UW Hosts IWPFI, Brings Together a World of Lung Imaging

Posted on September 2013

The 6th International Workshop for Pulmonary Functional Imaging (IWPFI) was held in Madison, WI July 18-20, 2013. Participants of the conference traveled to Wisconsin from an array of countries, including South Korea, Japan, Australia, England, Scotland, the Netherlands, Germany, India, and the United States.

The conference opened with welcoming remarks by Mark Schiebler, M.D., President of the 6th IWPF, Thomas Grist, M.D., Department Chair, Paul Deluca, Ph.D., UW Provost, and Hans-Ulrich Kauczor, M.D., IWPFI Chairman of the Board before launching into three full days of lectures in two locations – the Madison Concourse Hotel and the Health Sciences Learning Center. Provost DeLuca engaged a discussion about the status of UW-Madison as a major research institution in the United States.

The plenary session was opened by Hiroto Hatabu, M.D., Ph.D., founder of the IWPFI and a leading teacher of pulmonary functional imaging. His talk highlighted the twelve unsolved issues in functional pulmonary imaging. The specific issues that were discussed included the role of hyperpolarized gases in ventilation and how Xenon may be used clinically to determine segmental diffusion in the lung parenchyma.

In subsequent sessions, several leaders in the field of lung imaging spoke on varying subjects. Eric Hoffman, Ph.D. discussed the quantification of lung CT in emphysema and asthma. Yoshiharu Ohno, M.D., Ph.D. spoke about pulmonary quantification in MRI. Christopher François, M.D., Chief of Cardiovascular Imaging, showed his work on 4D flow MR imaging in the heart. He showed how using 4D flow imaging, with color-coded stream lines, right heart failure can be observed with more helical flow patterns in the ventricle and main pulmonary artery.

Christopher Meyer, M.D., reviewed the current knowledge of radiation induced lung fibrosis. Daisy Chen, M.D. presented her work on the use of CT/PET for early lung inflammation in human volunteers. Scott Nagle, M.D., Ph.D., chaired an outstanding session including world leaders in cystic fibrosis imaging as featured speakers, including Alan Brody, M.D., Harm Tiddens, M.D., PhD, Michael Puderbach, M.D., Talissa Altes, M.D., and Paul Guillerman, M.D.

The second day of the workshop, organized by Robert Jeraj, Ph.D., was dedicated to lung cancer imaging and radiation therapy. This featured Ken Krohn, Ph.D ., from the University of Washington, discussing the molecular imaging of hypoxia and proliferation. Robert Gilles, Ph.D. from Moffitt Cancer Center in Tampa presented his novel work using radionomics for the early classification of malignant lung nodules. Radionomics combines CT imaging features and correlates the growth rate and margin of these nodules, imaging phenotype, to the genotype of the resected specimen.

The afternoon session dealt with the problems of radiation therapy in the lung and how to deal with cardiac and lung motion. Paul Keall, Ph.D., from Sydney, Australia presented his group’s novel algorithm for the predication of respiratory and cardiac motion and limiting the exposure of normal lung tissue. Søren Bentzen, Ph.D., of UW’s Human Oncology program discussed the clinical features of radiation toxicity to the lung, while John Bayouth, M.D., discussed the practical techniques of radiation treatment planning to avoid pulmonary toxicity.

Larry Marks, M.D., Chair of Radiation Therapy at the University of North Carolina, gave an inspired lecture on the prediction of pulmonary injury after radiation therapy. UW Radiology’s own J. Louis Hinshaw, M.D., Chief of Abdominal Imaging, gave an excellent overview of the methods for percutaneous lung cancer ablation. The implementation of novel reconstruction methods for Low dose CT using PICCS was ably discussed by its inventor, Guanghong Chen, Ph.D., of UW’s Radiology and Medical Physics Departments.

The last day of the conference was split into two parallel sessions. The QIBA session chaired by David Lynch, MBBS, of National Jewish Medical Center in Denver, along with Phil Judy, Ph.D., of Harvard, discussed the methods needed for the quantification of CT Images in the future. The second parallel session was organized by Christopher François, M.D., and David Levin, M.D., Ph.D., of the Mayo Clinic that highlighted the right heart in pulmonary hypertension and a discussion of thromboembolic disease.

Joon Beom Seo, M.D. of Asan Hospital in Seoul Korea presented his group’s data on the use of dual-energy CT in the diagnosis of perfusion defects in patients with pulmonary emboli. They found that the absolute drop in lung perfusion, as measured by a drop in whole lung enhancement, was the most important feature of severity correlating best with patient outcome. Additionally, Jim Runo, M.D., of UW’s Department of Medicine Pulmonary Section presented the clinical aspects of pulmonary arterial hypertension treatment. Dr. Mark Schiebler, President and Scientific Program Director of the IWPFI, presented the UW experience with MR angiography for the diagnosis of pulmonary embolism.

The afternoon of the last day of the IWPFI was organized by Dr. Sean Fain of the UW Department of Medical Physics and Warren Gefter, M.D., of the University of Pennsylvania. The asthma session was an apt leadoff with an excellent lecture given by Nizar Jarjour, M.D., Professor and Chief of Pulmonary Medicine, the lead investigator of the Severe Asthma Research Project.

The Chronic Obstructive Pulmonary Disease (COPD) session was enlightening as well, helping to shed light on this difficult-to-treat disease. Dr. Keith Meyer, M.D., Professor of Medicine at UW in pulmonary and critical care shared his experiences in treating and diagnosing this profoundly debilitating disease. This session was highlighted by a panel discussion that included a the world experts in COPD CT imaging, including Drs. Hatabu, Lynch, Newell, Gefter, Seo, and Meyer, who tried to reach a consensus on whether or not all of the imaging metrics that we come up with are in any way meaningful for treatment and prognosis.

The organizers of the 6th IWPFI conference welcomed all interested scientists and students to participate in the discussion of lung cancer, pulmonary function, right heart and pulmonary artery physiology, cystic fibrosis, and COPD. Participants appreciated the excellent collection of well-known experts who provided the audience with a comprehensive overview of the field, as well as cutting-edge research.

The opportunities for learning and active dialogue that occurred between the various specialties were perhaps the highlight of the 6th IWPFI conference. The next meeting will be in Edinburgh, Scotland in September of 2015 and will be organized by Edwin Van Beek, M.D., PhD. This meeting will be paired with the European Society for Magnetic Resonance in Medicine and Biology (ESRMB).

This story was contributed by Dr. Schiebler.