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Imaging Partnerships Inside and Out

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UH Research & Education Update | November 2022

The Magnetic Resonance Imaging (MRI) research team in the Department of Radiology at University Hospitals and Case Western Reserve University has a long history of success in basic science and clinical research. Despite the pandemic, the team and research continue to grow exponentially. Since 2021, the group has received more than $38M in extramural funding, including seven R01s, three foundation grants, one UK grant, a leading role in a major SPARC/CMS contract grant, a Hartwell fellowship award, and numerous pilot grant awards.

The MRI research team has also significantly expanded from three to thirteen faculty members over the past few years. The multidisciplinary group is now comprised of seven physicists and engineers (Yong Chen, Chris Flask, Mark Griswold, Daniel Herzka, Dan Ma, Xin Yu, Debra McGivney) and six physician-scientists (Chaitra Badve, Leonardo Bittencourt, Ari Blitz, Amit Gupta, Holly Marshall, Sree Tirumani).

So what makes this team so successful? What does the group do differently by creating a dynamic team that transforms basic scientific discovery into clinical application / impact and delivers impressive academic achievements?

MRI UH CWRU Research TeamMRI Research Team: Row 1 Chaitra Badve, Leonardo Kayat Bittencourt, Ari Blitz, Yong Chen, Chris Flask. Row 2: Mark Griswold, Amit Gupta, Daniel Herzka, Dan Ma. Row 3: Holly Marshall, Debra McGivney, Donna Plecha, Sree Tirumani, Xin Yi.

Partnership: Team-Science

Chris Flask, PhD finds partnership as the key to this group’s success. "Our active partnership approach is not merely an MD having a clinical thought, sending it to a PhD, and then having them go back and forth. What we have in our MRI research group is the ability to establish true long-term partnerships where we have the PhD scientists work alongside the MDs in a mutually invested way; this makes the difference."

Dr. Leonardo Bittencourt compares the relationship to symbiosis. "Having two living beings live together sharing the same organism, and one produces thing that feeds the other. Although they can live individually, being together is much more profitable and interesting than living in isolation. This is how our team works."

The strong relationships between the radiologists, scientists, engineers and physicists allow the team to work together to design, create, and rapidly implement new innovative imaging methods that directly address important clinical needs and introduce practical solutions for emergent clinical questions.

“There is seamless flow of ideas between the group members without silos. This environment allowed me to pitch my research ideas by taking advantage of the already established strong MR research platform," says Sree Tirumani, MD.

For example, based on the collaboration between Dr. Tirumani, an experienced body radiologist, and Dr. Chen, an assistant professor at the School of Medicine, the team was recently awarded a new NIH R01 grant to develop kidney MR fingerprinting techniques to improve care for patients with renal cell carcinoma. The grant proposal was well received at the NIH study section and utilizes Dr. Chen’s cutting-edge imaging capabilities with to address a critical clinical question based on Dr. Tirumani’s clinical practice. Dr. Tirumani added, “While I knew the clinical question, my multidisciplinary collaboration with Yong Chen provided a comprehensive solution to the question. The result was two pilot grants funded by Society for Abdominal Radiology (SAR) and RSNA. The SAR pilot grant data partly helped get the NIH RO1.”

Partnership: Mentor-Mentee

The team's primary focus is a team-first mindset rather than individual achievement. The senior team members, Drs. Griswold, Flask, and Yu continue to engage and support the junior faculty to help them establish independent research areas and to refine grant proposals and publications. Genuine leadership and mentorship are essential in cultivating an inspirational research environment for young investigators. "This team's success would only occur if leadership takes the time to invest in each individual, letting them know that we as a group will support them in any way that we possibly can. This approach allows the earlier career scientists and clinicians to confidently attack their research programs." Dr. Flask added, "And when it does work as it is right now, it is extremely gratifying as a senior group member to witness all of these early career faculty become highly successful superstars in the field."

Dr. Bittencourt stated, “One thing that excited me the most about joining this group is that I would have the opportunity to work with experts with international reputations and giants in the field. These are colleagues whose publications I have been reading for a long time. Now they can bring our clinical ideas to life, and this experience has been very rewarding.”

Partnership: Industry

Partnership inside and out is crucial to this team’s success. Their long-standing research collaboration with Siemens MRI provides the team with dedicated research access to state-of-art clinical MRI systems, so that new ideas can be rapidly tested on the research MRI scanners followed by implementations in patients that can most benefit from the new technology.

Dr. Flask commented, “These critical research infrastructures supported by Siemens as well as our own institutions has allowed the translational MRI research programs to continue research efforts and thrive during the pandemic. For example, University Hospitals and Seidman Cancer Center supported the installation of a second research MRI scanner in 2020.  As a result, while many other MRI research groups around the world were completely shut down for months, our team continued to operate and innovate throughout the pandemic. These important studies involved the recruiting of many different patient groups including children with rare genetic diseases. The incredible grant success that we are seeing now is directly supported by our ability to continue to scan throughout the pandemic.”

Future

As for the future, the team will continue to grow and recruit more scientists and clinicians to expand research projects. The team plans to identify new strategic investment opportunities, including integrating radionuclide and MR technologies, involvement of Artificial Intelligence into clinical workflows, PET MRI fingerprinting capabilities, and brain studies in children with demyelinating diseases. At the same, the group led by Drs. Griswold, Badve, Ma, and Bittencourt are currently engaged in a process to disseminate these innovative MRI capabilities throughout the hospital system providing greater access to more patients.

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