medical Student Grant

24  
Dissecting the Role of p53 in the Response of
Primary Lung Cancers to Radiation Therapy
Efforts to improve radiation therapy are hindered by uncertainties in its cellular target and mechanisms
of cell death. Moreover, how specific gene mutations affect the response of lung cancers to radiation
therapy is unknown. For example, the p53 tumor-suppressor gene is frequently mutated in lung
cancers. Following ionizing radiation the p53 protein causes both a G1 cell cycle arrest and apoptosis,
which have opposite effects on cell survival. The consequences of p53 gene mutations on the
response of lung cancers to radiation therapy remain unclear.

We aim to clarify the role of p53 in radiation response using mouse models of primary lung cancers
which are now available in our laboratory. Using Cre-lox technology, we will generate primary lung
adenocarcinomas in the lungs of mice with either wild-type (WT) or no expression of p53. We will use
micro-computed tomography (micro-CT) to follow the response of lung tumors from each genotype (K-
Bradford Perez, BS ras mutation vs. K-ras mutation and p53 deletion) to radiation therapy. Tumor growth delay will be
Radiation Oncology measured using three dimensional volume assessments from serial CT scans at time points before
Duke University School of Medicine and after radiation treatment. We will also assess the degree of apoptosis and cell cycle arrest after
radiation treatment in lung tumors from each genotype. These studies will test our hypothesis that
lung cancers without p53 expression are less likely to undergo apoptosis and therefore are more
RSNA
resistant to radiation therapy.
Research Medical Student Grant
These findings will provide us with important insights into the critical role of p53 and its downstream
pathways in determining the response of lung adenocarcinomas to radiation therapy.

Surveillance with FDG PET/CT vs Conventional


Follow-up Algorithm and CT: Impact on Management
and Survival
The 5-year survival rate for head and neck cancer remains less than 60%. Despite adoption of
aggressive therapy, at least 30% of patients will relapse within 2 years of therapy. Accurate and timely
detection of recurrence may be critical for attempting surgical salvage and may offer a survival benefit.
There is no standard approach integrating diagnostic modalities into routine clinical work-up for
detecting recurrence and imaging decisions are at the discretion of the treating physician. PET/CT
may be a superior modality in this setting. However, previous studies lacked high statistical power and
lacked comparative data with NCCN guidelines and HRCT. At our institution, there is an established
surveillance program incorporating PET/CT which we will compare to the NCCN guidelines and
HRCT. We also aim to evaluate the impact of PET/CT on clinical management and survival as well as
its cost-effectiveness. The findings of this work may drastically alter management of patients with
Srikar Rao, BA
head and neck squamous cell carcinoma (HNSCC).
Radiology
Mount Sinai School of Medicine We will conduct a retrospective analysis of patient data from 2005–2008. We believe results will show
surveillance with FDG-PET/CT is superior to the NCCN follow-up algorithm as well as high resolution
RSNA CT (HRCT) in the early detection of recurrent HNSCC.
Research Medical Student Grant
 
 
25  
Evaluation of Hippocampal Damage and Episodic
Memory Loss in Multiple Sclerosis Using DTI
Until recently, little emphasis has been placed on cognitive deficits in multiple sclerosis (MS). Although
direct-effect gray matter pathology in MS brains is unknown, it is clear that greater than 50% of MS
patients become cognitively impaired with 30%–40% of patients demonstrating specific episodic
memory dysfunction. A portion of MS patients that present with memory deficits demonstrate relatively
few physical disabilities or white matter lesions. These findings suggest that hippocampal pathology,
unrelated to white matter lesion load, may cause memory impairment in MS patients. Diffusion tensor
imaging (DTI) is likely the best possible tool for in vivo study of the hippocampus. Specifically,
transverse diffusivity offers the most promising imaging measure available to detect the hippocampal
demyelination and axonal pathology in MS. The overall goal of the present study is to determine the
relationship between hippocampal damage, as determined by DTI measurements, and loss of episodic
memory in patients with MS. This work will contribute to a larger, ongoing, funded project of my
advisor’s, to develop imaging markers for cognitive changes in MS, specifically, those relating to the Chintan Shah, BS
loss of episodic memory. The long-term goal is to develop a sensitive biomarker for evaluation of Radiology
episodic memory that will be instrumental in the development and assessment of therapies to halt or Cleveland Clinic Foundation
slow memory loss in MS.
Canon U.S.A./RSNA
I will be participating in research-related clinical procedures, such as cognitive evaluations and MRI
examinations, and my major role will involve the image processing and statistical analysis. My advisor
Research Medical Student Grant
will be involved with many of the clinical aspects of the study, including selecting patients and
performing procedures. After initially training me, he will review my analyses of the imaging data at
both intermediate and final stages.

Enhanced Radiosensitization of Prostate Cancer


Cells Using Combined Treatments of Genistein and
Vitamin D
Prostate cancer (PCa) affects millions of men worldwide and although advances have been achieved,
numerous limitations still exist with current treatment options. Experimental evidence suggests that
genistein plus vitamin D is superior to genistein alone in treating PCa. Genistein is a soybean-derived
isoflavone which we have previously shown potentiates radiotherapy effects on PCa cells in vitro and
in animal models. The active form of vitamin D, 1 alpha-25-dihydroxyvitamin D3 [1,25(OH)2D3], is a
multifunctional hormone which in addition to regulating calcium and bone homeostasis also exerts
antiproliferative and pro-differentiation effects on PCa cells. 1,25(OH)2D3 induces apoptosis, inhibits
metastasis, and like genistein potentiates radiotherapy effects on PCa cells. In the absence of
radiation, genistein enhances the antiproliferative effects of 1,25(OH)2D3 by inhibiting CYP24, the
catabolic enzyme that initiates 1,25(OH)2D3 breakdown. Other downstream targets such as the
Alvin Thompson, PhD
vitamin D receptor (VDR), cell proliferation proteins (p21, cyclin D, IGFBP3), and antiapoptotic proteins
Radiation Oncology
(bcl2, bax) are also modulated by combined genistein and 1,25(OH)2D3 treatments. Based on the
findings that genistein or 1,25(OH)2D3 potentiates radiation-induced cell killing in PCa cells, we will Wayne State University School of
investigate whether the combination enhances the radiosensitization of PCa cells, beyond the effect Medicine
seen with each one independently combined with radiation. Time- and dose-dependent treatments
and clonogenic survival assays will be used to determine whether the combined treatment increases RSNA
the cytotoxicity effects in PC-3 PCa cells. Northern blot, western blot, and invasion assays will be used Research Medical Student Grant
to elucidate the treatment-induced changes that occur in downstream signaling pathways which are
involved in cell survival/death. Statistical analysis of the data will be performed to determine the
significance in three or more independent experiments.

We hope to validate our in vitro findings in an animal model and use the study to lead to strategies for
using safe compounds to enhance the effect of radiotherapy.

26  
Transcranial Sound Field Characterization Using
High-Focused Ultrasound (for the Purpose of
Mechanical Sonothrombolysis in Stroke)
Recently, Hoelscher, et al., demonstrated in vitro that transcranial high-focused ultrasound (HiFU)
enables clot liquification within 30 seconds of insonation in absence of further lytic agents (ie, tissue
plasminogen activator). Moreover, they demonstrated in a small series of cadaveric skulls that phase
aberration correction might be negligible to focus the ultrasound (US) beam after transskull insonation.

We believe that, once a preferred US parameter setting (ie, duty cycle, pulse length, duration) has
been evaluated, acoustic intensity might remain the only parameter which has to be adapted inter-
individually to achieve efficient transcranial sonothrombolysis independent from the individual skull
bone density and/or thickness. The goal of this project is to compare bone density and bone thickness
with acoustic signal absorption in a series of human cadaveric skulls and to test whether this three
Christian Welch, BS
parameters correlate with each other.
Radiology
University of California School of We aim to acquire 50 volumetric computed tomography (CT) datasets of cadaveric skulls to generate
Medicine, San Diego bone density and bone thickness maps. In parallel, we will characterize the transcranial sound fields
of these 50 skulls to assess the amount of the individual signal absorption and defocusing. The data
RSNA acquired will be used to compare bone density, bone thickness, and signal absorption for each skull
Research Medical Student Grant and to test whether they correlate using statistical methods. If correlation can be shown a coefficient
might be generated to compensate for inter-individual differences in bone density and/or bone
thickness to achieve comparable acoustic intensity exposure at the target site. This correlation
coefficient might contribute to provide optimal US exposure for each individual stroke patient by
compensating for individual bone characteristics. We strongly believe that this approach could be a
future landmark in stroke treatment using HiFU for non-invasive, mechanical clot lysis.
 
 

27  
Grant
Education Scholar
Includes recipients of the Education Seed Grant and Fellowship Training Grant (not available in 2010)

Developing a “Best Practice” National Registry for CT


Scans in Children
Five years after the Institute of Medicine (IOM) issued its pivotal report, “To Err is Human: Building a
Safer Health System,” JAMA 2005;19:2384-2390, Lucian Leape, MD, a leader in safety in medicine,
wrote, “improvement of the magnitude … [of change] …envisioned by the IOM requires a national
commitment to strict, ambitious, quantitative, and well-tracked national goals.” He explains that “no
comprehensive nationwide monitoring system exists for patient safety. ...The most important single
step … would be to set and adhere to strict, ambitious, quantitative and well-tracked national goals.”
This project, “Best Practice Registry for CT Scans in Children,” would identify patient safety/best
practice benchmarks, create a consortium to work on this issue and collect data as to how CT scans
are performed in children compared to these benchmarks.

Goals are to:


1. Improve my knowledge by learning the “science” of quality and safety. This will be done through Marilyn Goske, MD
graduate-level classes and partnering with national experts in quality at my institution. Radiology
2. Create a team of national pediatric radiology experts to develop a consensus for best practice for Cincinnati Children's Hospital
CT scans in children based on this science.
Medical Center
3. Develop a consortium of five hospitals to collect pilot data on CT scanning practice for pediatric
patients.
4. Work with the American College of Radiology (ACR) Quality and Safety team to pilot collection of
Derek Harwood-Nash
these measures of CT performance through the National Radiology Data Registry (NRDR). Education Scholar Grant
Agreement to work on this database has already been obtained from ACR.

Once the pilot phase is completed and evaluated, expansion into a nationwide CT registry may be
indicated. The goal is to establish benchmarks in best practice in CT for children by creating a small
community of thought leaders to evaluate five hospitals in this pilot with the ultimate goal to improve
patient safety through the creation of a national registry.

The influence of Evidence-Based Teaching


Methodology on Appropriate Imaging Utilization in a
Large Academic Radiology Department
Diagnostic imaging has become widely available and plays an increasing role in clinical diagnosis and
therapy. Inappropriate imaging utilization is also increasing at a high rate as referring clinicians are
often unsure what test to order and when. Such use is costly and can delay diagnosis and therapy
(thus decreasing patient throughput) and exposes patients to unnecessary ionizing radiation.

Appropriateness criteria for imaging tests are available but are not widely known or easily applied. The
long-term objectives of this research (or work) are to increase appropriate utilization of cardiothoracic
imaging studies in hospital settings. The short-term objectives of the study described herein are to
increase appropriate utilization of cardiothoracic imaging in our tertiary care academic center, by
disseminating appropriateness information and imaging pathways, via formal and informal teaching.
Aine Kelly, MD
The first specific aim of this proposal will be to devise clinical imaging pathways for cardiothoracic
Radiology (Cardiothoracic)
imaging modalities, using evidence-based guidelines. We will develop explicit guidelines (similar to the University of Michigan
ones that exist for pulmonary embolism) for patient work-up for cardiothoracic diagnostic imaging in
the clinical scenarios of cough, shortness of breath, and chest pain (cardiac, atypical, and non- GE Healthcare/RSNA
cardiac). Education Scholar Grant

The second specific aim is to educate clinical and radiology colleagues, using formal and informal
teaching methods such as short didactic presentations, handouts on important points, the use of flow
charts, and small group case based interactive sessions.

The outcome measure is increased clinicians’ and radiologists’ use of appropriateness criteria for
cardiothoracic imaging studies in their practice. This is expected to improve healthcare by improving
diagnosis and therapy in patient care, increasing reimbursements, decreasing costs, increasing
efficiency in the imaging department, increase patient throughput in clinical departments, and
decrease radiation burden.

28  
Developing a Curriculum for Teaching the Business
of Radiology
Organized academic radiology has largely ignored the needs of radiology trainees with respect to
teaching them the essentials of radiology practice management and business principles. Residents
and fellows enter their new careers vulnerable to and ignorant of pitfalls in establishing a radiology
office, purchasing equipment, negotiating contracts, ensuring accurate billing and collection, and
avoiding potential medicolegal entanglements. The proposed educational program is designed to
provide an electronic curriculum of 1 year's duration (24 lessons) for teaching these principles.

I will use the Education Scholar Grant to develop the skills needed to design Web-based electronic
interactive learning modules that incorporate video and static teaching material, to create the most
effective multiple-choice questions and answers for determining the knowledge gained by the viewer,
to input spread sheets that can be downloadable for offline use, and develop tools for assessing the
David Yousem, MD, MBA relevancy of the modules to clinical and academic practice. The value of the program will be tested
Russell H. Morgan Department of serially as well as via electronic surveys as trainees enter their careers.
Radiology and Radiological Science
I will spend time taking lessons on educational techniques and Web design while using the textbook I
Johns Hopkins Medical Institutions
co-edited, Radiology Business Practice: How to Succeed (2007) as a starting point for developing the
curriculum.
Philips Healthcare/RSNA Education
Scholar Grant The main benefit to the radiology community would be the development of a practical user-friendly
interactive online program that teaches business principles for a successful radiology practice whether
in academia or private practice.

Creating a Blended Introductory Radiology Course


for Geographic Dispersed Campuses
The aim of this proposal is to create open digital educational resources for introductory radiology
instruction in the preclinical medical school curriculum. This will include: 1) a standardized series of
introductory radiology modules with self-paced online instruction to augment live lectures; and 2) a
computer-based case application laboratory session. The two medical colleges at Michigan State
University are expanding their campuses and enrollment. Currently the introductory radiology course
is taught to over 350 students at one location, but by 2011 it will be taught to over 500 students at four
geographically dispersed locations. We want to ensure that consistency and quality are maintained.

We are looking at this expansion as an opportunity to redesign, pilot, and evaluate various educational
methods. We will identify best practices in radiology instruction and build on them to enhance delivery
of radiology curricular material in second year courses, the fourth year radiology elective clerkship and
Gerald Aben, MD radiology concepts in other clerkships.
Radiology
Michigan State University We propose to redesign the 10 introductory radiology lectures into blended instruction, with the live
lectures presented remotely via videoconferencing technology, as well as available by streaming
video. Each lecture will be accompanied by two online modules, one for preparation for the lecture,
RSNA
and the second for practice after the lecture. The modules will contain images, examples, and case
Education Seed Grant studies. Online office hours and a live lab at each site will allow students access to instructors.

We will make the modules and recorded lectures freely available online and will present the project at
national meetings. We hope to use this course redesign as a template for other courses. As the
primary care physician shortage worsens and medical schools expand their enrollments, the lessons
we learn from this project may help them.
 

29  
Teaching Systems-Based Analysis: Operational
Engineering and Management Concepts for
Radiology Residents
The goal of this preliminary study is to develop and test educational materials for teaching radiology
residents and fellows concepts of operational engineering and management to provide an intellectual
framework for management decisions, as well as to provide “hands-on” experience with the radiology
department’s LEAN improvement projects. This study will use a multidisciplinary approach integrating
the campus-wide resources available, especially those from the Department of Industrial and
Operational Engineering, Center for Research on Learning and Teaching, and the University of
Michigan Health Systems LEAN Program “Michigan Quality System” with concepts of managing for
innovation. One of the goals is to develop a series of radiology case-based teaching examples;
compelling stories that illustrate real-life management issues and have the residents make decisions
about these complex situations based on their readings and experience. Their analysis and proposed
Catherine Brandon, MD
solutions would then be compared with the actual results. By involving faculty specialized in teaching
techniques, these stories and their analysis and teaching points could be presented as an instructional
Radiology
package. Two additional goals would evaluate by interview and survey residents’ participation in University of Michigan
ongoing departmental improvement projects to discover the optimal period in their training for such
hands-on involvement and to determine the project characteristics most advantageous to resident GE Healthcare/RSNA Education
participation. Seed Grant

The main benefit to the radiology community would derive from the use of these case-based examples
by other radiology departments to supplement their residency education programs on systems-based
problems. These preliminary examples could be used as a basis for securing additional funding to
support a full 4-year program of case-based learning. Information gained on the timing and
characteristics of resident participation in hands-on systems improvement would also benefit other
residency training programs.

Training Tool For Colonic Insufflation and Scanning


in Virtual Colonoscopy
The goal of the study is to create a training module that can be used by radiologists and technologists
to learn how to perform CT colonography exams. Extensive training and experience is needed to learn
how to properly insufflate the colon using either a mechanical pressure-sensitive carbon dioxide pump
or manual insufflation of room air. While lectures and written material can provide a guide, actual
experience dealing with difficult cases is needed to obtain excellent scans necessary to properly
interpret CTC. However a visit to an institution or training program where technologists can view or
practice performing CTC has several drawbacks. First, information will not be retained unless a
sufficient volume of cases are performed in an ongoing basis. Second, many scenarios dealing with
different grades of patient pain, colonic spasm, retained fluid, and other pitfalls are difficult to teach.

This project will develop a prototype software-based training tool using an upgradable modular
graphics and text interface. Modules will simulate the patient, insufflator, CT scanner, and CT images Abraham Dachman, MD
produced. Radiology
The University of Chicago
A sophisticated hierarchy of possible patient, insufflator, and scanning conditions will be simulated
providing an interactive training environment that can be used to train and test students. The modules
RSNA
will be made using an existing graphics interface (National Instruments, LabView) that can be updated
and used by any CT vendor or insufflator vendor to accommodate the unique features of their
Education Seed Grant
equipment. This design will potentially enable national and even international use of the training tool.
The final product will be tested by training technologists who have not had CTC experience and testing
their proficiency and time needed to acquire the necessary skills.
 

30  
Integration of Radiation Oncology into the
Undergraduate Medical Curriculum
Radiation oncology is a subject that is not widely taught in the mainstream undergraduate medical
curriculum, nor is it well understood by medical students and physicians outside of the field; yet it is an
integral component of multidisciplinary cancer care. Integrating radiation oncology into the
undergraduate medical curriculum would serve to provide broad teaching opportunities for all medical
students including detailed review of anatomy and imaging, as well as an opportunity to teach
multidisciplinary cancer screening, diagnosis, and management.

I propose a multifaceted approach to the integration of radiation oncology education into the
undergraduate medical curriculum:

First, as a component of the Oncology Education Initiative, in which we have begun incorporating
Ariel Hirsch, MD formal didactic radiation oncology teaching into the 4th year of medical school during the radiology
core clerkship. Beginning with the class of 2009, the radiology core clerkship is being moved into the
Radiation Oncology
3rd year alongside core medicine and surgery rotations, which allows exposure to radiation oncology
Boston University Medical Center
earlier in the curriculum.
Varian Medical Systems/RSNA Second, a structured oncology block is being added to the 2nd year pre-clinical curriculum. As
Education Seed Grant Oncology Block Leader, this past year I have worked to design the curriculum for the oncology course,
which is planned for the final block of the academic year. Over the next year, we plan to meet in
periodic focus groups to discuss student feedback and obtain perceptions and critiques of the effort
from both pre-clinical and clinical faculty.

Third, PI-led educational programming has emerged as an excellent avenue to share what I have
learned as a medical educator with others and advance collaborative educational efforts on an
institutional level.

These three facets combine to support a basic understanding of the field and role of radiation
oncology as well as to promote a clinical mindset that seeks to explore and leverage the advantages
of interdisciplinary collaboration.

Development and Implementation of a National Web-


Based Examination System for Medical Students in
Radiology
Radiology clerkships and electives remain highly variable among medical schools, and there is no
standardized examination. Evaluations at institutions differ significantly in scope, detail, and
presentation method and many clerkship/elective directors are limited in time and academic
resources. Developing fair and comprehensive tests is time consuming and difficult.

There is significant variation in the level of expertise in writing questions; most are not validated and
thus are not necessarily testing students effectively and fairly.

We have collected over 600 questions from 11 medical schools. We plan to develop a centralized,
Web-based quiz database and exam-taking system. This would allow clerkship directors to contribute
Petra Lewis, MD
questions to a central bank, use this bank of questions to create exams, or use pre-existing exams
Radiology from the database. Students would then take these exams online. By eventually developing several
Dartmouth-Hitchcock Medical standardized exams similar to shelf exams, we have the opportunity to develop and apply standards
Center, Dartmouth Medical School for medical student education in radiology.

RSNA ExamWebTM will develop the database software and exam-taking system according to our
Education Seed Grant specifications and will provide server support. Questions will be collected and edited by a team of
radiology educators. Questions will be based on the AMSER National Radiology Curriculum for
Medical Students and test across the standard competencies. Course directors at individual medical
schools will be provided with secure access to construct their own exams, use or edit pre-existing
exams, and will be allocated PIN-type access for students to take examinations online. Eventually a
series of “shelf-type” AMSER-certified exams will be developed.

Question and exam performance analysis will be assessed on national pooled and individual
institutional data, allowing questions to be refined and pass marks set, as well as allow a comparison
among institutions.

31  
Radiologic Informatics Fellowship Program at Brigham
and Women's Hospital  
The specific aim of the RSNA Research & Education Foundation Institutional Fellowship in Radiologic
Informatics at the Center for Evidence-Based Imaging at Brigham and Women's Hospital, Harvard
Medical School, is to provide a formally designed training program in radiologic informatics consisting
of educational, research, and experiential components. The fellowship was created in response to a
present and future need for the training of radiologists in the specific area of information technology as
it relates to the radiologic sciences. The main purposes of the program are as follows:  

x To promote and enhance the understanding and utilization of information technologies within
radiology departments, to improve the quality, safety, and efficiency of care.  
x To increase the integration of systems and electronic access to image and relevant non-
image information within radiology and throughout the healthcare enterprise.  
x To assist in collaboration with industry in the establishment and implementation of clinical Ivan K. Ip, MD, MPH
requirements for medical imaging informatics technologies and tools.  
Brigham and Women's Hospital
Harvard Medical School
As part of the research activities for the 2009–2010 fellowship, we will investigate various user
interface devices currently unavailable in radiology. The idea is to have an in-depth understanding of
the adequacy/inefficiencies of the standard keyboard and mouse as interface devices in the setting of RSNA
radiology. Once these aspects are recognized, we will then create/design prototypes of various Fellowship Training Grant
alternative input devices interfaced to a commercially available PACS system. We expect that results
from this project will help shape the future of radiologist-computer interaction in the modern digital
image environment that would maximize performance, comfort, and operation.

Combined Fellowship Training in Musculoskeletal


Radiology and Imaging Informatics
The proposed fellowship program provides broad-based training in musculoskeletal radiology and
imaging informatics. The program consists of three components: 1) Clinical training in musculoskeletal
radiology, 2) a didactic informatics curriculum, and 3) research projects at the intersection thereof.

Forty percent of the program will be spent as a clinical imaging fellow at The Johns Hopkins Hospital
in the musculoskeletal radiology section. This work will have a strong focus on MRI, and will also
include radiography, CT, image-guided procedures, and participation in interdisciplinary conferences.
This work will be supervised by seven attending musculoskeletal radiologists.

Another 30% of the program will be spent as an informatics fellow in the Department of Diagnostic
Radiology and Nuclear Medicine at the University of Maryland Medical Center. The trainee will
participate in a year-long didactic curriculum, covering core technologies, imaging information Kenneth Wang, MD, PhD
systems, and leadership issues in radiology informatics. A series of projects and literature reviews will Radiology
complement lectures in topics such as decision support, enterprise imaging systems, and radiology Johns Hopkins Medical Institutions
reporting standards. Three faculty-level informaticists will supervise this work.
RSNA
The remaining 30% of the program will be devoted to original research at the intersection of
musculoskeletal radiology and imaging informatics, with direct mentorship from the scientific advisors
Fellowship Training Grant
and with specific goals of promoting quality in radiology interpretation, communication, and education
through informatics. Decision support will be a primary area of research during the program, and a
modular application framework for radiology decision support will be developed. An initial application
of this framework to problems in musculoskeletal imaging will also be implemented.

Upon completion of this program, the trainee will have gained a broad range of expertise in
musculoskeletal radiology and imaging informatics, and demonstrated original work in these areas.
The program will promote leadership in technology as a clinical radiologist and the ability to perform
ongoing research.

32  
RSNA/AUR/APDR/SCARD
Radiology Education Research Development Grant
Using Six Sigma Techniques to Reduce Radiation
Dose
Radiologists and technologists must work as a team in order to optimize the risk/benefit ratio of
fluoroscopic procedures.

In this project, a technologist with a strong quality and safety background will enroll in Six Sigma
Green Belt Training. As part of that course, she will develop the project charter for capturing dose
metrics from pediatric fluoroscopy procedures. Through a combination of classroom instruction, Web-
based training and collaborative learning with other Green Belt trainees, the applicant will learn the
Design, Measure, Analyze, Improve, and Control (DMAIC) steps.

The second project aim is to inspire technologists and other team members to actively seek process
improvement opportunities. The applicant’s experience as a technologist will provide valuable insight
Mandie Street, RT(R)(MR) into technologist workflow. The applicant has already demonstrated strong leadership and educator
Radiology skills through her role in the department’s Quality and Safety Office. As a result, she is uniquely
Washington University qualified to lead this process improvement project.

RSNA/AUR/APDR/SCARD
Radiology Education Research
Development Grant

 
 

33  
Nishard Abdeen, MD
Roentgen Resident/Fellow Research
Alan Best, MD
Award
Diagnostic Radiology Radiology
University of Ottawa University of Colorado, Denver
School of Medicine
Sunil Advani, MD
Radiation and Cellular James A. Betler, DO
Oncology Radiation Oncology
University of Chicago Allegheny General Hospital

Rajan Agarwal, MD, MBA Joseph J. Blake, MD


Radiology Radiology and Radiological
University of Pennsylvania Sciences
Health System Vanderbilt University Medical
Center
Demetrios Agriantonis, MD
Radiology Rachel Blitzblau, MD, PhD
Texas Tech University Health Therapeutic Radiology
Sciences Center Yale University School of
Medicine
Jeff Alpert, MD
Radiology SoHyun Boo, MD
Lenox Hill Hospital Radiology Junzo P. Chino, MD Devang J. Doshi, MD
West Virginia University Radiation Oncology Radiology
Morgan C. Althoen, MD Duke University Medical Center Baystate Medical Center
Radiology Charles Douglas Brooks, MD
Mercy Catholic Medical Center Radiology Asim F. Choudhri, MD Neal E. Dunlap, MD
Texas A&M HSC–College of Radiology Radiation Oncology
Wilson B. Altmeyer, MD Medicine/Scott & White University of Virginia University of Virginia Health
Radiology Hospital System
Ochsner Clinic Foundation Jonathan Chung, MD
New Orleans Richard Bruce, MD Radiology Carolyn S. Dupuis, MD
Radiology University of Washington Radiology
Christopher J. Anker, MD University of Wisconsin University of Massachusetts
Radiation Oncology Hospital and Clinics Paul Clark, DO Medical School
Huntsman Cancer Hospital, Radiology
University of Utah John Chi-Hung Chang, MD, Tripler Army Medical Center Kirsten Emery, MD
PhD Radiology
Ryan W. Arnold, MD Radiology Kevin J. Croce, MD SUNY Downstate Medical
Radiology Stanford University Radiology Center
Aultman Hospital University of Kentucky Medical
Govind Chavhan, MBBS, MD, Center Brenda Farnquist, MD
Mary Elizabeth Atherton, MD DNB Diagnostic Radiology
Radiology Diagnostic Imaging Andrew R. Deibler, MD Queen's University
University of Arkansas for The Hospital for Sick Children Radiology
Medical Sciences Wake Forest University School Myra Kay Feldman, MD
Sheema Chawla, MBBS, MD of Medicine Diagnostic Radiology
Kevin Auerbach, MD Radiation Oncology Allegheny General Hospital
Radiology University of Rochester Carlo Demandante, MD
Albany Medical Center Medical Center Radiation Oncology Steven Eric Finkelstein, MD
The University of Texas Health Radiation Oncology
W. C hris topher B aughman, MD Jonathan C. Cheng, MD, PhD Science Center at San Antonio Moffitt Cancer Center
Department of Radiology Radiation Oncology University of South Florida
MetroHealth Medical Center University of California, Irvine Paul B. DiDomenico, MD
Radiology Aaron Fischman, MD
Anne-Marie Beaudet, MD Bhishamjit Chera, MD David Grant USAF Medical Radiology
Radiology Radiation Oncology Center Mount Sinai School of Medicine
Memorial University University of Florida
Jonathan Dillman, MD Angelique C. Floerke, MD,
Luis S. Beltran, MD Alison Chetlen, DO Radiology PharmD
Radiology Radiology University of Michigan Health Radiology
Thomas Jefferson University Penn State Milton S. Hershey System George Washington University
Hospital Medical Center
Federico Discepola, MD Richard J. Gessman, MD
Radiology Department of Radiology
McGill University St. Vincent's Medical Center

34  
Wende N. Gibbs, MD Bradley Huth, MD Matthew Koshy, MD Joshua E. Meyer, MD
Radiology Radiation Oncology Radiation Oncology Radiation Oncology
Baylor University Drexel University College of University of Maryland New York Hospital of Queens/
Medical Center at Dallas Medicine, Hahnemann Weill Cornell Medical College
University Hospital Mark Landis, MD
Daniel Ginat, MD, MS Medical Imaging Asif Moinuddin, MD
Imaging Sciences Puneeth Iyengar, MD, PhD The University of Western Radiology/Nuclear Medicine
University of Rochester Medical Radiation Oncology Ontario Saint Louis University
Center The University of Texas
MD Anderson Cancer Center Kenneth Le, MD Matt T. Moore, MD
Daniel R. Gomez, MD Radiology Radiology
Radiation Oncology Bharathi Jagadeesan, MBBS Tulane University Hospital St. Joseph's Hospital & Medical
Memorial Sloan-Kettering Radiology Center
Cancer Center University of Minnesota Thu Trong Le, MD
Radiology Andrew Mullins, DO
Brandon Gunn, MD Adam J uyoung J ung, MD, P hD Santa Barbara Cottage Hospital Radiology
Radiation Oncology Radiology National Capital Consortium
The University of Texas The University of Texas Health David Lee, MD
Medical Branch at Galveston Science Center at San Antonio Radiology Akira Murakami, MD
Albert Einstein Medical Center Diagnostic Radiology
Shivani Gupta, MD Yasha Kadkhodayan, MD Boston University Medical
Radiology Radiology Justin Steven Lee, MD Center
St. Vincent's Catholic Medical Washington University Radiology
Center Georgetown University Hospital Amy Musk, MD
Joshua Kallen, MD Diagnostic Radiology
Soterios Gyftopoulos, MD Radiology Jeffrey Levsky, MD, PhD University of Maryland Medical
Radiology Hartford Hospital Radiology Center
Beth Israel Medical Center Montefiore Medical Center
Daniel R. Karolyi, MD, PhD Jeremy Neuman, MD
Marsha Lee Haley, MD Radiology Amanda Demetri Lewis, DO Radiology
Radiation Oncology Emory University Diagnostic Radiology Staten Island University
University of Pittsburgh Medical Hahnemann University Hospital Hospital
Center Medical Education Nicole M. K elleher-Linkonis , MD
Diagnostic Radiology Brett E. Lewis, MD, PhD
Program Joshua Nickerson, MD
Medical College of Virginia Radiation Oncology
Radiology
UMDNJ-Robert Wood Johnson
Ethan Hansen, MD University of Vermont/Fletcher
James Martin Kessler, MD Medical School
Radiology Allen Health Care
Radiology
North Shore University Hospital
Jacobi Medical Center Jie Li, MD
Refky Nicola, DO
Radiology
Samantha Lynn Heller, PhD, Diagnostic Radiology
Charles Y. Kim, MD Memorial Sloan-Kettering
MD Cooper University Hospital/
Radiology Cancer Center, New York
Radiology UMDNJ-Robert Wood Johnson
Duke University
NYU School of Medicine Daniel Mandell, MD Medical School
Hee Kyung Kim, MD Medical Imaging
Heidi B. Henslee, MD Radiology University of Toronto Mehul K. Patel, MD
Radiology Cincinnati Children's Hospital Radiation Oncology
University of South Alabama Medical Center Susan A. McCloskey, MD Henry Ford Health System
Radiation Oncology
Christine Hill-Kayser, MD Young W. Kim, MD Roswell Park Cancer Institute Ashish B. Patel, MD
Radiation Oncology Radiology Radiation Oncology
University of Pennsylvania Brooke Army Medical Center Mark W. McDonald, MD University of Maryland Medical
Radiation Oncology Center
Andrew Hines-Peralta, MD Randall Kimple, MD, PhD Emory University
Radiology Radiation Oncology Stephanie M. Perkins, MD
Beth Israel Deaconess Medical University of North Carolina Tasha L. McDonald, MD Radiation Oncology
Center Hospitals Radiation Medicine Washington University School
Oregon Health & Science of Medicine
Charles Wesley Hodge, MD Seth Klein, MD University
Radiation Oncology Radiology Kiley D. Perrich, MD
University of Wisconsin SUNY–Stony Brook University Samuel McGrath, MD Diagnostic Radiology
Radiation Oncology Dartmouth-Hitchcock Medical
Steve C. Hong, MD Angelos A. Konstas, MD William Beaumont Hospital Center
Diagnostic Radiology Radiology
William Beaumont Hospital Massachusetts General Sonali Mehandru, MD Joseph Platnick, MD
Hospital Radiology Radiology
Ryan Hung, MD, PhD University Hospitals Case Staten Island University
Radiology and Diagnostic Timothy Korytko, MD Medical Center Hospital
Imaging Radiation Medicine
University of Alberta Arthur G. James Cancer Kenneth Meng, MD Sanjay P. Prabhu, MBBS
Hospital, Ohio State University Radiological Sciences Pediatric Radiology
Medical Center University of California, Irvine Children's Hospital Boston

35  
Ario Rezaei, MD Yuji Seo, MD Andrew D. Smith, MD, PhD Jennifer Tynan, MD
Radiology Radiation Oncology Radiology Medical Imaging
University of Cincinnati University Hospitals Case Cleveland Clinic University of Saskatchewan
Medical Center
Andrew L. Rivard, MD, MS Joshua P. Smith, MD Venu Vadlamudi, MD
Radiology Curt Settlemoir, MD Radiology Diagnostic Radiology
University of Florida Diagnostic Radiology University of Alabama at Michigan State University Flint
Southern Illinois University Birmingham Area Medical Education
Clifford Grant Robinson, MD School of Medicine
Radiation Oncology Salil Soman, MD Waseet Z. Vance, MD
Cleveland Clinic Foundation Naishadh Shah, DO Radiology Radiation Oncology
Radiology UMDNJ-Robert Wood Johnson Columbia University Medical
Dave Roy, MD Temple University Hospital Medical School Center
Radiology New York Presbyterian
The University of Texas Navesh K. Sharma, DO, PhD Susanna Spence, MD Hospital
Southwestern Medical Center Radiation Oncology Diagnostic & Interventional
Fox Chase Cancer Center Imaging Vikram Venkatesh, MD
Ramin R. Saket, MD The University of Texas Medical Diagnostic Imaging
Radiology John J. Sheehan, MD School at Houston McMaster University
UCSD Medical Center Radiology
NorthShore University Michael Spiotto, MD, PhD Robert N. Walker, MD, MPH
Luke Scalcione, MD HealthSystem Radiation Oncology Radiology
Radiology Feinberg School of Medicine Stanford University Geisinger Medical Center
Winthrop-University Hospital
Timothy Norman Showalter, Ashmitha Srinivasan, MD Jessica Leigh Walls, BSc, MD
Todd C. Schirmang, MD MD Radiology Radiology Residency Program
Diagnostic Imaging Radiation Oncology Upstate Medical University University of British Columbia
Rhode Island Hospital/Brown Thomas Jefferson University
Medical School Hospital Nicholas J. Statkus, MD Nylah F. Wasti, MD
Diagnostic Radiology Radiology
Brian J. Schiro, MD Ravi Shridhar, MD, PhD Oregon Health & Science Eastern Virginia Medical
Radiology Radiation Oncology University School
UPMC Presbyterian Wayne State University
Jan Stauss, MD John M. Watkins, MD
David A. Schomas, MD Dorothy Sippo, MD Radiology Radiation Oncology
Radiation Oncology Radiology Brigham and Women's Hospital Medical University of South
Mayo Clinic St. Luke's–Roosevelt Hospital Carolina
Aaron Stevenson, MD
Adam Sciuk, MD Dee Dee K. Smart, MD, PhD Radiology Adam J. Weisbrod, MD
Radiology Radiation Oncology Branch University of Tennessee Medical Radiology
Louisiana State University National Cancer Institute Center, Knoxville Mayo Clinic
Health Sciences Center–
Shreveport Pal Suranyi, MD, PhD David Wilson, MD, PhD
Radiology Radiology
Medical University of South University of California, San
Carolina Francisco

Krishna Surapaneni, MD J oel Aaron Y alowitz, MD, P hD


Radiology Diagnostic Radiology
Long Island College Hospital Indiana University School of
Medicine
Uma Swamy, MD
Radiation Oncology Eddy S. Yang, MD, PhD
New York Methodist Hospital Radiation Oncology
Vanderbilt University Medical
Ronald Scott Swanger, MD Center
Radiology
New York Medical College Nam Chul Yu, MD
Radiological Sciences
Katharine Tansavatdi, MD UCLA Medical Center
Radiology
University of California at Davis Hadi Zahra, MD
Section of Radiation Oncology
Stuart Yukio Tsuji, MD Baylor College of Medicine
Radiation Oncology
University of California, San Katherine A. Zukotynski, MD
Francisco Joint Program in Nuclear
Medicine
Harvard Medical School
Jonathan Dillman, MD (center), radiology fellow at the University of Michigan
with N. Reed Dunnick, MD (left), department chair, and Isaac R. Francis, MD
(right), associate chair for research

36  
Award
 

Outstanding Researcher

Sanjiv Sam Gambhir, MD, PhD is the Virginia and D.K.


Ludwig Professor of Radiology and Bioengineering at Stanford University. He received his
bachelor of science degree in physics from Arizona State University in 1983. He
subsequently received both his medical degree and doctorate in biomathematics in 1993
while in the Medical Scientist Training Program (MSTP) at the University of California at
Los Angeles (UCLA). He completed an internship in internal medicine followed by a
residency in nuclear medicine and a fellowship in PET/CT, at the Center for Health
Sciences at UCLA. He rose up the ranks at UCLA to become director of the Crump Institute
for Molecular Imaging and professor/vice chair of molecular and medical pharmacology.

Dr Gambhir moved to Stanford in 2003 to direct the Molecular Imaging program and to lead
nuclear medicine. He brought over 35 scientists with him from UCLA and has grown the
program at Stanford to more than 150 scientists including 30 students, post-doctoral
fellows, and scientists in his own multimodality molecular imaging laboratory. He was
recently appointed head of the new Canary Center for Cancer Early Detection at Stanford
and was appointed the Virginia and D.K. Ludwig Endowed Professorship in Cancer
Research in 2009.

Professor Gambhir is internationally recognized as a leader in the field of molecular


imaging. His laboratory has developed fundamental new ways to image living subjects
including methods to image gene expression and cell trafficking. He has developed methods to image signal transduction pathways
including protein-protein interactions and other fundamental cellular events. Dr Gambhir has recently pioneered novel Raman nano-
molecular imaging strategies that are being clinically translated for endoscopic imaging. He has translated novel molecular imaging
strategies using reporter genes with PET/CT for pilot trials in gene and cell therapies. He
played a major role in obtaining reimbursement for FDG PET from the Centers for Medicare
“Dr Gambhir brings an extraordinary and Medical Services including the development of several cancer cost-effectiveness models
blend of focus, intensity, and creativity for lung, colorectal, and other cancers. He is currently working to advance the merger of in
to his work on imaging cellular and vitro and in vivo diagnostics using novel nanotechnology for earlier disease detection and
molecular events in vivo. A team builder individualized patient management.
and gifted scientist, he is renowned for
his work on imaging gene expression
and for the development of many clinical
Dr Gambhir has more than 20 patents pending or granted and is the author of over 325 peer-
algorithms for cost-effective cancer care reviewed journal articles, including publication in Nature Medicine, Nature Biotechnology,
involving PET imaging.” Nature Methods, Science, PLOS Medicine, PNAS, Journal of Nuclear Medicine, Radiology,
and many other journals. His work has been featured on the cover of over 20 journals
–Gary J. Becker, MD including Science, Journal of Nuclear Medicine, Circulation, JACC, Journal of Urology,
2009 President, RSNA; Executive Gastroenterology, FASEB, Cancer Cell, Nano Letters, and Nature Reviews Drug Discovery.
Director, American Board of Radiology
He is the co-editor of one of the best-selling books in the field of nuclear medicine, Nuclear
Medicine in Clinical Diagnosis and Treatment. He is also co-editor of a new book, Molecular
“Sanjiv Sam Gambhir is an innovative Imaging: Principles & Practice. He has received over $50 million in federal grant funding and
thinker, prolific writer, much sought-after currently is the principal investigator for several National Institutes of Health (NIH) R01s and
speaker, mentor, and thought leader. He program projects from the National Cancer Institute (NCI), including a Center for Cancer
is an excellent example of a physician Nanotechnology Excellence and the In Vivo Cellular and Molecular Imaging Centers.
scientist and has become a model for
what young research-oriented Dr Gambhir has trained more than 150 residents, fellows, post-doctoral scholars, graduate
radiologists can aspire.”
students, undergraduates, and high school students in his laboratories and clinic, and is head
–Peter L. Choyke, MD of a NCI-funded R25T post-doctoral training grant. Always in demand, Dr Gambhir has given
Chief, Molecular Imaging Program, NCI over 250 invited talks including more than 50 Keynotes at major international meetings. He
has served as President of the Academy of Molecular Imaging (AMI) and in numerous
advisory capacities to professional societies including RSNA and SNM. He is active in both
“Dr Gambhir is instrumental in educating AMI and Society for Molecular Imaging (SMI), serves on the NCI Scientific Advisory Board,
clinicians and scientists alike in the
application of PET in solving
and is an associate editor for several journals including Journal of Nuclear Medicine,
fundamental problems in biomedicine. Radiology, and Nature Clinical Practice Oncology.
His biggest contribution is moving gene
expression imaging from the bench to Dr Gambhir has received numerous awards including the Hounsfield Medal from Imperial
the bedside.” College, Tesla Medal from the UK Royal College of Radiologists, Holst Medal, Doris Duke
Distinguished Clinical Scientist Award, Paul C. Aebersold Award from the SNM, Achievement
–King C. P. Li, MD, MBA
Chair, Department of Radiology, The
Award from the SMI, and the Distinguished Basic Scientist Award from the AMI. He co-hosted
Methodist Hospital/Weill Medical College the 2007 Nobel Symposium on Imaging in Stockholm and was elected in 2008 as one of the
youngest members to the Institute of Medicine of the National Academies.

37  
Outstanding Educator Award
Elliot K. Fishman, MD is professor of radiology and oncology at
The Johns Hopkins University School of Medicine and director of Diagnostic Imaging and
Body CT at The Johns Hopkins Hospital. He began his medical career with a medical
degree from the University of Maryland Medical School and his radiology career with a
diagnostic radiology residency at Sinai Hospital of Baltimore and a computed body
tomography fellowship from Johns Hopkins.

From the start, Dr Fishman approached radiology from the standpoint of an educator–from
his earliest manuscripts focused on educating the practicing radiologist about body CT and
the value of 3D imaging to his later articles on the science of radiology education. He has
now produced more than 1000 journal publications, the majority of which include students
or trainees as first author or co-author, a testament to his ongoing role as mentor to
generations of residents, fellows, and junior faculty. His unique and engaging teaching
style, highly innovative and inspirational, has proven to be an effective tool for career
development for everyone he encounters.
“Elliot has demonstrated a commitment to and
In addition to journal publications, Dr effectiveness in educating radiologists,
Fishman has co-authored 10 books and technologists, and referring physicians through
monographs including innovation, communication, and inspiration
PocketRADIOLOGIST® Abdominal Top that is second to none. He has also mentored
100 Diagnoses and Multidetector Row CT: generations of residents, fellows, and junior
Principles, Techniques and Applications, now in its third edition, and 50 book chapters. faculty who have gone on to achieve success
He has developed 25 audiovisual and Web-based programs in his pursuit of widespread in their academic pursuits.”
dissemination of radiologic educational materials through computer-based methods, –Jonathan S. Lewin, MD
including CTisus.com, a Web site used by more than 60,000 radiologists and Professor and Chair, The Russell H. Morgan
technologists in over 120 countries worldwide. The site won the gold medal at the Department of Radiology and Radiological
American Roentgen Ray Society (ARRS) annual meeting and the Magna Cum Laude at Science, Johns Hopkins Medical Institutions
the RSNA scientific assembly and annual meeting.

Other awards and honors include election in 2002 to Alpha Omega Alpha—The Honors “Elliot Fishman has been at the forefront of
Medical Society and Aunt Minnie Awards in Radiology—“Best Educator” in 2001 and every new technical development in the field
of body CT and has surely educated more
2007 and “Best Researcher” in 2004. Additional honors include America’s Top Doctors, radiologists around the world about CT than
Castle Connolly Medical Ltd’s “America’s Top Doctors for Cancer” 2005–2009, anyone. I am proud to know him as a career-
“America’s Top Doctors” 2001–2009, and Medical Imaging Magazine’s “Top Radiologist long colleague and friend.”
in the Nation” in 2007.
–Michael P. Federle, MD
Professor and Associate Chair for Education
His contributions continue with 75 visiting professorships, numerous industrial
Department of Radiology, Stanford University
consultations, service to 40 advisory committees, and as reviewer, consultant, and Medical Center
member of editorial boards for more than 35 journals. He is an active member of at least
16 professional radiology organizations and has contributed to them all with thousands
of lectures and principal presentations, and countless abstracts presented at national “Elliot has been tirelessly innovative in
and international meetings. Each year, Dr Fishman brings to the RSNA scientific harnessing unexpected benefits of rapidly
assembly and annual meeting at least 20 education exhibits, scientific posters, scientific evolving technology for the purpose of
papers, plenary sessions, and refresher courses. effectively communicating clinical and
educational information. He envisioned how
In the last 20 years, Dr Fishman has coordinated more than 100 continuing medical 3D imaging would expand the usefulness of
education (CME) courses for the Johns Hopkins School of Medicine. His CME courses imaging beyond diagnosis to therapeutic
planning; and CTisus.org has harnessed the
focus on state-of-the-art body CT and include hot topics such as CT angiography and power of the Internet to allow any radiologist
cardiac imaging. He currently organizes 8–10 CME courses annually across the country anywhere in the world to bring these benefits
and recently added an international CME meeting. to their patients.”

Elliot Fishman has demonstrated a long-standing commitment to education directed –Alec J Megibow, MD, MPH
toward the improvement of the art and science of radiology and, ultimately, the benefit of Professor, New York University Medical
patient care. Center

38  
2009 RSNA Research & Education Foundation Board of Trustees

Back Row: Front Row:


E. Russell Ritenour, PhD William T. Thorwarth, Jr, MD
G. Scott Gazelle, MD, PhD Beverly B. Huckman, Secretary
James P. Borgstede, MD Theresa C. McLoud, MD
Hedvig Hricak, MD, PhD, Dr(hc) Jack E. Price, Chair
Burton P. Drayer, MD
Gary J. Becker, MD Not Available for Group Photo:
R. Gilbert Jost, MD, Treasurer Vijay M. Rao, MD

RSNA Research & Education Foundation


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