Erica Knavel Koepsel Creates iMRI Program

Posted on October 2022

Erica Knavel Koepsel, MD is no stranger to innovation in the field of interventional radiology at UW-Madison. She has been a Badger since medical school, where she was mentored by Fred Lee, MD, a nationwide leader in ablation. Through his mentorship, Dr. Knavel Koepsel gained an interest in Radiology. She went on to complete her Diagnostic Radiology Residency, even becoming Chief Resident, then pursued a fellowship in Interventional and Vascular Radiology, all at the University of Wisconsin. After her fellowship, she spent nearly four years as faculty/staff at Mayo Clinic in Rochester, Minnesota, where her experience in ablation at UW led her to work with David Woodrum, MD, PhD, who taught her different procedures using MR guidance. Dr. Knavel Koepsel proposed creating a similar program that focused on MR-guided procedures here at UW when she joined the faculty as an Assistant Professor in the Interventional Radiology section in 2021. 

Dr. Thomas Grist was very interested in exploring new innovative techniques using MRI to expand patient care at UW, so he was really supportive of me starting this program,” Dr. Knavel Koepsel added. 

Since becoming a UW-Madison faculty, Dr. Knavel Koepsel has been hard at work to jumpstart this new medical program, which is no easy feat. She forged relationships with cross-disciplinary partners, including Tudor Borza, MD, MS and David F. Jarrard, MD, from the Department of Urology, who connect her to qualified patients with prostate cancer that could be treated with cyro ablation. She further credits the rest of her team, Nurses Marci Alexander and Andrea Teske, MRI Techs Thomas McKinlay and Joseph Tran, Scientists Karl Vigen, PhD, Wally Block, PhD, and Tom Lilieholm and Radiology Manager Kristi Klein for making this program possible. Dr. Knavel Koepsel is collaborating with Professor Wally Block, PhD and graduate student Tom Lilieholm to develop custom software to guide placement of the ablation probes during prostate ablation and biopsy procedures. 

She adds, “There are added challenges with building an MRI-guided program like this, for example, there is limited MRI safe or MRI conditional equipment and the team must be trained and disciplined in MR safety in order to bring patients safely into the room.”

Dr. Knavel Koepsel and her team have already started treating patients, and so far, have completed two prostate cryoablations and four prostate biopsies. But the work does not stop there, she has been presenting on MRI guided treatment of vascular malformation treatments with her Mayo team at the Radiological Society of North America, iMRI, and ISSVA annual conferences, and was published in RadioGraphics. MRI guided cryo- and laser ablation of vascular malformations is an additional service line that Dr. Knavel Koepsel hopes to add to the iMRI practice. 

Dr. Knavel Koepsel would like to have trainees participate in the iMRI practice to gain exposure to these procedures since so few sites in the United States offer them. She states, “There are 11 MRI-Safe cryoablation devices in the United States, we have two of them in Madison – one at the VA and one at University Hospital. From our estimates, there are six other sites in the country that do these types of procedures.” 

We can’t wait to see how this program grows under Dr. Knavel Koepsel’s leadership!