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Transcript of 2011 grant-and-award-booklet web
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.
Bright Ideas Get Funded
2011rsna grants and awards
RSNA Research & Education Foundation
1RSNA.org/Foundation
grants and awards
Research Grant ProgramsResearch Scholar Grant 4–9To support junior faculty members who have completed the conventional resident/fellowship training
program(s); but have not yet been recognized as independent investigators. The purpose of the funding is to help
establish the recipient as an independent investigator, and to collect preliminary data that could lead to further
funding through established mechanisms such as the NIH. Recipients will devote a minimum of 40% of their time
in the approved research project. $75,000 annually for 2 years ($150,000 total) to be used as salary support for the
scholar.
Research Seed Grant 10–14To enable all levels of investigators throughout the world in defining objectives and testing hypotheses in prepa-
ration of major grant applications to corporations, foundations, and governmental agencies. The seed data from
these projects will indicate feasibility and appropriateness of the research prior to applying for funds from other
agencies. Up to $40,000 United States Dollars (USD) for a 1-year project. Open to international applicants.
Research Resident/Fellow Grant 15–23To provide young investigators an opportunity to gain further insight into scientific investigation and to gain
competence in research techniques and methods in anticipation of establishing a career in academic radiologic
science. Recipients will devote a minimum of 50% of their time in the approved research project under the guidance
of a scientific advisor/mentor. $50,000 for a 1-year fellow project or $30,000 for a 1-year resident project to be used
for salary and/or other research expenses.
Research Medical Student Grant 24–35To increase the opportunities for medical students to have a research experience in medical imaging and to
encourage them to consider academic radiology as an important option for their future. Recipients will gain
experience in defining objectives, developing research skills and testing hypotheses before making their final
choices for residency training programs. Students are expected to undertake a research project requiring full-
time efforts for at least 10 weeks under the guidance of a scientific advisor during personal/vacation time or
during a research elective approved by their medical school. $3,000 to be matched by the sponsoring department
($6,000 total) as a stipend for the student.
Education Grant ProgramsEducation Scholar Grant 36–39To 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. One year grant of up
to $75,000 USD for salary support and/or other project costs. In exceptional cases, grants of up to two years will
be considered.
RSNA/AUR/APDR/SCARD Education Research Development Grant 40–41To encourage innovation and improvement in health sciences education by providing research opportunities
to individuals throughout the world who are in pursuit of advancing the science of radiology education. Up to
$10,000 USD for a 1-year project to help cover the costs of research materials, research assistant support, and
limited principal investigator salary support.
Recognition AwardsRoentgen Resident/Fellow Research Award 42–44To recognize and encourage outstanding residents and fellows in radiologic research during the past year. Each par-
ticipating North American residency program will receive an award plaque with space to display brass nameplates
for each year’s recipient. The Foundation will also provide a personalized award for the department to present to the
selected resident or fellow.
your foundation—your future2011 was another outstanding year for the RSNA Research & Education Foundation. Through the generous support of our
individual donors, private practice and academic groups and our corporate partners, the Foundation was able to fund 72
grants totaling $2.6 million—the highest amount to date.
The cornerstone of the R&E Foundation’s mission is to advance medical imaging research, education and practice. Since its
inception, the Foundation has funded nearly 900 grants totaling well over $34 million. On average, every dollar awarded by
the Foundation results in over $30 of additional funds from sources such as the NIH. With this high return on investment,
the R&E Foundation has enabled over $1 billion in radiologic research.
Each and every day at institutions throughout North America and abroad, young investigators supported by the R&E
Foundation are performing vital research aimed to improve clinical care and patient outcomes, and ensure the future
of the specialty.
Today, the R&E Foundation’s 2011 grant recipients are conducting research in several exciting areas. A Research Scholar
grantee leads a comparative effectiveness trial on evaluation of pediatric small bowel Crohn disease using MR enterography
and ultrasound elastography—the first of its kind in humans—which may mark an important paradigm shift in the radiologic
assessment of Crohn disease. A Research Seed Grant recipient will study the use of DTP FDG-PET/CT in conjunction with
advanced image analysis to quantify in vivo tumor biology, predict clinical outcome, and improve disease staging in patients
with lung cancer. This research may provide a new, practical, informative and readily available diagnostic approach for
these patients. A recipient of a Research Resident Grant will conduct a pilot study on patient-specific dosimetry in pediatric
and adult CT—which could guide a larger scale study to create a dose reporting system tailored to individual patients.
These diligent individuals are hard at work, and a strong partner is critical to their success. The R&E Foundation is proud
to be that partner.
To support these investigators, the
Foundation offers many vehicles for
giving, including individual programs,
practice and academic group programs,
planned giving opportunities and
corporate and exhibitor partnerships.
I encourage you to take time to read
through the abstracts in this booklet to
learn more about our outstanding grant
recipients and their innovative projects.
Theresa C. McLoud, MD
Chair, Board of Trustees
RSNA R&E Foundation
RSNA Research & Education Foundation Board of Trustees
Back row, from left: G. Scott Gazelle, MD, PhD; Hedvig Hricak, MD, PhD, Dr (hc), Treasurer; Burton P. Drayer, MD, RSNA President; James P. Borgstede, MD; E. Russell Ritenour, PhD, Secretary; Valerie P. Jackson, MD
Front row, from left: Sarah S. Donaldson, MD; Theresa C. McLoud, MD, Chair; Richard L. Ehman, MD; Vijay M. Rao, MD
Not available for group photo: Gregory C. Karnaze, MD; Thomas N. McCausland
It is through the generosity of individuals, private practices and industry partners that the R&E Foundation is able to continue its investment in R&D for radiology. In 2011, grant awards were specially named to recognize the following individuals and companies for their contributions to the R&E Foundation, and the future of the specialty.
Derek Harwood-Nash, MD
n Peggy J. Fritzsche, MD
RSNA Presidents Circle
n Silver Anniversary Campaign Pacesetters
recognition and thanks
Dear Presidents Circle Donors,I wish to express my sincere appreciation for your generous dona-
tions, which have made it possible for me to conduct this important
research. My grant aims to provide accurate, patient-specific, dose
and risk estimates for the entire spectrum of pediatric and adult CT
exams. The outcome of this research will serve important functions
in promoting justified use of CT radiation, in establishing diagnostic
reference levels, and in optimizing CT protocols to minimize dose.
Many thanks to you all for enabling me to pursue my goals.
With my best regards,
Xiang Li, PhD
BRIGHT IDEAS. BETTER PATIENT CARE.
H e a l t h C a r e
MEDICAL
RSNA.org/Foundation 3
Not available for group photo: Gregory C. Karnaze, MD; Thomas N. McCausland
research scholar grantresearch grant programs
Hersh Chandarana, MD
RadiologyNew York University School of MedicineSiemens Healthcare/RSNA Research Scholar Grant
Evaluation and Prediction of Treatment Response in Liver Metastasis Undergoing Chemotherapy with Use of Dual Energy CT Iodine Quantification Technique
Colon cancer is the third most common cause of cancer-related
mortality in the United States. Liver metastases are the main cause
of death in these patients. Currently, treatment response is solely
assessed on the basis of size changes in the target lesions. Change
in size may, however, be a late manifestation in patients undergo-
ing targeted chemotherapy. Furthermore, different combinations
of chemotherapeutic agents are available, and selection of the right
combination chemotherapy is imperative to maximize efficacy and
minimize toxicity.
There is tremendous interest in identifying response-predicting
factors that can help tailor chemotherapy. The overall aim of this
project is to validate the use of quantitative measurement of treat-
ment response in patients undergoing antiangiogenic chemotherapy
for liver metastases from colon cancer, based on tumor vascularity
as measured by intralesional iodine concentration on contrast-
enhanced dual-energy CT (DECT). We hypothesize that intralesional
iodine concentration may prove to be a more sensitive and earlier
indicator of treatment response than traditional RECIST criteria.
If validated in this study, iodine concentration depicted on DECT
imaging can be used to predict and monitor treatment response
to antiangiogenic chemotherapy in patients with liver metastases
from colon cancer. The potential benefits of this technique would al-
low appropriate patient selection and earlier determination of drug
response, which could help develop personalized chemotherapy
regimens and lead to improved patient outcome. Furthermore, this
could become a method for the rapid assessment of the efficacy of
new antiangiogenic pharmaceutical agents or combination regi-
mens, allowing for more rapid drug development.
Jonathan R. Dillman, MD
RadiologyUniversity of MichiganAGFA HealthCare/RSNA Research Scholar Grant
Comparative Effectiveness of MR Enterography, Enteric Ultrasound, and Ultrasound Elastography Imaging in the Evaluation of Pediatric Small Bowel Crohn Disease
There is presently a paucity of data comparing magnetic resonance
enterography (MRE) and enteric ultrasound (EnUS) in the assess-
ment of pediatric small bowel Crohn disease. Prior studies evalu-
ating EnUS have used suboptimal reference standards, including
ileocolonoscopy and barium studies. If EnUS can be shown to have
significant positive agreement and comparable receiver-operating
characteristics (ROC) to MRE, this imaging technique could become
standard-of-care due to lower cost, shorter examination time, and
lack of need for sedation, contrast materials, and anti-peristaltic
medication.
Recently published research using an animal model has demon-
strated that ultrasound elastography imaging (UEI) has several
potential promising clinical applications in humans, including serv-
ing as an imaging biomarker for both response (and perhaps early
response) to medical therapy and the presence of bowel wall fibrosis
in small bowel Crohn disease. It is possible that UEI could influence
the decision to surgically manage certain children.
We propose to prospectively compare the diagnostic performance
of EnUS to MRE for the initial diagnosis and follow-up of pediat-
ric small bowel Crohn disease. All subjects will undergo baseline
(immediately prior to starting medical management) and serial
follow-up physician-performed systematic EnUS (including grey-
scale and Doppler imaging) and MRE examinations. EnUS and MRE
findings will be documented and assessed for agreement at baseline
and follow-up as well as correlated with a variety of laboratory
inflammatory markers and Pediatric Crohn Disease Activity Index
(PCDAI) scores. Changes in UEI bowel wall stiffness over time will
be correlated with other imaging findings as well as clinical data to
determine if this imaging technique can serve as a radiologic bio-
marker for response to medical therapy and the presence of bowel
wall fibrosis. Finally, we will formally survey the children and
parents in our study concerning their imaging preferences as well
as compare resource consumption by these imaging tests.
H e a l t h C a r e
5RSNA.org/Foundation
Qian Dong, MD
RadiologyUniversity of Michigan Hospitals and Health CentersBracco Diagnostics/RSNA Research Scholar Grant
Quantitative Imaging in Soft Tissue Sarcomas: Use of MRI Diffusion and MRI Perfusion Biomarkers to Predict Early Response to Neoadjuvant Chemotherapy
Nearly 15,000 new cases of sarcoma are diagnosed annually in the
U.S. with a loss of years of life that greatly outweighs the incidence
of these cancers. Although advances in multiagent chemotherapy
and surgery have improved prognosis, sarcomas still are fatal in up
to 50% of patients. A major obstacle to improving patient outcomes
is the inability to reliably determine success or failure of pre-oper-
ative (neoadjuvant) chemotherapy early in the course of treatment,
prior to surgery and histologic analysis of tumor specimens. As a
result, patients may continue on ineffective chemotherapy regi-
mens, experiencing adverse effects of treatment and missing the
critical opportunity to switch to an alternative protocol.
Our central hypothesis is that quantitative molecular and func-
tional imaging techniques can meet the need for early determination
of response to therapy in soft tissue sarcomas. We will use diffusion
and dynamic contrast-enhanced MR imaging (DCE-MRI) to measure
changes in cellular architecture and angiogenesis in patients
undergoing neoadjuvant chemotherapy for sarcomas. These studies
will establish imaging biomarkers as early predictors of treatment
efficacy in patients with soft tissue sarcomas.
Our long term goal is to use molecular imaging to assess response
to neoadjuvant chemotherapy within days or even hours of initiat-
ing chemotherapy, replacing ineffective current methods based on
late changes in tumor volume. By determining treatment efficacy
early in the course of therapy, we expect this research will ultimate-
ly allow oncologists to optimize treatment protocols for individual
patients, improving quality of life and enhancing disease-free
survival for patients with soft tissue sarcoma.
In summary, this research will develop molecular imaging techniques
to determine success or failure of pre-operative chemotherapy
in soft tissue sarcomas. These imaging techniques ultimately will
allow treatment protocols to be optimized for individual patients,
improving survival and quality of life for patients with soft tissue
sarcomas.
Jason Druzgal, MD, PhD
RadiologyUniversity of VirginiaRSNA Research Scholar Grant
Machine Learning Classification of Resting State Functional MRI Data in Autism Spectrum Disorders
Resting state functional MRI (rs-fMRI) measures spontaneous fluc-
tuations in blood oxygen level dependent (BOLD) signal, thought to
reflect fluctuation in underlying neuronal activity. Whole-brain rs-
fMRI of individuals of normal cognitive function has characterized
many long-range and short-range neural networks that demonstrate
reproducible temporal synchrony of resting state BOLD signal.
Applications of this rs-fMRI technique to several types of cognitive
pathology (including autism, schizophrenia, bipolar disorder, and
depression) have demonstrated consistent perturbations of this
temporal synchrony related to the underlying pathology.
Regarding the autism spectrum, my research group has discovered
several features of rs-fMRI temporal synchrony that are perturbed
at the population level, including long-range interhemispheric
connectivity and short-range regional homogeneity. These findings
certainly advance our understanding of the pathology underlying
the autism spectrum, but the clinical utility of this information is
currently limited. A more clinically relevant issue is whether the
features in a single rs-fMRI data set can be used to determine the
population from which the data originated. That is, can you make
the diagnosis of autism based on features in the rs-fMRI data? Re-
cent application of machine learning classification to fMRI data sets
suggests this to be a realistic possibility.
The current project proposes to develop a classifier that discrimi-
nates autistic patients from typically developing controls on the
basis of their rs-fMRI data. A support vector machine classifier will
be developed from an existing large rs-fMRI data set obtained from
a well-characterized population of autistic patients and typically de-
veloping control patients. The classifier will be internally assessed
for metrics of clinical validity, such as sensitivity, specificity, and
accuracy. Then the classifier will be externally validated with rs-
fMRI data obtained from a separate population of autistic individu-
als, at a different institution.
research scholar grant
research scholar grantMichael S. Gee, MD, PhD
RadiologyMassachusetts General HospitalCarestream Health/RSNA Research Scholar Grant
Evaluation of Diagnostic Magnetic Resonance (DMR) Technology for Molecular Characterization of Cancer Cells from Percutaneous Image-Guided Biopsy Specimens
The capability to perform real-time molecular analysis of human
tumors is expected to enable rational treatment decisions in an era
where molecularly targeted therapies are emerging. Attempts to
profile cancer cells to date largely have been unsuccessful, as exist-
ing clinical technologies are either too insensitive to distinguish
biomarker expression levels or lead to alterations in tumor cell phe-
notype, precluding accurate assessment. We have developed a novel,
broadly applicable, point-of-care method of diagnostic magnetic
resonance (DMR) that overcomes many of these limitations.
The technology utilizes magnetic resonance techniques confined
within a chip-sized micro-NMR device to measure the relaxation
time of tumor cell fine needle aspiration samples. The molecular
specificity of DMR is achieved through magnetic nanoparticles
that act as proximity sensors for specific molecular targets. We
have used this exquisitely sensitive technology to measure DNA
and mRNA, cancer cells, proteins, enzymes, metabolites, drug
concentrations, and bacteria. In preliminary experiments, we have
demonstrated the ability of DMR to profile expression of multiple
biomarkers on individual cancer cells simultaneously, with molecu-
lar sensitivity reaching 10
–14
M, better than conventional techniques
such as flow cytometry. The overall goal of this proposal is to
evaluate whether DMR can perform real-time molecular analysis
of biomarkers on human cancer cells isolated from percutaneous
image-guided fine needle aspiration, and to determine whether
DMR can be used to determine tumor susceptibility to molecularly-
targeted treatments.
Daniel Hamstra, MD, PhD
Radiation OncologyThe University of Michigan Medical CenterRSNA Research Scholar Grant
Molecular Dissection of the Role of Tumor Vasculature in Radiation Sensitivity
Radiation therapy plays a prominent role in the treatment of pa-
tients with prostate cancer. While prostate cancer exhibits signifi-
cant genetic heterogeneity, inactivation of the PTEN tumor suppres-
sor gene is one of the more common events, occurring in as many as
15 - 20% of all prostate cancers, and it is more common in high-grade
tumors. PTEN loss has been associated with higher Gleason grade,
increased tumor neo-angiogenesis, increased biochemical failure,
and radiation resistance. Further, tumor hypoxia and neo-vascular
growth, which are both common in prostate cancer, are both as-
sociated with radiation resistance and prostate cancer recurrence.
Neo-angiogenic blood vessel growth and proliferation are also
influenced by the PI3K/Akt/mTOR axis, and as a result the mam-
malian target of rapamycin (mTOR) may be a critical player in both
prostate tumor and prostate cancer stromal pathophysiology.
Despite the clear clinical associations between tumor vascular
factors and resistance to radiation therapy, it is unclear if these
vascular differences reflect the underlying biology of the tumor as
opposed to a mechanistic resistance to radiation therapy. Therefore,
we first propose to evaluate the role of endothelial cell responses to
radiation therapy using molecular modification of endothelial cell
radiation response and non-invasive imaging of endothelial cell
growth and response to therapy through bioluminescent imaging.
Second, given the potential role of the PI3K/Akt/mTOR axis in both
tumor and endothelial cell pathophysiology we propose to evaluate
this signaling axis as a target for radiation sensitization of both
prostate cancer and endothelial cells. Using models by which both
tumor and endothelial cells can be individually modulated, we will
assess the impact mTOR inhibition upon both cell-types individu-
ally and in combination.
7RSNA.org/Foundation
Moritz Kircher, MD, PhD
RadiologyMemorial Sloan-Kettering Cancer CenterBayer HealthCare Pharmaceuticals/RSNA Research Scholar Grant
A Dual-Modality MRI-SERS Nanoparticle for Molecular Imaging of Brain Tumors
Malignant gliomas, such as glioblastoma multiforme, remain a
therapeutic challenge worldwide. Surgical resection is usually the
initial primary treatment. However, visualization of the tumor
margins during surgery is imprecise. Current imaging methods are
often limited by inadequate sensitivity, specificity, and/or spatial
resolution. We have developed a new brain tumor imaging strategy
based on a dual-modality MRI-Raman nanoparticle probe (MRI-R)
that allows combined preoperative MRI and intraoperative Raman
imaging with a single nanoparticle injection. We have demonstrated
the unique properties of MRI-R in our preliminary studies: a) MRI-R
is detectable by MRI and by Raman in the picomolar range in vivo.
b) MRI-R nanoparticles are sequestered by the tumor (> 1 week), al-
lowing c) pre-operative and intra-operative imaging to be performed
with a single intravenous nanoparticle injection; d) Raman imaging
enables accurate delineation of tumor margins intraoperatively.
We propose to 1) optimize nanoparticle chemistry, 2) validate
nanoparticle imaging in biological systems, and 3) determine the ac-
curacy of pre- and intraoperative brain tumor delineation in animal
models.
The MRI-R particle chemistry will first be optimized by interro-
gating the effect of varying concentrations of Gd and maleimide-
DOTA during the incubation procedure, as assessed by inductively
coupled plasma atomic emission spectroscopy. MR detectability will
be assessed in phantom experiments. Further characterization of
MRI-R behavior will include determination of differential uptake
in brain tumor cells in culture, whole body biodistribution studies,
and detailed toxicity studies. Accuracy of MRI-R to delineate tumor
margins will be assessed by careful correlation of in vivo MRI and
Raman images with histology.
The conceptual advance presented here could lead to a signifi-
cant advance in both brain tumor imaging and tumor resection.
Since gold-silica based nanoparticles are already in clinical trials
and hand-held Raman imaging devices have been developed, this
approach holds significant promise for clinical translation and ap-
plication by neurosurgeons.
Chan Hong Moon, PhD
RadiologyUniversity of PittsburghAGFA HealthCare/RSNA Research Scholar Grant
Sodium/Proton MR Imaging of Knee Cartilage in Osteoarthritis
Knee osteoarthritis (OA) is a complex, heterogeneous condition
that is a common cause of disability in the aging population. One
of the hallmarks of the pathophysiology of OA is the breakdown
of cartilage in joints. Conventional radiographs are an insensitive
measure of OA pathology and have not allowed for the evaluation of
treatment effects on early structural and physiological changes in
cartilage. However, recent advances in high-resolution MR imaging
of OA cartilage anatomy and physiology have improved our under-
standing of the patho-physiochemical changes in articular cartilage.
In particular, sodium MRI is a promising technique for the detection
of changes in proteoglycan content of cartilage associated with
early stage OA. Unfortunately, clinically useful sodium MRI can
be technically challenging due to the intrinsically low MR signal and
concentration. In order to realize the clinical potential of sodium
MRI as a reliable imaging biomarker for the characterization of
cartilage quality, the optimization of sodium MRI techniques and rig-
orous testing of sodium quantification must be undertaken. Recent
technical advances in high-field MRI allow us to acquire morphologic
and physiologic imaging of knee cartilage with improved SNR and
spatial resolution, thus facilitating accurate characterization and
quantification of structural and physiochemical changes of carti-
lage associated with OA.
The primary objective of this proposal is to develop and evaluate
methods for the quantification and characterization of structural
and sodium concentration changes in OA knee cartilage using high-
field proton/sodium MRI. Our central hypothesis is that new dual-
tuned MR imaging permits a precise in-vivo structural and physio-
chemical analysis of knee cartilage associated with OA. The specific
aims are to (1) develop and evaluate methods for sodium MRI of
knee cartilage at 3T and 7T MR, and (2) evaluate and compare the
differences in the sodium concentration and volume and thickness
of knee cartilage between OA patients and normal controls.
H e a l t h C a r e
research scholar grant
research scholar grantMark S. Shiroishi, MD
Radiology, Division of NeuroradiologyKeck School of Medicine, University of Southern CaliforniaGE Healthcare/RSNA Research Scholar Grant
Assessing the Value of Perfusion and Permeability MR Imaging to Characterize Pseudoprogression and Pseudoresponse in Patients with High-Grade Glioma
The traditional method of determining response to therapy for
glioblastoma is based on the MacDonald criteria. This relies on
changes in enhancement characteristics and has been shown to be
inadequate in distinguishing between true progression of disease
and treatment related effects. This uncertainty complicates treat-
ment decisions as well as clinical trial design. A phenomenon has
recently been recognized in which chemoradiation treatment may
cause an increase in the size of enhancing lesions. It is analogous
to delayed radiation necrosis, but occurs much earlier—usually in
the first 12 months of therapy. In these cases, there is no true tumor
progression; hence, the entity is termed “pseudoprogression.” It
occurs in up to 20% of patients who have undergone chemoradiation
and can explain about half of all cases of increasing lesions and
enhancement after this treatment.
“Pseudoresponse” is also a newly described condition in which
some patients with recurrent high-grade glioma treated with
anti-angiogenic drugs such as bevacizumab demonstrate a rapid
decrease in contrast enhancement and edema without a true anti-
tumor effect. This is likely a result of “repairing” of the blood brain
barrier.
In order to better distinguish between true disease progression and
pseudoprogression, as well as between true response and pseudo-
response, we will conduct a prospective investigation of patients
with newly diagnosed and recurrent high-grade glioma with the
goal of evaluating the added benefit of advanced MR techniques,
such as perfusion and permeability MRI as well as MR spectros-
copy and diffusion tensor imaging. Patients with true progression
of disease, as well as those with true response to therapy, will be
included as controls. Overall survival estimated using the Kaplan-
Meier method will be compared. Standard Student’s t test will be
initially used to compare the perfusion and permeability measures,
metabolite ratios, and diffusion metrics for all groups of patients.
James A. Tanyi, PhD
Radiation MedicineKnight Cancer Institute, Oregon Health & Science UniversityRSNA Research Scholar Grant
Incorporating the Effects of Transcytolemmal Water Exchange in Pharmacokinetic Analysis of DCE-MRI Data in the Prediction of Head and Neck Cancer Response to Chemoradiation
Preclinical and clinical data suggest that changes in head and neck
squamous cell carcinoma (HNSCC) cell cycle kinetics following a
brief exposure to radiotherapy, either alone or with chemotherapy,
can be used to evaluate treatment efficacy in terms of loco-regional
control, disease-free survival and overall survival. Dynamic
Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI), the
acquisition of serial magnetic resonance images before, during and
after the administration of an intravenous small molecular weight
gadolinium-based contrast agent, can be used to measure these
changes. For a tumor, the signal intensity measurements of DCE-
MRI may reflect a composite of tumor perfusion, vessel permeabil-
ity and the volume of the extravascular-extracellular space. Thus,
DCE-MRI may provide a more robust characterization of tumor
physiologic behavior rather than its anatomic appearance.
Models have been developed for the analysis of DCE-MRI data that
typically neglect the compartmental nature of tissue and the indi-
rect nature of contrast agent detection. To date such models have
assumed a linear relationship between the measured longitudinal
(or spin-lattice) relaxation rate constant (1/T1) of water protons
and the concentration of contrast agent. However, this assumption
is not valid for all concentrations of any contrast agent of interest
in tissue. The proposed study will investigate a novel pharmaco-
kinetic model (the “Shutter-speed” model) that takes into account
transcytolemmal and transendothelial water exchange during the
assessment of contrast enhancement dynamics.
We will test the hypothesis that DCE-MRI can be used to predict
treatment outcome in terms of local control and progression-free
survival in patients with loco-regionally advanced HNSCC. This
preliminary assessment will allow us to identify and appreciate
potential study limitations, and derive corrective measures before
embarking on a large-scale trial.
9RSNA.org/Foundation
Zhen Jane Wang, MD
Radiology and Biomedical ImagingUniversity of California, San Francisco Medical CenterGE Healthcare/RSNA Research Scholar Grant
Noninvasive Assessment of Renal Tumor Aggressiveness Using Hyperpolarized [1-13C] Magnetic Resonance Spectroscopic Imaging: a Pilot Study
The incidence of renal cell carcinoma is rising by 3% per year, and
it is recognized that many of these are small (< 4cm), indolent, and
may not require aggressive treatment. Therefore the management
options for these small tumors have expanded from surgical resec-
tion to include less invasive tumor ablation and active surveillance.
However, triage of therapies is currently difficult due to our inabil-
ity to reliably determine renal tumor aggressiveness noninvasively.
The long-term goal of our research is to determine whether hyper-
polarized [1-13C] magnetic resonance spectroscopic imaging (MRSI),
an extraordinary new technique that highlights the increased glycoly-
sis in cancer, can noninvasively characterize renal tumor aggres-
siveness, and appropriately select those patients who will benefit
from less invasive treatment or active surveillance.
The specific aims of this pre-clinical study are to test the hy-
potheses that 1) hyperpolarized [1-13C] MRSI can distinguish the
metabolic profile of low versus high metastatic potential renal cell
carcinomas in a murine xenograft tumor model; and 2) the meta-
bolic profiles determined by hyperpolarized [1-13C] MRSI correlate
with immunohistochemical and histopathological analysis of tumor
aggressiveness. Successful completion of the project will add to our
understanding of the biology of renal tumors.
We will use the data and experience gained from this project to
apply for a NIH R01 grant for clinical trials in patients with renal
tumors using hyperpolarized [1-13C] MRSI. Noninvasive imaging
characterization of tumor biological behavior using metabolic bio-
markers will advance the state-of-the-art in oncologic imaging and
greatly improve our ability to provide patient and tumor-specific
care.
David Woodrum, MD, PhD
RadiologyMayo ClinicRSNA Research Scholar Grant
Influence of Differential Cellular Heat Shock (Stress) Protein Expression on Cellular Death from Focal Laser Ablation
Hepatocellular carcinoma (HCC) is the seventh most common can-
cer worldwide and third leading cause of cancer-related death. In
HCC, there is overexpression of several heat shock proteins (HSPs),
whose function is to inhibit cellular death, promote angiogenesis,
and increase thermotolerance. The current gold standard for defini-
tive treatment of HCC is orthotopic liver transplantation; however,
many patients do not meet the inclusion criteria for transplant.
Non-surgical patients are treated with catheter-based or percutane-
ous-based ablative techniques. Unfortunately, the “Achilles heel” of
these techniques is high recurrence rate after ablation. Recurrences
occur at the edge of the tumor margin and ablative zone.
Our central hypothesis to be tested in the present proposal is that
HCC is resistant to thermal ablation because of increased cellular
expression of HSPs in cells contained in the ablative margin and
that inhibition of these proteins will increase the thermosensitiv-
ity of these neoplastic cells, leading to increased ablation efficacy.
The knowledge gained by successful completion of this proposal
will allow us to rapidly translate these findings to clinical trials to
investigate the efficacy of commercially available HSP inhibitors
combined with ablative techniques to treat patients with HCC.
research scholar grant
10 r&[email protected]
research seed grant
Vikram S. Dogra, MD
RadiologyUniversity of RochesterToshiba America Medical Systems/RSNA Research Seed Grant
Photoacoustic Imaging and Spectroscopy of Prostate
Photoacoustic (PA) imaging is a new and innovative technique
for the evaluation of biological tissues. It is dependent on opti-
cal properties of soft tissue mainly the absorption and scattering
coefficients, which in turn are dependent on tissue structure and
composition. In PA imaging, tissue is irradiated with near-infrared
(NIR) laser beam. Interaction of NIR beam in the tissue generates
acoustic wave (PA signal), which can be detected using conven-
tional ultrasound (US) technology. Strength of PA signal detected
is highly dependent on the laser wavelength used to irradiate the
tissue. Mapping of PA signal variability on laser wavelength helps
to characterize different tissue types. This property will also allow
photo acoustic spectroscopy (PAS).
The major objective of this project is to determine if the PA signal
and PAS from prostate tissue measured ex vivo can differentiate be-
tween malignant and benign prostate tissue. The research proposed
has the follow-ing specific aims:
Aim 1: Fabricate a PA Imaging Camera to study the PA properties of
excised human prostate tissue specimens.
Aim 2: Perform PA Imaging and PAS analysis of excised human
prostate tissue samples and correlate with histology.
The long-term impact of this work is to provide initial data to
validate the in vivo use of PA imaging in differentiating malignant
from benign prostate pathologies.
Gholam R. Berenji, MD
Nuclear MedicineVA Greater Los Angeles Healthcare SystemPhilips Healthcare/RSNA Research Seed Grant
DICOM Structured Report to Track Patient’s Radiation Dose to Organs from Abdominal CT Exams
The dramatic increase of diagnostic imaging capabilities over the
past decade has contributed to increased radiation exposure to pa-
tient populations. Several factors have contributed to the increase
in imaging procedures: wider availability of imaging modalities, in-
crease in technical capabilities, rise in demand by patients and cli-
nicians, favorable reimbursement, and lack of guidelines to control
utilization. The primary focus of this research is to provide in-depth
information about radiation doses that patients receive as a result
of CT exams, with the initial investigation involving abdominal CT
exams. Current dose measurement methods (i.e. CTDIvol Computed
Tomography Dose Index) do not provide direct information about
a patient’s organ dose. We have developed a method to determine
CTDIvol normalized organ doses using a set of organ specific expo-
nential regression equations. These exponential equations along
with measured CTDIvol are used to calculate organ dose estimates
from abdominal CT scans for eight different patient models. For
each patient, organ dose and CTDIvol are estimated for an abdomi-
nal CT scan. We will then develop a DICOM SR (Structured Report)
to store the pertinent patient information on radiation dose to their
abdominal organs.
research grant programs
11RSNA.org/Foundation
Ron C. Gaba, MD
RadiologyUniversity of Illinois at ChicagoPhilips Healthcare/RSNA Research Seed Grant
Polymeric Iohexol Nanoconjugates for Targeted Transcatheter Drug Delivery: Quantitative CT Analysis of Spatial Distribution in a Rabbit VX2 Liver Tumor Model
research seed grantVinay Duddalwar, MD, FRCR
RadiologyUniversity of Southern CaliforniaHitachi Medical Systems/RSNA Research Seed Grant
Assessing the Role of Contrast Enhanced Ultrasound in the Evaluation and Management of Renal Masses in Patients with Poor Renal Function
The management of renal masses, especially small lesions has
changed dramatically with the concept of active surveillance.
The role of imaging is critical in these patients. We propose that
contrast enhanced ultrasound scans will provide adequate char-
acterization of renal masses and provide information relevant for
surgical planning in patients with compromised renal function.
We propose that contrast enhanced ultrasound may be able to dif-
ferentiate different types of renal masses.
Aim 1: Can CEUS provide adequate characterization of renal
masses and provide additional information relevant for surgical
planning in patients with compromised renal function? In addition,
can it identify patients who would be suitable for active surveil-
lance in this group?
Aim 2: Does dynamic and semi-quantitative evaluation of renal
masses during CEUS lead to better characterization of renal
masses? Are there specific patterns that are reproducible?
Data from this study will be analyzed to evaluate three possible
future directions:
1) CEUS as an imaging modality of choice in patients
with compromised renal function
2) Semiquanitative data being analyzed to identify any
differentiating factors between low and high grade
renal carcinomas, malignancies from lesions such as
angiomyolipomas and oncocytomas. If proven, this would
be an effective way of monitoring effects of anti angiogenic
chemotherapy on patients who only receive chemotherapy.
3) CEUS data could be used to identify the efficacy of
preoperative embolization on renal masses.
Transcatheter arterial chemoembolization (TACE) is an established
treatment for surgically unresectable hepatocellular carcinoma
(HCC). This therapy exploits the predominant hepatic arterial per-
fusion of hypervascular liver cancer to administer targeted tumor
therapy using chemotherapeutic agents. Contemporary TACE utiliz-
es drug-eluting beads (DEBs) for delivery of doxorubicin to neoplas-
tic tissue, but current therapy is potentially limited by incomplete
drug penetration into tumor due to peripheral or inhomogeneous
microsphere deposition as well as mechanical vessel occlusion and
concomitant risk for cancer neovasculogenesis.
Nanoparticles represent a new transcatheter treatment platform
that holds promise for improving drug delivery by enhancing
chemotherapy penetration into tumor without causing vascu-
lar ischemia. Biodegradable polylactide (PLA) nanoconjugates
represent a novel nanoparticle system with superior drug loading
and sustained drug release characteristics as compared to other
nanoparticle devices. These agents, which have not been previously
applied in the study of liver TACE, may be loaded with a radi-
opaque contrast agent, such as iohexol, for non-invasive imaging of
nanoparticle distribution.
The goal of this proposed project is to validate the use of PLA nano-
conjugates for transcatheter liver embolotherapy by characterizing
the biodistribution of unique radiodense PLA encapsulated iohexol
nanoconjugates after nanoparticle TACE in a rabbit VX2 tumor
animal model of HCC. Development of therapeutic PLA nanoconju-
gates and non-invasive confirmation of their accumulation within
tumor has implications on the understanding of nanoparticle drug
delivery and deposition during TACE, and will permit future basic
science and clinical translational studies aimed at assessing and
optimizing tumor drug delivery using these agents.
12 r&[email protected]
Friedrich Knollmann, MD, PhD
RadiologyUniversity of PittsburghRSNA Research Seed Grant
Computed Tomography Perfusion Imaging of Lung Cancer
The treatment of advanced stage lung cancer is limited by a lack
of predictive methods that would allow an early assessment of
treatment success. Contrast-enhanced computed tomography has re-
cently been established as a robust method to assess regional tissue
blood flow, and should offer direct insight into tumor blood flow,
which is the target of anti neo angiogenic therapy.
Computed Tomography Perfusion (CTP) Imaging has the potential
to improve patient management by predicting treatment response.
Correlating tumor response during cancer therapy with patient
survival is the most stringent approach to validate CTP as a predic-
tive marker for treatment outcome. However, the accuracy of such
measurements still needs to be determined, before the method is
applied on a wider scale to predict patient survival.
In comparing the CTP blood flow measurements in lung cancer with
changes in tumor size, 30 subjects will be examined with both a
standard CT series of the chest and a CTP protocol of the tumor. Fol-
lowing the injection of a 30cc bolus of an iodinated contrast agent in
a 64 row multi-detector CT unit, one image will be acquired every 3
seconds over a 40s period at 100 kV, and 100mA tube current.
The perfusion sequence will be repeated after the patient has left
the exam room to determine the reproducibility of the test.
Images will be evaluated using standard CT blood flow software.
Color-encoded maps of regional blood flow will be used to classify
the blood flow pattern, and mean tumor blood flow derived.
The ultimate patient value of the CTP method will be demonstrated
by directly correlating tumor perfusion parameters before and after
the initiation of chemotherapy with patient survival, in comparison
to the prognostic value of measuring tumor size with the current
standard of care CT method.
Puneeth Iyengar, MD, PhD
Radiation OncologyUT Southwestern Medical Center-DallasRSNA Research Seed Grant
Use of an Inducible Cancer Cachexia Mouse Model to Study Inflammatory Effects on Lung Cancer Radiation Response
Lung cancer continues to be the leading cause of cancer death
worldwide. Our ability to control lung disease has not changed
much in the last 30 years, suggesting a need for new intervention.
For decades, it has been perceived that inflammation is a key con-
tributor to lung cancer development. Less emphasis has been placed
on evaluating how systemic inflammation could also significantly
influence radiation sensitivity through the modulation of tumor
suppressive mechanisms including autophagy and DNA damage
signaling.
Cachexia is an inflammatory process which is often associated with
intermediate and late stage lung cancer and includes symptoms
of weight loss, muscle atrophy, and fat loss. There are not many
treatment options for lung cancer patients with cachexia even
though new studies have demonstrated improved survival for these
patients through aggressive palliation. We believe that unique, yet
undetermined, systemic molecules that are components of the ca-
chectic inflammatory state are both drivers of tumor development
and therapeutic resistance.
With this study, we hope to 1) Model cachexia in vivo; 2) Assess
the influence of cachexia on lung tumor progression and radiation
resistance with this inducible murine system; and 3) Identify vital
secretory proteins that are expressed during cachexia and critical
to lung cancer radiation resistance. The inherent biology and role
of cachexia in influencing lung cancer patient performance status,
disease progression, response to therapy, and survival outcomes
is still an open ended question. It is not misleading to surmise that
reversing some of the pathophysiologic consequences and mecha-
nisms of cachexia may help in all four areas –performance status,
disease progression, therapy outcome, and survival. To that end,
believing that cachexia represents one end of the systemic inflam-
matory spectrum, we propose evaluating the relevant pathophysiol-
ogy of cachexia in an inducible mouse model.
research seed grant
13RSNA.org/Foundation
Drew A. Torigian, MD, MA
RadiologyUniversity of Pennsylvania School of MedicinePhilips Healthcare/RSNA Research Seed Grant
Utility of DTP FDG-PET/CT and Advanced Image Analysis to Quantify In Vivo Tumor Biology, Predict Clinical Outcome, and Improve Disease Staging in Lung Cancer
Lung cancer is a prevalent and deadly cancer with a wide spectrum
of biological behavior, such that some patients with early stage
disease may survive a long time after surgical treatment whereas
others may experience disease recurrence and shortened survival.
TNM staging and clinicopathological prognostic markers used to
establish risk stratifications among lung cancer patients do not
account for all observed variability in lung cancer-related survival,
and tumors with identical clinicopathological characteristics can be
associated with different expression profiles and clinical outcomes.
Conventional structural imaging approaches at the time of diag-
nosis provide limited information about tumor biology or future
patient outcome, and have suboptimal sensitivities and specificities
for detection and characterization of sites of metastatic disease in
anatomical sites such as the lymph nodes. Laboratory assays of mo-
lecular expression may be useful to help predict clinical outcome,
but do not provide regional spatial information relevant to disease
staging. Thus, there is an urgent need for new yet practical non-
invasive quantitative diagnostic methods to quantify in vivo lung
cancer tumor biology, to improve prediction of clinical outcome,
and to improve disease staging.
Single time point (STP) FDG-PET/CT is routinely used in lung can-
cer patients to provide some information about patient prognosis
and to improve disease staging accuracy, although still suboptimal
in diagnostic performance. We therefore propose to prospectively
evaluate dual time point (DTP) FDG-PET/CT, a modified version
of FDG-PET/CT, in conjunction with advanced image analysis
techniques in patients with surgically resectable lung cancer to as-
sess its utility for simultaneous improved in vivo quantification of
tumor biology, improved clinical outcome prediction, and improved
disease staging. The results, if successful, will have significant
implications for optimizing individualized patient management,
and will provide requisite preliminary data for future, larger scale
research studies.
An Tang, MD
RadiologyUniversity of MontrealToshiba America Medical Systems/RSNA Research Seed Grant
Randomized Trial of Liraglutide and Insulin Therapy on Hepatic Steatosis as Measured by MRI and MRS in Metformin-treated Patients with Type 2 Diabetes: an Open Pilot Study
Non-alcoholic fatty liver disease (NAFLD) can now be identified in
70% of patients with type 2 diabetes. Insulin can be introduced at
any point in the treatment of diabetes, but is potentially lipogenic.
Preliminary studies have shown conflicting results on the impact of
insulin on fatty liver.
This study is conducted to test the hypothesis that in type 2 diabetic
adults with NAFLD who are resistant to metformin, treatment with
liraglutide in combination with metformin will cause an absolute
reduction in liver fat superior to insulin-metformin treatment
within a 3-month period, as measured by in vivo MRI and MRS.
This will be a prospective, open label, randomized parallel trial to
evaluate whether 12 weeks of treatment with liraglutide-metformin
will improve steatosis in type 2 diabetic adults with NAFLD
compared to treatment with insulin-metformin. Before and post-
treatment MRI and MRS will be read blindly for quantification of
steatosis. The primary outcome measure is defined as an improve-
ment in steatosis of 5% before and after treatment between the two
treatment groups.
Thirty-six patients will be randomized to either study group. After
baseline metabolic measurements by blood sampling, transient
ultrasound elastography, MRI and MRS, all subjects will be given
metformin with a starting dose of 500 mg in one tablet twice daily.
In addition, patients will be randomized to receive either liraglutide
or insulin glargine for a duration of 3 months.
The results of this study will provide preliminary data for a large-
scale study comparing the two therapeutic regimens and establish
the utility of MRI and MRS to monitor medical treatment in dia-
betic patients with fatty liver disease.
research seed grant
14 r&[email protected]
Robert J. Young, MD
RadiologyMemorial Sloan-Kettering Cancer CenterFujifilm Medical Systems/RSNA Research Seed Grant
Using Functional MRI and Diffusion Tensor Imaging of the Language Pathway to Optimize Brain Tumor Resection
Surgical resection remains the most effective treatment for many
patients with primary and secondary brain tumors, improving both
the length and quality of survival. Surgery must maximize tumor
resection while avoiding adjacent eloquent brain structures, since
their inadvertent injury can cause profound neurological deficits.
Two noninvasive functional techniques can identify the eloquent
brain and facilitate surgical planning for these patients: Functional
MRI (fMRI) to identify the eloquent cortex is useful in guiding deci-
sion making about whether to attempt a resection, determining the
neurosurgical approach, and guiding the intraoperative stimula-
tion.
Diffusion Tensor Imaging (DTI) is a new technique to identify the
eloquent white matter, which is less accessible and less reliable to
stimulate at surgery. Tractography programs can analyze the DTI
data and display white matter fiber trajectories in 3D space. We will
compare two different tractography algorithms (standard vs. proba-
bilistic) in mapping the arcuate fasciculus that connects Broca’s
Area with Wernicke’s Area. We will develop a solution to import the
tractography results into the neuronavigation software, then corre-
late the fMRI- and DTI-identified loci with the intraoperative stimu-
lation loci to determine the accuracies of our techniques. Accurate
noninvasive prediction of the arcuate fasiculus may lead to changes
in the surgical approach and help preserve patient function.
The data gathered in this pilot study will be used to help support the
development of an R01 grant, which will seek to deliver rapid auto-
mated or semiautomated analyses to the neurosurgeon in real-time.
The current grant will provide us with invaluable experience and
preliminary data to submit a competitive grant in 18 - 24 months.
Further work will be necessary to optimize the imaging sequences
and analyses, and incorporation into the neuronavigational system,
and to study and develop corrections for factors presented by brain
tumors such as edema, tumor infiltration and abnormal vascularity
and permeability.
research seed grant
My interest lies in the area of liver cancer and minimally
invasive transcatheter treatment methods—obtaining the RSNA
Research Seed Grant will allow me to focus on the investigation of drug
delivery in minimally invasive oncologic therapy. As hepatocellular
carcinoma (HCC) represents a significant public health problem and
because of the importance of interventional radiologic catheter directed
drug delivery in treating this disease, I believe development and
application of novel, forward-thinking delivery vehicles, such as
nanoparticle platforms, and imaging devices and agents to better
understand, optimize, and confirm targeted liver cancer therapy are of
significant importance. Clinical translation into human patients would
be a long-term goal after validation of methodology in animal models.
Ron C. Gaba, MD
BRIGHT IDEAS. BETTER PATIENT CARE.
15RSNA.org/Foundation
Daniel J. Durand, MD
The Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University School of MedicineRSNA Research Fellow Grant
Molecular Imaging of Choline Metabolism in Musculoskeletal Soft Tissue Masses by C-11 Choline PET/CT and MR Spectroscopy
Choline is an essential nutrient that plays a key role in cell mem-
brane biosynthesis and cell proliferation. Concentrations of choline
and its related metabolites are elevated in malignant tissue due
primarily to increased cell membrane synthesis. Both C-11 choline
PET/CT and MR spectroscopy represent novel methods for quantify-
ing in vivo choline metabolism non-invasively. We hypothesize that
these methods can be used prospectively to characterize musculo-
skeletal soft tissue masses (STMs) as benign or malignant prior to
biopsy.
Aim 1: We will determine whether quantitative changes in absolute
choline concentration as measured by MR spectroscopy correlate
with histopathological endpoints for musculoskeletal soft tissue
masses (STMs). STMs referred for biopsy (deemed indeterminate
by clinical and conventional imaging work-up) will be included,
and absolute choline concentration will be quantified by single
voxel MR spectroscopy. Histopathologic measures will include final
pathologic diagnosis as well as Ki-67 indexing. We will determine
the diagnostic accuracy of MRS for distinguishing benign from
malignant disease using receiver operator characteristic (ROC)
analysis.
Aim 2: We will determine whether quantitative changes in cho-
line uptake as measured by C-11 choline PET/CT correlate with
histopathological endpoints for musculoskeletal soft tissue masses
(STMs). Patients from Aim 1 will also undergo C-11 PET/CT prior to
biopsy. Histopathologic endpoints will be the same as for Aim 1. We
will determine the diagnostic accuracy of C-11 choline PET/CT for
distinguishing benign from malignant disease using ROC analysis.
In addition, we will determine whether intralesional variations
in C-11 choline uptake correlate with intralesional variations in
histopathology.
Overall, the goal of this research is to determine whether predictive
models utilizing non-invasive measures of choline metabolism may
allow more selective and/or more effective biopsy of STMs in the
future.
Jeremy Burt, MD
RadiologyJohns Hopkins University School of MedicineSilver Anniversary Campaign Pacesetters Research Fellow Grant
Diagnosis of Arrhythmogenic Right Ventricular Dysplasia using T1 Mapping for Identification of Myocardial Fibrofatty Infiltration
Arrhythmogenic right ventricular dysplasia (ARVD) is a genetic
cardiomyopathy histopathologically characterized by fibrofatty re-
placement of the myocardium and is an important cause of exercise-
related sudden death in young individuals. The condition is most
frequently diagnosed between ages 20 to 40. The implications of
diagnosis are need for a permanently implanted cardiac defibrilla-
tor and risk of sudden death. The diagnosis of ARVD is challenging
due to the variability of imaging findings, disease expression, and
clinical presentation. Current diagnosis is based upon histopatho-
logic, imaging, and electrocardiographic criteria proposed by the
Task Force of Cardiomyopathies.
MRI is frequently requested to “rule out” ARVD, since early symp-
toms of ARVD (tachyarrhythmia, palpitations, and syncope) are
common. Unfortunately, misdiagnosis by imaging physicians is fre-
quent. One reason for misdiagnosis is the current lack of validated
MRI features compared to histopathology. Both fat and fibrosis
are histologic hallmarks of ARVD, yet neither has been validated
as a noninvasive imaging criterion. In this proposal, we seek to
investigate the use of T1 mapping of the myocardium using MRI in
ARVD. T1 mapping has been developed for other cardiomyopathies
to detect collagen deposition. T1 mapping has the potential for
improved tissue discrimination in ARVD due to additive T1 effects
of both fat and collagen (both causing T1 shortening). Quantifica-
tion of postcontrast myocardial T1 time may help standardize the
diagnosis of this life-threatening condition.
In this work, we will perform a retrospective analysis of patients
in the Johns Hopkins database who previously had MRI examina-
tions for ARVD using the Look-Locker technique for T1 mapping.
In addition, we will perform a prospective study using a modified
Look-Locker T1 mapping technique for patients referred for MRI
diagnosis of ARVD. The goal of this project is to provide a validated,
quantitative method for myocardial tissue characterization in
ARVD.
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research grant programsresearch fellow grant
16 r&[email protected]
Randall J. Kimple, MD, PhD
Human OncologyUniversity of Wisconsin-MadisonRSNA Research Fellow Grant
Molecular Mechanisms of Radiation Response Modulation by Human Papillomavirus in Head and Neck Squamous Cell Carcinoma
Human papillomavirus (HPV)-associated head and neck squamous
cell carcinoma (HNSCC) is a growing public health concern. These
patients are younger and present with more advanced disease than
patients with traditional tobacco and alcohol associated HNSCC, yet
paradoxically have improved outcomes. The mechanisms underly-
ing these improved outcomes remain unclear. The work proposed
has two primary goals: 1) to provide for the continued career devel-
opment of the principal investigator (PI) and establish his inde-
pendence so that he can lead a research program investigating the
radiation response in virally associated cancers; and, 2) to under-
stand how HPV-positive HNSCC differs in its response to radiation
therapy from traditional HNSCC. During his research fellowship,
the PI is obtaining additional training in molecular virology, hu-
man papillomavirus biology, and mouse models of cancer to enable
him to compete for independent funding following completion of his
research fellowship.
Aim 1 seeks to explain why HPV-positive HNSCC is more sensitive
than traditional HNSCC to ionizing radiation using standard assays
of radiation survival and both in vitro and in vivo model systems.
The molecular pathways underlying radiation sensitivity will be
investigated while focusing on an enhanced apoptotic response in
HPV-positive HNSCC. Alterations in patterns of gene expression
following radiation will be used to identify potential therapeutic
targets. Aim 2 examines the ability of inhibitors of the epidermal
growth factor receptor (EGFR) to sensitize HPV-positive HNSCC
to radiation in vitro and in vivo. Effects of EGFR inhibition on
downstream signaling pathways will be assessed to identify critical
molecular pathways.
These studies will provide details regarding the mechanism of
increased sensitivity to radiation and will identify important
targets for the development of novel therapies to improve outcomes
of patients with both HPV-positive and HPV-negative head and neck
cancer.
Alessandro Furlan, MD
RadiologyUniversity of PittsburghSiemens Healthcare/RSNA Research Fellow Grant
Assessment of Transplanted Kidney using Quantitative Sodium MR Imaging
Renal allograft dysfunction requires prompt and accurate diagnosis
to avoid graft loss over time. It is particularly important to distin-
guish between acute tubular necrosis (ATN) and acute rejection
(AR), because treatment differs between the two disorders. Because
biopsy is currently the only diagnostic tool to differentiate ATN
from AR, there is a need for a non-invasive method. Renal function
is strictly dependent on the creation and maintenance of a cortico-
medullary sodium gradient that allows for water reabsorption and
urine concentration. In this project we propose to develop in vivo
quantitative sodium MR imaging of human kidney using ultra-
short TE sequence and dedicated multi-channel, dual-tuned proton/
sodium RF coil at clinic 3T scanner, and to apply this technique for
the non-invasive evaluation of renal allograft function.
The hypotheses of the study are that 1) sodium MR imaging can
accurately and reproducibly measure sodium concentration
gradient (CMSG) in kidney, and that 2) variations in renal sodium
concentration gradient are associated with renal pathophysiology
(ATN vs. AR). Accuracy and reproducibility of the sodium measure-
ments obtained with our method will be tested respectively using
a dedicated phantom study, and repeated imaging of three normal
volunteers and three kidney transplant patients. CMSG will be
quantified calculating the mean medulla-to-cortex sodium concen-
tration ratio, and more precisely with a pixel-by-pixel measurement
along the corticomedullary gradient. CMSG will then be measured
from transplanted kidneys and compared between renal allograft
with normal (n=5) and histologically (biopsy) proven ATN (n=5)
and AR (n=5). The success of our proposed study will lead to the
development of accurate and reproducible renal sodium MR imag-
ing technique, the advancement of our knowledge on renal allograft
pathophysiology, and the application of a new imaging biomarker to
diagnose renal allograft ATN and AR.
research fellow grant
17RSNA.org/Foundation
Aaron So, PhD
Diagnostic ImagingSt. Joseph’s Health Care LondonRSNA Research Fellow Grant
Validation of Quantitative CT Myocardial Perfusion Measurement with Dual Energy CT Scanning
Coronary CT angiography (CTA) has become a routine non-invasive
procedure for detecting coronary artery disease (CAD) by anatomic
visualization of stenosis severity. The use of dynamic contrast en-
hanced CT imaging (CT perfusion) for quantitative measurement of
myocardial perfusion (MPF) in CAD patients can provide additional
information regarding the fuctional significance of a coronary le-
sion detected by coronary CTA. One of the obstacles for incorporat-
ing MPF measurement into CTA protocol for comprehensive CAD
evaluation has been inaccuracies in the measurement due to beam
hardening arising from high density contrast in the heart chambers
following a bolus injection. Although post-reconstruction correction
algorithm has been developed to reduce beam hardening artifact in
CT images, such correction method is suboptimal because the X-ray
path length through high density contrast can only be approxi-
mately modeled.
Dual energy CT (DECT) scanning allows reconstruction of monoen-
ergetic (keV) images, which are free of beam hardening artifacts,
from two polyenergetic CT scans acquired at two different kVps.
Advances in detector technology have resulted in X-ray detectors
with fast scintillation decay time which permits ‘interlaced’ acqui-
sition of projections at two kVps to minimize patient motion error,
which is important for cardiac imaging and to minimize spectral
contamination between projection views. Because DECT scanning
can minimize beam hardening artifact by projection-based deriva-
tion of monoenergetic images, we posit that DECT measurement of
MPF will be more accurate, which is a prerequisite for using CT, a
widely available imaging modality, for the comprehensive assess-
ment of CAD.
Bela Kis, MD, PhD
RadiologyBrigham & Women’s HospitalRSNA Research Fellow Grant
Effects of Focused Ultrasound on Cerebral Microvascular Endothelial Cells and Pericytes - Investigating the Molecular Mechanisms of Focused Ultrasound-Induced Blood-Brain Barrier Opening
The blood-brain barrier (BBB) is a functional unit of cells which
maintains the stability of the brain microenvironment by strictly
controlling the movement of molecules and cells between the blood
and the brain. While BBB is a necessary physiological gatekeeper,
this barrier is a real obstacle to deliver drugs to treat brain patholo-
gies. It has been shown that focused ultrasound (FUS) is capable
of temporary and localized BBB disruption. FUS combined with
MRI-guidance can provide a noninvasive targeted drug delivery to
the brain. However, the mechanism of FUS-induced BBB opening is
largely unknown.
The goals of the proposed experiments are to study the molecular
mechanism of BBB opening induced by FUS in cerebral endothelial
cells (CECs) and pericytes, the two major constituents of the BBB.
We will use primary cultures of rat CECs and pericytes and differ-
ent co-culture systems which represent the closest possible pheno-
type to the in vivo BBB. These in vitro settings allow us to study
those intracellular mechanisms which are extremely difficult to
study in the in vivo complexity of the brain. First, we will study the
effect of FUS treatment on BBB permeability for different marker
molecules to determine the quality and time course of FUS-induced
BBB opening. Second, we demonstrate FUS-induced cellular shape
changes in CECs and pericytes. Third, we will study the effect of
FUS on organization of major cytoskeletal proteins in CECs and
pericytes. Fourth, we will demonstrate the subcellular re-distribu-
tion of tight-junction proteins in CECs following FUS treatment.
And fifth, we will study the effect of FUS on major intracellular
signaling pathways (Ca2+ and cAMP) which are instrumental in
BBB permeability.
The proposed experiments will shed light on the mechanisms of this
therapeutically very important phenomenon, FUS-induced BBB
opening, which is much needed information to advance this technol-
ogy towards clinical use.
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research fellow grant
18 r&[email protected]
Candice A. Bookwalter, MD, PhD
RadiologyUniversity Hospitals Case Medical Center/Case Western Reserve UniversityPeggy J. Fritzsche, MD Research Resident Grant
Motion Artifact Removal by Retrospective Resolution Reduction for Applications in Body Imaging
Ghosting or streaking artifacts due to motion can obscure impor-
tant clinical information in magnetic resonance images. MR ab-
dominal imaging is especially adversely affected by motion artifact
due to breathing, and breath holds are often long and difficult for
patients even with fast imaging methods. In addition, failed breath
holds are almost always identified only after image acquisition, and
no robust method for salvaging the images is available. Assuming
that a patient can initially hold their breath but may fail sometime
during the acquisition, there will be a transition between uncor-
rupted data, where the patient is not breathing, and data corrupted
by motion due to breathing.
We have developed a novel algorithm called Motion Artifact Remov-
al by Retrospective Resolution Reduction (MARs) which automati-
cally detects the transition and removes corrupted data. Specifical-
ly, for the rectilinear trajectory the transition will be automatically
detected by an abrupt decrease in correlation coefficients between
the acquired PE lines and the GRAPPA navigators. For the radial
MARs algorithm, the echo magnitude also demonstrates a sharp
change at the time breathing resumes. Preliminary studies using
rectilinear MARs have demonstrated decreased motion artifact with
the cost of decreased resolution. We aim to further optimize the
rectilinear MARs algorithm and develop a radial MARs algorithm.
Finally, we proposed to compare the corrected and uncorrected rec-
tilinear and radial images by independent observer ratings in a two
alternative forced choice paradigm. Should the diagnostic quality of
MARs corrected images prove superior to uncorrected images, this
method would solve an unmet need in body imaging.
Carmen Bergom, MD, PhD
Radiation OncologyMedical College of WisconsinRSNA Research Resident Grant
SmgGDS and Altered Small GTPase Prenylation as Novel Radiosensitization Targets in Breast Cancer
Advances in understanding the molecular basis of breast cancer
progression and resistance have led to new treatments, such as
HER2 and estrogen signaling inhibition. However, radiation and
chemotherapy resistance remain major challenges in managing
local-regional and distant disease. Small GTPases, which are mem-
bers of the Rho, Rac, Ras, and Rap families, regulate breast cancer
development and progression and can alter sensitivity to radiation
and chemotherapy. Identifying new ways to suppress small GTPase
activation in breast cancer may provide new treatment approaches.
The proposed research is based on our discovery that breast cancer
cells express elevated levels of SmgGDS, a unique protein known
to activate multiple members of the small GTPase families. We
discovered that breast cancer cells express two SmgGDS splice
variants, SmgGDS-558 and SmgGDS-607, which differentially affect
small GTPase prenylation. Silencing expression of these SmgGDS
splice variants in breast cancer cells significantly diminishes cell
proliferation and anchorage-independent cell growth, and increases
doxorubicin-induced apoptosis. Increased SmgGDS mRNA levels
in breast cancer also correlate with a lower likelihood of com-
plete pathologic response with neoadjuvant chemotherapy. Taken
together, SmgGDS emerges as a promising target to alter breast
cancer therapeutic responses.
Our overall hypothesis is that SmgGDS attenuates irradiation-in-
duced cell death, revealing a new target for breast cancer radio-
sensitization. This hypothesis will be tested in the following aims.
Aim 1: Determine whether SmgGDS splice variants differentially
promote radiation resistance in cultured breast cancer cells. Aim 2:
Determine whether SmgGDS splice variants sensitize human breast
tumor xenografts to radiation, and determine whether radiosensi-
tization is due to acute cell death in vivo using a novel radiotracer,
99mTc-duramycin. This study will define the role of SmgGDS splice
variants in breast cancer radiation resistance. The anticipated find-
ings are expected to uncover new therapeutic targets to alter small
GTPase activity and treatment responses in breast cancer.
research resident grantresearch grant programs
19RSNA.org/Foundation
Albert Chang, MD, PhD
Radiation OncologyWashington University School of Medicine/Barnes Jewish HospitalVarian Medical Systems/RSNA Research Resident Grant
64Cu-Radiolabeled Somatostatin Analogs for Targeted Imaging and Therapy of Medulloblastoma
Medulloblastoma is the most common pediatric brain malignancy.
Although patient survival has increased, current treatments cause
long-term impairments. Standard imaging techniques provide good
anatomic detail but minimal biological information. Small lesions
can be missed and treatment effect is often difficult to discern from
tumor progression. Therefore, improved imaging and therapeutic
options are necessary. Medulloblastoma overexpresses the soma-
tostatin subtype 2 receptor (SSTr2). The goal is to characterize and
evaluate Copper-64 (64Cu) radiolabeled somatostatin analogs for
targeted imaging and therapy of medulloblastoma. The impact is
improvement in the detection and monitoring of medulloblastoma
and improvement in outcome with reduction in treatment-related
side effects.
111In-DTPA-octreotide is FDA-approved for SPECT imaging of
tumors overexpressing somatostatin receptors, but image resolu-
tion and sensitivity are lacking. Somatostatin analogs labeled with
positron emitters demonstrated promising results with higher
resolution images and greater sensitivity than 111In-DTPA-OC.
Radiolabeled SSTr2 ligands were also investigated as targeted
agents. Treatment with Yttrium-90 and Lutetium-177 radiolabeled
somatostatin analogs demonstrated responses including significant
tumor regression or remission. The administered activity was
limited due to renal toxicity.
The positron and beta minus decay of 64Cu allow for the develop-
ment of radiopharmaceuticals with both imaging and therapeutic
properties. Our preliminary results demonstrate the potential of
64Cu-radiolabeled somatostatin analogs for imaging and radio-
therapy in xenograft models with colorectal tumors engineered to
overexpress SSTr2. In the proposed research, 64Cu-radiolabeled
somatostatin analogs will be characterized and evaluated for in vivo
PET imaging and targeted radiotherapy of medulloblastoma.
Hypothesis: 64Cu-radiolabeled SSTr2 agonists are effective agents
for in vivo PET imaging and targeted radiotherapy of medulloblas-
toma.
Scott Bratman, MD, PhD
Radiation OncologyStanford University Medical CenterPhilips Healthcare/RSNA Research Resident Grant
Stromal Contributions to Self-renewal and Radiation Resistance of Breast Cancer Stem Cells
Breast cancer is diagnosed in one out of nine women over the
course of their lifetime and accounts for over 40,000 deaths annually
in the United States. Radiation therapy and chemotherapy, which
generally target rapidly dividing cells, have improved outcomes
and extended survival in breast cancer patients, yet recurrence and
treatment resistance remain frequent. Breast tumor initiating cells
(TICs), sometimes called cancer stem cells, and the tumor-associ-
ated stroma have largely been ignored in drug development. Prior
work has demonstrated that TICs from diverse tumor types are
relatively resistant to ionizing radation. Normal stem cells depend
on stromal cells for the formation of a stem cell “niche”, but the role
of the stromal cells in breast TIC function and treatment resistance
has not been explored.
Here, we propose a set of experiments, which aim to define the
effects of stromal fibroblasts on breast TIC self-renewal, differentia-
tion, and resistance to ionizing radiation. First, normal and tumor-
associated fibroblasts from primary normal and tumor murine
breast tissues will be isolated, and their effects on TIC functions
will be assayed in a 3D culture system and an orthotopic mouse
model. Next, we will test the impact of the stromal fibroblasts on
TIC viability after irradiation, and this will be correlated with
changes in reactive oxygen species levels and IR-induced DNA dam-
age. Finally, we will identify secreted factors responsible for these
effects; specifically, we will test SDF-1 and HGF—known secreted
stromal factors that promote tumor growth—for effects on TIC func-
tion and radiation resistance. Altogether, this research proposal,
which will better characterize the unique microenvironment within
the TIC-stromal niche, has the potential to lead to the development
of novel radiation sensitizers and other classes of cancer therapeu-
tics.
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research resident grant
20 r&[email protected]
Mai-Lan Ho, MD
RadiologyBeth Israel Deaconess Medical CenterBracco Diagnostics/RSNA Research Resident Grant
Sodium-23 MRI for Seizure Focus Localization in Epileptic Patients
Accurate localization of seizure foci is critical for evaluating pa-
tients with medically intractable forms of partial epilepsy. However,
current noninvasive imaging and clinical techniques– including
proton MRI/MRS, DTI, fMRI, ASL, PET, SPECT, MEG, EEG, and
neuropsychological testing– are not always successful at lateraliz-
ing and localizing seizure onset centers.
Sodium-23 MRI is an emerging new technology with promising appli-
cations in brain imaging. Maintenance of normal transmembrane
sodium gradients is critical for osmotic regulation, pH stabiliza-
tion, and transmission of action potentials. Therefore, measured
sodium concentrations can be used as an operational index of tissue
viability and cellular/metabolic integrity. We hypothesize that the
acute neuronal hyperexcitability and chronic gliosis associated
with epilepsy will augment transmembrane resting potentials
and expand the interstitial space, producing a relative increase in
regional sodium levels.
Our laboratory group has successfully optimized sodium MRI at 3T
for normal brain, using single-quantum imaging with a modified
3D GRE pulse sequence to overcome the inherently low SNR. This
protocol will be further developed to include coregistered sodium
MRI/MRS, T2W proton MRI/MRS, and ASL. Metabolite concentra-
tion maps will be generated for age and gender-matched controls to
establish standard reference values. We will confirm sodium MRI
functionality in patients with well-localized seizure foci, based on
matching findings from proton MRI, EEG, and semiology. Subse-
quently, we will conduct a pilot study of patients with suspected le-
sions based on EEG and semiology, but negative findings on proton
MRI. This will provide requisite preliminary data for a future NIH
R01 grant application.
Key objectives of this research include comparison of inter-modal-
ity performance, quantification of metabolite concentrations, and
clinico-radiologic correlation in known and putative seizure foci.
Development of clinically viable sodium MRI technology for whole-
brain imaging has long-term applications for investigating disease
pathophysiology, performing presurgical evaluation, and monitor-
ing response to treatment.
James Hansen, MD
Therapeutic RadiologyYale-New Haven HospitalRSNA Research Resident Grant
Targeting Cancer with a Cell-Penetrating Anti-DNA Antibody
Most cancer therapies are severely limited by significant side ef-
fects due to non-specific tissue toxicity, and identification of novel
agents that are selectively toxic to malignant cells or selectively
sensitize tumors to treatment is a key goal in cancer research. We
have discovered that an anti-DNA antibody that penetrates into cell
nuclei, 3E10, enhances cancer cell radiosensitivity. Moreover, this
effect is potentiated in cancer cells deficient in DNA repair. 3E10
has potential as a therapeutic agent selective for cancers deficient
in DNA repair, which is relevant to numerous human malignan-
cies including breast, ovarian, pancreatic, and prostate cancers.
The ability of 3E10 to penetrate into cells and nuclei distinguishes
it from all antibodies currently approved for cancer therapy, and
3E10 is the first member of a new class of radiosensitizing agents.
The goal of this project is to establish 3E10 as a novel platform from
which new targeted therapies for cancer may be developed, and we
propose to: 1. Investigate the mechanism by which 3E10 enhances
cancer cell radiosensitivity. 2. Evaluate the potential of 3E10 in
targeted cancer therapy.
research resident grant
21RSNA.org/Foundation
Xiang Li, PhD
RadiologyDuke UniversityRSNA Presidents Circle Research Resident Grant
Patient-Specific Dosimetry in Pediatric and Adult Computed Tomography
Computed tomography (CT) is the single largest source of medical
radiation to the U.S. population. The last few years have witnessed
growing efforts to manage CT radiation, particularly efforts to
track radiation dose and to adapt scanning techniques to patient
size. These efforts can greatly benefit from a dose-reporting system
that provides estimates of radiation dose and potential cancer risk
specific to each patient and each CT exam. Enabling such a patient-
specific dose-reporting system is our long-term objective. This
application represents the pilot phase.
In this phase, we propose to estimate patient-specific dose and risk
for 26 patients representing body habitus from newborn to obese
adult and for the entire spectrum of clinical CT protocols (thoracic,
abdominal, neurological, cardiac, musculoskeletal, vascular, and
interventional exams). The 26 patients will be selected from a da-
tabase of patients, for whom full-body computer models have been
created from clinical CT data. A validated Monte Carlo program
will be used to simulate the anatomical coverage and acquisition
condition in each protocol. The simulated organ dose will be used to
estimate cancer risk. For each protocol, we will determine conver-
sion coefficients from reference dose quantities (e.g., CT dose index,
dose-length product, equilibrium dose) to patient dose quantities
(organ dose, effective dose, organ risk, total cancer risk) and derive
these conversion coefficients as functions of patient size, age, and
gender.
The findings of this pilot study will guide a larger scale study to
enable a system of patient-specific dose estimation and reporting in
CT. Such a system could guide individualized protocol optimization.
For patients who undergo sequential exams, knowledge of dose and
risk could aid in deciding exam frequency. Cumulative dose and
risk profiles of individual patients could also be used to identify pa-
tients who have reached a certain exposure level so that alternative
low-dose or non-radiation imaging procedures may be sought.
Thomas J. Klein, MD, PhD
Therapeutic RadiologyYale-New Haven HospitalRSNA Research Resident Grant
Genetic Analysis of the Tissue-Wide Response to Ionizing Radiation
The goal of most clinical radiation treatment is to eradicate micro-
scopic malignant disease from within an otherwise normal organ,
often requiring equivalent doses be delivered to both normal and
cancerous cells. While strategies that maximize the differences in
the radiobiology of these tissues have led to improvements in our
ability to destroy malignant cells with fewer effects on the sur-
rounding tissues, enhancement of the therapeutic ratio remains
a clinical challenge. Currently, there are very few genetically tracta-
ble approaches to studying the radiation response of tumors as they
grow within an otherwise normal tissue. Our lab has developed
a novel system for inducing and analyzing tumors in vivo in Dro-
sophila larvae. These tumors are induced to form within otherwise
normal epithelial tissues, thus mimicking the growth of many solid
tumors (e.g. breast, lung, colon, prostate). This system provides an
ideal platform for studying the interactions that take place between
wild-type and malignant tissues, as well as the signaling pathways
that regulate those interactions.
Our model is simple, robust, and highly genetically manipulable.
In the current proposal, we outline the development of a novel
model system in which the effects of radiation on solid tumors and
the surrounding normal epithelium can be analyzed in a system-
atic fashion. We aim to establish protocols for the irradiation and
analysis of Drosophila larvae, both for wild-type organisms and
for those in which tumors have been induced. We will analyze the
effects of mutation of genes known to be involved directly in the
cellular response to ionizing radiation, as well as those genes that
are likely to be involved in the tissue-wide radiation response. Hav-
ing established proof-of-principle, we intend to perform a genome-
wide screen to identify novel pathways involved in the radiation
response, potentially revealing novel targets to be exploited for
therapeutic gain.
research resident grant
22 r&[email protected]
Cullen Taniguchi, MD, PhD
Radiation OncologyStanford UniversityRSNA Research Resident Grant
Investigating the Radioprotective Effect of PHD2 in Colorectal Epithelium Through a Novel Mouse Model
The dose-limiting factor for radiation delivery to tumors in the
abdomen and pelvis is often toxicity to the normal cells of the
gastrointestinal (GI) tract. Moreover, although symptoms from GI
toxicity can be particularly distressing to patients, there are no ef-
fective therapies to prevent these unwanted side effects. Normal GI
epithelia exist in a state of mild hypoxia, and hypoxic gene expres-
sion is required to maintain the normal physiologic functions of the
GI tract. Based on this, we reasoned that the genes in the VHL/HIF/
PHD axis might participate in the radiation response of the gut. To
test this hypothesis, we developed an adenovirus vector to deliver
Cre recombinase (AdCre) specifically to the distal colon/rectum of
mice harboring a homozygous floxed allele of VHL. When AdCre
was delivered to the colorectal epithelium of VHLfl/fl mice, VHL ex-
pression was decreased by 70%, which resulted in a 50% increase in
the regrowth of crypts in the distal colon after 12Gy of whole-body
irradiation, when compared to mice treated with a control GFP ad-
enovirus. These data provide proof of principle that the VHL/HIF/
PHD axis may have a biological role in radioprotection.
Unfortunately, VHL is not a compelling or tractable therapeutic
target, but we believe that we can phenocopy this protective effect
by geneticially ablating or inhibiting prolyl hydroxylase domain-
containing protein 2 (PHD2), which works with VHL to negatively
regulate HIF levels during normoxia. Through the use of our
unique colorectal knockout technique as well as pharmacologic inhi-
bition PHD2, we hope to validate the radioprotective properties of
PHD2 in vivo and use these data to develop therapeutics that can be
rapidly translated to the clinic to spare normal tissues in the lower
GI tract from radiation damage, potentially allowing for safer and
more effective delivery of radiation therapy for many thousands of
cancer patients annually.
Brendan McCullough, MD, PhD
RadiologyUniversity of WashingtonCook Medical Cesare Gianturco/RSNA Research Resident Grant
Mortality, Major Medical Complications, and Costs Associated with Percutaneous Vertebroplasty versus Conservative Therapy for the Treatment of Osteoporotic Vertebral Fractures
Percutaneous vertebroplasty (PV) has been developed as a minimal-
ly-invasive treatment for painful osteoporotic vertebral fractures
that are refractory to conservative therapy. Numerous studies have
shown significant improvements in pain, disability, and quality of
life with PV, but two recent randomized controlled trials failed to
show any benefit of PV over sham treatment. Osteoporotic vertebral
fractures, however, are of greater concern than these subjective
outcome measures suggest: one year mortality has been reported
to be as high as 28%, higher than that seen with hip fractures. The
reason for this is likely related to the disabling effect of the injury
in combination with significant underlying comorbidities. The
previous studies examining the effectiveness of PV have not been
designed to compare relatively rare events like death and major
medical complications between treatment groups. We hypothesize
that PV will limit the disability associated with the fracture and
result in lower rates of mortality and major medical complications
compared to conservative treatment.
This project will use the Medicare Part B claims database to iden-
tify patients with osteoporotic vertebral fractures treated with PV
or conservative therapy. We will compare proportions of deaths
and major medical complications by treatment group using logistic
regression and controlling for comorbidities. Additionally, we will
compare the total medical costs following the injury using linear
regression to evaluate the cost effectiveness of PV.
Reductions in the rates of death and major medical complications
following osteoporotic vertebral fractures with PV compared to
conservative therapy would reshape the debate regarding the ef-
fectiveness of this procedure. Three-quarters of PV procedures are
performed by radiologists; as such, the results of this study have the
potential to significantly alter our practice.
MEDICAL
research resident grant
23RSNA.org/Foundation
Sina Tavakoli, MD
RadiologyUniversity of Texas Health Science Center at San AntonioRSNA Research Resident Grant
In Vivo Imaging of Vascular Remodeling Using a Novel Dual-Modality Matrix Metalloproteinase-2 Activatable Folate Receptor-beta Targeting Delivery System
Targeting macrophage activation as a means to detect early
inflammatory events is a widely investigated approach in imaging
vascular remodeling with promising results in animals. However,
suboptimal accuracy of current approaches challenges their clini-
cal application. The central hypothesis of this proposal is that a
uniquely designed delivery system that selectively targets activated
macrophages at sites of vascular inflammation will improve the
accuracy of imaging.
We propose two Specific Aims: in Aim 1, we propose to determine
ex-vivo the selectivity of our novel dual-modality 99m-Tc and Alexa
Fluor-546-labeled matrix metalloproteinase-2 activatable folate
receptor (FR)-beta targeting delivery system for activated macro-
phages. The ex vivo kinetics and specificity of tracer binding to
FR-beta will be determined in mouse activated macrophages, and
compared to binding and uptake in non-activated macrophages,
endothelial and vascular smooth muscle cells. The goal of Aim 2 is
to determine in vivo whether microSPECT/CT imaging using this
delivery system allows for the early detection of injury-induced
vascular remodeling in mice and monitoring of disease progression.
The in vivo image acquisition and tracer dose will be optimized
by dynamic imaging of apoE-/- mice with injury-induced carotid
remodeling throughout a 6-hour period. The specificity of the
imaging will be confirmed by pre-administration of excess non-
labeled folate. Tracer uptake will be quantified and compared with
autoradiography and gamma-counting to address the accuracy of
in vivo imaging. Finally, the ability of in vivo imaging to monitor
the extent and progression of vascular remodeling will be addressed
in longitudinal imaging of individual animals at 1, 2 and 4 weeks
after carotid injury. Uptake data will be correlated with histological
indices of vascular remodeling to address the biological relevance
of the imaging.
We anticipate that the proposed experiments will lead to the
development of a novel, multi-functional imaging modality to non-
invasively detect early events associated with vascular injury and
to monitor disease progression.
research resident grant
BRIGHT IDEAS. BETTER PATIENT CARE.
Dear Donors, It is truly an honor to receive the 2011-2012 Peggy J. Fritzsche, MD RSNA Resident
Research Grant and I wanted to express my appreciation to the many donors who made
it possible. Like Dr. Fritzsche, I am one of five children and I grew up in Ohio, where
I am currently a second year resident of University Hospitals Case Medical Centers/Case
Western Reserve University.
The RSNA Resident Research Grant has given me dedicated research time that
otherwise would not have been possible. I will develop new technical skills, embark
on my first clinical research project, and acquire additional skills to direct my own
independent research program in the future.
I look forward to honoring Dr. Fritzsche’s tradition of promoting MRI by researching a new, automatic and
retrospective motion correction method for body MRI. Thank you again for making this grant possible.
Sincerely,
Candice A. Bookwalter, MD, PhD
24 r&[email protected]
research medical student grant
Sanjay Aneja, BS
Therapeutic RadiologyYale School of MedicineRSNA Research Medical Student Grant
The Role of County-Level Radiology and Radiation Oncology Services in the Management of Breast Cancer
The factors associated with geographic variations in breast cancer
outcomes remain unexplored. Accompanying geographic dispari-
ties in breast cancer outcomes are geographic maldistribution of
radiology and radiation oncology services across the United States.
Our study would test whether geographic variations in three breast
cancer-related outcome measures-mortality, incidence, and clinical
management-are related to the maldistribution of radiology and
radiation oncology services.
To evaluate this relationship with respect to breast cancer mortal-
ity, we will utilize county-level mortality and incidence merged data
from the NCI-SEER program and the National Program for Cancer
Registries. We will obtain county-level data on mammography tech-
nology, radiologist, and radiation oncologist densities, using the 2010
Area Resource File (ARF). We will then build an incidence-adjusted
regression model testing the significance of increasing radiologist
density, radiation oncologist density, and mammography access on
breast cancer mortality.
To evaluate this relationship with respect to breast cancer inci-
dence, we will use county-level NCI-SEER data on breast cancer
staging. We will again use the ARF data to build a second model,
testing whether increased radiologist density and mammography
availability are associated with higher county-level proportions of
early stage breast cancer. To evaluate this relationship with respect
to clinical practice, we will use county-level NCI-SEER data on the
proportions of mastectomies versus breast conserving surgeries.
Using ARF data, we will build a third model testing whether pa-
tients in counties with higher radiation oncologist density are more
likely to receive breast-conserving surgery.
The long-term goal of our work is to analyze health system and
population factors associated with the geographic variations in
breast cancer outcomes and treatment patterns. Our work impacts
clinical medicine because it potentially identifies geographic
disparities in the management of breast cancer. Moreover, our work
informs policy makers of the importance of radiology and radiation
oncology services in breast cancer treatment.
Henry Andoh, BA
RadiologyDartmouth Medical SchoolCanon U.S.A./RSNA Research Medical Student Grant
Magnetic Resonance Imaging Features that Predict the Biologic Behavior of Head and Neck Cancer
There are 75,000 head and neck cancer (HNC) cases diagnosed in the
U.S. and approximately 30,000 deaths due to disease each year. Fol-
lowing surgical resection, 10 - 30% of resected cancers recur at the
primary site despite negative histologic margins. Potential theories
that explain the high local recurrence rate include persistence of
minimal residual disease at the margin and the presence of precur-
sor lesions that subsequently develop into carcinoma. Studies have
demonstrated that CT and MRI (T1 and T2 weighted sequences) lack
the sensitivity to reliably detect residual disease while PET suffers
from low spatial resolution which results in false negative findings.
However, studies have demonstrated that the presence of DNA mu-
tations of TP53, a tumor suppressor gene, serves as an independent
predictor of local recurrence. In addition, squamous cell head and
neck (HNSCC) patients with clinical and radiologic N0 necks and 15-
20% risk of nodal metastasis receive elective neck dissection despite
the fact that only 30% of these patients harbor micrometastases as
confirmed by histopathology. Therefore 70% of patients receive elec-
tive neck dissection without clear clinical benefit.
Diffusion weighted imaging (DWI) and dynamic contrast-enhanced
MR (DCE-MRI) have been shown to be predictive of the biologic
behavior of tumors in other regions of the body, but application to
head and neck cancer has been limited. This study examines two
hypotheses utilizing DWI and MR perfusion: 1) The presence of
TP53-mutated DNA within or surrounding the primary tumor cor-
relates with significantly lower ADC values than regions of interest
with no TP53-mutated DNA; 2) DCE-MRI perfusion parameters
(kTrans and rBV) are significantly different at the primary tumor
site in lymph node positive compared to lymph node negative
HNSCC .
research grant programs
25RSNA.org/Foundation
research medical student grant
Katelyn Atkins, BS
Radiation OncologyOregon Health & Science UniversityRSNA Research Medical Student Grant
The Role of PACS-2 in Radiation-Induced Gastrointestinal Syndrome
Understanding the molecular basis of how cells respond to acute
radiation will benefit rational approaches to selectively protect
healthy cells, thereby increasing the therapeutic index of radio-
therapy while minimizing radioresistance of tumors or causing sec-
ondary malignancies. The tumor suppressor p53 promotes survival
by increasing expression of the cyclin-dependent kinase inhibitor
p21, which induces growth arrest of gastrointestinal (GI) epithelial
cells following exposure to ionizing radiation (IR). However, the
molecular mechanism underlying this phenomenon is incompletely
understood.
We recently identified the multi-functional sorting protein PACS-2
as a critical regulator of IR-induced p21 expression in vivo. PACS-
2-/- mice have a repressed induction of p21 following IR, suggesting
PACS-2 is a novel regulator of acute radiation damage. The experi-
ments outlined in this proposal will test the hypothesis that PACS-
2-/- mice will have a diminished capacity to promote p53-dependent
growth arrest and will therefore be sensitized to radiation-induced
GI epithelium damage and GI syndrome-mediated death. We will
utilize immunohistochemical techniques to analyze proliferation,
crypt survival, and mitotic catastrophe in small intestine samples
from wild type and PACS-2-/- mice following IR. Additionally, we
will determine by survival analysis whether PACS-2-/- mice are
sensitized to GI syndrome-mediated death. I will complete these
experiments with the guidance of my scientific advisor, as well as
our collaborators in the Knight Cancer Institute, the Knight Cancer
Diagnostic Laboratories and the Department of Radiation Medicine
at OHSU. The proposed work is significant to the radiobiological
sciences because the development of targeted adjunct therapies re-
lies on a detailed understanding of the complex molecular machin-
ery controlling the cell’s response to radiation injury. Therefore,
understanding the molecular circuitry of PACS-2’s radioprotective
role may identify novel therapeutic strategies to enhance protec-
tion of normal GI epithelium by protecting or promoting PACS-2
function.
W. Chad Armstrong, BA
RadiologyUniversity of Mississippi Medical CenterRSNA Research Medical Student Grant
Differentiating Benign From Malignant Lung Nodules Using Nodule Enhancement on Multiphasic Contrast-enhanced CT and Early Volumetric Size Changes
Staging of hepatocellular carcinoma (HCC) and renal cell carcinoma
(RCC) is of the utmost importance for determining the appropriate
treatment strategy for a patient’s care. Patients without metastatic
spread have much better 5-year survival rates than those with meta-
static disease. Differentiating between benign and metastatic lung
nodules in HCC and RCC patients is critical for correctly staging
disease, especially since the lungs are the most common location for
metastatic spread of HCC and RCC. However, up to 50% of surgically
excised lung nodules turn out to be benign, and primary methods of
differentiation such as biopsy and FDG-PET CT scans are invasive
and carry low risks of morbidity and mortality or add cost to the
patient’s care. Since metastatic HCC and RCC lung nodules are
hypervascular, multiphasic contrast-enhanced CT (CECT) may offer
key, noninvasive diagnostic insight into differentiating between
benign or malignant nodules.
Our aim is to identify if the absolute enhancement of lung nodules
> 8 mm in size found during a multiphasic CECT staging examina-
tion for HCC and RCC can be used to differentiate benign from
metastatic lung nodules. If this is possible, then the multiphasic
CECT could provide a noninvasive, inexpensive and accurate
means of staging HCC and RCC in patients with indeterminate lung
nodules. Our second aim is to determine if volumetric lung nodule
size changes on short interval follow up after a multiphasic CECT
staging examination for HCC and RCC can be used to differentiate
benign from metastatic lung nodules measuring > 3 mm. It is now
accepted that volumetric measurements of lung nodule growth on
CT can detect an increase in size earlier that axial CT size measure-
ments. Therefore, volumetric measurements from follow up scans
may provide quicker identification of metastatic spread to the lungs
than conventional axial CT size measurements.
26 r&[email protected]
Alec Block, BS, BA
Radiation OncologyLoyola University Medical Center Stritch School of MedicineRSNA Research Medical Student Grant
Patient Specific Imaging Dose Assessment for IGRT
Image-guided radiation therapy (IGRT) uses advanced imaging tech-
niques to better localize the target volume and is the means by which
the high degree of accuracy and precision required for modern
radiotherapy techniques is achieved. However, several recent articles
in the popular press have many patients concerned that too much
radiation exposure, either in the form of diagnostic images (such
as from IGRT) or therapeutic doses, puts them at risk for serious
adverse effects. In our clinic, daily kilo-voltage (kV) images are used
for patient setup verification and repositioning. Weekly cone beam
computed tomography (CBCT) scans are used to acquire high-reso-
lution volumetric images to verify the internal anatomy. Multiple
studies have reported measurements of the imaging doses delivered
by different kV planar and CBCT systems, but these studies have
not clinically applied these measurements to actual patient data.
The aims of this study are two-fold: 1. To measure the imaging doses
of our kV planar and CBCT systems using realistic phantoms. 2.
To use these measurements to retrospectively estimate the imag-
ing doses delivered to approximately 100 patients based on the kV
planar and CBCT imaging that they received during their treat-
ment. Our hypothesis is that by using phantom studies to measure
the amount of imaging dose delivered by departmental IGRT
protocols, we will be able to retrospectively estimate the amount of
imaging dose received by IGRT patients. Once the imaging dose is
quantified, future studies will focus on measures that can be taken
to adjust technique parameters in order to decrease this dose, while
producing high quality images.
Ryan Baker, BS
Radiation OncologyMoffitt Cancer Center(Ryan is enrolled at the University of South Florida College of Medicine)RSNA Research Medical Student Grant
Stereotactic Radiotherapy (SBRT) to the Lung: Quantifying the Risk of Radiation Pneumonitis
Surgery remains the standard of care for treatment of early-stage,
peripheral non small-cell lung cancers. However, many patients
are not candidates for resection due to poor baseline pulmonary
function or other co-morbidities. Traditional doses of radiation lead
to poor local control. SBRT has significantly improved outcomes
in these patients. However, given that these patients typically have
pulmonary compromise, radiation oncologists have been concerned
about radiation pneumonitis (RP) in this population. Published
guidelines regarding dose constraints or other clinical factors
which might predispose to radiation pneumonitis in SBRT patients
are scant.
From 2006 - present, we have treated approximatley 400 patients
with SBRT to the lung. We have prospectively gathered toxicity data
using CTC-AE v3 (and, more recently v4) criteria, including RP, dur-
ing treatment and at each followup. We will gather relevant clinical
information (oxygen use, smoking history, current smoking status,
history of pulmonary or cardiac comorbidity) as well as dosimetric
information for lung (V5, V13, V20, mean lung dose, minimum and
maximum lung doses) and heart (minimum, mean, and maximum
doses). Tumor location will also be annotated. We will then run
univariate and multivariate analyses to determine clinical and/or
dosimetric predictors of radiation pneumonitis.
A few dosimetric parameters have been proposed when using SBRT
to treat tumors in the lung. However, the author readily admits that
these are largely conjectural (1). We will determine hard criteria
which will further guide radiation oncologists when treating pa-
tients with SBRT.
(1) Timmerman R. An overview of hypofractionation and introduction to this issue
of seminars in radiation oncology. Seminars in radiation oncology 2008;18:215-222.
research medical student grant
27RSNA.org/Foundation
Danny Costantini, PhD
Diagnostic ImagingHospital for Sick Children, University of TorontoPhilips Healthcare/RSNA Research Medical Student Grant
Imaging Cell Proliferation with FLT PET: A Pilot Study in Pediatric Lymphoma Patients with Equivocal FDG PET Findings
Residual masses on follow-up surveillance imaging are frequently
detected in pediatric patients with Hodgkin’s lymphoma (HL).
Positron emission tomography (PET) using 3’-deoxy-3’-[fluorine-18]-
fluorothymidine (FLT) can image cellular proliferation, and may
prove useful in distinguishing fibrotic or necrotic residual mass
lesions from those that may be harboring malignancy in pediatric
patients previously treated for Hodgkin’s lymphoma.
This is a prospective pilot-scale clinical study evaluating the
clinical use of FLT PET in twenty (20) pediatric patients with HL.
Primary Measure: Our primary measure is to obtain a preliminary
estimate of the diagnostic performance (sensitivity, specificity, ac-
curacy) of FLT PET in identifying residual malignant lesions which
receive an equivocal FDG PET/CT diagnosis.
Any HL patient at SickKids who receives an equivocal post-therapy
FDG PET/CT diagnosis after completion of chemotherapy is eligible
for recruitment. The FLT PET scan will be performed 1-5 days after
FDG PET/CT. For FLT PET, each patient will receive FLT intrave-
nously (5.2 MBg/kg), and imaging will be conducted approximately
60 minutes after injection using a Phillips Gemini GXL PET/CT
scanner. FLT PET images will be analyzed in a random sequence
and evaluated in a blinded fashion. Analysis will involve comparing
the FLT PET results to the best reference standard available includ-
ing histology, if available, as well as clinical and imaging follow up.
The diagnostic performance (sensitivity, specificity, accuracy) will
be calculated retrospectively based on the information acquired
from the completed FLT PET studies.
This study will generate preliminary data to guide the design of a
larger trial of FLT PET in pediatric HL patients. In the long term,
many children with benign processes may potentially benefit by
adjunct FLT PET by avoiding lengthy follow-up evaluations, un-
necessary biopsy or aggressive chemo-radiotherapy, whereas those
children found to have residual tumor will gain precious time for
salvage therapy.
Christopher D. Corso, PhD
Radiation OncologyEmory University School of MedicineRSNA Research Medical Student Grant
Evaluation of the Heat Shock Protein 90 Inhibitor Ganetespib as a Radiosensitizing Agent in Human Breast Cancer Models in Vitro
Heat shock protein 90 (Hsp90) is a molecular chaperone that plays
a key role in the folding, stability and function of many oncogenic
signaling proteins including Akt, Her2/neu, Survivin, bcr-abl and
mutated p53, among others. Hsp90 expression is elevated in a wide
spectrum of malignancies including mammary carcinoma cells and
its activity appears to be required in order to permit accumulation
of over-expressed and mutated oncogenes. Preclinical anti-tumor
activity of Hsp90 inhibitors have been reported in several human
cancer cell lines including triple positive and triple negative breast
cancers. There are however, very limited data on the combination
of radiation with Hsp90 inhibitors in the treatment of breast can-
cers. Since radioresistance is associated with increased expression
of many of the client proteins of Hsp90 such as Akt and Her2/neu,
it is hypothesized that treatment with the novel Hsp90 inhibitor,
ganetespib, prior to irradiation will have a synergistic effect as
compared to either treatment alone.
This work aims to explore the efficacy of ganetespib in combination
with radiation in breast cancer cell lines of varying ER/PR receptor
and Her2 status. The effects of ganetespib will also be evaluated in
an inflammatory breast cancer cell line which is one of the most ag-
gressive forms of primary breast carcinoma, with poorer outcomes
correlated with ER negativity. Clonogenic survival studies, MTT
viability assays, and apoptotic studies will be performed on four
cell lines following treatment with ganetespib and radiation: BT-474
(ER/PR+, Her2+), MDA-MB-231 (ER/PR -, Her2-), MCF-7 (ER/PR+,
Her2-) and SUM190 (ER/PR -, Her2+) which is a cell line for inflam-
matory breast carcinoma. The effects of ganetespib on the levels of
Hsp90 client-proteins including Akt, EGFR, Her2/neu, and VEGF
will be studied in an effort to further understand the mechanisms
by which the Hsp90 inhibitors confer radiosensitization in breast
cancer cell lines.
research medical student grant
28 r&[email protected]
Carl DeSelm, PhD
Radiation OncologyWashington University School of MedicineRSNA Research Medical Student Grant
The Role of PIKE in Cervical Cancer: a Potential Novel Therapeutic Target
Survival after treatment of cervical cancer can be predicted by
tumor metabolic response to [18F]-fluorodeoxyglucose positron
emission tomography (FDG-PET) post-therapy. In gene expression
profiling of human cervical cancer tissue, we recently identified
the PI3K/Akt pathway as significantly associated with post-therapy
FDG-PET uptake in human subjects. The mechanism of Akt regula-
tion in cervical cancer cells is unknown. PI3K Enhancer (PIKE), a
small GTPase that positively regulates Akt in glioblastoma multi-
forme and other cells, is upregulated in many cancer cells, includ-
ing cervical cancer. This proposal is designed to test the hypothesis
that manipulation of PIKE influences cancer cell response to
therapy, and that PIKE positively regulates Akt in cervical cancer
cells through GTP-dependent phosphorylation of Akt. Thus, our
aims are 1) to determine whether PIKE expression or inhibition
influences cervical cancer cell responsiveness to chemo-radiation,
and 2) to determine whether PIKE regulates cervical cancer cell
survival, proliferation, and response to treatment by GTP binding
and Akt activation. These experiments are designed to generate
preclinical data in support of the use of PIKE and Akt inhibition as
a novel therapeutic strategy for cervical cancer.
Ryan Cotter, BA
RadiologyMount Sinai School of MedicineCovidien/RSNA Research Medical Student Grant
Comparison of MR Imaging and PET/CT in Head and Neck Cancers: Developing a Clinical Rationale for Combined PET/MR Imaging
The aim of this project is to investigate the sensitivity and specific-
ity of combined FDG PET/CT and MR imaging in the detection of
squamous cell cancer of the head and neck (HNSCC) recurrence ver-
sus that of conventional MRI or PET/CT imaging alone. Currently,
there is little data evaluating the use of MRI and PET/CT compara-
tively in HNSCC recurrence, and most image-based monitoring
is currently performed by PET/CT and/or contrast-enhanced CT.
However, contemporary research suggests that combined PET/MRI
monitoring may be more advantageous. MRI is known to be better
in the characterization of tissues and may provide superior infor-
mation with respect to the extent of tumor involvement in HNSCC.
Since the acquisition of data in a combined PET-MR scanner will be
simultaneous rather than sequential as in PET-CT, there is no mis-
registration between the MR and PET images, allowing for accurate
spatial and temporal correlation between the data sets.
Consequently, FDG-PET and MRI fusion may exploit the combina-
tion of metabolic information and superior tissue definition to
avoid false readings in suspected recurrent cases. Consecutive
patient data from 2005 to 2012 will be analyzed retrospectively. Prob-
ability of malignancy of each lesion will be assessed on a 5-point
scale for both conventional MRI and conventional PET studies. MR
findings will be compared to findings from FDG PET/CT and to
contrast-enhanced CT, if available. Interpretation of the images will
be conducted independently by a board-certified nuclear medicine
physician and a neuroradiologist. The readers will be blinded to
each other and the clinical data. Given the increasing utilization
of PET-CT, if PET-MRI is at least as sensitive and specific as PET-
CT, there may be a shift of imaging towards PET-MR scanners.
However, the use of conventional MR compared to FDG PET/CT for
clinical utilization must first be validated.
research medical student grant
29RSNA.org/Foundation
Bradley Hunter, MPH
Radiation OncologyUniversity of Rochester School of Medicine and DentistryRSNA Research Medical Student Grant
The Staging and Treatment of Extranodal Hodgkin’s and Non-Hodgkin’s Lymphoma
The staging of extranodal Hodgkin’s lymphoma has been a source of
debate and controversy for over 40 years. This is troubling consider-
ing that extranodal involvement from primary nodal sites (Stage
IIE) is a relatively common finding in patients with lymphomas.
Both the implicit controversy in regards to extranodal extension in
Hodgkin’s disease, as well as the relative lack of studies investigat-
ing extranodal extension in non-Hodgkin’s disease, underscore the
contribution that research that assesses and attempts to reconcile
the possibility of inconsistency in clinical staging of an E lesion
would make to the literature.
The fundamental aims of this project are (1) to examine the fre-
quency and primary prognostic risk factors of extranodal involve-
ment from primary nodal tumors in Hodgkin’s and non-Hodgkin’s
lymphomas, (2) characterize the prognostic significance of this
extranodal involvement, and (3) assess the accuracy with which
lymphomas are staged.
The study population will consist of individuals who were diag-
nosed with Hodgkin’s or non-Hodgkin lymphoma between 1/1/2001
and 12/31/2010 and are currently registered in the Tumor Registry
Database at Strong Memorial Hospital. Using previously validated
risk stratification systems and patient records, patients will be
classified as presenting with early stage Hodgkin’s lymphoma,
advanced stage Hodgkin’s lymphoma, aggressive non-Hodgkin’s
lymphoma, or indolent non-Hodgkin’s lymphoma. These patient
classifications will be used to compare patients’ actual radiation
and chemotherapy treatment courses to those recommended based
on their assigned classification. Additionally, de facto accuracy of
the Ann Arbor designations “IIE” and “IV” will be assessed via the
results of a survey of 6 case reports which will be used for staging
by leading experts in the field. The results of this survey will be
used to identify discrete criteria used in clinical practice to differen-
tiate Stage IIE disease from that of Stage IV disease.
Caleb Graham, BS
RadiologyUniversity of Mississippi Medical CenterRSNA Research Medical Student Grant
Identifying CT Imaging Biomarkers and Criteria to Predict Disease Outcome in Locally Advanced Squamous Cell Cancers of the Head and Neck
Locally advanced squamous cell cancers of the head and neck
(LA-SCCHN) are highly vascular and often treated by a combina-
tion of chemotherapy, irradiation, and/or surgery. While concur-
rent chemoradiation is generally considered the standard of care,
neoadjuvant chemotherapy is appealing because it allows for an
assessment of tumor response and selection for organ preservation.
Because of the widespread use of CT in evaluating LA-SCCHN on
neoadjuvant chemotherapy, a predictive CT imaging biomarker
would be useful and widely applicable. Identification of poor
responders early in the course of therapy may reduce treatment-
related toxicity and cost and allow for a therapeutic intervention
before the disease burden significantly advances.
Baseline tumor volume, vascularity, and necrosis and interval
changes in tumor size/volume and vascularity after 2 or 3 cycles
of neoadjuvant chemotherapy have been independently predictive
of patient outcome in LA-SCCHN. In addition, changes in tumor
attenuation (enhancement) on contrast-enhanced CT and CT texture
analysis of target lesions, which has correlated with tumor vascu-
larity in metastatic lung cancer and renal cell carcinoma, may be
useful in predicting outcome in patients with LA-SCCHN.
We propose to retrospectively evaluate locoregional tumor size/
volume, attenuation (enhancement), and texture on the baseline
neck CT and changes in the locoregional tumor size/volume, attenu-
ation (enhancement), and texture on the initial post-therapy neck
CT (after 2 or 3 cycles of therapy) and associate these findings with
patient outcomes in 117 patients with LA-SCCHN on neoadjuvant
chemotherapy. Our goal is to identify CT imaging findings that
predict patient outcome in patients with LA-SCCHN on neoadjuvant
chemotherapy and combine the most predictive imaging findings
into a single CT imaging biomarker (or criterion).
research medical student grant
30 r&[email protected]
Matthew Knecht, BS
Radiation OncologyLoma Linda University School of MedicineRSNA Research Medical Student Grant
Stereotactic Localization Accuracy in Intracranial Radiosurgery Applications
Frame-based stereotactic localization is important for radiosurgery
procedures that deliver very high doses to targets close to critical
neural structures, such as the brain stem and optic nerves. The
long-term goal of this research is to develop advanced methods of
radiosurgical targeting in the brain and spinal cord with narrow ra-
diation beams. Historical data indicate that the achievable accuracy
with existing techniques is of the order of +/- 1 mm. By combining
three dimensional (3D) regression methods in combination with
modern CT and MRI imaging equipment we hypothesize that the
accuracy of contemporary stereotactic localization methods can be
much better than 1 mm. The largest contribution to the localization
error is that of selecting the center of the fiducial rods of an exter-
nal 9-12 rod fiducial system in the CT or MRI image selected for
targeting. The 3D regression method planned for this project will
utilize data automatically extracted from multiple high-resolution
CT and distortion-corrected 3T MR images to develop the stereo-
tactic transformation equation. The improved stereotactic trans-
formation will then be tested by its ability to give the locations of
embedded markers within a stereotactic phantom (Lucy¸, Standard
Imaging) scanned with CT and MR imaging. We will also test its
ability to provide targeting information for narrow proton beams
directed at radiopaque targets embedded within a beam localization
film, which are also contained in the phantom. Analyzing mean and
standard deviation of the difference between predicted and known
(lab-inspected) coordinates of the phantom targets, and the center of
the proton beams and the desired film targets, we will test the valid-
ity of the given hypothesis. The results of this study will benefit
both clinical and scientific applications of radiosurgery techniques
requiring a very high degree of accuracy.
Ankaj Khosla, BA
RadiologyMayo ClinicCanon U.S.A./RSNA Research Medical Student Grant
Impact of Trans-endplate Cement Leakage on Vertebroplasty Outcomes
Spine augmentation is commonly performed to treat painful verte-
bral compression fractures. It is estimated that vertebroplasty, the
most common type of augmentation, is performed 48,000 times per
year in the United States. Vertebroplasty involves the insertion of
a needle into the vertebral body, usually transpedicularly, for the
placement of bone cement into the fractured vertebra. However,
no definitive evidence based guidelines exist for certain technical
aspects of vertebroplasty. For instance, no definitive studies have
shown whether cement placement near the endplate is beneficial, or
whether cement leakage from the endplates into the disc space has
any impact on outcome. Leakage through the endplate might logi-
cally be considered advantageous if it “seals” a fracture involving
the endplate. Alternatively, such leakage into the disk space might
place the patient at elevated risk for future fracture and thus worse
long-term outcome.
The aim of the study is to determine the impact of cement endplate
placement and leakage into the disc space during vertebroplasty
on patient outcomes, particularly pain and subsequent fractures.
The medical records of 590 first-time vertebroplasty patients will
be examined in close detail. Data to be collected include: presence/
absence of cement extension to the endplate edge (superior, inferior
or both), endplate leakage (superior, inferior, or both) and any sub-
sequent adjacent level fractures. The patients will be divided into
three groups: patients with no cement extension to the endplate,
patients with cement extension to the endplate but no leakage into
the disc space and patients with cement extension to the endplate
and leakage into the disc space. The changes in pain scores and sub-
sequent adjacent level fractures will be compared among the three
groups. This will enable retrospective determination of the impact
of cement placement on patient outcome, and hopefully guided
physicians as to cement placement during vertebroplasty.
research medical student grant
31RSNA.org/Foundation
Coronary artery disease remains the highest cause of morbidity
and mortality in the United States. Recently, stem cell therapy
has shown exciting promise for improving cardiac function and
minimizing disease complications. The successful derivation of
induced pluripotent stem (iPS) cells provides an unlimited source
of somatic cells such as cardiomyocytes, offering incredible new
avenues for the future of regenerative medicine. However, it is criti-
cal to validate these cells’ in vivo behavior and fate after autologous
transplantation in pre-clinical large animal models before they can
be applied to the clinical realm. First, iPS cells proliferate logarith-
mically in vitro, and can potentially cause tumors in vivo. Second,
the in vivo survival kinetics of iPS cell derivatives, such as cardio-
myocytes and endothelial cells, is currently unknown. Tracking and
monitoring of iPS cell derivatives after patient delivery is essential
for safety and an enhanced understanding of the mechanisms of
in vivo myogenesis and angiogenesis. The pig makes an excellent
anatomical and physiological model for evaluating and validating
patient-specific iPS cell-based therapies.
The aim of this proposal will be to track stem cell fate in a pre-
clinical large animal model using combined positron emission
tomography and computed tomography (PET/CT) imaging. We
propose to label pig iPS cells with a PET reporter gene using a novel
nonviral site-specific targeting vector. Cardiomyocytes derived
from individual-specific porcine iPS cells will then be subjected to
autologous transplantation. The in vivo survival, proliferation, and
engraftment of transplanted individual-specific cardiomyocytes
will subsequently be evaluated with molecular imaging techniques.
PET will provide physiological information related to cell fate and
myocardial function, while CT will provide anatomical information
regarding cell location. Using porcine iPS cells and their derivatives
to perform autologous transplanation and longitudinal molecular
imaging will provide valuable information on the ultimate clinical
translation of human patient-specific iPS cell therapies.
Marina Mityul, BS
RadiologyWashington University School of Medicine in St. LouisRSNA Research Medical Student Grant
Examining Biomarkers of Pre-Clinical Alzheimer’s Disease using MRI and PET
Kazim Narsinh, BA, (MD)
RadiologyStanford University School of MedicineRSNA Research Medical Student Grant
Longitudinal Imaging of Induced Pluripotent Stem Cell-derived Cardiomyocytes in a Large Animal Model
As the U.S. population ages, we anticipate dramatic increases in the
prevalence of Alzheimer’s disease (AD). This, in combination with
the scarcity of standardized and conclusive diagnostic procedures,
makes early diagnosis of AD a serious public health concern. Using
PIB PET, we can now detect amyloid plaques, the hallmark of AD
pathology, in the brains of asymptomatic people. It is unclear, how-
ever, which of these individuals is at highest risk for developing
AD and over what time period. It has been demonstrated that AD
patients have altered blood flow in diseased areas of their brains.
Arterial spin labeling (ASL) is an MRI measurement of cerebral
blood flow which, combined with PIB PET, may be useful in diag-
nosis of pre-clinical AD. The purpose of the study is to evaluate the
utility of ASL MRI as a biomarker of pre-clinical AD. In this project
we will correlate regional blood flow (ASL) with regional PIB PET
uptake. The hypothesis is that early in pre-clinical AD, areas of the
brain with early amyloid deposition will have inflammation and
increased cerebral blood flow compared to the same regions in age-
and gender-matched controls.
research medical student grant
32 r&[email protected]
Anthony Rizzo, BA
Radiation OncologyCleveland Clinic Lerner College of Medicine of Case Western Reserve UniversityRSNA Research Medical Student Grant
Construction of an Atlas for Automatic Contouring of Stem Cell Niches in the Human Brain for Retrospective Analyses of GBM Survival
Conventional radiation therapy combined with surgery and drug
treatment, are important components of the standard of care
for glioblastoma multiforme (GBM). Despite this three-pronged
approach, the median survival for GBM patients is only about 14
months with early recurrences often found in the brain. Efforts to
decrease the recurrence, and understand the role that radiation can
have towards this end, are an important area of continued research.
Evers et al. indicated that one approach to decreasing recurrence
involves understanding of the radiation doses delivered to stem cell
niches of the adult brain. The objective of our project is to create
and test an anatomical atlas of subcortical brain structures, based
on computed tomography (CT) scans, for retrospective evaluation of
radiation dose to these stem cell niches. Using a computer-assisted
target volume delineation (CAT) system, this atlas will provide
rapid segmentation (automatic contour generation) of normal brain
structures in scans from 962 patients who were treated for GBM
with conventional radiation therapy at the Cleveland Clinic. These
treatments occurred from Jan. 2000 to December 2009, and all data
is stored in an IRB-approved database. Our study will assess the po-
tential of automatic contouring as a tool for retrospective analysis.
We will evaluate the radiation dose delivered to stem cell niches
of the adult brain and examine patient survival following conven-
tional radiation therapy. These niches include the periventricular
region of the lateral ventricles—the subventricular zone (SVZ)—and
the subgranular zone (SGZ) of the hippocampal formation. If the
dose delivered to the SVZ and SGZ is predictive of patient survival,
it could serve as a clinical parameter in the treatment planning of
GBM.
Tan B. Nguyen, BS
RadiologyUniversity of California, Los Angeles, David Geffen School of MedicineRSNA Research Medical Student Grant
Comparison of Functional Diffusion Map (fDM) Characteristics Between Different Molecular Signatures in Human Glioblastoma
Glioblastoma multiforme (GBM) is the most common and ag-
gressive primary brain tumor and is often associated with poor
response to initial treatment and poor overall prognosis. Functional
diffusion maps (fDMs), which examine voxel-wise changes in ADC
over time in diffusion-weighted images (DWI), have the potential to
serve as a valuable new imaging biomarker for brain tumors. We
believe that fDMs may provide valuable information regarding the
spatial extent and relative degree of tumor cellularity.
In order to further this claim, the proposed project will explore the
relationship between the rate of change in fDM volumes and several
important molecular/genetic signatures that are known to confer
a response benefit in patients with GBM. From empirical clinical
data, we have observed interesting patterns in fDM volume kinetics
that appear to reflect the proposed relationship. Due to the known
response benefit of temozolomide in patients exhibiting MGMT pro-
moter methylation, we hypothesize that the two distinct temporal
patterns observed in the fDM volume kinetic profiles of patients
treated with radiotherapy followed by adjuvant temozolomide may
correlate with expression of this molecular marker.
We will also examine fDM characteristics of isocitrate dehydro-
genase 1 (IDH1) mutation in glioblastoma patients after similar
cytotoxic therapy. We expect IDH1 mutation to result in increased
radiosensitivity and similarly increased cell death. Preliminary
data support these hypotheses and make a great case for evaluating
these relationships in more detail. Specific aims include determin-
ing the difference in rate of change of fDM hypocellular volume
between MGMT+ and MGMT- gliomas, and between IDH1 mutant
and wild-type gliomas, following cytotoxic treatment. The project
will involve computation of fDMs from DWI images in glioblastoma
patients with known molecular/genetic profiles. The results will
contribute important evidence that fDMs are a valuable imaging
biomarker for measuring and predicting tumor response.
research medical student grant
33RSNA.org/Foundation
Kevin Spitler, PhD
RadiologyUniversity of California, Los Angeles, David Geffen School of MedicineRSNA Research Medical Student Grant
Detecting White Matter Viability in Cervical Spondylotic Myelopathy: Prospective Analysis of Diffusion Tensor Imaging for Identification of Surgical Candidates
Degenerative disc disease (DDD) is a component of normal ag-
ing with an incidence of 10% at age 25 and 75% by age 65. The most
debilitating form of DDD, cervical spondylotic myelopathy (CSM), is
also the most common acquired cause of spinal cord dysfunction in
adults over age 50. As adults over age 65 are the fastest growing seg-
ment of the United States population, CSM is expected to increase
its already significant burden of multiple billions of dollars per year
in healthcare costs. Three quarters of patients with CSM undergo
stepwise loss of function secondary to white matter necrosis, and
this progression motivates many patients to elect decompression
surgery. Despite evaluation with somatosensory evoked potentials,
and measurement of spinal cord compression or spinal cord signal
change with T1 and T2 MR imaging, it remains unclear which
patients will benefit from decompression surgery.
At present, no accurate noninvasive method to predict potential for
neurological recovery following operative intervention exists. Ad-
ditionally, for patients that choose conservative non-operative treat-
ment, a non-invasive modality is required to monitor subclinical
disease progression, and, if needed, to determine optimal timing of
surgery. To address these deficiencies, the proposed project will test
an advanced MR imaging modality, diffusion tensor imaging (DTI),
for its potential to determine optimal timing of surgery and patient
selection for optimal outcomes from decompression surgery for
CSM. To accomplish the first goal, DTI will quantify cervical spine
integrity in subjects with severe CSM before and after decompres-
sion surgery. The improvement in DTI will be correlated with func-
tional sensory and motor function measured clinically. Secondly,
DTI will quantify cervical spine integrity in subjects with mild to
moderate CSM over time. This prospective study will evaluate the
ability of DTI to predict future clinical assessment and to identify a
threshold for recommendation of surgical intervention.
Stephanie Soriano, BS, MA
RadiologyUniversity of WashingtonRSNA Research Medical Student Grant
Radiofrequency-Enhanced Gene Therapy of Cholangiocarcinoma: Towards Intrabiliary MRI-Guided/RF-Enhanced Local Gene Therapy
The prognosis of pancreatobiliary malignances with biliary ob-
struction is very poor due to unresectable lesions at the time of pre-
sentation and rapidly evolving primary resistance to chemotherapy
and radiotherapy. Gene therapy is a frontier of modern medicine,
with nearly 1,000 gene therapy trials worldwide. Gene-directed
enzyme prodrug therapy (GDEPT) is currently the most promising
strategy for genetic treatment of cancers. GDEPT relies on the in-
tratumor delivery of a transgene to encode its enzyme, which then
activates a systemically-delivered prodrug to be toxic to kill tumor
cells via the mechanisms of inhibiting DNA polymerase and block-
ing DNA replication. Among the candidate genes, herpes simplex
virus thymidine kinase gene/gancyclovir prodrug (HSV-tk/GCV)
represents a promising example for clinical application of GDEPT.
However, a critical weakness with systemic HSV-tk/GCV therapy
is its low HSV-tk gene transfection and therefore low tumor kills
by GCV. We have recently established an intraluminal MRI/RFH
prototype system, with its key component being an FDA-approved
MR-imaging-heating-guidewire (MRIHG). The MRIHG has unique
“3-in-1” function for (i) intraluminal MRI; (ii) guiding interven-
tional procedures; and (iii) enhancing gene transfection/expression.
Based on this prototype system, we are developing a new interven-
tional oncology technique, named “Intrabiliary MRI-guided, radiofre-
quency heat (RFH)-enhanced local gene therapy.” As the initial step,
the current project focuses on establishing the “proofs-of-principle”
of this new concept. To this end, we designed two specific aims:
Aim I: In vitro evaluation of using RFH to enhance HSV-tk gene
transduction in human cholangiocarcinoma cells. Aim II: In vivo
validation of the feasibility of using RFH to enhance HSV-tk gene
therapy of human cholangiocarcimas in animal models.
The success of this project should enable us to establish the ground-
work for the next step – to develop intrabiliary MRI/RF technology-
integrated gene therapy of pancreatobiliary malignancies.
research medical student grant
34 r&[email protected]
Evan Thomas, MS
Radiation OncologyUniversity of Alabama - BirminghamRSNA Research Medical Student Grant
Utilization of Dual Energy CT for Treatment Planning Scans in Patients with Metal Artifact
When a prospective radiation treatment patient undergoes a CT
scan for treatment planning, in vivo high-Z materials are notorious
for compromising the accuracy and visual integrity of the CT data.
These objects, such as dental implants, produce what are known as
metal streak artifacts in the scan. The artifacts have two important
implications which remain problematic for treatment planning.
The first and most obvious complication is the reduction in visual
quality of the images. This hinders delineation of both target and
organ-at-risk (OAR) volumes in affected CT slices. The second com-
plication is adulteration of acquired CT data which compromises
the accuracy of later dosimetric calculation.
We propose to solve this problem by utilizing a newly available CT
scanning method called dual-energy CT (DECT). DECT features
the ability to rapidly switch between 140/80 kV modes utilizing a
single x-ray tube and acquire two distinct imaging spectra. The
contribution of a designated Z material (e.g. a metallic implant)
can be subtracted from the fusion of the two spectra in a process
known as metal artifact subtraction (MARS). In this study, MARS
will be assessed in two phases for its ability to ameliorate the effects
on treatment plan quality in patients with metal artifacts. In the
first phase, we will employ MARS on planning phantoms modified
to contain metal implants. Radiation dose will be calculated and
delivered, and film and ionization chambers will assess the dosi-
metric accuracy. In the second phase, the technique will be employed
on a patient for each type of implant. Expert radiation oncologists
will contour critical structures in CT volumes of both original and
MARS-employed image sets and evaluate the improvement in their
ability to delineate relevant structures.
If this technique is demonstrated effective for the treatment planning
problems posed by metal artifacts, we will develop a protocol for its
routine clinical utilization.
Marshall Strother, BA
RadiologyWashington UniversityRSNA Research Medical Student Grant
Testing the Effectiveness of the CT Dose Check Initiative
Radiologists have long strived to optimize patient radiation expo-
sure. The risks associated with exposure are routinely cited by
clinicians as the deciding factors in decisions to forgo radiographic
studies. At the same time, it is extremely common for radiation
dose to vary significantly—sometimes up to sixfold—for identi-
cal studies, even when protocols have been put in place to reduce
such variation. In this study, we propose to implement and test
the effectiveness of a semi-automated system to reduce unjustified
variability in radiation dosage in common computed tomography
procedures.
Data from all CT exams performed at Barnes Jewish Hospital and
St. Louis Children’s Hospital will be collected using RADIANCE
and Syngo software. Data will be cleaned, and a variety of statisti-
cal analyses will be performed to identify problematic variation. A
combination of manual audit and advanced data mining techniques
will be employed to identify the circumstances responsible for
variation and to systematically categorize incidents by these failure
modes. This analysis will be used to prioritize and plan interven-
tions targeted at reducing problematic variation using the CT
Dose Check software as a supplement to organizational training
and other standard methods. When possible, these methods will be
automated using standard computational tools to assist in continu-
ous auditing, which will continue after the end of the project to
evaluate the effectiveness of interventions and assess the need for
future work.
Previous work has shown that it is possible to significantly op-
timize radiation exposure with similar interventions on smaller
scales. Automating this process and increasing its scale has the
potential to broadly affect the way patients are protected from ex-
cessive and sub-diagnostic radiation exposure during CT scans.
research medical student grant
35RSNA.org/Foundation
Patrick Tyler, BS
RadiologyNorthwestern University Feinberg School of MedicineRSNA Research Medical Student Grant
MRI-Guided Nanoembolization for Liver Cancer
For patients with unresectable hepatocellular carcinoma, there
are few treatment options currently available. Advancements in
transarterial chemoembolization (TACE) have emerged that may
provide some benefit to these patients, but optimal dosing regimens
remain unknown. The purpose of this project is to use MR imaging
to optimize and quantify the local delivery of therapeutic nanopar-
ticles to VX2 liver tumors in rabbits. Doxorubicin (DOX) will be
coupled to supraparamagnetic iron oxide nanoparticles (SPIOs).
Methods: 20 rabbits will be used in this study. VX2 tumors will be
surgically implanted in the liver according to previously published
protocols. For intra-tumoral delivery, rabbits will be assigned to a
low dose group (0.5 mg/kg) and a high dose group (1.5 mg/kg) with
DOX dosages calculated based on current TACE protocols. Rabbits
will undergo X-ray digital subtraction angiography (DSA) to place a
catheter in the left hepatic artery (LHA), and will then be trans-
ferred to a Bruker 7T ClinScan MRI horizontal bore scanner.
A baseline Multi-Echo GRE scan will be performed, followed by
infusion of the entire dose volume and a post-infusion Multi-Echo
GRE scan to obtain an R2* pulse sequence map of targeted tis-
sues. Tumor and surrounding hepatic parenchyma samples will be
obtained at necropsy for inductively-coupled plasma mass spec-
trometry analysis (ICPMS), which allows quantification of the NP
in tissue. ?R2* will be calculated from pre-treatment and post-treat-
ment MRI scans and correlated with the ICPMS tissue concentra-
tion. This project will contribute to developing the next generation
of TACE by devising a new system of dosimetry for locally delivered
nanotherapies that employs MRI.
Allison Tillack, MA
RadiologyUniversity of Colorado Denver (Allison is enrolled at the University of California, San Francisco)Fujifilm Medical Systems/RSNA Research Medical Student Grant
An Evaluation of the Impact of Clinically Embedded Reading Rooms on Radiologist-Clinician Communication
In the era of Picture Archiving and Communication Systems
(PACS), there are fewer opportunities for radiologists to interact
face-to-face with their clinician colleagues. As an attempt to address
this problem and to promote in-person consultation of radiologists
by referring physicians, some health care facilities have embedded
radiology reading rooms in clinical areas. This study investigates
whether locating reading rooms in clinical areas at a large, tertiary
care academic hospital in the US is in fact associated with increased
rates of direct communication between radiologists and clinicians.
Results of this research will suggest whether reading room location
significantly impacts the patterns and the character of interperson-
al clinician-radiologist communication. Because better communica-
tion among medical specialists presumably translates into improve-
ments in patient care, the results of this study will be of importance
not only to the field of radiology, but also for efforts to augment the
quality of health care.
research medical student grant
36 r&[email protected]
Stephen Brown, MD
RadiologyChildren’s Hospital Boston and Harvard Medical SchoolGE Healthcare/RSNA Education Scholar Grant
Program to Enhance Relational and Communication Skills for Radiologists (PERCS-Radiology)
Expectations are rapidly evolving for how radiologists commu-
nicate with patients, requiring radiologists to convey cognitively
complex information under emotionally charged conditions. Few
educational opportunities exist to help radiologists acquire the
skills to approach these conversations effectively. The Program
to Enhance Relational and Communication Skills for Radiologists
(PERCS-Radiology) seeks to fill this gap and to enhance radiology
trainees’ confidence and skills when communicating with patients
about difficult topics.
The objectives of the proposed program are to: 1) improve radiol-
ogy trainees’ preparedness to communicate with patients about a
new, unexpected or difficult diagnosis; 2) help radiology trainees
effectively disclose radiological errors to patients and families; and
3) enhance trainees’ success in discussing radiation safety with
patients.
The proposed daylong workshops will combine didactic and
educational media presentations with realistic improvised enact-
ments and feedback between workshop participants and profes-
sional actors. Radiology trainees are the core learning group.
Participants will also include attending radiologists, technologists,
nurses, clinicians, and patient representatives. Faculty facilita-
tors include experts in healthcare communication pedagogy. The
learning model emphasizes collaboration among professionals from
varying disciplines and levels of experience, integration of patient/
family perspectives, and a safe environment that respects multiple
viewpoints.
The main outcome measure will be participants’ self-assessments of
preparation, communication skills, confidence, and anxiety when
holding difficult conversations on questionnaires administered
before, immediately after, and 6 months after the workshops.
We anticipate that PERCS-Radiology can be developed into self-
sustaining workshops for radiologists and affiliated professionals
nationally. Workshops could provide CME and risk-management
credits, and fulfill ACGME requirements for proficiencies in Profes-
sionalism and Communication.
Julia Fielding, MD and Alfred D. Llave, MD
RadiologyUniversity of North Carolina at Chapel HillRSNA Education Scholar Grant
Meeting the Challenges of Radiology Resident Education in the 21st Century: Redefining the Radiology Classroom through RAD-SHARE, Radiology (See, Hear And Respond Education)—A Collaborative Pilot Endeavor
The aim of Radiology: See, Hear And Respond Education (RAD-
SHARE) is to create a robust, novel, and unique interactive online
learning community among training institutions for mutual benefit.
The objectives of RAD-SHARE will be accomplished through the cre-
ation of lecture modules called “radactics” which will be authored by
various contributors from different programs who share the vision of
the project. The “radactics” will emphasize the use of adult learning
principles, and the inculcation of new core competencies and stan-
dards of practice. The latest interactive learning technologies will be
integrated in the portal to facilitate group and self-directed learning.
RAD-SHARE will be implemented in two phases through a concerted
multi-institutional effort. During the pilot phase, initial learning
experience of residents from participating institutions will be evalu-
ated objectively. According to a pre-defined format, a lecture module
in uroradiology (the initial representative example) will be created
and uploaded onto the portal. To assess learning among residents,
standardized tests will be administered following completion of the
module. Subjective feedback regarding ease of use and functionality
will be obtained from module contributors and learners, respectively.
The second phase will focus on systems adjustments based on the
initial experience, progressive completion of the lecture curriculum,
and evaluation of interactive learning features.
This RAD-SHARE initiative will be an opportunity to assess the effec-
tiveness of a novel interactive resource for learning and the feasibil-
ity of multi-institutional sharing of educational resources for mutual
benefit. The RAD-SHARE project may serve as a model to establish
collaborative knowledge sharing that would potentially benefit other
academic communities. to establish collaborative knowledge sharing
that would potentially benefit other academic communities.
education grant programseducation scholar grant
37RSNA.org/Foundation
Mannudeep K. Kalra, MD
RadiologyMassachusetts General HospitalGE Healthcare/RSNA Education Scholar Grant
CT Virtual Autopsy for Radiation Dose Reduction and Radiological-Pathological Correlation Training Programs
Postmortem examinations generally show an error rate for clini-
cally significant conditions in approximately 20 - 30% of postmor-
tem examinations in most studies. Despite this, there has been a
continuing decline in the rate of autopsies, with academic institu-
tions having an autopsy rate of 10 - 20% and community hospitals
having an autopsy rate in many cases bordering on zero. This error
rate has occurred despite modern laboratory and radiology testing
including cross-sectional imaging techniques. Because postmortem
radiographic examination may be more acceptable to next of kin of
deceased and possibly also to attending physicians may be one step
in reversing the decline of information that could be obtained only
by autopsy. Correlation with assistance from imaging techniques
after death.
Recently, use of CT and MRI has been described for postmortem
imaging (virtopsy) in conjunction with autopsy. Virtopsy can add
information to the autopsy and enable a more focused autopsy. Yet
in most academic institutions, benefits of virtopsy have not been
exploited. Our proposal seeks to address this discrepancy, by devel-
oping two model training programs for radiologists, residents and
medical students. The first program will use imaging data acquired
from CT virtopsy at different radiation dose levels through different
body regions to develop a training module for educating radiology
personnel on perception of pathologically proven abnormalities at
different levels of radiation doses. Unlike antemortem CT, postmor-
tem CT can be repeated several times without risks to the body and
would not require simulated low dose images, which are not ideal
in our experience. The second program will create a teaching mod-
ule of 2- and 3- dimensional CT and MR imaging data with relevant
photographic documentation from gross and microscopic autopsy
examinations. The latter module will help enhance understanding
of the radiologic and pathologic correlation of different disease
processes leading to death.
Sharad Goyal, MD
Radiation OncologyUMDNJ/Robert Wood Johnson Medical School, UMDNJ/New Jersey Medical School & The Cancer Institute of New JerseyRSNA Education Scholar Grant
COntouring in Radiation Oncology Education (CORE)—A Self-Assessment Module (SAM) for Radiation Oncologists
Maintenance of Certification (MOC) is a process where a practicing
physician provides evidence to peers and the public that he or she
continually gains knowledge, maintains quality of care, and im-
proves his or her practice. The American Board of Radiology (ABR)
strongly encourages all radiation oncologists with time-limited and
lifetime certificates to participate.
We hope to create the COntouring in Radiation Oncology Education
(CORE); a Self-Assessment Module (SAM) that fulfills MOC require-
ments set forth by the ABR. Following breast conserving surgery
for early stage breast cancer, visualization of the postsurgical exci-
sion cavity can be difficult and target volume delineation practices
of radiation oncologists can vary widely. It is important to accu-
rately contour target volumes given the increased research into,
and clinical use of, accelerated partial breast irradiation (APBI),
where only the tumor bed with margin is irradiated. Previous stud-
ies have shown that without guidelines, practicing physicians have
substantial variations in target volume delineation which can have
significant dosimetric and clinical impact. Cavity visualization can
be difficult given post-surgical changes and lack of surgical clips or
implanted fiducial markers to aid visualization.
Our goal is to create a SAM whereby trainees or physicians in the
MOC program can learn or refresh skills and knowledge in critical
postsurgical breast changes, postsurgical cavity visualization, and
target volume delineation with requisite expansions. Immediate
feedback will be provided as physicians are able to practice con-
touring on sample CT images overlaid with standard contours from
leading academic radiation oncologists who specialize in breast
radiotherapy.
The outcome of this project will give physicians more educational
options when re-certifying as a diplomate of the ABR in radiation
oncology and assist trainees to learn this new technique which may
become an important treatment option for women with early stage
breast cancer.
education scholar grant
38 r&[email protected]
Jie Li, MD and Elizabeth A. Morris, MD
RadiologyBeijing Cancer Hospital & Beijing Institute for Cancer Research, Peking University School of OncologyDerek Harwood-Nash/RSNA Education Scholar Grant
Developing an Educational Program on Breast Imaging for the Chinese Radiology Society with International Cooperation
Knowledge of breast imaging has grown dramatically over the past
decade, and the field is changing rapidly. However, breast imaging
in China has not developed in step with the field. Limited educa-
tional resources, a lack of specialty training in breast imaging, and
language barriers have opened up a large gap between Chinese
radiology and the international breast imaging community with
regard to knowledge and information, interpreting skill and clinical
research.
The objective of this project is to disseminate updated knowledge
in the field of breast imaging to the Chinese Society of Radiology
(CSR), provide special training and educational resources on breast
imaging in China, and enhance Chinese radiologists’ experience in
the use of BI-RADS¸ in order to improve their clinical practice and
research in breast cancer imaging.
The scholar will develop a breast imaging educational program
in collaboration with Memorial Sloan-Kettering Cancer Center
(MSKCC). The goals of the program will be to implement BI-RADS
in medical practice, create a quality assurance system, establish
a clinical fellowship training program, and ultimately develop a
clinical training center for breast imaging in China. As part of the
educational program, a nationwide continuing medical education
program on breast imaging will be instituted, with invited experts
from the U.S.A., to provide updated knowledge and workshops for
Chinese radiologists. In addition, an educational website on breast
imaging will be set up, providing free, unlimited learning resourc-
es, links and information on breast imaging to Chinese radiologists.
It is expected that the program will strengthen the clinical skills
of Chinese radiologists in breast cancer detection and diagnosis,
help to build up quality assurance systems for breast imaging in
China, stimulate research and international communication, and
ultimately improve clinical practice and research in breast cancer
care in China.
Lonie R. Salkowski, MD
RadiologyUniversity of Wisconsin—Madison, School of Medicine and Public HealthPhilips Healthcare/RSNA Education Scholar Grant
A Paradigm Shift in Teaching Anatomy: Development of New Educational Methods for Health Care Professionals to Learn Anatomy through Radiology Correlation
The goal of my proposal is to become more efficient and effective in
teaching the complexities of radiology anatomy and radiation safety
to healthcare students.
Class hours are being cut as the wealth of information to be taught
is increasing. New and developing concepts are being taught often
at the expense of the fundamentals. Anatomy education is vital in
the technical, undergraduate and graduate fields of healthcare rang-
ing from radiology technologists, PT/OT students, medical students
and radiology residents. Each group of students requires specific
and different levels of understanding of anatomic principles and
how they relate to radiologic imaging. The introduction of radiology
early into the anatomy curriculum provides a means of demonstrat-
ing the human anatomy with the relevance and importance of the
anatomic principles in the healthcare sciences.
I am devoted to teaching and curriculum development in radiologic
anatomy to diverse groups of students. The changes in classroom
time and restrictions require me to gain additional competence and
expertise beyond the scope of what I currently possess. Gaining
additional knowledge and skill sets by acquiring my masters degree
in education and leadership will provide me with the tools to be
more effective and innovative in the classroom and beyond. These
skills will prepare me to optimally engage the student learner
within the limited resources of education hours.
I am passionate about teaching fundamentals that serve as a solid
framework that students can develop and expand upon. I am
interested in developing programs to challenge student thinking
beyond memorization. The programs I have developed thus far have
progressed without any formal training. I believe that given the
opportunity to attain additional training in education concepts, I
will become a more effective leader and scholar in health profession
education.
education scholar grant
39RSNA.org/Foundation
education scholar grantXiaoming Yang, MD, PhD
RadiologyUniversity of Washington School of MedicineRSNA Education Scholar Grant
Toward Clinical Translation of Interventional Molecular Imaging: An Educational Program for New Generations of Interventional Radiologists
Molecular imaging is an emerging technology for in vivo detection
of biological events at molecular/cellular levels. It has demonstrated
great promise in early diagnosis of diseases and precise guidance of
advanced treatments, such as gene and cell therapies. Recent com-
mon interest in molecular imaging among diagnostic and interven-
tional radiologists has led to a new concept, called interventional
molecular imaging. This concept, by combining interventional radi-
ology (IR) with molecular imaging, aims to fully apply the advantag-
es of both imaging fields. Specifically, interventional radiology can
extend the capabilities of currently-available molecular imaging
techniques in (i) reaching deep-seated targets; (ii) getting a close
look at small targets; (iii) precisely guiding delivery of non-targeted
imaging tracers/therapeutics; and (iv) super-selectively enhancing
the effectiveness of targeted imaging and treatment.
To prompt successful translation of interventional molecular imag-
ing from benches/animal labs to clinical practice, one of crucial
steps is to get the new generations of interventional radiologists
prepared for application of this new technology. To this end, we
have designed an educational program that will provide IR trainees
with hands-on experience in interventional molecular imaging.
Through practicing a relatively complex IR procedure, transjugular
intrahepatic portosystemic shunt (TIPS), with subsequent mo-
lecular MRI-guided intraTIPS agent delivery on near-human-sized
pigs, the trainees will not only gain understanding of the concept
of interventional molecular imaging but also become familiar with
the necessary techniques. We propose a 3-phase program, including
(i) a 2-hour theory course on TIPS and interventional molecular
imaging; (ii) a pre-clinical hands-on training on the TIPS procedure
and subsequent MRI-guided intraTIPS agent delivery; and (iii) a
hands-on experience in confirming successful agent delivery using
various laboratory methods.
Our long-term goal is to attract the interest and attention of new
IR generations to molecular imaging-integrated interventional
technologies, and thereby facilitate the translation of interventional
molecular imaging to clinical practice on humans.
My RSNA R&E funding will
help fast-track my studies of novel therapeutic targets to alter
bio-chemical signaling in breast cancer, and advance my long-
term career goal—a position in an academic radiation oncol-
ogy department which couples clinical practice with basic and
translational research.
Carmen Bergom, MD, PhD
BRIGHT IDEAS. BETTER PATIENT CARE.
40 r&[email protected]
Supriya Gupta, MBBS, MD
RadiologyMassachusetts General HospitalRSNA/AUR/APDR/SCARD Radiology Education Research Development Grant
Education in International Radiology Outreach: Development of Multi-language Web-based Modules and Providing Training for Diagnosing Acute Clinical Conditions Using Ultrasound
Advancement in imaging modalities has boosted and complemented
radiologist’s diagnostic skills. Nevertheless, ultrasound continues
to be the prime imaging modality for evaluating acute conditions in
emergency department in many resource-poor rural settings and is
the imaging modality of choice for some diseases even in developed
countries. Importance of this modality is amplified in resource-poor
countries where it proves to be easily available, easy to perform,
rapid, accurate and repeatable even if it is being performed by
non-radiologist physicians. Our objective for developing a training
curriculum, including web-based multi-language lectures, video
demonstrations, hands-on training workshop and developing an
(OSCE) Objective Structured Clinical Examination for medical
personnel at Butaro Hospital, Rwanda, would serve as a benchmark
for developing similar and more effective programs in other devel-
oping countries. Such a training course would enhance imaging
utilization in these countries while developing quality standards for
diagnosing acute abdominal and pelvic emergencies in rural areas.
Joshua Dowell, MD, PhD
RadiologyNorthwestern University Feinberg School of MedicineRSNA/AUR/APDR/SCARD Radiology Education Research Development Grant
A Pharmacopeia iPhone/iPad Mobile Communication Application for the Interventional Radiologist
Interventional radiology (IR) is becoming increasingly indepen-
dent as a clinical discipline. An understanding of commonly used
medications is pivotal to patient safety and efficiency. The purpose
of this project is to pilot the practicality of a handheld, mobile soft-
ware solution to assist the interventional radiologist. This mobile
application may make medications encountered in daily IR practice
more readily accessible, increase one’s comfort and knowledge in
selecting appropriate medications and dealing with adverse effects,
and ultimately reduce medical dosing errors.
The current literature of commonly used drugs for the manage-
ment of disease treated by the interventionalist will be reviewed
and guidelines compiled. An IR pharmacopeia application will be
developed for the iPhone/iPad, a mobile communications device
platform. IR personnel will then be surveyed on the functionality,
usage, and opinion of the application in daily practice. This mobile
application will promote patient safety and may aid in reducing
medical dosing errors.
rsna/aur/apdr/scard education research development granteducation grant programs
41RSNA.org/Foundation
rsna/aur/apdr/scard education research development grant
Carolyn Wang, MD
RadiologyUniversity of WashingtonRSNA/AUR/APDR/SCARD Radiology Education Research Development Grant
Prospective Randomized Study of Contrast Reaction Management Curricula: High-Fidelity Hands-on Simulation Versus Computer-based Interactive Simulation
In phase 1, high-fidelity simulation-based training was compared
to standard didactic lecture, which demonstrated equal results on
written tests, but improved performance during a high-fidelity se-
vere contrast reaction scenario. Unfortunately high-fidelity simula-
tion laboratories are not widely available and are expensive. There-
fore we created a computer-based interactive module for teaching
contrast reaction management and want to prospectively compare
its effectiveness to hands-on high-fidelity simulation-based training.
Subjects will be randomized to either curriculum based on their
experience questionnaire responses. They will take written exams
before and after the intervention to establish baseline knowledge
and immediate learning. Six months later, all participants will take
a different written exam to assess knowledge retention and undergo
performance testing with a different high-fidelity severe contrast
reaction scenario. If the computer-based interactive simulation is
equally effective, it may be a more cost-effective widely available
means to standardize contrast reaction training for trainees and
academic and community practicing radiologists.
The peer review process
is competitive, but it is an excellent training ground for NIH grant
writing. My funding will help me determine which second-line
treatment is more likely to improve liver fat in patients with type 2
diabetes, and promote the adoption of MR-based fat quantification
techniques, potentially alleviating the need for liver biopsy.
An Tang, MD
BRIGHT IDEAS. BETTER PATIENT CARE.
Amir Abdelmalik, MDSaint Louis University
Asif Abdullah, MDUniversity of Toledo Medical Center
Bryan G. Allen, MDUniversity of Iowa Hospitals and Clinics
Laura M. Allen, MDUniversity of California, IrvineRadiological Sciences
Mu’taz Morshed Abdallah Alnassar, MBBSUniversity of TorontoMedical Imaging
Nila Alsheik, MDUniversity of Wisconsin School of Medicine and Public Health
Hebert Alberto Vargas Alvarez, MDMemorial Sloan-Kettering Cancer Center
Asim K. Bag, MDUniversity of Alabama at Birmingham
Mohammad Bahador, MDUniversity of Missouri- Columbia
Richard L. Barger Jr., MDWilliam Beaumont Hospital
Ranjit Bindra, MD, PhDMemorial Sloan-Kettering Cancer Center
David Bonekamp, MD, PhDJohns Hopkins
Daniel J. Boulter, MDMedical University of South Carolina
Ashley Bragg, MDUniversity of Arkansas for Medical Sciences
Olga R. Brook, MDBeth Israel Deaconess Medical Center
Ilene Burach, MDHahnemann University Hospital Drexel University College of Medicine
Alissa J. Burge, MDNorth Shore University Hospital
Mark Burshteyn, MDTemple University Hospital
Sherwin Chan, MD, PhDUniversity of Washington
Arindam Rano Chatterjee, MDUT/Methodist Healthcare
Leslie Chatterson, MDUniversity of Saskatchewan
William Chen, MDUniversity Hospitals Seidman Cancer Center
Praveena Cheruvu, MDUniversity of Rochester Medical Center
Francis Cloran, MDSan Antonio Uniformed Services Health Education Consortium
Randi J. Cohen, MDFox Chase Cancer Center
Rivka R. Colen, MDDana-Farber Cancer Institute
Andrew C. Cordle, MD, PhDMetroHealth Medical Center
Andreu Costa, MDUniversity of Ottawa
Kelly Lynn Cox, DOCleveland ClinicImaging Institute
Ildiko Csiki, MD, PhDVanderbilt University Medical Center
Megan Daly, MDStanford University
Sherwin Danaie, MDGeorge Washington University
Shadpour Demehri, MDBrigham and Women’s Hospital, Harvard Medical School
Robert Benjamin Den, MDThomas Jefferson University & Hospitals, Inc.
Matthew D. Dobbs, MDVanderbilt University Medical Center
John Dufton, MDQueen’s University
Neal Dunlap, MDUniversity of Virginia
Siobhan M. Flanagan, MDUniversity of Minnesota
Carl Flink, MDAllegheny General Hospital
Shira Galper, MDYale-New Haven Hospital/Yale University School of Medicine
Xavier Garcia-Rojas, MDUniversity of Texas Health Sciences Center San Antonio
Amol J. Ghia, MDUniversity of Utah
Peter Ghobrial, MDBaystate Medical Center
Saurabh Guleria, MDChildren’s Hospital of Wisconsin, Medical College of Wisconsin
Ajay Gupta, MDNewYork-Presbyterian Hospital, Weill Cornell Medical College
Jagan Dewan Gupta, MDTulane University School of Medicine
Shiva Gupta, MDNew York Medical College
Ihab Haddadin, MDUMDNJ-Robert Wood Johnson Medical School
Amer Hanano, MDSUNY Downstate Medical Center
Robert F. Hanna, MDColumbia University Medical Center
Matthew Hardee, MD, PhDNew York University
Cameron Hassani, MDLong Island College Hospital
roentgen resident/fellow research award
Laura M. Allen, MD, Recipient, with Arash Anavim, MD, Program Director
roentgen resident/fellow research award
Michael D. Hasselle, MDUniversity of Chicago
Meredith L. Hayes, MD, MSMayo Clinic-Rochester
Robert G. Hayter, MDHospital of Saint Raphael
Jeremy J. Heit, MD, PhDMassachusetts General Hospital
Mack P. Hendrix, MDMedical College of Virginia/VCU
Kristin Higgins, MDDuke University Medical Center
David Hirschl, MDMontefiore Medical Center
Nickoleta Hoefling, MDUniversity of Michigan
Anastasia Hryhorczuk, MDChildren’s Hospital-Boston
Albert Hsiao MD, PhDStanford University
Zain Husain, MDUniversity of Maryland Medical Center
Benjamin Hyman, MDTexas A&M HSC COM Scott & White Hospital
Joseph Ippolito, MD, PhDMallinckrodt Institute of Radiology
Jason N. Itri, MD, PhDUniversity of Pennsylvania Hospital
Paul M. Jaffray, MDUniversity of Massachusetts Medical School
Ramin Javan, MDBaptist Memorial Hospital
Alisa Johnson, MDUniversity of Vermont/Fletcher Allen Health Care
Bhishak Kamat, MDCooper University Hospital
Aaron P. Kamer, MDIndiana University School of Medicine
Alisa Kanfi, MDHartford Hospital
Mohammad K. Khan, MD, PhDCleveland Clinic
Rachel Anne Lagos, DOWest Virginia University
David Lee, MDWilliam Beaumont Hospital
Joanne S. Lee, MDAlbert Einstein Medical Center
Stefanie Lee, MDThe University of Western Ontario
Forrester D. Lensing, MDBaylor University Medical Center at Dallas
Marie-Hélène Lévesque, MDUniversity Laval
Ruby J. Lien, MDSt. Luke’s-Roosevelt Hospital Center
Dorota Linda, MDMcMaster University
Heng-Hsiao E. Liu, MDThe University of Texas Medical School at Houston
Yuxin Li, MD, PhDVA Greater Los Angeles Healthcare System
Chikaodili I. Logie, MDUniversity of Maryland Medical Center
George Emmett Lynskey, MDBeth Israel Medical Center
Daniel J. Ma, MDWashington University School of Medicine
Anton Mahne, MDBryn Mawr Hospital
Richard H. Marshall Jr., MDOchsner Clinic Foundation
Heath McCullough, MDWake Forest Baptist Health
Scott McNally, MD, PhDUniversity of Utah
Jeet Minocha, MDNorthwestern University
Monika Misra, MDJacobi Medical Center
Lex Mitchell, MDTripler Army Medical Center
Anoushiravan Montaserkoohsari, MDAultman Hospital
Benjamin Mou, BSc, MDCancerCare Manitoba
Waleed Fouad Mourad MD, MScUniversity Of Mississippi Medical Center
Kambiz Nael, MDDavid Geffen School of Medicine at UCLA
Xuan V. Nguyen, MDUniversity of Kentucky
Brandon W. Nichols, MDUniversity of South Alabama
Josef R. Noga, MDEastern Virginia Medical School
Krisha J. Opfermann, MDMedical University of South Carolina
Hansel J. Otero, MDTufts Medical Center
Christopher A. Parham, MD, PhDUniversity of North Carolina School of Medicine
Biraj M. Patel, MDUniversity of Cincinnati
Jay Patel, MDEmory University
Parul Patel, MDUniversity of Rochester
Sohil H. Patel, MDNYU School of Medicine
Peter Paximadis, MDWayne State University
Ben E. Paxton, MDDuke University Medical Center
Paul Gabriel Peterson, MDNational Capital Consortium
roentgen resident/fellow research award
Monika Misra, MD, Recipient (middle), with Jill Leibman, MD (left) and Melvin Zelefsky, MD, Department Chair
43RSNA.org/Foundation
44 r&[email protected] r&[email protected]
Jake Pirkle, MDUniversity of Tennessee Medical Center
Benjamin E. Plotkin, MDLos Angeles County-Harbor-UCLA Medical Center
Ryan Alexander Priest, MDOregon Health & Science University
M. Reza Rajebi, MDUpstate Medical University
Anand Dorai Raju, MDLe Bonheur Children’s Hospital- University of Tennessee Health Science Center
Taruna Ralhan, MDSt. Joseph’s Hospital and Medical Center
Vinay Ravi, MDDartmouth-Hitchcock Medical Center
Sapna Rawal, MDMcGill University
Amar Rewari, MD, MBACancer Institute of New Jersey/UMDNJ
Jared R. Robbins, MDHenry Ford Health System
Nicholas Roman, MD, PhDVirginia Commonwealth University
Paul Saconn, MDWake Forest University Baptist Medical Center
Parmbir Singh Sandhu, MDUniversity of California, Davis
Jorge Luis Sarmiento, MDTexas Tech University Health Sciences Center, Paul L. Foster School of Medicine
Ambreen Sattar, MDDetroit Medical Center/Wayne State University
Jacob Scott, MDMoffitt Cancer Center
Fabio Settecase, MDUniversity of California San Francisco
Salman S. Shah, MDMount Sinai School of Medicine
Mohammed Bilal Shaikh, MDSUNY-Stony Brook University
Richard E. Sharpe Jr., MD, MBAThomas Jefferson University Hospital
Joseph Shelton, MDEmory University
Sindu Sheth, MDUniversity of Southern California
Nasir Siddiqui, MDUniversity of Pittsburgh Medical Center
Charles B. Simone II, MDNational Cancer Institute, National Capital Consortium, Bethesda
Heath Skinner, MD, PhDMD Anderson Cancer Center
John G. Stewart, MDUniversity of Alabama at Birmingham
Teerath Peter Tanpitukpongse, MDWinthrop University Hospital
Ajay Tejwani, MDNew York Methodist Hospital
Vincent Timpone, MDDavid Grant USAF Medical Center
Mitesh Trivedi, MDChristiana Care Health System
Venu Vadlamudi, MDMSU Flint Area Medical Education
Vladimir Valakh, MDAllegheny General Hospital
Kalyani Vallurupalli, MDSIU School of Medicine
Artur Velcani, MDSt. Vincent’s Medical Center
Franco Verde, MDGeisinger Medical Center
Nicholas L. Walle, MDRhode Island Hospital Brown Medical School
Danny Wang, MDAlbany Medical Center
Tony J. Wang, MDColumbia University Medical Center
Rodney Wegner, MDUniversity of Pittsburgh Medical CenterRadiation Oncology
Terence Williams, MD, PhDUniversity of Michigan Health Systems
Onalisa Winblad, MDUniversity of Kansas Medical Center
Michal Wolski, MDUniversity of Texas Medical Branch at Galveston
Joseph H. Yacoub, MDUniversity of Chicago
Hooman Yarmohammadi, MDUniversity Hospitals Case Medical Center
Takeshi Yokoo, MD, PhDUniversity of California San Diego
Jennifer Young, MDMemorial University
Jennifer Yu, MD, PhDUniversity of California San Francisco
Jing Zeng, MDJohns Hopkins School of Medicine
Joseph Zikria, MDLenox Hill Hospital
Xavier Garcia-Rojas, MD, Recipient, with Rajeev Suri, MD, Program Director
roentgen resident/fellow research award
the RSNA Research & Education Foundation has enabled
the brightest minds in radiology and related sciences to
discover new methods to fight disease, devise sophisticated
new technologies, improve the patient care process and
cultivate the workforce of the future.
For more information or to apply
for a grant, please contact:
Scott Walter
630-571-7816
Diane Georgelos
630-590-7789
Since 1984
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.
Bright Ideas Get Funded
2011rsna grants and awards
RSNA Research & Education Foundation
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RSNA.org/Foundation