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$5.5M Alzheimer's Disease Connectome Grant from NIH

NIH awarded a prestigious four-year Alzheimer's Disease Connectome Grant of ~$5.5 million to a collaborative team headed by Dr. Shijiang Li, PhD, Department of Biophysics at Medical College of Wisconsin, and Drs. Barbara Bendlin, PhD, Department of Medicine and Vivek Prabhakaran, MD, PhD, Department of Radiology at the University of Wisconsin School of Medicine and Public Health (SMPH). Read the full story at SMPH News.

Three Radiology Researchers Earn RSNA Travel Awards

Congratulations to Abdominal Imaging Fellow Dr. Elizabeth Maddox, Radiology Resident Dr. B. Dustin Pooler, and second year medical student Kyle Malecki on winning 2016 Radiological Society of North America (RSNA) Student Travel Awards for young investigators!

Dr. Maddox's electronic scientific presentation titled "Ultrasound (US) of Indeterminate Adnexal Cysts: Incidence of Ovarian Cancer" will be presented at the RSNA 2016 Annual Meeting in Chicago, IL, on Monday, November 28 at 12:15 p.m. This work is part of an ongoing project with her co-fellow, Ashley Cahoon, MD, and her mentors, Drs. Elizabeth Sadowski and Jessica Robbins. The goals of their research are to evaluate the outcomes of sonographically indeterminate adnexal lesions and determine what role MRI plays in guiding clinicians in the care of these women. The ultimate hope is to catch ovarian cancers at an earlier and more treatable stage.

Two others from UW-Madison, B. Dustin Pooler, MD, a fourth-year radiology resident, and Kyle Malecki, an MD candidate, also received the RSNA Student Travel Award. Dr. Pooler will be presenting a paper titled “Prospective Evaluation of Reduced Dose Computed Tomography for the Detection of Low-contrast Liver Lesions” on Tuesday, November 29 at 11:10 a.m. Kyle Malecki will be giving a presentation titled “Accuracy of Liver Surface Nodularity Quantification at MDCT as a Noninvasive Biomarker for Staging Liver Fibrosis” on Sunday, November 27 at 11:05 a.m.

Dr. Pooler’s research revolves around attempting to use lower-dose CT techniques while still maintaining accurate diagnoses in situations where the imaging target has naturally low contrast with the background. “The conclusion to be drawn is that while reduced dose CT techniques and reconstruction algorithms are very promising for some imaging scenarios, we as radiologists must be careful in our application of ‘low dose’ imaging, as ambitious dose reduction may not be appropriate in all situations,” Dr. Pooler explained.

Kyle Malecki has worked with Drs. Megan Lubner and Perry Pickhardt on his research. The goal of this research, Kyle explained, was "to determine the predictive value of a new tool, called Liver Surface Nodularity, to measure the degree of hepatic fibrosis on cross-sectional CT images." Currently, the gold standard for assessing liver fibrosis is the liver biopsy which is an invasive procedure that presents certain risks to the patient. The study demonstrated strong results in carrying out that task, comparable to other non-invasive methods. According to Kyle, the research has several implications including that this tool "could be used retrospectively in patients with liver disease to non-invasively stage fibrosis, and could be used to monitor therapies over time without the need for repeat liver biopsies", reducing risk to the patient.

The Travel Awards are new for RSNA in 2016. In February of this year the RSNA Board of Directors announced the creation of the Travel Award Program with the hope of easing the expenses young investigators face while traveling to RSNA. Of all the young investigators who have been invited to share their work at the meeting, the top 400 have been offered the award.

Dr. David Bluemke and Radiology Moving to Madison

I am delighted to inform you that our friend and colleague, David Bluemke, MD, PhD, has been appointed as the next Editor of our field’s flagship journal Radiology. While this is good news for Dr. Bluemke and the Radiological Society of North America (RSNA), I am also thrilled to announce that he will be joining our department and moving the journal to Madison!

David is a good friend and colleague to many in our department, and I count myself fortunate to know him for more than 20 years. Born and raised in Brookfield Wisconsin, David received his undergraduate degree in Chemical Engineering from UW-Madison and is a true Badger at heart. He has made numerous contributions to our field in his role as Professor of Radiology at Johns Hopkins (1993-2008) where he served as Chief of MRI, and as Senior Investigator and Radiologist-in-Chief at the National Institutes of Health Clinical Sciences Center since 2008.

“I have always felt that Radiology at Madison has encompassed the best of medicine, science, and technology – in close combination with collegiality and professionalism,” Dr. Bluemke recently commented. “I am thrilled to bring the journal Radiology to the UW, and look forward to working with the Radiology staff both on the journal activities and departmental mission.”

A nice synchronicity: This month’s cover of Radiology features the work from the University of Wisconsin Department of Radiology.
Dr. Bluemke will have a full time appointment as Professor of Radiology in our department beginning July 1, 2017, with funding from the RSNA to support his role as Editor. While David’s editorial duties will undoubtedly be his primary focus and constitute 80% of his effort, our department will partner with the RSNA to insure that Dr. Bluemke has the opportunity to continue his strong connection to clinical and academic radiology at a local level for the remainder of his time. Dr. Bluemke and the RSNA will work together to move the headquarters of the journal to Madison. He and his wife Bonnie are looking forward to moving back “home” to the great state of Wisconsin.

One important factor in his decision to join our department is the high quality and outstanding clinical and academic productivity of our faculty and staff in both Radiology and Medical Physics at the University of Wisconsin School of Medicine and Public Health. Dr. Bluemke anticipates many opportunities for our faculty and staff to contribute to the mission of the journal, and I know that we will benefit from his expertise and the knowledge of all the visitors to the journal headquarters.

- Tom Grist, MD, FACR

Read more about Dr. Bluemke’s appointment with RSNA at RSNA.org

First Wisconsin Spore Grant Brings $12m for Cancer Research

Wisconsin has recently obtained its first elusive SPORE Grant. The SPORE (Specialized Program of Research Excellence) grant is a large multi-investigator grant spearheaded by Paul Harari (Chair of Human Oncology) focusing on Head and Neck Cancers (HNC). The objective of the grant is to promote translational laboratory and clinical research to improve overall outcomes for patients with head and neck cancer. The grant is for five years and includes $15 million along with institutional matching funds. Associate Professor Jamey Weichert, PhD (Department of Radiology) is involved in one of the four major RO1 level projects titled "Therapeutic Combination of CLR1404 with External Beam Radiation in Head and Neck Cancer," which will be led by Paul M. Harari, MD and Gregory K. Hartig, MD. It is being hailed as a, "…highly innovative project with an exceptional potential for a tremendous impact in the management of HNC, in fact, management of all solid tumors that use radiation therapy. There is no obvious weakness in this project. This project received a perfect impact score of 1.0." If successful, the SPORE grant will help towards improving the quality of life for many HNC patients and may provide insight into using internal/external radiotherapy combinations in other cancers as well. Read more about this grant and the work at med.wisc.edu/

Dr. Rowley Receives RSNA Honored Educator Award

Dr. Howard A. Rowley, Professor of Radiology, Neurology, and Neurosurgery has earned a prestigious Radiological Society of North America (RSNA) Honored Educator Award in 2016. This achievement recognizes an individual's dedication to furthering the profession of radiology and commitment to radiology education by delivering high-quality educational content for RSNA endeavors. Established in 2011, the Honored Educator Award recognizes RSNA members who have produced an array of RSNA educational resources in the past calendar year. Based on the number of qualifying activities, eligible RSNA members are presented with the Honored Educator Award in recognition of their contribution. Dr. Rowley is internationally recognized for his contributions to stroke trials, dementia research, and advanced imaging techniques. He is President of the American Society of Neuroradiology (ASNR) for 2016-2017. This award serves as a benchmark of academic productivity in support of a meaningful and successful radiology career and commitment to radiology education. Previous departmental winners include Dr. Jeffrey P. Kanne, who received the award in 2012 and again in 2013.

Longer CT Colonography Screening Interval May Be Safe, Analysis Suggests

A new analysis of screening intervals for CT colonography (CTC) found that it may be safe to wait as long as five to ten years to screen again after an initial negative scan. The results are good news for the cost-effectiveness profile of CTC, investigators report in Radiology.

The group from the University of Wisconsin-Madison led by Drs. Perry Pickhardt, Dustin Pooler (4th year resident), and David Kim of the Department of Radiology, Dr. Ifeanyi Mbah of the Department of Obstetrics and Gynecology, and Dr. Jennifer Weiss of the Department of Medicine, analyzed results from 1,429 patients who returned for repeat screening CTC more than five years, on average, after their initial negative CTC exam. They compared the CTC findings at follow-up with the initial screening and found fewer advanced lesions than usual and just two small cancers in the cohort.

Pickhardt and colleagues analyzed the results of all patients who had positive findings at follow-up, comparing them with the initial CTC results. Positive findings were defined as polyps 6 mm or larger, a threshold that typically requires follow-up.

At follow-up CTC, the percentage of patients with positive results (12.1%) was lower than the percentage of patients (14.3%) who were positive on initial screening.

"The interval cancer rate at routine CT colonography surveillance was lower than the cancer rate seen at initial screening, as well as the reported interval rates at [optical colonoscopy]," the team wrote.

The results support the five- to ten-year screening interval for CTC suggested in the 2005 CT Colonography Reporting and Data System (C-RADS) recommendations from the University of Wisconsin-Madison, according to lead author and Professor of Radiology Dr. Perry Pickhardt. "Going beyond five years further improves cost-effectiveness," he added.

Dr. Pickhardt Named Most Influential Radiology Researcher

October 26, 2016 is a good day to be Perry Pickhardt, MD. We are pleased to announce that Dr. Pickhardt was selected as the Most Influential Radiology Researcher for 2016 in The Minnies.

From The Minnies

It might be a bit of an overstatement to say that 2016 saw the fulfillment of a life's work in research for Dr. Perry Pickhardt (for one thing, he still has many years left in his career), but it's not far from the truth. This year, the U.S. Preventive Services Task Force (USPSTF) included CT colonography among the tests it recommends—a watershed event that will ultimately lead to Medicare reimbursement and more widespread use of imaging-based screening for colon cancer. The USPSTF's action represents a validation for Pickhardt, who was the lead author on a landmark study published in 2003 that demonstrated the value of CT colonography (also known as virtual colonoscopy) as a colon screening tool. Since then, numerous attempts to gain a USPSTF recommendation fell short, despite the publication of a growing body of evidence—much of it involving Pickhardt and his colleagues—in favor of the test. Pickhardt came to radiology through an early interest in physics. While taking a graduate school course in medical physics, he realized it was the images that piqued him the most. Following medical school at the University of Michigan, he entered radiology residency at Mallinckrodt Institute of Radiology at Washington University in St. Louis. The U.S. Navy had paid for Pickhardt's medical school, so instead of a fellowship, he started a four-year stint in the U.S. Navy as a military radiologist. His service took him from the U.S. military base at Guantanamo Bay, Cuba, just prior to the 9/11 terrorist attacks, to Walter Reed National Naval Medical Center in Bethesda, MD, in the early 2000s. It was at Walter Reed that Pickhardt performed the research study screening veterans with CT that would ultimately be published in 2003, even though he was a junior radiologist at the time. "In the Navy, you can advance quickly," he noted. Over the years, Pickhardt has examined CT colonography from a number of angles, estimating that he's published more than 100 papers on the topic, a number that rises close to 200 when research on extracolonic findings is included. But he pointed out that he's also actively researching other areas, such as volumetric texture analysis, liver disease, and low-dose CT protocols. "It's not about the numbers; it's that each paper answers a question," he told AuntMinnie.com. "I always feel like each paper solves little pieces of a puzzle, and that's what drives me." Pickhardt currently has two main areas of research interest. First, he is trying to determine the factors that lead some polyps to develop into colorectal cancer, while the vast majority remain benign. More knowledge in this area could help make CT colonography more precise and help physicians better determine which patients should be sent on for invasive colonoscopy. Second, he is studying opportunistic screening, or using the data from CT colonography studies to screen for other conditions, such as osteoporosis. That would make CT colonography even more cost-effective as a screening test, he believes. While the USPSTF recommendation was welcome news, Pickhardt believes that there's still much work to be done before CT colonography becomes a routine screening test—in particular, convincing primary care physicians to refer patients. If that doesn't happen, then all the research papers and clinical studies could be for nothing. "Now I want to see [CT colonography] help the bottom line in terms of patients," Pickhardt said. "If it doesn't lead to that, then it's all just academics." Read about other Minnies winners at auntminnie.com

Imaging Phantoms from Calimetrix are Heading to Market

After years of building high-quality magnetic resonance imaging phantoms for research, a team from UW Radiology enlisted the university's startup incubator Discovery to Product (D2P) to help bring the discoveries to market, establishing a company called Calimetrix. Imaging phantoms are specially-designed objects used to assess the performance of MRI devices. Such testing is frequently performed by individual academic institutions or in multi-center clinical trials. Founded by Professor Scott Reeder, MD, PhDAssistant Professor Diego Hernando, PhDSenior Scientist Jean Brittain, PhD, and former Assistant Scientist Samir Sharma, PhD, the company started selling its first phantom, the Calimetrix Fat Fraction Phantom, in the fall of 2016. Calimetrix is the latest in a long line of startups with roots in UW Radiology, following in the footsteps of NeuWave Medical and Standard Imaging. These ventures are a testament to the entrepreneurship resources at UW-Madison, including the Wisconsin Alumni Research Foundation (WARF), the School of Business’ Weinert Center for Entrepreneurship, and the aforementioned D2P. The wheels for Calimetrix were set in motion in April 2015, when Invention Disclosure Reports (IDR) for two phantoms were submitted to WARF. Intellectual Property Manager Stephanie Whitehorse saw both applications, and quickly contacted the team, suggesting they submit an entry into D2P's Igniter Program even as the deadline was fast approaching. "We needed to give a presentation as part of the application for the Igniter Program, and we were scrambling to put the slides together in under a week." said Sharma. Thankfully, their mad dash paid off when they were selected for the Igniter Program. Throughout the next year, D2P walked the founding members through the process of starting a company; building a business plan, connecting them with accountants and lawyers, and adapting the phantom technology to be consumer friendly. "That's an area where we didn't have a lot of experience, but D2P has been extremely helpful," said Hernando. One of the biggest differences between making phantoms for in-house research and making them for sale was shelf life, according to Hernando. Some phantoms made for UW research were scanned only once, so oxidation or deterioration wasn't a large concern. However, selling them to the public requires Calimetrix to ensure consistent readings over time. Another focal point in the development process was ease of use. To ensure reproducibility and usability, the team has been working with Hippo Engineering, a mechanical engineering firm based in Rice Lake, WI. "It needs to be intuitive, with only one way to operate it so users don't struggle," said Sharma. Today, Calimetrix is in the final stages of bringing their phantoms to market; seeking out production and office space and recruiting employees. They are initially offering a fat [WDD4] phantom, that will calibrate MRI-based fat measurement in scanners. Importantly, this phantom builds on the group’s expertise in the development of MRI-based fat quantification. This phantom is useful for endeavors like multi-center clinical trials, where researchers will want to ensure consistency across multiple sites. This phantom will be followed by iron and diffusion models over the following year. The fat and iron phantoms are the only ones of their kind available to the general public, and the diffusion phantom is a significant improvement over the models currently available, according to Hernando. Visit www.calimetrix.com to learn more about the phantoms or to contact the team.

Burnside and Mcmillan Receive UW2020 Round 2 Funding

L-R: Amy Trentham-Dietz (Population Health Sciences), James Shull (Oncology), Elizabeth Burnside (Radiology), David Page (Biostatistics and Medical Informatics), John Hampton (UW Carbone Comprehensive Cancer Center), and Irene Ong (Biostatistics and Medical Informatics)
Two projects involving UW Radiology are among the fourteen highly-innovative projects that have been chosen for a second round of funding by the University of Wisconsin–Madison Office of the Vice Chancellor for Research and Graduate Education for the UW2020. Sponsored by the Wisconsin Alumni Research Foundation (WARF), the goal of UW2020 is to stimulate and support highly innovative and groundbreaking research at the University of Wisconsin–Madison over the next five years. This initiative seeks to fund research projects that have the potential to fundamentally transform a field of study. Alan McMillan, PhD, Associate Scientist in the Departments of Radiology and Biomedical Engineering, is co-principal investigator on a project that has been awarded a Round 2 UW2020 grant for research on the neural processes that go into simple decision-making. The project, “Building a Next Generation, Whole Brain Imaging Platform Using Simultaneous PET, fMRI, Behavioral Pharmacology, and Mathematical Modeling of Decision Making,” combines positron emission tomography and MRI to map the relationship between neural activity, the dopamine system, and cognitive performance. Dr. Elizabeth Burnside, Professor of Radiology at the University of Wisconsin School of Medicine and Public Health, Chief of the Breast Imaging Section, and Vice Chair of Health Services at Outcomes, has received a 2-year, $500K grant for, "Translating Novel Breast Cancer Genetic Markers from the Bench to the Clinic," in which she is the principal investigator. Dr. Burnside’s research has received $4.6 million in external funding since 2006. Dr. Burnside's study examines entire genomes of breast cancer patients along with identifying a growing list of individual parts of DNA sequences called single nucleotide polymorphisms, or SNPs, that appear to predict the risk of developing breast cancer. But even as more SNPs are found, improvements in risk prediction have been modest. Her goal is to advance the precise targeting of breast cancer prevention and early detection by rapidly moving from the discovery of these genetic markers to their application in clinical settings. Furthermore, the study hopes to add to the markers' predictive power by pairing SNP discoveries with more information on an observed physical difference, breast density, which captures the effects of both genes and the environment. This project creates a new collaborative, multidisciplinary team and uses data from the Wisconsin Women's Health Study to translate basic research to the clinic, create better breast cancer data sets, and improve prediction models to stratify breast cancer risk—all with the hope of decreasing the burden of breast cancer in Wisconsin and beyond.

SIIM Wisconsin Regional Conference

logo for SIIM On Monday, October 24, we look forward to joining together with thought leaders from the local medical imaging informatics community. The University of Wisconsin in proud to host the Society for Imaging Informatics in Medicine for the 2016 Wisconsin Regional Meeting. Same day registration is available. Learn more at siim.org