The Cai Research Group has been selected for more than a dozen honors and awards from the Society of Nuclear Medicine and Molecular Imaging (SNMMI) over the previous two years. SNMMI is a nonprofit scientific and professional organization that promotes the science, technology, and practical application of nuclear medicine and molecular imaging. The society strives to optimize imaging to improve health outcomes.

Among the recipients of these honors was Professor Weibo Cai, who was elected Fellow of SNMMI at their 2019 Annual Meeting. “I am truly humbled and deeply honored to be elected as a SNMMI Fellow. It is the most prestigious honor that I have received to date. It is a recognition to long-time SNMMI members and symbolizes distinguished service to SNMMI, as well as exceptional achievement in the field of nuclear medicine and molecular imaging,” says Cai, Vilas Distinguished Achievement Professor in the Departments of Radiology and Medical Physics, with affiliation in Biomedical Engineering, Materials Science and Engineering, and Pharmaceutical Sciences. At the time of election, Cai was the youngest SNMMI Fellow. This is the second society where Cai was elected Fellow. In 2018, he was elected Fellow of the American Institute for Medical and Biological Engineering (AIMBE).

In 2019, research group members Carolina Ferreira, Tuanwei Sun, and Emily Ehlerding received travel awards to attend the SNMMI Annual Meeting (a total of only seven Travel Awards were given out). Dawei Jiang, then a postdoc in the Cai Group, was the sole recipient of the Michael J. Welch Postdoctoral Travel Grant. At the Annual Meeting, members from the Cai Research Group swept the Center for Molecular Imaging Innovation and Translation (CMIIT) Young Investigator Award (YIA) symposium, which is the first time a single research group has garnered the top three spots. Lei Kang, Emily Ehlerding and Dalong Ni placed first, second, and third, respectively. Carolina Ferreira took second in the SNMMI’s Radiopharmaceutical Sciences Council (RPSC) YIA Symposium. In addition to wins in the symposiums, abstracts by Dalong Ni and Zachary Rosenkrans were two of 10 abstracts chosen for Press Release.

In 2020, Zachary Rosenkrans received the SNMMI Bradley-Alavi Student Fellowship. In addition, he had two abstracts selected to compete in the 2020 SNMMI Annual Meeting CMIIT YIA symposium, where only seven total abstracts are chosen to compete. Former Cai Lab member Carolina Ferreira, now a postdoctoral scholar at Harvard Medical School/Massachusetts General Hospital, won first place in the symposium.

Six former Cai Research Group members were selected as “Ones to Watch” by SNMMI, which recognizes early career professionals with the potential to shape the future of precision medicine. In 2019 Dawei Jiang, Emily Ehlerding, and Feng Chen were among the 30 selected. Jiang currently works as a Professor in Huazhong University of Science and Technology in China, Ehlerding works at the Society for Immunotherapy of Cancer, and Chen works at Elucida Oncology, Inc. In 2020 Dalong Ni, Sixiang Shi, and Reinier Hernandez were among the 30 selected. All three are faculty, with Ni as Professor at Shanghai Jiao Tong University, Shi as Assistant Professor at Hong Kong Polytechnic University, and Hernandez as Assistant Professor at UW-Madison.

Professor Cai is thrilled that his lab members are getting recognized for their hard work. “I am certainly extremely proud of the achievements of all my former and present group members. Together they have received more than 100 awards to date, and more than a dozen of my trainees have started independent research groups at world-class universities,” says Cai.

Kevin Johnson, PhD, received a 2020 ICTR Pilot Award for his research “Accelerated MRI Using of Crowdsourcing and Machine Learning Reconstructions.” Howard Rowley, MD and Laura Eisenmenger, MD were also collaborators on this research. In their work, Drs. Johnson, Rowley and Eisenmenger investigate a scheme for crowd sourcing image quality using machine learned metrics from user rankings of corrupted images.

Scott Reeder, MD, PhD, received a 2020 ICTR Pilot Award for his research “Novel Method for Rapid 3D T2-Mapping with Magnetic Resonance Imaging.” Dr. Reeder is the PI and is collaborating with Diego Hernando, PhD. The primary goal of this proposal is to develop a novel phase-based T2-mapping method for quantitative tissue characterization using MRI.

Vivek Prabhakaran, MD, PhD, is a collaborator on a research project that received a 2020 ICTR Pilot Award. The project, entitled “Investigation of Neural Network Dysfunction underlying Refractory Epilepsy in Children,” is led by PI Raheel Ahmed, MD, PhD in the Department of Neurological Surgery at the UWSMPH. The proposal aims to investigate the large-scale cortical network dysfunction that underlies the pathogenesis and clinical outcomes in epilepsy.

Jason Pinchot, MD, is also a collaborator on a research project that received a 2020 ICTR Award. His work, “Spatially-resolved mRNA Expression in Congenital Vascular Anomalies to Reveal New Therapeutic Targets,” will perform unbiased spatial transcriptomics to quantitate transcriptomic changes across human skin layers for the most common mutations in vascular anomalies. Led by PI Lisa Arkin in the Department of Dermatology at the UWSMPH, this research is critical to establish precisely how these mosaic variants drive disease progression, and subsequently to design or repurpose therapies that specifically target pathologic cells, penetrate to the appropriate depth in skin, and spare normal tissue.

The UW – Madison School of Medicine and Public Health helped create an Artificial Intelligence (AI) model for predicting supplemental Oxygen need for COVID-19 patients. The model was devised by researchers at NVIDIA and Massachusetts General Brigham Hospital to help physicians determine the best course of treatment for patients reporting to the ER with COVID-19 symptoms.

After establishing the model, the researchers began a federated learning initiative with 20 hospitals in eight different countries, including UW. Each institution provided data from chest X-rays, vitals, and lab results to construct the model’s algorithm. UW was chosen because it has the infrastructure to provide the curated datasets needed for this model. Out of the 20 sites, UW provided the second most data, helping to rapidly improve the tool so that it could be used during the current pandemic.

Department of Radiology Assistant Professor John Garrett was the Principal Investigator at UW and helped facilitate the school’s involvement in this project. In addition to success in creating the AI model, Garrett believes UW’s participation was significant because it provided a valuable opportunity to participate in a federated learning project, allowed UW to network with other institutions, and set the groundwork for future trials with AI models.

“I see this type of work as a significant step towards more broad acceptance of clinical AI tools. It can be challenging to build and then trust a tool like this with a single site’s data to validate, but traditional ways of performing multi-center studies require years of work. Federated learning lowers the barrier to this type of collaboration without sacrificing security or HIPAA compliance. I think it represents a way for researchers to much more rapidly iterate and develop new tools,” says Garrett.   

The recent surge of COVID-19 cases in Wisconsin has highlighted how valuable AI models are in the current world. “The major implication of the current surge has placed an emphasis on the value of these tools which are now validated and ready to test clinically. Although we will need to work with the IRB and other compliance groups before rolling this out in clinical practice, there is clearly a need for tools like this to help us utilize our resources efficiently,” he says.

Learn more about the AI Model here.

The Departments of Human Oncology and Radiology recently unveiled a new MRI scanner in the radiation oncology clinic at University Hospital. This machine will enhance patient care and provide opportunities for multidisciplinary collaboration aimed at advancing MRI use in radiation oncology. The location of this GE Healthcare 1.5T wide-bore MRI scanner within the radiation oncology clinic is particularly convenient for cancer patients. As needed, they can obtain CT and MRI imaging in a single location. The new scanner provides high-precision MR imaging for diagnosis and radiation treatment planning with superb soft-tissue contrast. In addition, MRI provides the ability to measure physiological motion, such as breathing and cardiac motion. The scanner’s size and suite of associated radiation therapy tools will enable simulation planning for patients in their precise radiation treatment position. “What that means for patients is that we have more accurate alignment between different datasets we use to devise cancer treatment plans,” says Dr. Carri Glide-Hurst, DHO director of radiation oncology physics. The new MRI scanner will support a variety of radiation treatment methods. One priority is to obtain the most up-to-date information of a patient’s disease state prior to stereotactic radiosurgery (SRS)—a form of high-dose of radiation treatment for primary brain tumors, brain metastases, and other intracranial conditions. Another high priority for the MRI scanner is to support gynecological brachytherapy, a type of radiation therapy that delivers radiation internally by placing a radiation source in or near a tumor through the use of applicators that are placed under anesthesia. “Additional MRI time for brachytherapy patients will enable optimal treatment planning and image-guided adaptive brachytherapy, which can result in improved tumor control and decreased toxicity,” says Dr. Kristin Bradley, a Department of Human Oncology (DHO) professor who specializes in gynecological brachytherapy. “Having this scanner housed within the clinic minimizes travel distance and time for patients, which is important for patients receiving general anesthesia.” In the future, the new scanner may enable high-quality imaging in the treatment position for selected breast cancer patients. “This could help us more precisely identify the lumpectomy cavity, visualize the brachial plexus, or assess residual lymph nodes after neoadjuvant chemotherapy,” says Dr. Bethany Anderson, a DHO associate professor who specializes in treating breast cancer. The new MRI will also be valuable in radiation planning for cancers where soft tissue contrast is important, such as in the abdomen or pelvis. Through a comprehensive research agreement with GE Healthcare researchers from DHO and Radiology will work with GE engineers to develop software and hardware technologies to advance the use MRI in radiation therapy. For example, this partnership could open up new imaging opportunities to measure the effects of cancer treatment on patients. “MRI provides great soft-tissue contrast and ways of assessing tumor response to therapy. With a state-of-the-art MRI scanner it’s possible to develop quantitative response biomarkers,” says Dr. Thomas Grist, Chair of the Department of Radiology. "The use of MRI in radiation treatment planning could also help identify treatment effects on radiosensitive tissues," says Dr. Scott Reeder, professor and chief of MRI in the Department of Radiology. Several collaborative projects will explore this idea. “I’m excited by the opportunity to collaborate with an engaged, dynamic, and talented group of health care providers in radiation oncology and to contribute to helping patients in new ways through our combined expertise,” Dr. Reeder says. Dr. Grist adds: “We have amazing expertise in diagnostic imaging and radiation oncology, great support from Medical Physics and GE Healthcare all aimed at improving the treatment of cancer in this effort. By having this scanner physically located in the department where radiation therapy is delivered, we will accelerate our ability to translate more than four decades of MRI research and innovation into clinical practice to improve the health of our patients.”   -Rob Kelly  

Using a custom artificial intelligence algorithm called CV19-Net, the UW research team dug into a vast resource database of tens of thousands of COVID-19 chest X-rays to show its method could identify pneumonia caused by COVID-19 at a sensitivity of 88%, according to Guang-Hong Chen, PhD, professor of Medical Physics and Radiology at the University of Wisconsin School of Medicine and Public Health.

From the tens of thousands of X-rays available, the team pared down the number of X-ray images to train the artificial intelligence algorithm and then evaluated the performance of the CV19-Net algorithm over  5,900 X-rays from approximately 3,000 patients between Feb. 1 and May 3, 2020.

To compare to diagnoses generated by the human eye, Dr. Chen’s team asked three expert thoracic radiologists experienced with COVID-19 pneumonia X-ray images to examine 500 chest X-ray images from the CV19-Net database. The three radiologists were able to correctly perform diagnosis with accuracy of 76%, 68% and 72%. In contrast, the CV19-Net algorithm examined the images and achieved a diagnostic accuracy of 84%.

“It is clear, based on the data; we conclude that artificial intelligence can identify COVID-19 pneumonia better than the human eye,” Dr. Chen said. The results of the research were recently published in the journal Radiology.

Chen and the research team that includes Ran Zhang, PhD, assistant scientist in medical physics, and Scott Reeder, MD, PhD, professor of radiology and medical physics, both at the UW School of Medicine and Public Health, and other researchers and clinicians at both UW School of Medicine and Public Health and Henry Ford Health System in Detroit, Michigan. Reeder is also a UW Health radiologist.

The team is currently determining how to utilize this new technology to help health care workers in the field identify COVID-19 cases in just minutes using X-ray techniques rather than more costly and less available computerized tomography (CT) scans, Dr. Reeder said.

Such an algorithm could even be deployed into the X-ray machine itself so that the detection of COVID-19 pneumonia could be made before the images are transmitted to the radiologist’s computer screen, he said.

“The algorithm could even page the radiologist to alert them to review the case in a real-time manner, so that a diagnosis and report can be made within just a few minutes,” Dr. Reeder said. “Indeed, it would be a straightforward extension to even generate a preliminary report, before the radiologist has even reviewed the X-ray images.”

Dr. Chen and his team are working with scientists at Epic, a Verona, Wisconsin, company that provides health record software to hospital systems, and UW Health to develop the clinical use of the algorithm. The algorithm would produce a COVID-19 risk score immediately after a chest X-ray image is taken, Dr. Chen said.

A next step would be to create a more universal algorithm for COVID-19 screening, he said, not just for COVID-19 cases with pneumonia findings, but also other COVID-19 cases, like people with with mild or no pneumonia findings.“Once developed, this could become a fully automatic tool for COVID screening,” Dr. Chen said. “Again, it just underscores the power and potential of artificial intelligence in medical practice.”

The work received funding from the Wisconsin Partnership Program

-Emily Kumlien, UW Health Media

  The Women Physicians in Radiology (WPR) committee was founded in 2009 by Drs. Susan Rebsamen, Elizabeth Sadowski, Lynn Broderick, and Elizabeth Burnside. The mission of WPR was twofold: to facilitate the success of women in all ranks of the radiology community and to promote academic and clinical excellence in all faculty, residents, and students, regardless of gender identification. The group sponsors several events every year, including journal clubs, book discussions, and social events with discussions that focus on issues affecting women in the medical workplace. The WPR leadership has also developed and integrated a Resident Professional Development lecture series within the residency curriculum, which includes topics such as Work Life Balance, Interviewing Skills, Contract Negotiation, and Malpractice. When the group began in 2009, there were 16 women faculty members from the academic and community practices of the department. Over the past 10 years, the department has experienced significant growth, successfully recruiting new women faculty to bring the current total to 29. WPR has fostered an environment of support, mentorship, and growth for many, while promoting the professional development and advancement of women within the field of radiology. Many women faculty hold leaderships positions within the Department of Radiology and beyond. More recently, WPR has formed new partnerships with groups such as the Medical Student Radiology Interest Group to create a pipeline for mentorship within the School of Medicine and Public Health. The WPR continues to find opportunities for growth through identifying and serving the needs of women radiologists. UW Department of Radiology women faculty members are not only making a difference at home, but many hold both state and national leadership positions and are involved in service activities: State and National Leadership and Service Pamela Propeck, MD, FACR: ABR Trustee and ABR Breast Online Longitudinal Assessment Chair Lynn Broderick, MD, FACR: ACR Chair Thoracic Subcommittee on Practice Parameters, WI Radiological Society President/Chair Fellowship Committee, ABR Senior Editor Online Assessment Thoracic Susan Rebsamen MD, FACR: Wisconsin Radiological Society President Daniela Martin MD: ACR Appropriateness Criteria Expert Panel on Thoracic Imaging Elizabeth Sadowski, MD, FSAR: ACR ORADS MRI Educational Committee Chair Elizabeth Burnside, MD, MPH, MSA, FACR: ACR Harvey L. Neiman Health Policy Institute Board of Directors Meg Lubner, MD, FSAR: Head of GI Scientific Subcommittee, ARRS Amy Fowler, MD, PhD: Vice-Chair, NRG Oncology Imaging Committee and Chair, Society of Nuclear Medicine and Molecular Imaging Breast Cancer Imaging Outreach Working Group Institutional Leadership and Service Elizabeth Burnside MD, MPH, MS, FACR: Senior Associate Dean, Deputy Director of Institute of Clinical Translational Science Elizabeth Sadowski, MD, FSAR: UW Office of the Vice Provost for Faculty and Staff Affairs, Hostile and Intimidating Behavior Liaison Meg Lubner, MD, FSAR: President, UWH Medical Board Kara Gill, MD: Medical Director of the AFCH Imaging Pavilion Amy Fowler, MD, PhD: Co-Director, Breast Cancer Research Advisory Network (BCRAN); UW Carbone Cancer Center Lori Mankowski, Gettle, MD, MBA: UW SMPH Chapter of the AAMC Group on Women in Medicine and Science Steering committee Vice Chair/Department Leadership Jessica Robbins, MD: Vice Chair of Faculty Development Daniela Martin, MD: Director of Diversity and Inclusion Department of Radiology Division/Associate Division Chiefs Tabby Kennedy, MD: Division Chief of Neuroradiology Roberta Strigel, MD: Division Chief of Breast Imaging and Intervention; Chief of Breast MRI Kara Gill, MD: Division Chief of Pediatric Imaging Meg Lubner, MD: Associate Division Chief Abdominal Imaging and Intervention Imaging Modality Chiefs Carolyn Haerr, MD: Leader, Mammography for Unity Point/Meriter Pamela Propeck, MD, FACR: Chair of Community Division Steering Committee and Leader, Mammography for GHC and Mauston Meg Lubner, MD: Modality Chief of CT and CT Research Lori Mankowski Gettle, MD, MBA: Modality Chief of Ultrasound and Ultrasound Research Jane Lyon, MD: Pediatric Radiology and Fetal Body MRI Modality Chief Susan Rebsamen, MD: Director Pediatric Neuroradiology Residency Leadership Mai Elezaby, MD: Associate Residency Program Director and Head of the Residency Selection Committee Lori Mankowski Gettle, MD, MBA: Associate Residency Program Director Allison Grayev, MD: Associate Residency Program Director Nevein Ibrahim, MD: Associate Director of the Nuclear Medicine and Molecular Imaging Residency Program Medical Student Leadership Allison Grayev, MD: Co-Director of Phase 1 (pre-clinical) Radiology Curriculum Tabby Kennedy, MD: Assistant Block Leader Acute Care, Phase 2, Co-Director of the Phase 3 Senior Diagnostic Radiology Elective Jane Lyon, MD: Director of the Pediatric Radiology Rotation within Care Across the Life Cycle, Phase 2 Daniela Martin, MD, Mai Elezaby, MD, and Allison Grayev, MD: Faculty mentors for the Radiology Interest Group

Dr. Jamey Weichert, faculty member of the UW Department of Radiology in the Imaging Sciences Section, and Director of the Contrast Agent Development Laboratory, recently received a $12.5 million dollar, five-year NCI PO1 grant from the National Institutes of Health. Dr. Weichert’s research is focused on the development of new cancer imaging and therapy agents. The lab uses known biochemistry pathways to design molecules that selectively target cancer cells and cancer stem cells.

This specific grant is for Dr. Weichert’s project entitled “Molecular Targeted Radionuclide Therapy for Tumor Immunomodulation and Enhancing Immunotherapy Response.” Dr. Weichert and Zachary Morris, MD, PHD, Assistant Professor in the Department of Human Oncology serve as co-principal investigators of the multi-disciplinary grant which studies the impact of combining targeted radionuclide therapy (TRT) with immunotherapies on tumor microenvironment with the goal of stimulating the immune system to recognize and kill cancer cells as well as induce T-cell immunity against the target cancer.

“Preclinical results thus far suggest a high cure rate is feasible in several different tumor types,” said Dr. Weichert. “Our hope is to show that low radiation doses of TRT can enable the ability of the immune system to recognize and kill tumor cells systemically while also inducing T cell memory specific to solid cancers.”

Developed in the Weichert lab, NM600, a third-generation tumor-selective alkylphosphocholine (APC) chelate capable of selectively delivering a variety of imaging and therapy metal isotopes to a variety of tumor types, is utilized as the TRT agent which is capable of delivering relatively low radiation doses found to be necessary for immuno-stimulation in a variety of tumor types regardless of anatomic location, including the brain. Other theranostic agents currently used in the clinic or in late stage trials will also be combined with immunotherapy. TRT agents will be radiolabeled with beta- and alpha-emitters to study the relative efficacy of using different types of radiation as well.

The grant combines 4 projects with 3 new core facilities. The projects include new TRT agents (Drs. Weichert and Morris) used in combination with three prominent immunotherapy approaches including immune checkpoint inhibitors (Drs. Morris and Weichert)  immunocytokines (Drs. Sondel and Morris) and DNA-based prostate cancer vaccines (Drs. Doug McNeel and Weichert). Three core labs will support these studies including a isotope production and radiochemistry core lead by Jon Engle and Reinier Hernandez (Medical Physics and Radiology), a new advanced dosimetry core lead by Bryan Bednarz and Joe Grudzinski (Medical Physics and Radiology) and biostats core lead by KyungMann Kim (Biostatistics).

“It appears that there is a distinct radiation dosing window of opportunity for TRT to modulate tumor cell immune response,” Dr. Weichert said. “We have found that using advanced PET or SPECT imaging of the TRT agent is necessary for accurate and personalized TRT dose determination. Rodent findings will be translated into companion canine cancer patients at the UW School of Veterinary Medicine in collaboration with Dr. David Vail,” Dr. Weichert said.

The grant is accompanied by a generous $2.1M institutional match being provided from the Chancellor’s Office, Carbone Cancer Center, School of Medicine and Public Health, and the Departments of Radiology, Human Oncology, and Medical Physics.

“I was told by the NCI that this is the first ever TRT-based P01 grant – and it is very rare to get them approved on the first try,” Weichert said. “My lab’s total extramural grant support currently totals $19.2M, all of which is focused on TRT immune modulation. The PO1 also funds a new Advanced Dosimetry Core as well as a new Radiochemistry Core, both of which will eventually support our departmental clinical theranostics initiative” Weichert continued. “It all started with a UW2020 grant ($500K) in 2016 which has since spawned over $30M in follow-on funding! A huge strength of our application was the amazingly strong collaborative team which provides exceptional expertise in immunotherapy, radiotherapy, advanced dosimetry, isotope production and radiochemistry development, and TRT agent discovery and development. Moreover the team is experienced in translating technology to clinical trial status. Very few other institutions possess this unique level of expertise and resources.”

The Wisconsin Partnership Program is pleased to welcome Jason W Stephenson, MD to the Partnership Education and Research Committee (PERC). Dr. Stephenson was appointed by Dean Robert Golden, and replaces Dr. Tracy Downs, who has served on the committee over the past four years. Dr. Stephenson is an associate professor in the SMPH Department of Radiology. He is board certified in diagnostic radiology. Dr. Stephenson’s expertise, clinical interests and commitment to resident and medical student education will greatly inform and enhance the PERC’s work. The Wisconsin Partnership Program thanks Dr. Downs for his leadership and contributions to PERC. In addition to serving on PERC, Dr. Downs served on the PERC’s Executive Committee and provided thoughtful and thorough review and evaluation of PERC grant applications. He also brought a very important voice and perspective to the Partnership Program’s health equity work and participated in its inaugural Advancing Health Equity conference. The Partnership Education and Research Committee broadly represents SMPH faculty, staff and leadership, and allocates and distributes funds designated for education and research aimed at improving the health of Wisconsin residents. Original article: http://wpp.cmail19.com/t/ViewEmail/d/189ED324F917E0E82540EF23F30FEDED/79AB7C3285E0CDBBD8E2A916412CAE5B

 

The Department of Radiology, along with the medical student Radiology Interest Group, hosted a new event for incoming medical students - Intro to Radiology: Fact or Fiction Panel. Panelists (including Dr. Mai Elezaby, Dr. Jane Lyon, Dr. Daniela Martin, Dr. Teresa Martin-Carreras, and Dr. JP Yu) shared their experiences as radiologists and helped to clear up some prevailing misconceptions about the field. Despite the all-virtual format, students spent their noon hour asking insightful questions and also had the opportunity to be matched with radiology mentors!