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Cai Research Group Update: SNMMI and RSNA Annual Meetings

The Molecular Imaging and Nanotechnology Laboratory (mi.wisc.edu) had another successful year at the Society of Nuclear Medicine and Molecular Imaging (SNMMI) Annual Meeting in San Diego this past June. They received multiple awards, including two Cai Group members, Christopher G. England and Shreya Goel, receiving Travel Awards to attend the meeting. There were only 15 Travel Awards given this year (another awardee from UW-Madison was Hector Valdovinos, a graduate student in Medical Physics). In addition, Reinier Hernandez and Sixiang Shi also each received a UW-Madison Conference Presentation Funds Student Research Travel Grant to attend the meeting. There are many Young Investigator Award (YIA) Symposiums at the SNMMI Annual Meeting, where the highest-scored abstracts were chosen to compete in the symposium. Three of the Cai Group abstracts were chosen to compete in three different YIA Symposiums, and Christopher G. England received a 1st place in the Cardiovascular Council YIA Symposium. At the meeting, the Chinese American Society of Nuclear Medicine and Molecular Imaging (CASNMMI) had a competition for a Young Scientist Award, and a former Cai Group postdoc Haiming Luo, now a postdoc at Harvard Medical School/Massachusetts General Hospital, received the 2nd place prize for his work performed in the Cai Laboratory. Sixiang Shi and Haiming Luo both received the SNMMI Alavi-Mandell Award for their 2015 publications in the Journal of Nuclear Medicine, official journal of SNMMI. At the SNMMI Annual Meeting there are several summary sessions and highlight lectures where leaders in the field summarize the best abstracts presented at the Annual Meeting. Many of the Cai Group abstracts were presented in the highlight lecture, which covers a diverse scope of research areas including oncology, cardiovascular diseases, and diabetes. Additionally, Professor Cai himself co-organized and co-moderated four Continuing Education sessions, all of which were well attended.

Four Cai Group Members Receive RSNA Travel Awards

Four members of the Cai Research Group attended the 2016 Radiological Society of North America (RSNA) annual meeting in November and each received an award. Dawei Jiang, Shreya Goel, and Emily Ehlerding each received an RSNA Travel Award. Of all the young investigators who have been invited to share their work at the meeting, the top 400 have been offered the award. Christopher England received a Travel Award to attend RSNA from Novus Biologicals, LLC, Colorado. In addition, he was selected to the Introduction to Academic Radiology for Scientists (ITARSc) Program at RSNA 2016.

Dr. Kanne Selected as First ACR Choosing Wisely Champion

Dr. Jeffrey Kanne has been selected by the American College of Radiology (ACR) as the first Champion in the American Board of Internal Medicine’s Choosing Wisely Champions program. This award is part of a nationwide initiative by the Choosing Wisely program to recognize physicians who are reducing unnecessary medical tests and procedures in their medical practice. In his time at UW, Dr. Kanne has focused on reducing unneeded radiographs through efforts such as working with specialists in other departments and promoting the use of the ACR Appropriateness Criteria, several of which he helped to create. Read more about Dr. Kanne’s award at the American College of Radiology

Dr. JP Yu Wins NARSAD Young Investigator Grant

Dr. JP Yu has received a 2016 NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation. This foundation, formerly known as the National Alliance for Research on Schizophrenia and Depression (NARSAD), awards grants to individuals whose research they believe could help alleviate suffering caused by mental illness. This past year, the Brain & Behavior Research Foundation awarded nearly $13.7 million in support of the Young Investigator Program to support the work of promising young scientists with innovative ideas in mental health research. Dr. Yu’s project, funded under the New Technologies grant category, is entitled "Diffusion Tensor Imaging and Behavior Correlates in a Disc1 Model of Schizophrenia" and utilizes a new genetic rat model of schizophrenia that Dr. Yu developed here at the University of Wisconsin-Madison. Since the initial discovery of Disc1 almost 15 years ago, numerous studies have uncovered compelling evidence that the biological pathways involving Disc1and its protein network play pivotal roles in the pathologies relevant to schizophrenia, autism, and mood disorders. A leading motivation for studying Disc1 is to ultimately develop more effective therapeutic interventions than those that are currently available. While the Disc1 protein itself might not be a viable drug target, understanding the molecular pathways that Disc1mediates has already begun to uncover new pathways and targets that are responsive to pharmacologic intervention. Dr. Yu’s lab, with their new Disc1 knockout model, aims to unpack the neuroimaging and behavioral features of Disc1 to better understand its contribution in the neuropsychopathogenesis of schizophrenia and to establish a platform to explore pharmacologic interventions which may ameliorate a major mental illness.

Dr. Reeder 2011 Paper Most-Cited in JMRI

Dr. Scott Reeder, professor in the Department of Radiology, is the author of the top-cited paper published in the Journal of Magnetic Resonance Imaging (JMRI) between the years 2011 and 2014. His paper, “Quantitative Assessment of Liver Fat with Magnetic Resonance Imaging and Spectroscopy,” deals with non-invasive techniques for accurately and objectively quantifying liver fat, particularly relating to nonalcoholic fatty liver disease. The paper first appeared in the October 2011 edition of JMRI and to date has been cited 334 times. Fatty liver disease affects an estimated 80 million people in the US and the current gold standard of detection is a liver biopsy which carries certain risks. Reeder’s paper goes over non-invasive techniques of measuring liver fat using ultrasound and CT and important limitations of those methods before detailing the possibilities MR imaging presents in detecting liver fat content. This paper has played an important role quantitatively analyzing imaging methods and techniques which have the potential to fill a considerable clinical need. The full paper can be accessed at NCBI.  

Dr. Christiane Burton Receives Silvia Fedoruk Prize

Dr. Christiane Burton, a research associate with the CT Protocol Optimization Team, was recently awarded the Silvia Fedoruk prize at the Canadian Organization of Medical Physics 63rd annual scientific meeting. The Silvia Fedoruk prize is awarded to the best paper on a subject in the field of medical physics relating to work carried out mainly within a Canadian institution. Burton conducted her research at the Robarts Research Institute at Western University in London, Ontario, Canada. The paper looked at energy subtraction angiography (ESA), an imaging method worked on in the 1980s at the University of Wisconsin with image quality considered poor relative to that of digital subtraction angiography (DSA), the reference standard in angiography. Burton specifically tried to determine if it was a technical or physical limitation that had initially hampered ESA and if that limitation could be overcome in a modern clinical environment. In an initial test, she found that ESA produced images of quantitatively similar quality to DSA, a contradiction of numerous previous studies. Following further investigation it was determined that scatter and detector electronic noise needed to be very low in order for energy subtraction angiography to produce images comparable to DSA, conditions not achievable in the past and difficult, though not impossible, to achieve at present. All of this suggests that ESA methods could offer a viable alternative to DSA when implemented under optimal conditions. Burton also presented on this topic at the American Association of Physicists in Medicine annual conference in 2016, receiving a 3rd place award. The group is a strong contender to receive an NIH grant this year to continue their ESA work. Burton, who is currently volunteering with medical physics at University Hospital, will be taking part in the imaging committee at the Canadian Organization of Medical Physicists next year and hopes to serve as the postdoctoral representative on the Committee on Women in the University at UW–Madison. More information about the Sylvia Fedoruk award can be found at the Canadian Organization of Medical Physicists website.

Dr. JP Yu Named 2017 KL2 Scholar

Congratulations to Dr. JP Yu, who has been named one of the 2017 KL2 Scholars through the UW Institute for Clinical and Translational Research (ICTR). The KL2 Scholars Program is a four-year career development program for training and supporting junior faculty from diverse backgrounds and disciplines who are actively engaged in translational research and provides junior faculty the opportunity to develop an independent research program. Dr. Yu is one of four scholars selected this year from across the UW–Madison campus and will participate in career development workshops, train in core translational research competencies, and benefit from protected research time and individualized mentorship. The Integrative Neuroimaging Systems Laboratory directed by Dr. Yu is a systems neuroimaging laboratory focused on the neuroimaging of schizophrenia, autism spectrum disorder (ASD), and other closely related neuropsychiatric diseases. Utilizing unique genetic models of both schizophrenia and ASD, Dr. Yu’s lab explores the impact of genetic mutations on global measures of neural structure and connectivity. Further recognizing the role of the environment in shaping both neural structure and behavior, Dr. Yu’s lab also investigates how environmental factors such as the gut microbiome, aerobic exercise, and stress can further influence brain structure. His mentors for the KL2 program are Elizabeth Meyerand, a professor in the Departments of Medical Physics and Biomedical Engineering, and Dr. Vaishali Bakshi, an associate professor in the Department of Psychiatry.

Dr. David Bluemke at SCCT 2017

Dr. David Bluemke, visiting professor in the Department of Radiology and incoming editor of the journal Radiology, presented at the Society of Cardiovascular Computed Tomography annual meeting earlier last month. Bluemke gave two lectures at the conference on the topic of new and emerging CT technology. The first, “Emerging Technology That Will Soon Change how Cardiovascular CT is Practiced,” dealt with both the potential that machine learning algorithms have for replacing manual analysis of CT scans of the heart as well as the introduction of new CT scanners able to evaluate the entire body quickly enough to image the heart without cardiac gating. The presentation also looked at ways that dual energy or spectral CT can create a more comprehensive CT examination that can characterize myocardial infarct in a way previously only available with MRI. The second presentation was titled “Photon-Counting CT” and covered a new generation of CT scanners which have the ability to produce spatial resolution double that of conventional CT scanners. These photon-counting scanners remove several steps in the process of converting x-rays into a digital image which reduces image noise, using technology initially created for use in particle detectors at the European Organization for Nuclear Research (CERN). These scanners operate with a radiation dose 30-40% less than that of current CT scans and allow for spectral/multi-energy CT to always be available. Dr. Bluemke’s experience with photon-counting detectors dates back to his time at the National Institutes of Health where their Clinical Center investigated prototype technology early in 2016. Following his presentations Dr. Bluemke was interviewed by Dave Fornell, the editor of Diagnostic and Interventional Cardiology. The interview covered some of the content in Bluemke’s two lectures and is available at the Diagnostic and Interventional Cardiology website.

Dr. Cho Receives WMIC Best Clinical Paper Award

The World Molecular Imaging Congress has awarded Steve Y. Cho, MD, the 2017 Best Clinical Paper award for his paper published last year on a new PSMA-targeted PET radiotracer. The paper was published in Molecular Imaging and Biology and titled, “PSMA-Based [18F]DCFPyL PET/CT Is Superior to Conventional Imaging for Lesion Detection in Patients with Metastatic Prostate Cancer.” Conventional imaging modalities such as CT and bone scan are limited in their detection of metastatic prostate cancer. This paper evaluates the ability of a novel second-generation (PSMA)-targeted PET radiotracer called [18F]DCFPyL in detecting metastatic prostate cancer. The study was conducted at Johns Hopkins University where Dr. Cho was a faculty member before his move to UW-Madison, with analysis done by Dr. Cho and his former resident, Dr. Steven Rowe, during Cho’s time at UW. The imaging agent 18F-DCFPyl was developed by Cho’s former mentor and colleague, Dr. Martin Pomper. Dr. Cho’s study compared the findings of conventional imaging modalities and [18F]DCFPyL PET used in the same patients. The study shows strong preliminary evidence for the effectiveness of this particular radiotracer in detecting metastatic prostate cancer and speaks to the value of PSMA-targeted PET imaging for detecting prostate cancer.

Dr. Pickhardt Receives Multi-Million Dollar NIH Grant

Perry Pickhardt, MD, professor in the Department of Radiology and Chief of Gastrointestinal Imaging, recently secured a multi-institutional multi-million dollar NIH R01 grant to continue his colorectal cancer and CT colonography work for the next five years. The prestigious National Institutes of Health Research Project (R01) grants are a testament to the impact and quality of Pickhardt’s work. The aim of the project is to gain insight into what dictates the progression of certain colorectal polyps into colorectal cancer. Almost all colorectal cancers develop from adenomas or serrated polyps. These polyps affect 30-50% of the adult population but only develop into cancer in 6-7% of people by the age of 80. The molecular mechanisms that determine which polyps become cancerous is virtually unknown. The principal investigators on the grant, in addition to Pickhardt, are Dr. Richard Halberg of the University of Wisconsin and Dr. William Grady of the University of Washington. The project also involves Drs. Kristina Matkowskyj and Irene Ong from the University of Wisconsin, Dr. Jerome Liang of the Stony Brook School of Medicine, and Dr. Mary Redman from the Fred Hutchinson Cancer Research Center. Pickhardt and colleagues will use a large series of human colorectal polyps whose growth patterns have been assessed over time using CT colonography. The growth patterns and other characteristics of the polyps such as textural analysis will be correlated with results from exome sequencing, gene expression studies, and high-density methylation arrays. All of this will be used to try to determine if the state of the colorectal polyp at formation dictates whether it is benign or premalignant. The resulting findings should help in identifying risk in certain individuals as well as making colorectal cancer more preventable in the larger population.

Advances in Imaging: 3D Digital Breast Tomosynthesis

For nearly 50 years, mammography has been the gold standard for breast imaging. This routine test has proved to be simple, inexpensive, and readily available across the world. However, that may change in the near future when more results are in on the newest technology, 3D digital breast tomosynthesis, which is currently available in all eight of UW Health’s breast imaging locations. Tomosynthesis is showing great promise to become widely recognized as an overall better imaging tool. “More studies are showing us that tomosynthesis improves our ability to see cancer over standard mammography,” said Mai Elezaby, MD, assistant professor in the UW School of Medicine and Public Health Department of Radiology’s Breast Imaging Section. With the near-three-dimensional imagery it provides, radiologists have more nuanced imaging available to review and make diagnoses. The technology used to image breast tissue to detect cancers has made great advances since the 1970s, when screen film mammography was the detection mode of choice for breast cancer. Standard mammography is a two-dimensional technology that primarily outlines the edges of the tissue. Since then, advancements in technology presented us with digital imaging, which improved on the earlier film-based mammography, making it possible to diagnose cancer in younger patients and patients with dense breast tissue. “What’s certain is that data from numerous studies since the beginning of mammography in the 1970s support that screening with standard mammography detects breast cancers when they are small enough to provide the best results with treatment,” Elezaby said. However, standard mammography (2D) is not perfect. Sometimes standard mammography does not detect all cancers, giving false negatives. The most recent improvement in this technology is digital breast tomosynthesis, also known as 3D mammography. “Tomosynthesis gives us the ability to look through the breast in multiple layers,” Elezaby said. “Studies have shown that this new way of imaging improves the ability to see cancers and in particular, better see cancers that matter more,” Elezaby continued. “Overall, it has improved our performance of making the diagnosis of invasive cancer by 40%.” In addition to helping radiologists to better see and diagnose cancers, tomosynthesis has had additional diagnostic benefits. “When we use a standard 2D mammogram, if we would see something of concern in their imaging, we would call patients back to clinic for further testing, whether it be more imaging or even biopsies where a big proportion end up being false-positive benign disease,” Elezaby said. “With 3D tomosynthesis, we have seen about a 17% drop in false-positive recalls and unnecessary imaging.” Tomosynthesis is as safe as a mammogram, delivering superior imaging with the same amount of radiation exposure. The main difference is that with tomosynthesis, the radiation is split to enable multiple views from more angles, making it more efficient. “As a research institution, we look for information to prove one diagnostic procedure is better than another,” Elezaby said. “More studies are looking into the long term benefit of 3D tomosynthesis over standard mammography. We are eagerly looking forward to the results of these studies , but all indications say 3D tomosynthesis will improve upon the performance of the standard mammogram.” Not all health care providers and insurance companies are on board yet with this new technology. “It is our hope across UW Health that more and more caregivers continue to embrace tomosynthesis,” Elezaby continued. “And likewise, that insurance companies step up their coverage. At this point, it is covered 100% by Medicare, but not all insurance companies will cover it,” she added. Breast Imaging Section Chief Elizabeth Burnside, MD, also sees the value of this new technology. “UW Health is dedicated to enhancing the patient health experience as we strive to improve outcomes ,” she said, “3D tomosynthesis enables radiologists to avoid false alarms without sacrificing early and accurate breast cancer diagnoses.” 3D tomosynthesis is available at all UW Health breast imaging locations and is becoming more frequently recognized as a first-line screening tool for breast cancers. Patients can ask their primary care doctor to have their next breast exam using digital breast tomosynthesis.