2011 grant-and-award-booklet web

Improving patient care by supporting research and education in radiology and related scientific disciplines through funding grants and awards to individuals and institutions that will advance radiologic research, education and practice.

Bright Ideas Get Funded

2011rsna grants and awards

RSNA Research & Education Foundation

1RSNA.org/Foundation

grants and awards

Research Grant ProgramsResearch Scholar Grant 4–9To support junior faculty members who have completed the conventional resident/fellowship training

program(s); but have not yet been recognized as independent investigators. The purpose of the funding is to help

establish the recipient as an independent investigator, and to collect preliminary data that could lead to further

funding through established mechanisms such as the NIH. Recipients will devote a minimum of 40% of their time

in the approved research project. $75,000 annually for 2 years ($150,000 total) to be used as salary support for the

scholar.

Research Seed Grant 10–14To enable all levels of investigators throughout the world in defining objectives and testing hypotheses in prepa-

ration of major grant applications to corporations, foundations, and governmental agencies. The seed data from

these projects will indicate feasibility and appropriateness of the research prior to applying for funds from other

agencies. Up to $40,000 United States Dollars (USD) for a 1-year project. Open to international applicants.

Research Resident/Fellow Grant 15–23To provide young investigators an opportunity to gain further insight into scientific investigation and to gain

competence in research techniques and methods in anticipation of establishing a career in academic radiologic

science. Recipients will devote a minimum of 50% of their time in the approved research project under the guidance

of a scientific advisor/mentor. $50,000 for a 1-year fellow project or $30,000 for a 1-year resident project to be used

for salary and/or other research expenses.

Research Medical Student Grant 24–35To increase the opportunities for medical students to have a research experience in medical imaging and to

encourage them to consider academic radiology as an important option for their future. Recipients will gain

experience in defining objectives, developing research skills and testing hypotheses before making their final

choices for residency training programs. Students are expected to undertake a research project requiring full-

time efforts for at least 10 weeks under the guidance of a scientific advisor during personal/vacation time or

during a research elective approved by their medical school. $3,000 to be matched by the sponsoring department

($6,000 total) as a stipend for the student.

Education Grant ProgramsEducation Scholar Grant 36–39To provide funding opportunities for individuals with an active interest in radiologic education. Any area of

education related to the radiologic sciences is eligible for Education Scholar Grant support. One year grant of up

to $75,000 USD for salary support and/or other project costs. In exceptional cases, grants of up to two years will

be considered.

RSNA/AUR/APDR/SCARD Education Research Development Grant 40–41To encourage innovation and improvement in health sciences education by providing research opportunities

to individuals throughout the world who are in pursuit of advancing the science of radiology education. Up to

$10,000 USD for a 1-year project to help cover the costs of research materials, research assistant support, and

limited principal investigator salary support.

Recognition AwardsRoentgen Resident/Fellow Research Award 42–44To recognize and encourage outstanding residents and fellows in radiologic research during the past year. Each par-

ticipating North American residency program will receive an award plaque with space to display brass nameplates

for each year’s recipient. The Foundation will also provide a personalized award for the department to present to the

selected resident or fellow.

your foundation—your future2011 was another outstanding year for the RSNA Research & Education Foundation. Through the generous support of our

individual donors, private practice and academic groups and our corporate partners, the Foundation was able to fund 72

grants totaling $2.6 million—the highest amount to date.

The cornerstone of the R&E Foundation’s mission is to advance medical imaging research, education and practice. Since its

inception, the Foundation has funded nearly 900 grants totaling well over $34 million. On average, every dollar awarded by

the Foundation results in over $30 of additional funds from sources such as the NIH. With this high return on investment,

the R&E Foundation has enabled over $1 billion in radiologic research.

Each and every day at institutions throughout North America and abroad, young investigators supported by the R&E

Foundation are performing vital research aimed to improve clinical care and patient outcomes, and ensure the future

of the specialty.

Today, the R&E Foundation’s 2011 grant recipients are conducting research in several exciting areas. A Research Scholar

grantee leads a comparative effectiveness trial on evaluation of pediatric small bowel Crohn disease using MR enterography

and ultrasound elastography—the first of its kind in humans—which may mark an important paradigm shift in the radiologic

assessment of Crohn disease. A Research Seed Grant recipient will study the use of DTP FDG-PET/CT in conjunction with

advanced image analysis to quantify in vivo tumor biology, predict clinical outcome, and improve disease staging in patients

with lung cancer. This research may provide a new, practical, informative and readily available diagnostic approach for

these patients. A recipient of a Research Resident Grant will conduct a pilot study on patient-specific dosimetry in pediatric

and adult CT—which could guide a larger scale study to create a dose reporting system tailored to individual patients.

These diligent individuals are hard at work, and a strong partner is critical to their success. The R&E Foundation is proud

to be that partner.

To support these investigators, the

Foundation offers many vehicles for

giving, including individual programs,

practice and academic group programs,

planned giving opportunities and

corporate and exhibitor partnerships.

I encourage you to take time to read

through the abstracts in this booklet to

learn more about our outstanding grant

recipients and their innovative projects.

Theresa C. McLoud, MD

Chair, Board of Trustees

RSNA R&E Foundation

RSNA Research & Education Foundation Board of Trustees

Back row, from left: G. Scott Gazelle, MD, PhD; Hedvig Hricak, MD, PhD, Dr (hc), Treasurer; Burton P. Drayer, MD, RSNA President; James P. Borgstede, MD; E. Russell Ritenour, PhD, Secretary; Valerie P. Jackson, MD

Front row, from left: Sarah S. Donaldson, MD; Theresa C. McLoud, MD, Chair; Richard L. Ehman, MD; Vijay M. Rao, MD

Not available for group photo: Gregory C. Karnaze, MD; Thomas N. McCausland

2 r&[email protected]

It is through the generosity of individuals, private practices and industry partners that the R&E Foundation is able to continue its investment in R&D for radiology. In 2011, grant awards were specially named to recognize the following individuals and companies for their contributions to the R&E Foundation, and the future of the specialty.

Derek Harwood-Nash, MD

n Peggy J. Fritzsche, MD

RSNA Presidents Circle

n Silver Anniversary Campaign Pacesetters

recognition and thanks

Dear Presidents Circle Donors,I wish to express my sincere appreciation for your generous dona-

tions, which have made it possible for me to conduct this important

research. My grant aims to provide accurate, patient-specific, dose

and risk estimates for the entire spectrum of pediatric and adult CT

exams. The outcome of this research will serve important functions

in promoting justified use of CT radiation, in establishing diagnostic

reference levels, and in optimizing CT protocols to minimize dose.

Many thanks to you all for enabling me to pursue my goals.

With my best regards,

Xiang Li, PhD

BRIGHT IDEAS. BETTER PATIENT CARE.

H e a l t h C a r e

MEDICAL

RSNA.org/Foundation 3

Not available for group photo: Gregory C. Karnaze, MD; Thomas N. McCausland


research scholar grantresearch grant programs

Hersh Chandarana, MD

RadiologyNew York University School of MedicineSiemens Healthcare/RSNA Research Scholar Grant

Evaluation and Prediction of Treatment Response in Liver Metastasis Undergoing Chemotherapy with Use of Dual Energy CT Iodine Quantification Technique

Colon cancer is the third most common cause of cancer-related

mortality in the United States. Liver metastases are the main cause

of death in these patients. Currently, treatment response is solely

assessed on the basis of size changes in the target lesions. Change

in size may, however, be a late manifestation in patients undergo-

ing targeted chemotherapy. Furthermore, different combinations

of chemotherapeutic agents are available, and selection of the right

combination chemotherapy is imperative to maximize efficacy and

minimize toxicity.

There is tremendous interest in identifying response-predicting

factors that can help tailor chemotherapy. The overall aim of this

project is to validate the use of quantitative measurement of treat-

ment response in patients undergoing antiangiogenic chemotherapy

for liver metastases from colon cancer, based on tumor vascularity

as measured by intralesional iodine concentration on contrast-

enhanced dual-energy CT (DECT). We hypothesize that intralesional

iodine concentration may prove to be a more sensitive and earlier

indicator of treatment response than traditional RECIST criteria.

If validated in this study, iodine concentration depicted on DECT

imaging can be used to predict and monitor treatment response

to antiangiogenic chemotherapy in patients with liver metastases

from colon cancer. The potential benefits of this technique would al-

low appropriate patient selection and earlier determination of drug

response, which could help develop personalized chemotherapy

regimens and lead to improved patient outcome. Furthermore, this

could become a method for the rapid assessment of the efficacy of

new antiangiogenic pharmaceutical agents or combination regi-

mens, allowing for more rapid drug development.

Jonathan R. Dillman, MD

RadiologyUniversity of MichiganAGFA HealthCare/RSNA Research Scholar Grant

Comparative Effectiveness of MR Enterography, Enteric Ultrasound, and Ultrasound Elastography Imaging in the Evaluation of Pediatric Small Bowel Crohn Disease

There is presently a paucity of data comparing magnetic resonance

enterography (MRE) and enteric ultrasound (EnUS) in the assess-

ment of pediatric small bowel Crohn disease. Prior studies evalu-

ating EnUS have used suboptimal reference standards, including

ileocolonoscopy and barium studies. If EnUS can be shown to have

significant positive agreement and comparable receiver-operating

characteristics (ROC) to MRE, this imaging technique could become

standard-of-care due to lower cost, shorter examination time, and

lack of need for sedation, contrast materials, and anti-peristaltic

medication.

Recently published research using an animal model has demon-

strated that ultrasound elastography imaging (UEI) has several

potential promising clinical applications in humans, including serv-

ing as an imaging biomarker for both response (and perhaps early

response) to medical therapy and the presence of bowel wall fibrosis

in small bowel Crohn disease. It is possible that UEI could influence

the decision to surgically manage certain children.

We propose to prospectively compare the diagnostic performance

of EnUS to MRE for the initial diagnosis and follow-up of pediat-

ric small bowel Crohn disease. All subjects will undergo baseline

(immediately prior to starting medical management) and serial

follow-up physician-performed systematic EnUS (including grey-

scale and Doppler imaging) and MRE examinations. EnUS and MRE

findings will be documented and assessed for agreement at baseline

and follow-up as well as correlated with a variety of laboratory

inflammatory markers and Pediatric Crohn Disease Activity Index

(PCDAI) scores. Changes in UEI bowel wall stiffness over time will

be correlated with other imaging findings as well as clinical data to

determine if this imaging technique can serve as a radiologic bio-

marker for response to medical therapy and the presence of bowel

wall fibrosis. Finally, we will formally survey the children and

parents in our study concerning their imaging preferences as well

as compare resource consumption by these imaging tests.

H e a l t h C a r e


Qian Dong, MD

RadiologyUniversity of Michigan Hospitals and Health CentersBracco Diagnostics/RSNA Research Scholar Grant

Quantitative Imaging in Soft Tissue Sarcomas: Use of MRI Diffusion and MRI Perfusion Biomarkers to Predict Early Response to Neoadjuvant Chemotherapy

Nearly 15,000 new cases of sarcoma are diagnosed annually in the

U.S. with a loss of years of life that greatly outweighs the incidence

of these cancers. Although advances in multiagent chemotherapy

and surgery have improved prognosis, sarcomas still are fatal in up

to 50% of patients. A major obstacle to improving patient outcomes

is the inability to reliably determine success or failure of pre-oper-

ative (neoadjuvant) chemotherapy early in the course of treatment,

prior to surgery and histologic analysis of tumor specimens. As a

result, patients may continue on ineffective chemotherapy regi-

mens, experiencing adverse effects of treatment and missing the

critical opportunity to switch to an alternative protocol.

Our central hypothesis is that quantitative molecular and func-

tional imaging techniques can meet the need for early determination

of response to therapy in soft tissue sarcomas. We will use diffusion

and dynamic contrast-enhanced MR imaging (DCE-MRI) to measure

changes in cellular architecture and angiogenesis in patients

undergoing neoadjuvant chemotherapy for sarcomas. These studies

will establish imaging biomarkers as early predictors of treatment

efficacy in patients with soft tissue sarcomas.

Our long term goal is to use molecular imaging to assess response

to neoadjuvant chemotherapy within days or even hours of initiat-

ing chemotherapy, replacing ineffective current methods based on

late changes in tumor volume. By determining treatment efficacy

early in the course of therapy, we expect this research will ultimate-

ly allow oncologists to optimize treatment protocols for individual

patients, improving quality of life and enhancing disease-free

survival for patients with soft tissue sarcoma.

In summary, this research will develop molecular imaging techniques

to determine success or failure of pre-operative chemotherapy

in soft tissue sarcomas. These imaging techniques ultimately will

allow treatment protocols to be optimized for individual patients,

improving survival and quality of life for patients with soft tissue

sarcomas.

Jason Druzgal, MD, PhD

RadiologyUniversity of VirginiaRSNA Research Scholar Grant

Machine Learning Classification of Resting State Functional MRI Data in Autism Spectrum Disorders

Resting state functional MRI (rs-fMRI) measures spontaneous fluc-

tuations in blood oxygen level dependent (BOLD) signal, thought to

reflect fluctuation in underlying neuronal activity. Whole-brain rs-

fMRI of individuals of normal cognitive function has characterized

many long-range and short-range neural networks that demonstrate

reproducible temporal synchrony of resting state BOLD signal.

Applications of this rs-fMRI technique to several types of cognitive

pathology (including autism, schizophrenia, bipolar disorder, and

depression) have demonstrated consistent perturbations of this

temporal synchrony related to the underlying pathology.

Regarding the autism spectrum, my research group has discovered

several features of rs-fMRI temporal synchrony that are perturbed

at the population level, including long-range interhemispheric

connectivity and short-range regional homogeneity. These findings

certainly advance our understanding of the pathology underlying

the autism spectrum, but the clinical utility of this information is

currently limited. A more clinically relevant issue is whether the

features in a single rs-fMRI data set can be used to determine the

population from which the data originated. That is, can you make

the diagnosis of autism based on features in the rs-fMRI data? Re-

cent application of machine learning classification to fMRI data sets

suggests this to be a realistic possibility.

The current project proposes to develop a classifier that discrimi-

nates autistic patients from typically developing controls on the

basis of their rs-fMRI data. A support vector machine classifier will

be developed from an existing large rs-fMRI data set obtained from

a well-characterized population of autistic patients and typically de-

veloping control patients. The classifier will be internally assessed

for metrics of clinical validity, such as sensitivity, specificity, and

accuracy. Then the classifier will be externally validated with rs-

fMRI data obtained from a separate population of autistic individu-

als, at a different institution.

research scholar grant


research scholar grantMichael S. Gee, MD, PhD

RadiologyMassachusetts General HospitalCarestream Health/RSNA Research Scholar Grant

Evaluation of Diagnostic Magnetic Resonance (DMR) Technology for Molecular Characterization of Cancer Cells from Percutaneous Image-Guided Biopsy Specimens

The capability to perform real-time molecular analysis of human

tumors is expected to enable rational treatment decisions in an era

where molecularly targeted therapies are emerging. Attempts to

profile cancer cells to date largely have been unsuccessful, as exist-

ing clinical technologies are either too insensitive to distinguish

biomarker expression levels or lead to alterations in tumor cell phe-

notype, precluding accurate assessment. We have developed a novel,

broadly applicable, point-of-care method of diagnostic magnetic

resonance (DMR) that overcomes many of these limitations.

The technology utilizes magnetic resonance techniques confined

within a chip-sized micro-NMR device to measure the relaxation

time of tumor cell fine needle aspiration samples. The molecular

specificity of DMR is achieved through magnetic nanoparticles

that act as proximity sensors for specific molecular targets. We

have used this exquisitely sensitive technology to measure DNA

and mRNA, cancer cells, proteins, enzymes, metabolites, drug

concentrations, and bacteria. In preliminary experiments, we have

demonstrated the ability of DMR to profile expression of multiple

biomarkers on individual cancer cells simultaneously, with molecu-

lar sensitivity reaching 10

–14

M, better than conventional techniques

such as flow cytometry. The overall goal of this proposal is to

evaluate whether DMR can perform real-time molecular analysis

of biomarkers on human cancer cells isolated from percutaneous

image-guided fine needle aspiration, and to determine whether

DMR can be used to determine tumor susceptibility to molecularly-

targeted treatments.

Daniel Hamstra, MD, PhD

Radiation OncologyThe University of Michigan Medical CenterRSNA Research Scholar Grant

Molecular Dissection of the Role of Tumor Vasculature in Radiation Sensitivity

Radiation therapy plays a prominent role in the treatment of pa-

tients with prostate cancer. While prostate cancer exhibits signifi-

cant genetic heterogeneity, inactivation of the PTEN tumor suppres-

sor gene is one of the more common events, occurring in as many as

15 - 20% of all prostate cancers, and it is more common in high-grade

tumors. PTEN loss has been associated with higher Gleason grade,

increased tumor neo-angiogenesis, increased biochemical failure,

and radiation resistance. Further, tumor hypoxia and neo-vascular

growth, which are both common in prostate cancer, are both as-

sociated with radiation resistance and prostate cancer recurrence.

Neo-angiogenic blood vessel growth and proliferation are also

influenced by the PI3K/Akt/mTOR axis, and as a result the mam-

malian target of rapamycin (mTOR) may be a critical player in both

prostate tumor and prostate cancer stromal pathophysiology.

Despite the clear clinical associations between tumor vascular

factors and resistance to radiation therapy, it is unclear if these

vascular differences reflect the underlying biology of the tumor as

opposed to a mechanistic resistance to radiation therapy. Therefore,

we first propose to evaluate the role of endothelial cell responses to

radiation therapy using molecular modification of endothelial cell

radiation response and non-invasive imaging of endothelial cell

growth and response to therapy through bioluminescent imaging.

Second, given the potential role of the PI3K/Akt/mTOR axis in both

tumor and endothelial cell pathophysiology we propose to evaluate

this signaling axis as a target for radiation sensitization of both

prostate cancer and endothelial cells. Using models by which both

tumor and endothelial cells can be individually modulated, we will

assess the impact mTOR inhibition upon both cell-types individu-

ally and in combination.


Moritz Kircher, MD, PhD

RadiologyMemorial Sloan-Kettering Cancer CenterBayer HealthCare Pharmaceuticals/RSNA Research Scholar Grant

A Dual-Modality MRI-SERS Nanoparticle for Molecular Imaging of Brain Tumors

Malignant gliomas, such as glioblastoma multiforme, remain a

therapeutic challenge worldwide. Surgical resection is usually the

initial primary treatment. However, visualization of the tumor

margins during surgery is imprecise. Current imaging methods are

often limited by inadequate sensitivity, specificity, and/or spatial

resolution. We have developed a new brain tumor imaging strategy

based on a dual-modality MRI-Raman nanoparticle probe (MRI-R)

that allows combined preoperative MRI and intraoperative Raman

imaging with a single nanoparticle injection. We have demonstrated

the unique properties of MRI-R in our preliminary studies: a) MRI-R

is detectable by MRI and by Raman in the picomolar range in vivo.

b) MRI-R nanoparticles are sequestered by the tumor (> 1 week), al-

lowing c) pre-operative and intra-operative imaging to be performed

with a single intravenous nanoparticle injection; d) Raman imaging

enables accurate delineation of tumor margins intraoperatively.

We propose to 1) optimize nanoparticle chemistry, 2) validate

nanoparticle imaging in biological systems, and 3) determine the ac-

curacy of pre- and intraoperative brain tumor delineation in animal

models.

The MRI-R particle chemistry will first be optimized by interro-

gating the effect of varying concentrations of Gd and maleimide-

DOTA during the incubation procedure, as assessed by inductively

coupled plasma atomic emission spectroscopy. MR detectability will

be assessed in phantom experiments. Further characterization of

MRI-R behavior will include determination of differential uptake

in brain tumor cells in culture, whole body biodistribution studies,

and detailed toxicity studies. Accuracy of MRI-R to delineate tumor

margins will be assessed by careful correlation of in vivo MRI and

Raman images with histology.

The conceptual advance presented here could lead to a signifi-

cant advance in both brain tumor imaging and tumor resection.

Since gold-silica based nanoparticles are already in clinical trials

and hand-held Raman imaging devices have been developed, this

approach holds significant promise for clinical translation and ap-

plication by neurosurgeons.

Chan Hong Moon, PhD

RadiologyUniversity of PittsburghAGFA HealthCare/RSNA Research Scholar Grant

Sodium/Proton MR Imaging of Knee Cartilage in Osteoarthritis

Knee osteoarthritis (OA) is a complex, heterogeneous condition

that is a common cause of disability in the aging population. One

of the hallmarks of the pathophysiology of OA is the breakdown

of cartilage in joints. Conventional radiographs are an insensitive

measure of OA pathology and have not allowed for the evaluation of

treatment effects on early structural and physiological changes in

cartilage. However, recent advances in high-resolution MR imaging

of OA cartilage anatomy and physiology have improved our under-

standing of the patho-physiochemical changes in articular cartilage.

In particular, sodium MRI is a promising technique for the detection

of changes in proteoglycan content of cartilage associated with

early stage OA. Unfortunately, clinically useful sodium MRI can

be technically challenging due to the intrinsically low MR signal and

concentration. In order to realize the clinical potential of sodium

MRI as a reliable imaging biomarker for the characterization of

cartilage quality, the optimization of sodium MRI techniques and rig-

orous testing of sodium quantification must be undertaken. Recent

technical advances in high-field MRI allow us to acquire morphologic

and physiologic imaging of knee cartilage with improved SNR and

spatial resolution, thus facilitating accurate characterization and

quantification of structural and physiochemical changes of carti-

lage associated with OA.

The primary objective of this proposal is to develop and evaluate

methods for the quantification and characterization of structural

and sodium concentration changes in OA knee cartilage using high-

field proton/sodium MRI. Our central hypothesis is that new dual-

tuned MR imaging permits a precise in-vivo structural and physio-

chemical analysis of knee cartilage associated with OA. The specific

aims are to (1) develop and evaluate methods for sodium MRI of

knee cartilage at 3T and 7T MR, and (2) evaluate and compare the

differences in the sodium concentration and volume and thickness

of knee cartilage between OA patients and normal controls.

H e a l t h C a r e



research scholar grantMark S. Shiroishi, MD

Radiology, Division of NeuroradiologyKeck School of Medicine, University of Southern CaliforniaGE Healthcare/RSNA Research Scholar Grant

Assessing the Value of Perfusion and Permeability MR Imaging to Characterize Pseudoprogression and Pseudoresponse in Patients with High-Grade Glioma

The traditional method of determining response to therapy for

glioblastoma is based on the MacDonald criteria. This relies on

changes in enhancement characteristics and has been shown to be

inadequate in distinguishing between true progression of disease

and treatment related effects. This uncertainty complicates treat-

ment decisions as well as clinical trial design. A phenomenon has

recently been recognized in which chemoradiation treatment may

cause an increase in the size of enhancing lesions. It is analogous

to delayed radiation necrosis, but occurs much earlier—usually in

the first 12 months of therapy. In these cases, there is no true tumor

progression; hence, the entity is termed “pseudoprogression.” It

occurs in up to 20% of patients who have undergone chemoradiation

and can explain about half of all cases of increasing lesions and

enhancement after this treatment.

“Pseudoresponse” is also a newly described condition in which

some patients with recurrent high-grade glioma treated with

anti-angiogenic drugs such as bevacizumab demonstrate a rapid

decrease in contrast enhancement and edema without a true anti-

tumor effect. This is likely a result of “repairing” of the blood brain

barrier.

In order to better distinguish between true disease progression and

pseudoprogression, as well as between true response and pseudo-

response, we will conduct a prospective investigation of patients

with newly diagnosed and recurrent high-grade glioma with the

goal of evaluating the added benefit of advanced MR techniques,

such as perfusion and permeability MRI as well as MR spectros-

copy and diffusion tensor imaging. Patients with true progression

of disease, as well as those with true response to therapy, will be

included as controls. Overall survival estimated using the Kaplan-

Meier method will be compared. Standard Student’s t test will be

initially used to compare the perfusion and permeability measures,

metabolite ratios, and diffusion metrics for all groups of patients.

James A. Tanyi, PhD

Radiation MedicineKnight Cancer Institute, Oregon Health & Science UniversityRSNA Research Scholar Grant

Incorporating the Effects of Transcytolemmal Water Exchange in Pharmacokinetic Analysis of DCE-MRI Data in the Prediction of Head and Neck Cancer Response to Chemoradiation

Preclinical and clinical data suggest that changes in head and neck

squamous cell carcinoma (HNSCC) cell cycle kinetics following a

brief exposure to radiotherapy, either alone or with chemotherapy,

can be used to evaluate treatment efficacy in terms of loco-regional

control, disease-free survival and overall survival. Dynamic

Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI), the

acquisition of serial magnetic resonance images before, during and

after the administration of an intravenous small molecular weight

gadolinium-based contrast agent, can be used to measure these

changes. For a tumor, the signal intensity measurements of DCE-

MRI may reflect a composite of tumor perfusion, vessel permeabil-

ity and the volume of the extravascular-extracellular space. Thus,

DCE-MRI may provide a more robust characterization of tumor

physiologic behavior rather than its anatomic appearance.

Models have been developed for the analysis of DCE-MRI data that

typically neglect the compartmental nature of tissue and the indi-

rect nature of contrast agent detection. To date such models have

assumed a linear relationship between the measured longitudinal

(or spin-lattice) relaxation rate constant (1/T1) of water protons

and the concentration of contrast agent. However, this assumption

is not valid for all concentrations of any contrast agent of interest

in tissue. The proposed study will investigate a novel pharmaco-

kinetic model (the “Shutter-speed” model) that takes into account

transcytolemmal and transendothelial water exchange during the

assessment of contrast enhancement dynamics.

We will test the hypothesis that DCE-MRI can be used to predict

treatment outcome in terms of local control and progression-free

survival in patients with loco-regionally advanced HNSCC. This

preliminary assessment will allow us to identify and appreciate

potential study limitations, and derive corrective measures before

embarking on a large-scale trial.


Zhen Jane Wang, MD

Radiology and Biomedical ImagingUniversity of California, San Francisco Medical CenterGE Healthcare/RSNA Research Scholar Grant

Noninvasive Assessment of Renal Tumor Aggressiveness Using Hyperpolarized [1-13C] Magnetic Resonance Spectroscopic Imaging: a Pilot Study

The incidence of renal cell carcinoma is rising by 3% per year, and

it is recognized that many of these are small (< 4cm), indolent, and

may not require aggressive treatment. Therefore the management

options for these small tumors have expanded from surgical resec-

tion to include less invasive tumor ablation and active surveillance.

However, triage of therapies is currently difficult due to our inabil-

ity to reliably determine renal tumor aggressiveness noninvasively.

The long-term goal of our research is to determine whether hyper-

polarized [1-13C] magnetic resonance spectroscopic imaging (MRSI),

an extraordinary new technique that highlights the increased glycoly-

sis in cancer, can noninvasively characterize renal tumor aggres-

siveness, and appropriately select those patients who will benefit

from less invasive treatment or active surveillance.

The specific aims of this pre-clinical study are to test the hy-

potheses that 1) hyperpolarized [1-13C] MRSI can distinguish the

metabolic profile of low versus high metastatic potential renal cell

carcinomas in a murine xenograft tumor model; and 2) the meta-

bolic profiles determined by hyperpolarized [1-13C] MRSI correlate

with immunohistochemical and histopathological analysis of tumor

aggressiveness. Successful completion of the project will add to our

understanding of the biology of renal tumors.

We will use the data and experience gained from this project to

apply for a NIH R01 grant for clinical trials in patients with renal

tumors using hyperpolarized [1-13C] MRSI. Noninvasive imaging

characterization of tumor biological behavior using metabolic bio-

markers will advance the state-of-the-art in oncologic imaging and

greatly improve our ability to provide patient and tumor-specific

care.

David Woodrum, MD, PhD

RadiologyMayo ClinicRSNA Research Scholar Grant

Influence of Differential Cellular Heat Shock (Stress) Protein Expression on Cellular Death from Focal Laser Ablation

Hepatocellular carcinoma (HCC) is the seventh most common can-

cer worldwide and third leading cause of cancer-related death. In

HCC, there is overexpression of several heat shock proteins (HSPs),

whose function is to inhibit cellular death, promote angiogenesis,

and increase thermotolerance. The current gold standard for defini-

tive treatment of HCC is orthotopic liver transplantation; however,

many patients do not meet the inclusion criteria for transplant.

Non-surgical patients are treated with catheter-based or percutane-

ous-based ablative techniques. Unfortunately, the “Achilles heel” of

these techniques is high recurrence rate after ablation. Recurrences

occur at the edge of the tumor margin and ablative zone.

Our central hypothesis to be tested in the present proposal is that

HCC is resistant to thermal ablation because of increased cellular

expression of HSPs in cells contained in the ablative margin and

that inhibition of these proteins will increase the thermosensitiv-

ity of these neoplastic cells, leading to increased ablation efficacy.

The knowledge gained by successful completion of this proposal

will allow us to rapidly translate these findings to clinical trials to

investigate the efficacy of commercially available HSP inhibitors

combined with ablative techniques to treat patients with HCC.



research seed grant

Vikram S. Dogra, MD

RadiologyUniversity of RochesterToshiba America Medical Systems/RSNA Research Seed Grant

Photoacoustic Imaging and Spectroscopy of Prostate

Photoacoustic (PA) imaging is a new and innovative technique

for the evaluation of biological tissues. It is dependent on opti-

cal properties of soft tissue mainly the absorption and scattering

coefficients, which in turn are dependent on tissue structure and

composition. In PA imaging, tissue is irradiated with near-infrared

(NIR) laser beam. Interaction of NIR beam in the tissue generates

acoustic wave (PA signal), which can be detected using conven-

tional ultrasound (US) technology. Strength of PA signal detected

is highly dependent on the laser wavelength used to irradiate the

tissue. Mapping of PA signal variability on laser wavelength helps

to characterize different tissue types. This property will also allow

photo acoustic spectroscopy (PAS).

The major objective of this project is to determine if the PA signal

and PAS from prostate tissue measured ex vivo can differentiate be-

tween malignant and benign prostate tissue. The research proposed

has the follow-ing specific aims:

Aim 1: Fabricate a PA Imaging Camera to study the PA properties of

excised human prostate tissue specimens.

Aim 2: Perform PA Imaging and PAS analysis of excised human

prostate tissue samples and correlate with histology.

The long-term impact of this work is to provide initial data to

validate the in vivo use of PA imaging in differentiating malignant

from benign prostate pathologies.

Gholam R. Berenji, MD

Nuclear MedicineVA Greater Los Angeles Healthcare SystemPhilips Healthcare/RSNA Research Seed Grant

DICOM Structured Report to Track Patient’s Radiation Dose to Organs from Abdominal CT Exams

The dramatic increase of diagnostic imaging capabilities over the

past decade has contributed to increased radiation exposure to pa-

tient populations. Several factors have contributed to the increase

in imaging procedures: wider availability of imaging modalities, in-

crease in technical capabilities, rise in demand by patients and cli-

nicians, favorable reimbursement, and lack of guidelines to control

utilization. The primary focus of this research is to provide in-depth

information about radiation doses that patients receive as a result

of CT exams, with the initial investigation involving abdominal CT

exams. Current dose measurement methods (i.e. CTDIvol Computed

Tomography Dose Index) do not provide direct information about

a patient’s organ dose. We have developed a method to determine

CTDIvol normalized organ doses using a set of organ specific expo-

nential regression equations. These exponential equations along

with measured CTDIvol are used to calculate organ dose estimates

from abdominal CT scans for eight different patient models. For

each patient, organ dose and CTDIvol are estimated for an abdomi-

nal CT scan. We will then develop a DICOM SR (Structured Report)

to store the pertinent patient information on radiation dose to their

abdominal organs.

research grant programs


Ron C. Gaba, MD

RadiologyUniversity of Illinois at ChicagoPhilips Healthcare/RSNA Research Seed Grant

Polymeric Iohexol Nanoconjugates for Targeted Transcatheter Drug Delivery: Quantitative CT Analysis of Spatial Distribution in a Rabbit VX2 Liver Tumor Model

research seed grantVinay Duddalwar, MD, FRCR

RadiologyUniversity of Southern CaliforniaHitachi Medical Systems/RSNA Research Seed Grant

Assessing the Role of Contrast Enhanced Ultrasound in the Evaluation and Management of Renal Masses in Patients with Poor Renal Function

The management of renal masses, especially small lesions has

changed dramatically with the concept of active surveillance.

The role of imaging is critical in these patients. We propose that

contrast enhanced ultrasound scans will provide adequate char-

acterization of renal masses and provide information relevant for

surgical planning in patients with compromised renal function.

We propose that contrast enhanced ultrasound may be able to dif-

ferentiate different types of renal masses.

Aim 1: Can CEUS provide adequate characterization of renal

masses and provide additional information relevant for surgical

planning in patients with compromised renal function? In addition,

can it identify patients who would be suitable for active surveil-

lance in this group?

Aim 2: Does dynamic and semi-quantitative evaluation of renal

masses during CEUS lead to better characterization of renal

masses? Are there specific patterns that are reproducible?

Data from this study will be analyzed to evaluate three possible

future directions:

1) CEUS as an imaging modality of choice in patients

with compromised renal function

2) Semiquanitative data being analyzed to identify any

differentiating factors between low and high grade

renal carcinomas, malignancies from lesions such as

angiomyolipomas and oncocytomas. If proven, this would

be an effective way of monitoring effects of anti angiogenic

chemotherapy on patients who only receive chemotherapy.

3) CEUS data could be used to identify the efficacy of

preoperative embolization on renal masses.

Transcatheter arterial chemoembolization (TACE) is an established

treatment for surgically unresectable hepatocellular carcinoma

(HCC). This therapy exploits the predominant hepatic arterial per-

fusion of hypervascular liver cancer to administer targeted tumor

therapy using chemotherapeutic agents. Contemporary TACE utiliz-

es drug-eluting beads (DEBs) for delivery of doxorubicin to neoplas-

tic tissue, but current therapy is potentially limited by incomplete

drug penetration into tumor due to peripheral or inhomogeneous

microsphere deposition as well as mechanical vessel occlusion and

concomitant risk for cancer neovasculogenesis.

Nanoparticles represent a new transcatheter treatment platform

that holds promise for improving drug delivery by enhancing

chemotherapy penetration into tumor without causing vascu-

lar ischemia. Biodegradable polylactide (PLA) nanoconjugates

represent a novel nanoparticle system with superior drug loading

and sustained drug release characteristics as compared to other

nanoparticle devices. These agents, which have not been previously

applied in the study of liver TACE, may be loaded with a radi-

opaque contrast agent, such as iohexol, for non-invasive imaging of

nanoparticle distribution.

The goal of this proposed project is to validate the use of PLA nano-

conjugates for transcatheter liver embolotherapy by characterizing

the biodistribution of unique radiodense PLA encapsulated iohexol

nanoconjugates after nanoparticle TACE in a rabbit VX2 tumor

animal model of HCC. Development of therapeutic PLA nanoconju-

gates and non-invasive confirmation of their accumulation within

tumor has implications on the understanding of nanoparticle drug

delivery and deposition during TACE, and will permit future basic

science and clinical translational studies aimed at assessing and

optimizing tumor drug delivery using these agents.


Friedrich Knollmann, MD, PhD

RadiologyUniversity of PittsburghRSNA Research Seed Grant

Computed Tomography Perfusion Imaging of Lung Cancer

The treatment of advanced stage lung cancer is limited by a lack

of predictive methods that would allow an early assessment of

treatment success. Contrast-enhanced computed tomography has re-

cently been established as a robust method to assess regional tissue

blood flow, and should offer direct insight into tumor blood flow,

which is the target of anti neo angiogenic therapy.

Computed Tomography Perfusion (CTP) Imaging has the potential

to improve patient management by predicting treatment response.

Correlating tumor response during cancer therapy with patient

survival is the most stringent approach to validate CTP as a predic-

tive marker for treatment outcome. However, the accuracy of such

measurements still needs to be determined, before the method is

applied on a wider scale to predict patient survival.

In comparing the CTP blood flow measurements in lung cancer with

changes in tumor size, 30 subjects will be examined with both a

standard CT series of the chest and a CTP protocol of the tumor. Fol-

lowing the injection of a 30cc bolus of an iodinated contrast agent in

a 64 row multi-detector CT unit, one image will be acquired every 3

seconds over a 40s period at 100 kV, and 100mA tube current.

The perfusion sequence will be repeated after the patient has left

the exam room to determine the reproducibility of the test.

Images will be evaluated using standard CT blood flow software.

Color-encoded maps of regional blood flow will be used to classify

the blood flow pattern, and mean tumor blood flow derived.

The ultimate patient value of the CTP method will be demonstrated

by directly correlating tumor perfusion parameters before and after

the initiation of chemotherapy with patient survival, in comparison

to the prognostic value of measuring tumor size with the current

standard of care CT method.

Puneeth Iyengar, MD, PhD

Radiation OncologyUT Southwestern Medical Center-DallasRSNA Research Seed Grant

Use of an Inducible Cancer Cachexia Mouse Model to Study Inflammatory Effects on Lung Cancer Radiation Response

Lung cancer continues to be the leading cause of cancer death

worldwide. Our ability to control lung disease has not changed

much in the last 30 years, suggesting a need for new intervention.

For decades, it has been perceived that inflammation is a key con-

tributor to lung cancer development. Less emphasis has been placed

on evaluating how systemic inflammation could also significantly

influence radiation sensitivity through the modulation of tumor

suppressive mechanisms including autophagy and DNA damage

signaling.

Cachexia is an inflammatory process which is often associated with

intermediate and late stage lung cancer and includes symptoms

of weight loss, muscle atrophy, and fat loss. There are not many

treatment options for lung cancer patients with cachexia even

though new studies have demonstrated improved survival for these

patients through aggressive palliation. We believe that unique, yet

undetermined, systemic molecules that are components of the ca-

chectic inflammatory state are both drivers of tumor development

and therapeutic resistance.

With this study, we hope to 1) Model cachexia in vivo; 2) Assess

the influence of cachexia on lung tumor progression and radiation

resistance with this inducible murine system; and 3) Identify vital

secretory proteins that are expressed during cachexia and critical

to lung cancer radiation resistance. The inherent biology and role

of cachexia in influencing lung cancer patient performance status,

disease progression, response to therapy, and survival outcomes

is still an open ended question. It is not misleading to surmise that

reversing some of the pathophysiologic consequences and mecha-

nisms of cachexia may help in all four areas –performance status,

disease progression, therapy outcome, and survival. To that end,

believing that cachexia represents one end of the systemic inflam-

matory spectrum, we propose evaluating the relevant pathophysiol-

ogy of cachexia in an inducible mouse model.

research seed grant


Drew A. Torigian, MD, MA

RadiologyUniversity of Pennsylvania School of MedicinePhilips Healthcare/RSNA Research Seed Grant

Utility of DTP FDG-PET/CT and Advanced Image Analysis to Quantify In Vivo Tumor Biology, Predict Clinical Outcome, and Improve Disease Staging in Lung Cancer

Lung cancer is a prevalent and deadly cancer with a wide spectrum

of biological behavior, such that some patients with early stage

disease may survive a long time after surgical treatment whereas

others may experience disease recurrence and shortened survival.

TNM staging and clinicopathological prognostic markers used to

establish risk stratifications among lung cancer patients do not

account for all observed variability in lung cancer-related survival,

and tumors with identical clinicopathological characteristics can be

associated with different expression profiles and clinical outcomes.

Conventional structural imaging approaches at the time of diag-

nosis provide limited information about tumor biology or future

patient outcome, and have suboptimal sensitivities and specificities

for detection and characterization of sites of metastatic disease in

anatomical sites such as the lymph nodes. Laboratory assays of mo-

lecular expression may be useful to help predict clinical outcome,

but do not provide regional spatial information relevant to disease

staging. Thus, there is an urgent need for new yet practical non-

invasive quantitative diagnostic methods to quantify in vivo lung

cancer tumor biology, to improve prediction of clinical outcome,

and to improve disease staging.

Single time point (STP) FDG-PET/CT is routinely used in lung can-

cer patients to provide some information about patient prognosis

and to improve disease staging accuracy, although still suboptimal

in diagnostic performance. We therefore propose to prospectively

evaluate dual time point (DTP) FDG-PET/CT, a modified version

of FDG-PET/CT, in conjunction with advanced image analysis

techniques in patients with surgically resectable lung cancer to as-

sess its utility for simultaneous improved in vivo quantification of

tumor biology, improved clinical outcome prediction, and improved

disease staging. The results, if successful, will have significant

implications for optimizing individualized patient management,

and will provide requisite preliminary data for future, larger scale

research studies.

An Tang, MD

RadiologyUniversity of MontrealToshiba America Medical Systems/RSNA Research Seed Grant

Randomized Trial of Liraglutide and Insulin Therapy on Hepatic Steatosis as Measured by MRI and MRS in Metformin-treated Patients with Type 2 Diabetes: an Open Pilot Study

Non-alcoholic fatty liver disease (NAFLD) can now be identified in

70% of patients with type 2 diabetes. Insulin can be introduced at

any point in the treatment of diabetes, but is potentially lipogenic.

Preliminary studies have shown conflicting results on the impact of

insulin on fatty liver.

This study is conducted to test the hypothesis that in type 2 diabetic

adults with NAFLD who are resistant to metformin, treatment with

liraglutide in combination with metformin will cause an absolute

reduction in liver fat superior to insulin-metformin treatment

within a 3-month period, as measured by in vivo MRI and MRS.

This will be a prospective, open label, randomized parallel trial to

evaluate whether 12 weeks of treatment with liraglutide-metformin

will improve steatosis in type 2 diabetic adults with NAFLD

compared to treatment with insulin-metformin. Before and post-

treatment MRI and MRS will be read blindly for quantification of

steatosis. The primary outcome measure is defined as an improve-

ment in steatosis of 5% before and after treatment between the two

treatment groups.

Thirty-six patients will be randomized to either study group. After

baseline metabolic measurements by blood sampling, transient

ultrasound elastography, MRI and MRS, all subjects will be given

metformin with a starting dose of 500 mg in one tablet twice daily.

In addition, patients will be randomized to receive either liraglutide

or insulin glargine for a duration of 3 months.

The results of this study will provide preliminary data for a large-

scale study comparing the two therapeutic regimens and establish

the utility of MRI and MRS to monitor medical treatment in dia-

betic patients with fatty liver disease.

research seed grant


Robert J. Young, MD

RadiologyMemorial Sloan-Kettering Cancer CenterFujifilm Medical Systems/RSNA Research Seed Grant

Using Functional MRI and Diffusion Tensor Imaging of the Language Pathway to Optimize Brain Tumor Resection

Surgical resection remains the most effective treatment for many

patients with primary and secondary brain tumors, improving both

the length and quality of survival. Surgery must maximize tumor

resection while avoiding adjacent eloquent brain structures, since

their inadvertent injury can cause profound neurological deficits.

Two noninvasive functional techniques can identify the eloquent

brain and facilitate surgical planning for these patients: Functional

MRI (fMRI) to identify the eloquent cortex is useful in guiding deci-

sion making about whether to attempt a resection, determining the

neurosurgical approach, and guiding the intraoperative stimula-

tion.

Diffusion Tensor Imaging (DTI) is a new technique to identify the

eloquent white matter, which is less accessible and less reliable to

stimulate at surgery. Tractography programs can analyze the DTI

data and display white matter fiber trajectories in 3D space. We will

compare two different tractography algorithms (standard vs. proba-

bilistic) in mapping the arcuate fasciculus that connects Broca’s

Area with Wernicke’s Area. We will develop a solution to import the

tractography results into the neuronavigation software, then corre-

late the fMRI- and DTI-identified loci with the intraoperative stimu-

lation loci to determine the accuracies of our techniques. Accurate

noninvasive prediction of the arcuate fasiculus may lead to changes

in the surgical approach and help preserve patient function.

The data gathered in this pilot study will be used to help support the

development of an R01 grant, which will seek to deliver rapid auto-

mated or semiautomated analyses to the neurosurgeon in real-time.

The current grant will provide us with invaluable experience and

preliminary data to submit a competitive grant in 18 - 24 months.

Further work will be necessary to optimize the imaging sequences

and analyses, and incorporation into the neuronavigational system,

and to study and develop corrections for factors presented by brain

tumors such as edema, tumor infiltration and abnormal vascularity

and permeability.

research seed grant

My interest lies in the area of liver cancer and minimally

invasive transcatheter treatment methods—obtaining the RSNA

Research Seed Grant will allow me to focus on the investigation of drug

delivery in minimally invasive oncologic therapy. As hepatocellular

carcinoma (HCC) represents a significant public health problem and

because of the importance of interventional radiologic catheter directed

drug delivery in treating this disease, I believe development and

application of novel, forward-thinking delivery vehicles, such as

nanoparticle platforms, and imaging devices and agents to better

understand, optimize, and confirm targeted liver cancer therapy are of

significant importance. Clinical translation into human patients would

be a long-term goal after validation of methodology in animal models.

Ron C. Gaba, MD



Daniel J. Durand, MD

The Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University School of MedicineRSNA Research Fellow Grant

Molecular Imaging of Choline Metabolism in Musculoskeletal Soft Tissue Masses by C-11 Choline PET/CT and MR Spectroscopy

Choline is an essential nutrient that plays a key role in cell mem-

brane biosynthesis and cell proliferation. Concentrations of choline

and its related metabolites are elevated in malignant tissue due

primarily to increased cell membrane synthesis. Both C-11 choline

PET/CT and MR spectroscopy represent novel methods for quantify-

ing in vivo choline metabolism non-invasively. We hypothesize that

these methods can be used prospectively to characterize musculo-

skeletal soft tissue masses (STMs) as benign or malignant prior to

biopsy.

Aim 1: We will determine whether quantitative changes in absolute

choline concentration as measured by MR spectroscopy correlate

with histopathological endpoints for musculoskeletal soft tissue

masses (STMs). STMs referred for biopsy (deemed indeterminate

by clinical and conventional imaging work-up) will be included,

and absolute choline concentration will be quantified by single

voxel MR spectroscopy. Histopathologic measures will include final

pathologic diagnosis as well as Ki-67 indexing. We will determine

the diagnostic accuracy of MRS for distinguishing benign from

malignant disease using receiver operator characteristic (ROC)

analysis.

Aim 2: We will determine whether quantitative changes in cho-

line uptake as measured by C-11 choline PET/CT correlate with

histopathological endpoints for musculoskeletal soft tissue masses

(STMs). Patients from Aim 1 will also undergo C-11 PET/CT prior to

biopsy. Histopathologic endpoints will be the same as for Aim 1. We

will determine the diagnostic accuracy of C-11 choline PET/CT for

distinguishing benign from malignant disease using ROC analysis.

In addition, we will determine whether intralesional variations

in C-11 choline uptake correlate with intralesional variations in

histopathology.

Overall, the goal of this research is to determine whether predictive

models utilizing non-invasive measures of choline metabolism may

allow more selective and/or more effective biopsy of STMs in the

future.

Jeremy Burt, MD

RadiologyJohns Hopkins University School of MedicineSilver Anniversary Campaign Pacesetters Research Fellow Grant

Diagnosis of Arrhythmogenic Right Ventricular Dysplasia using T1 Mapping for Identification of Myocardial Fibrofatty Infiltration

Arrhythmogenic right ventricular dysplasia (ARVD) is a genetic

cardiomyopathy histopathologically characterized by fibrofatty re-

placement of the myocardium and is an important cause of exercise-

related sudden death in young individuals. The condition is most

frequently diagnosed between ages 20 to 40. The implications of

diagnosis are need for a permanently implanted cardiac defibrilla-

tor and risk of sudden death. The diagnosis of ARVD is challenging

due to the variability of imaging findings, disease expression, and

clinical presentation. Current diagnosis is based upon histopatho-

logic, imaging, and electrocardiographic criteria proposed by the

Task Force of Cardiomyopathies.

MRI is frequently requested to “rule out” ARVD, since early symp-

toms of ARVD (tachyarrhythmia, palpitations, and syncope) are

common. Unfortunately, misdiagnosis by imaging physicians is fre-

quent. One reason for misdiagnosis is the current lack of validated

MRI features compared to histopathology. Both fat and fibrosis

are histologic hallmarks of ARVD, yet neither has been validated

as a noninvasive imaging criterion. In this proposal, we seek to

investigate the use of T1 mapping of the myocardium using MRI in

ARVD. T1 mapping has been developed for other cardiomyopathies

to detect collagen deposition. T1 mapping has the potential for

improved tissue discrimination in ARVD due to additive T1 effects

of both fat and collagen (both causing T1 shortening). Quantifica-

tion of postcontrast myocardial T1 time may help standardize the

diagnosis of this life-threatening condition.

In this work, we will perform a retrospective analysis of patients

in the Johns Hopkins database who previously had MRI examina-

tions for ARVD using the Look-Locker technique for T1 mapping.

In addition, we will perform a prospective study using a modified

Look-Locker T1 mapping technique for patients referred for MRI

diagnosis of ARVD. The goal of this project is to provide a validated,

quantitative method for myocardial tissue characterization in

ARVD.

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research grant programsresearch fellow grant


Randall J. Kimple, MD, PhD

Human OncologyUniversity of Wisconsin-MadisonRSNA Research Fellow Grant

Molecular Mechanisms of Radiation Response Modulation by Human Papillomavirus in Head and Neck Squamous Cell Carcinoma

Human papillomavirus (HPV)-associated head and neck squamous

cell carcinoma (HNSCC) is a growing public health concern. These

patients are younger and present with more advanced disease than

patients with traditional tobacco and alcohol associated HNSCC, yet

paradoxically have improved outcomes. The mechanisms underly-

ing these improved outcomes remain unclear. The work proposed

has two primary goals: 1) to provide for the continued career devel-

opment of the principal investigator (PI) and establish his inde-

pendence so that he can lead a research program investigating the

radiation response in virally associated cancers; and, 2) to under-

stand how HPV-positive HNSCC differs in its response to radiation

therapy from traditional HNSCC. During his research fellowship,

the PI is obtaining additional training in molecular virology, hu-

man papillomavirus biology, and mouse models of cancer to enable

him to compete for independent funding following completion of his

research fellowship.

Aim 1 seeks to explain why HPV-positive HNSCC is more sensitive

than traditional HNSCC to ionizing radiation using standard assays

of radiation survival and both in vitro and in vivo model systems.

The molecular pathways underlying radiation sensitivity will be

investigated while focusing on an enhanced apoptotic response in

HPV-positive HNSCC. Alterations in patterns of gene expression

following radiation will be used to identify potential therapeutic

targets. Aim 2 examines the ability of inhibitors of the epidermal

growth factor receptor (EGFR) to sensitize HPV-positive HNSCC

to radiation in vitro and in vivo. Effects of EGFR inhibition on

downstream signaling pathways will be assessed to identify critical

molecular pathways.

These studies will provide details regarding the mechanism of

increased sensitivity to radiation and will identify important

targets for the development of novel therapies to improve outcomes

of patients with both HPV-positive and HPV-negative head and neck

cancer.

Alessandro Furlan, MD

RadiologyUniversity of PittsburghSiemens Healthcare/RSNA Research Fellow Grant

Assessment of Transplanted Kidney using Quantitative Sodium MR Imaging

Renal allograft dysfunction requires prompt and accurate diagnosis

to avoid graft loss over time. It is particularly important to distin-

guish between acute tubular necrosis (ATN) and acute rejection

(AR), because treatment differs between the two disorders. Because

biopsy is currently the only diagnostic tool to differentiate ATN

from AR, there is a need for a non-invasive method. Renal function

is strictly dependent on the creation and maintenance of a cortico-

medullary sodium gradient that allows for water reabsorption and

urine concentration. In this project we propose to develop in vivo

quantitative sodium MR imaging of human kidney using ultra-

short TE sequence and dedicated multi-channel, dual-tuned proton/

sodium RF coil at clinic 3T scanner, and to apply this technique for

the non-invasive evaluation of renal allograft function.

The hypotheses of the study are that 1) sodium MR imaging can

accurately and reproducibly measure sodium concentration

gradient (CMSG) in kidney, and that 2) variations in renal sodium

concentration gradient are associated with renal pathophysiology

(ATN vs. AR). Accuracy and reproducibility of the sodium measure-

ments obtained with our method will be tested respectively using

a dedicated phantom study, and repeated imaging of three normal

volunteers and three kidney transplant patients. CMSG will be

quantified calculating the mean medulla-to-cortex sodium concen-

tration ratio, and more precisely with a pixel-by-pixel measurement

along the corticomedullary gradient. CMSG will then be measured

from transplanted kidneys and compared between renal allograft

with normal (n=5) and histologically (biopsy) proven ATN (n=5)

and AR (n=5). The success of our proposed study will lead to the

development of accurate and reproducible renal sodium MR imag-

ing technique, the advancement of our knowledge on renal allograft

pathophysiology, and the application of a new imaging biomarker to

diagnose renal allograft ATN and AR.

research fellow grant


Aaron So, PhD

Diagnostic ImagingSt. Joseph’s Health Care LondonRSNA Research Fellow Grant

Validation of Quantitative CT Myocardial Perfusion Measurement with Dual Energy CT Scanning

Coronary CT angiography (CTA) has become a routine non-invasive

procedure for detecting coronary artery disease (CAD) by anatomic

visualization of stenosis severity. The use of dynamic contrast en-

hanced CT imaging (CT perfusion) for quantitative measurement of

myocardial perfusion (MPF) in CAD patients can provide additional

information regarding the fuctional significance of a coronary le-

sion detected by coronary CTA. One of the obstacles for incorporat-

ing MPF measurement into CTA protocol for comprehensive CAD

evaluation has been inaccuracies in the measurement due to beam

hardening arising from high density contrast in the heart chambers

following a bolus injection. Although post-reconstruction correction

algorithm has been developed to reduce beam hardening artifact in

CT images, such correction method is suboptimal because the X-ray

path length through high density contrast can only be approxi-

mately modeled.

Dual energy CT (DECT) scanning allows reconstruction of monoen-

ergetic (keV) images, which are free of beam hardening artifacts,

from two polyenergetic CT scans acquired at two different kVps.

Advances in detector technology have resulted in X-ray detectors

with fast scintillation decay time which permits ‘interlaced’ acqui-

sition of projections at two kVps to minimize patient motion error,

which is important for cardiac imaging and to minimize spectral

contamination between projection views. Because DECT scanning

can minimize beam hardening artifact by projection-based deriva-

tion of monoenergetic images, we posit that DECT measurement of

MPF will be more accurate, which is a prerequisite for using CT, a

widely available imaging modality, for the comprehensive assess-

ment of CAD.

Bela Kis, MD, PhD

RadiologyBrigham & Women’s HospitalRSNA Research Fellow Grant

Effects of Focused Ultrasound on Cerebral Microvascular Endothelial Cells and Pericytes - Investigating the Molecular Mechanisms of Focused Ultrasound-Induced Blood-Brain Barrier Opening

The blood-brain barrier (BBB) is a functional unit of cells which

maintains the stability of the brain microenvironment by strictly

controlling the movement of molecules and cells between the blood

and the brain. While BBB is a necessary physiological gatekeeper,

this barrier is a real obstacle to deliver drugs to treat brain patholo-

gies. It has been shown that focused ultrasound (FUS) is capable

of temporary and localized BBB disruption. FUS combined with

MRI-guidance can provide a noninvasive targeted drug delivery to

the brain. However, the mechanism of FUS-induced BBB opening is

largely unknown.

The goals of the proposed experiments are to study the molecular

mechanism of BBB opening induced by FUS in cerebral endothelial

cells (CECs) and pericytes, the two major constituents of the BBB.

We will use primary cultures of rat CECs and pericytes and differ-

ent co-culture systems which represent the closest possible pheno-

type to the in vivo BBB. These in vitro settings allow us to study

those intracellular mechanisms which are extremely difficult to

study in the in vivo complexity of the brain. First, we will study the

effect of FUS treatment on BBB permeability for different marker

molecules to determine the quality and time course of FUS-induced

BBB opening. Second, we demonstrate FUS-induced cellular shape

changes in CECs and pericytes. Third, we will study the effect of

FUS on organization of major cytoskeletal proteins in CECs and

pericytes. Fourth, we will demonstrate the subcellular re-distribu-

tion of tight-junction proteins in CECs following FUS treatment.

And fifth, we will study the effect of FUS on major intracellular

signaling pathways (Ca2+ and cAMP) which are instrumental in

BBB permeability.

The proposed experiments will shed light on the mechanisms of this

therapeutically very important phenomenon, FUS-induced BBB

opening, which is much needed information to advance this technol-

ogy towards clinical use.

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research fellow grant


Candice A. Bookwalter, MD, PhD

RadiologyUniversity Hospitals Case Medical Center/Case Western Reserve UniversityPeggy J. Fritzsche, MD Research Resident Grant

Motion Artifact Removal by Retrospective Resolution Reduction for Applications in Body Imaging

Ghosting or streaking artifacts due to motion can obscure impor-

tant clinical information in magnetic resonance images. MR ab-

dominal imaging is especially adversely affected by motion artifact

due to breathing, and breath holds are often long and difficult for

patients even with fast imaging methods. In addition, failed breath

holds are almost always identified only after image acquisition, and

no robust method for salvaging the images is available. Assuming

that a patient can initially hold their breath but may fail sometime

during the acquisition, there will be a transition between uncor-

rupted data, where the patient is not breathing, and data corrupted

by motion due to breathing.

We have developed a novel algorithm called Motion Artifact Remov-

al by Retrospective Resolution Reduction (MARs) which automati-

cally detects the transition and removes corrupted data. Specifical-

ly, for the rectilinear trajectory the transition will be automatically

detected by an abrupt decrease in correlation coefficients between

the acquired PE lines and the GRAPPA navigators. For the radial

MARs algorithm, the echo magnitude also demonstrates a sharp

change at the time breathing resumes. Preliminary studies using

rectilinear MARs have demonstrated decreased motion artifact with

the cost of decreased resolution. We aim to further optimize the

rectilinear MARs algorithm and develop a radial MARs algorithm.

Finally, we proposed to compare the corrected and uncorrected rec-

tilinear and radial images by independent observer ratings in a two

alternative forced choice paradigm. Should the diagnostic quality of

MARs corrected images prove superior to uncorrected images, this

method would solve an unmet need in body imaging.

Carmen Bergom, MD, PhD

Radiation OncologyMedical College of WisconsinRSNA Research Resident Grant

SmgGDS and Altered Small GTPase Prenylation as Novel Radiosensitization Targets in Breast Cancer

Advances in understanding the molecular basis of breast cancer

progression and resistance have led to new treatments, such as

HER2 and estrogen signaling inhibition. However, radiation and

chemotherapy resistance remain major challenges in managing

local-regional and distant disease. Small GTPases, which are mem-

bers of the Rho, Rac, Ras, and Rap families, regulate breast cancer

development and progression and can alter sensitivity to radiation

and chemotherapy. Identifying new ways to suppress small GTPase

activation in breast cancer may provide new treatment approaches.

The proposed research is based on our discovery that breast cancer

cells express elevated levels of SmgGDS, a unique protein known

to activate multiple members of the small GTPase families. We

discovered that breast cancer cells express two SmgGDS splice

variants, SmgGDS-558 and SmgGDS-607, which differentially affect

small GTPase prenylation. Silencing expression of these SmgGDS

splice variants in breast cancer cells significantly diminishes cell

proliferation and anchorage-independent cell growth, and increases

doxorubicin-induced apoptosis. Increased SmgGDS mRNA levels

in breast cancer also correlate with a lower likelihood of com-

plete pathologic response with neoadjuvant chemotherapy. Taken

together, SmgGDS emerges as a promising target to alter breast

cancer therapeutic responses.

Our overall hypothesis is that SmgGDS attenuates irradiation-in-

duced cell death, revealing a new target for breast cancer radio-

sensitization. This hypothesis will be tested in the following aims.

Aim 1: Determine whether SmgGDS splice variants differentially

promote radiation resistance in cultured breast cancer cells. Aim 2:

Determine whether SmgGDS splice variants sensitize human breast

tumor xenografts to radiation, and determine whether radiosensi-

tization is due to acute cell death in vivo using a novel radiotracer,

99mTc-duramycin. This study will define the role of SmgGDS splice

variants in breast cancer radiation resistance. The anticipated find-

ings are expected to uncover new therapeutic targets to alter small

GTPase activity and treatment responses in breast cancer.

research resident grantresearch grant programs


Albert Chang, MD, PhD

Radiation OncologyWashington University School of Medicine/Barnes Jewish HospitalVarian Medical Systems/RSNA Research Resident Grant

64Cu-Radiolabeled Somatostatin Analogs for Targeted Imaging and Therapy of Medulloblastoma

Medulloblastoma is the most common pediatric brain malignancy.

Although patient survival has increased, current treatments cause

long-term impairments. Standard imaging techniques provide good

anatomic detail but minimal biological information. Small lesions

can be missed and treatment effect is often difficult to discern from

tumor progression. Therefore, improved imaging and therapeutic

options are necessary. Medulloblastoma overexpresses the soma-

tostatin subtype 2 receptor (SSTr2). The goal is to characterize and

evaluate Copper-64 (64Cu) radiolabeled somatostatin analogs for

targeted imaging and therapy of medulloblastoma. The impact is

improvement in the detection and monitoring of medulloblastoma

and improvement in outcome with reduction in treatment-related

side effects.

111In-DTPA-octreotide is FDA-approved for SPECT imaging of

tumors overexpressing somatostatin receptors, but image resolu-

tion and sensitivity are lacking. Somatostatin analogs labeled with

positron emitters demonstrated promising results with higher

resolution images and greater sensitivity than 111In-DTPA-OC.

Radiolabeled SSTr2 ligands were also investigated as targeted

agents. Treatment with Yttrium-90 and Lutetium-177 radiolabeled

somatostatin analogs demonstrated responses including significant

tumor regression or remission. The administered activity was

limited due to renal toxicity.

The positron and beta minus decay of 64Cu allow for the develop-

ment of radiopharmaceuticals with both imaging and therapeutic

properties. Our preliminary results demonstrate the potential of

64Cu-radiolabeled somatostatin analogs for imaging and radio-

therapy in xenograft models with colorectal tumors engineered to

overexpress SSTr2. In the proposed research, 64Cu-radiolabeled

somatostatin analogs will be characterized and evaluated for in vivo

PET imaging and targeted radiotherapy of medulloblastoma.

Hypothesis: 64Cu-radiolabeled SSTr2 agonists are effective agents

for in vivo PET imaging and targeted radiotherapy of medulloblas-

toma.

Scott Bratman, MD, PhD

Radiation OncologyStanford University Medical CenterPhilips Healthcare/RSNA Research Resident Grant

Stromal Contributions to Self-renewal and Radiation Resistance of Breast Cancer Stem Cells

Breast cancer is diagnosed in one out of nine women over the

course of their lifetime and accounts for over 40,000 deaths annually

in the United States. Radiation therapy and chemotherapy, which

generally target rapidly dividing cells, have improved outcomes

and extended survival in breast cancer patients, yet recurrence and

treatment resistance remain frequent. Breast tumor initiating cells

(TICs), sometimes called cancer stem cells, and the tumor-associ-

ated stroma have largely been ignored in drug development. Prior

work has demonstrated that TICs from diverse tumor types are

relatively resistant to ionizing radation. Normal stem cells depend

on stromal cells for the formation of a stem cell “niche”, but the role

of the stromal cells in breast TIC function and treatment resistance

has not been explored.

Here, we propose a set of experiments, which aim to define the

effects of stromal fibroblasts on breast TIC self-renewal, differentia-

tion, and resistance to ionizing radiation. First, normal and tumor-

associated fibroblasts from primary normal and tumor murine

breast tissues will be isolated, and their effects on TIC functions

will be assayed in a 3D culture system and an orthotopic mouse

model. Next, we will test the impact of the stromal fibroblasts on

TIC viability after irradiation, and this will be correlated with

changes in reactive oxygen species levels and IR-induced DNA dam-

age. Finally, we will identify secreted factors responsible for these

effects; specifically, we will test SDF-1 and HGF—known secreted

stromal factors that promote tumor growth—for effects on TIC func-

tion and radiation resistance. Altogether, this research proposal,

which will better characterize the unique microenvironment within

the TIC-stromal niche, has the potential to lead to the development

of novel radiation sensitizers and other classes of cancer therapeu-

tics.

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research resident grant


Mai-Lan Ho, MD

RadiologyBeth Israel Deaconess Medical CenterBracco Diagnostics/RSNA Research Resident Grant

Sodium-23 MRI for Seizure Focus Localization in Epileptic Patients

Accurate localization of seizure foci is critical for evaluating pa-

tients with medically intractable forms of partial epilepsy. However,

current noninvasive imaging and clinical techniques– including

proton MRI/MRS, DTI, fMRI, ASL, PET, SPECT, MEG, EEG, and

neuropsychological testing– are not always successful at lateraliz-

ing and localizing seizure onset centers.

Sodium-23 MRI is an emerging new technology with promising appli-

cations in brain imaging. Maintenance of normal transmembrane

sodium gradients is critical for osmotic regulation, pH stabiliza-

tion, and transmission of action potentials. Therefore, measured

sodium concentrations can be used as an operational index of tissue

viability and cellular/metabolic integrity. We hypothesize that the

acute neuronal hyperexcitability and chronic gliosis associated

with epilepsy will augment transmembrane resting potentials

and expand the interstitial space, producing a relative increase in

regional sodium levels.

Our laboratory group has successfully optimized sodium MRI at 3T

for normal brain, using single-quantum imaging with a modified

3D GRE pulse sequence to overcome the inherently low SNR. This

protocol will be further developed to include coregistered sodium

MRI/MRS, T2W proton MRI/MRS, and ASL. Metabolite concentra-

tion maps will be generated for age and gender-matched controls to

establish standard reference values. We will confirm sodium MRI

functionality in patients with well-localized seizure foci, based on

matching findings from proton MRI, EEG, and semiology. Subse-

quently, we will conduct a pilot study of patients with suspected le-

sions based on EEG and semiology, but negative findings on proton

MRI. This will provide requisite preliminary data for a future NIH

R01 grant application.

Key objectives of this research include comparison of inter-modal-

ity performance, quantification of metabolite concentrations, and

clinico-radiologic correlation in known and putative seizure foci.

Development of clinically viable sodium MRI technology for whole-

brain imaging has long-term applications for investigating disease

pathophysiology, performing presurgical evaluation, and monitor-

ing response to treatment.

James Hansen, MD

Therapeutic RadiologyYale-New Haven HospitalRSNA Research Resident Grant

Targeting Cancer with a Cell-Penetrating Anti-DNA Antibody

Most cancer therapies are severely limited by significant side ef-

fects due to non-specific tissue toxicity, and identification of novel

agents that are selectively toxic to malignant cells or selectively

sensitize tumors to treatment is a key goal in cancer research. We

have discovered that an anti-DNA antibody that penetrates into cell

nuclei, 3E10, enhances cancer cell radiosensitivity. Moreover, this

effect is potentiated in cancer cells deficient in DNA repair. 3E10

has potential as a therapeutic agent selective for cancers deficient

in DNA repair, which is relevant to numerous human malignan-

cies including breast, ovarian, pancreatic, and prostate cancers.

The ability of 3E10 to penetrate into cells and nuclei distinguishes

it from all antibodies currently approved for cancer therapy, and

3E10 is the first member of a new class of radiosensitizing agents.

The goal of this project is to establish 3E10 as a novel platform from

which new targeted therapies for cancer may be developed, and we

propose to: 1. Investigate the mechanism by which 3E10 enhances

cancer cell radiosensitivity. 2. Evaluate the potential of 3E10 in

targeted cancer therapy.



Xiang Li, PhD

RadiologyDuke UniversityRSNA Presidents Circle Research Resident Grant

Patient-Specific Dosimetry in Pediatric and Adult Computed Tomography

Computed tomography (CT) is the single largest source of medical

radiation to the U.S. population. The last few years have witnessed

growing efforts to manage CT radiation, particularly efforts to

track radiation dose and to adapt scanning techniques to patient

size. These efforts can greatly benefit from a dose-reporting system

that provides estimates of radiation dose and potential cancer risk

specific to each patient and each CT exam. Enabling such a patient-

specific dose-reporting system is our long-term objective. This

application represents the pilot phase.

In this phase, we propose to estimate patient-specific dose and risk

for 26 patients representing body habitus from newborn to obese

adult and for the entire spectrum of clinical CT protocols (thoracic,

abdominal, neurological, cardiac, musculoskeletal, vascular, and

interventional exams). The 26 patients will be selected from a da-

tabase of patients, for whom full-body computer models have been

created from clinical CT data. A validated Monte Carlo program

will be used to simulate the anatomical coverage and acquisition

condition in each protocol. The simulated organ dose will be used to

estimate cancer risk. For each protocol, we will determine conver-

sion coefficients from reference dose quantities (e.g., CT dose index,

dose-length product, equilibrium dose) to patient dose quantities

(organ dose, effective dose, organ risk, total cancer risk) and derive

these conversion coefficients as functions of patient size, age, and

gender.

The findings of this pilot study will guide a larger scale study to

enable a system of patient-specific dose estimation and reporting in

CT. Such a system could guide individualized protocol optimization.

For patients who undergo sequential exams, knowledge of dose and

risk could aid in deciding exam frequency. Cumulative dose and

risk profiles of individual patients could also be used to identify pa-

tients who have reached a certain exposure level so that alternative

low-dose or non-radiation imaging procedures may be sought.

Thomas J. Klein, MD, PhD

Therapeutic RadiologyYale-New Haven HospitalRSNA Research Resident Grant

Genetic Analysis of the Tissue-Wide Response to Ionizing Radiation

The goal of most clinical radiation treatment is to eradicate micro-

scopic malignant disease from within an otherwise normal organ,

often requiring equivalent doses be delivered to both normal and

cancerous cells. While strategies that maximize the differences in

the radiobiology of these tissues have led to improvements in our

ability to destroy malignant cells with fewer effects on the sur-

rounding tissues, enhancement of the therapeutic ratio remains

a clinical challenge. Currently, there are very few genetically tracta-

ble approaches to studying the radiation response of tumors as they

grow within an otherwise normal tissue. Our lab has developed

a novel system for inducing and analyzing tumors in vivo in Dro-

sophila larvae. These tumors are induced to form within otherwise

normal epithelial tissues, thus mimicking the growth of many solid

tumors (e.g. breast, lung, colon, prostate). This system provides an

ideal platform for studying the interactions that take place between

wild-type and malignant tissues, as well as the signaling pathways

that regulate those interactions.

Our model is simple, robust, and highly genetically manipulable.

In the current proposal, we outline the development of a novel

model system in which the effects of radiation on solid tumors and

the surrounding normal epithelium can be analyzed in a system-

atic fashion. We aim to establish protocols for the irradiation and

analysis of Drosophila larvae, both for wild-type organisms and

for those in which tumors have been induced. We will analyze the

effects of mutation of genes known to be involved directly in the

cellular response to ionizing radiation, as well as those genes that

are likely to be involved in the tissue-wide radiation response. Hav-

ing established proof-of-principle, we intend to perform a genome-

wide screen to identify novel pathways involved in the radiation

response, potentially revealing novel targets to be exploited for

therapeutic gain.



Cullen Taniguchi, MD, PhD

Radiation OncologyStanford UniversityRSNA Research Resident Grant

Investigating the Radioprotective Effect of PHD2 in Colorectal Epithelium Through a Novel Mouse Model

The dose-limiting factor for radiation delivery to tumors in the

abdomen and pelvis is often toxicity to the normal cells of the

gastrointestinal (GI) tract. Moreover, although symptoms from GI

toxicity can be particularly distressing to patients, there are no ef-

fective therapies to prevent these unwanted side effects. Normal GI

epithelia exist in a state of mild hypoxia, and hypoxic gene expres-

sion is required to maintain the normal physiologic functions of the

GI tract. Based on this, we reasoned that the genes in the VHL/HIF/

PHD axis might participate in the radiation response of the gut. To

test this hypothesis, we developed an adenovirus vector to deliver

Cre recombinase (AdCre) specifically to the distal colon/rectum of

mice harboring a homozygous floxed allele of VHL. When AdCre

was delivered to the colorectal epithelium of VHLfl/fl mice, VHL ex-

pression was decreased by 70%, which resulted in a 50% increase in

the regrowth of crypts in the distal colon after 12Gy of whole-body

irradiation, when compared to mice treated with a control GFP ad-

enovirus. These data provide proof of principle that the VHL/HIF/

PHD axis may have a biological role in radioprotection.

Unfortunately, VHL is not a compelling or tractable therapeutic

target, but we believe that we can phenocopy this protective effect

by geneticially ablating or inhibiting prolyl hydroxylase domain-

containing protein 2 (PHD2), which works with VHL to negatively

regulate HIF levels during normoxia. Through the use of our

unique colorectal knockout technique as well as pharmacologic inhi-

bition PHD2, we hope to validate the radioprotective properties of

PHD2 in vivo and use these data to develop therapeutics that can be

rapidly translated to the clinic to spare normal tissues in the lower

GI tract from radiation damage, potentially allowing for safer and

more effective delivery of radiation therapy for many thousands of

cancer patients annually.

Brendan McCullough, MD, PhD

RadiologyUniversity of WashingtonCook Medical Cesare Gianturco/RSNA Research Resident Grant

Mortality, Major Medical Complications, and Costs Associated with Percutaneous Vertebroplasty versus Conservative Therapy for the Treatment of Osteoporotic Vertebral Fractures

Percutaneous vertebroplasty (PV) has been developed as a minimal-

ly-invasive treatment for painful osteoporotic vertebral fractures

that are refractory to conservative therapy. Numerous studies have

shown significant improvements in pain, disability, and quality of

life with PV, but two recent randomized controlled trials failed to

show any benefit of PV over sham treatment. Osteoporotic vertebral

fractures, however, are of greater concern than these subjective

outcome measures suggest: one year mortality has been reported

to be as high as 28%, higher than that seen with hip fractures. The

reason for this is likely related to the disabling effect of the injury

in combination with significant underlying comorbidities. The

previous studies examining the effectiveness of PV have not been

designed to compare relatively rare events like death and major

medical complications between treatment groups. We hypothesize

that PV will limit the disability associated with the fracture and

result in lower rates of mortality and major medical complications

compared to conservative treatment.

This project will use the Medicare Part B claims database to iden-

tify patients with osteoporotic vertebral fractures treated with PV

or conservative therapy. We will compare proportions of deaths

and major medical complications by treatment group using logistic

regression and controlling for comorbidities. Additionally, we will

compare the total medical costs following the injury using linear

regression to evaluate the cost effectiveness of PV.

Reductions in the rates of death and major medical complications

following osteoporotic vertebral fractures with PV compared to

conservative therapy would reshape the debate regarding the ef-

fectiveness of this procedure. Three-quarters of PV procedures are

performed by radiologists; as such, the results of this study have the

potential to significantly alter our practice.

MEDICAL



Sina Tavakoli, MD

RadiologyUniversity of Texas Health Science Center at San AntonioRSNA Research Resident Grant

In Vivo Imaging of Vascular Remodeling Using a Novel Dual-Modality Matrix Metalloproteinase-2 Activatable Folate Receptor-beta Targeting Delivery System

Targeting macrophage activation as a means to detect early

inflammatory events is a widely investigated approach in imaging

vascular remodeling with promising results in animals. However,

suboptimal accuracy of current approaches challenges their clini-

cal application. The central hypothesis of this proposal is that a

uniquely designed delivery system that selectively targets activated

macrophages at sites of vascular inflammation will improve the

accuracy of imaging.

We propose two Specific Aims: in Aim 1, we propose to determine

ex-vivo the selectivity of our novel dual-modality 99m-Tc and Alexa

Fluor-546-labeled matrix metalloproteinase-2 activatable folate

receptor (FR)-beta targeting delivery system for activated macro-

phages. The ex vivo kinetics and specificity of tracer binding to

FR-beta will be determined in mouse activated macrophages, and

compared to binding and uptake in non-activated macrophages,

endothelial and vascular smooth muscle cells. The goal of Aim 2 is

to determine in vivo whether microSPECT/CT imaging using this

delivery system allows for the early detection of injury-induced

vascular remodeling in mice and monitoring of disease progression.

The in vivo image acquisition and tracer dose will be optimized

by dynamic imaging of apoE-/- mice with injury-induced carotid

remodeling throughout a 6-hour period. The specificity of the

imaging will be confirmed by pre-administration of excess non-

labeled folate. Tracer uptake will be quantified and compared with

autoradiography and gamma-counting to address the accuracy of

in vivo imaging. Finally, the ability of in vivo imaging to monitor

the extent and progression of vascular remodeling will be addressed

in longitudinal imaging of individual animals at 1, 2 and 4 weeks

after carotid injury. Uptake data will be correlated with histological

indices of vascular remodeling to address the biological relevance

of the imaging.

We anticipate that the proposed experiments will lead to the

development of a novel, multi-functional imaging modality to non-

invasively detect early events associated with vascular injury and

to monitor disease progression.



Dear Donors, It is truly an honor to receive the 2011-2012 Peggy J. Fritzsche, MD RSNA Resident

Research Grant and I wanted to express my appreciation to the many donors who made

it possible. Like Dr. Fritzsche, I am one of five children and I grew up in Ohio, where

I am currently a second year resident of University Hospitals Case Medical Centers/Case

Western Reserve University.

The RSNA Resident Research Grant has given me dedicated research time that

otherwise would not have been possible. I will develop new technical skills, embark

on my first clinical research project, and acquire additional skills to direct my own

independent research program in the future.

I look forward to honoring Dr. Fritzsche’s tradition of promoting MRI by researching a new, automatic and

retrospective motion correction method for body MRI. Thank you again for making this grant possible.

Sincerely,

Candice A. Bookwalter, MD, PhD


research medical student grant

Sanjay Aneja, BS

Therapeutic RadiologyYale School of MedicineRSNA Research Medical Student Grant

The Role of County-Level Radiology and Radiation Oncology Services in the Management of Breast Cancer

The factors associated with geographic variations in breast cancer

outcomes remain unexplored. Accompanying geographic dispari-

ties in breast cancer outcomes are geographic maldistribution of

radiology and radiation oncology services across the United States.

Our study would test whether geographic variations in three breast

cancer-related outcome measures-mortality, incidence, and clinical

management-are related to the maldistribution of radiology and

radiation oncology services.

To evaluate this relationship with respect to breast cancer mortal-

ity, we will utilize county-level mortality and incidence merged data

from the NCI-SEER program and the National Program for Cancer

Registries. We will obtain county-level data on mammography tech-

nology, radiologist, and radiation oncologist densities, using the 2010

Area Resource File (ARF). We will then build an incidence-adjusted

regression model testing the significance of increasing radiologist

density, radiation oncologist density, and mammography access on

breast cancer mortality.

To evaluate this relationship with respect to breast cancer inci-

dence, we will use county-level NCI-SEER data on breast cancer

staging. We will again use the ARF data to build a second model,

testing whether increased radiologist density and mammography

availability are associated with higher county-level proportions of

early stage breast cancer. To evaluate this relationship with respect

to clinical practice, we will use county-level NCI-SEER data on the

proportions of mastectomies versus breast conserving surgeries.

Using ARF data, we will build a third model testing whether pa-

tients in counties with higher radiation oncologist density are more

likely to receive breast-conserving surgery.

The long-term goal of our work is to analyze health system and

population factors associated with the geographic variations in

breast cancer outcomes and treatment patterns. Our work impacts

clinical medicine because it potentially identifies geographic

disparities in the management of breast cancer. Moreover, our work

informs policy makers of the importance of radiology and radiation

oncology services in breast cancer treatment.

Henry Andoh, BA

RadiologyDartmouth Medical SchoolCanon U.S.A./RSNA Research Medical Student Grant

Magnetic Resonance Imaging Features that Predict the Biologic Behavior of Head and Neck Cancer

There are 75,000 head and neck cancer (HNC) cases diagnosed in the

U.S. and approximately 30,000 deaths due to disease each year. Fol-

lowing surgical resection, 10 - 30% of resected cancers recur at the

primary site despite negative histologic margins. Potential theories

that explain the high local recurrence rate include persistence of

minimal residual disease at the margin and the presence of precur-

sor lesions that subsequently develop into carcinoma. Studies have

demonstrated that CT and MRI (T1 and T2 weighted sequences) lack

the sensitivity to reliably detect residual disease while PET suffers

from low spatial resolution which results in false negative findings.

However, studies have demonstrated that the presence of DNA mu-

tations of TP53, a tumor suppressor gene, serves as an independent

predictor of local recurrence. In addition, squamous cell head and

neck (HNSCC) patients with clinical and radiologic N0 necks and 15-

20% risk of nodal metastasis receive elective neck dissection despite

the fact that only 30% of these patients harbor micrometastases as

confirmed by histopathology. Therefore 70% of patients receive elec-

tive neck dissection without clear clinical benefit.

Diffusion weighted imaging (DWI) and dynamic contrast-enhanced

MR (DCE-MRI) have been shown to be predictive of the biologic

behavior of tumors in other regions of the body, but application to

head and neck cancer has been limited. This study examines two

hypotheses utilizing DWI and MR perfusion: 1) The presence of

TP53-mutated DNA within or surrounding the primary tumor cor-

relates with significantly lower ADC values than regions of interest

with no TP53-mutated DNA; 2) DCE-MRI perfusion parameters

(kTrans and rBV) are significantly different at the primary tumor

site in lymph node positive compared to lymph node negative

HNSCC .

research grant programs



Katelyn Atkins, BS

Radiation OncologyOregon Health & Science UniversityRSNA Research Medical Student Grant

The Role of PACS-2 in Radiation-Induced Gastrointestinal Syndrome

Understanding the molecular basis of how cells respond to acute

radiation will benefit rational approaches to selectively protect

healthy cells, thereby increasing the therapeutic index of radio-

therapy while minimizing radioresistance of tumors or causing sec-

ondary malignancies. The tumor suppressor p53 promotes survival

by increasing expression of the cyclin-dependent kinase inhibitor

p21, which induces growth arrest of gastrointestinal (GI) epithelial

cells following exposure to ionizing radiation (IR). However, the

molecular mechanism underlying this phenomenon is incompletely

understood.

We recently identified the multi-functional sorting protein PACS-2

as a critical regulator of IR-induced p21 expression in vivo. PACS-

2-/- mice have a repressed induction of p21 following IR, suggesting

PACS-2 is a novel regulator of acute radiation damage. The experi-

ments outlined in this proposal will test the hypothesis that PACS-

2-/- mice will have a diminished capacity to promote p53-dependent

growth arrest and will therefore be sensitized to radiation-induced

GI epithelium damage and GI syndrome-mediated death. We will

utilize immunohistochemical techniques to analyze proliferation,

crypt survival, and mitotic catastrophe in small intestine samples

from wild type and PACS-2-/- mice following IR. Additionally, we

will determine by survival analysis whether PACS-2-/- mice are

sensitized to GI syndrome-mediated death. I will complete these

experiments with the guidance of my scientific advisor, as well as

our collaborators in the Knight Cancer Institute, the Knight Cancer

Diagnostic Laboratories and the Department of Radiation Medicine

at OHSU. The proposed work is significant to the radiobiological

sciences because the development of targeted adjunct therapies re-

lies on a detailed understanding of the complex molecular machin-

ery controlling the cell’s response to radiation injury. Therefore,

understanding the molecular circuitry of PACS-2’s radioprotective

role may identify novel therapeutic strategies to enhance protec-

tion of normal GI epithelium by protecting or promoting PACS-2

function.

W. Chad Armstrong, BA

RadiologyUniversity of Mississippi Medical CenterRSNA Research Medical Student Grant

Differentiating Benign From Malignant Lung Nodules Using Nodule Enhancement on Multiphasic Contrast-enhanced CT and Early Volumetric Size Changes

Staging of hepatocellular carcinoma (HCC) and renal cell carcinoma

(RCC) is of the utmost importance for determining the appropriate

treatment strategy for a patient’s care. Patients without metastatic

spread have much better 5-year survival rates than those with meta-

static disease. Differentiating between benign and metastatic lung

nodules in HCC and RCC patients is critical for correctly staging

disease, especially since the lungs are the most common location for

metastatic spread of HCC and RCC. However, up to 50% of surgically

excised lung nodules turn out to be benign, and primary methods of

differentiation such as biopsy and FDG-PET CT scans are invasive

and carry low risks of morbidity and mortality or add cost to the

patient’s care. Since metastatic HCC and RCC lung nodules are

hypervascular, multiphasic contrast-enhanced CT (CECT) may offer

key, noninvasive diagnostic insight into differentiating between

benign or malignant nodules.

Our aim is to identify if the absolute enhancement of lung nodules

> 8 mm in size found during a multiphasic CECT staging examina-

tion for HCC and RCC can be used to differentiate benign from

metastatic lung nodules. If this is possible, then the multiphasic

CECT could provide a noninvasive, inexpensive and accurate

means of staging HCC and RCC in patients with indeterminate lung

nodules. Our second aim is to determine if volumetric lung nodule

size changes on short interval follow up after a multiphasic CECT

staging examination for HCC and RCC can be used to differentiate

benign from metastatic lung nodules measuring > 3 mm. It is now

accepted that volumetric measurements of lung nodule growth on

CT can detect an increase in size earlier that axial CT size measure-

ments. Therefore, volumetric measurements from follow up scans

may provide quicker identification of metastatic spread to the lungs

than conventional axial CT size measurements.


Alec Block, BS, BA

Radiation OncologyLoyola University Medical Center Stritch School of MedicineRSNA Research Medical Student Grant

Patient Specific Imaging Dose Assessment for IGRT

Image-guided radiation therapy (IGRT) uses advanced imaging tech-

niques to better localize the target volume and is the means by which

the high degree of accuracy and precision required for modern

radiotherapy techniques is achieved. However, several recent articles

in the popular press have many patients concerned that too much

radiation exposure, either in the form of diagnostic images (such

as from IGRT) or therapeutic doses, puts them at risk for serious

adverse effects. In our clinic, daily kilo-voltage (kV) images are used

for patient setup verification and repositioning. Weekly cone beam

computed tomography (CBCT) scans are used to acquire high-reso-

lution volumetric images to verify the internal anatomy. Multiple

studies have reported measurements of the imaging doses delivered

by different kV planar and CBCT systems, but these studies have

not clinically applied these measurements to actual patient data.

The aims of this study are two-fold: 1. To measure the imaging doses

of our kV planar and CBCT systems using realistic phantoms. 2.

To use these measurements to retrospectively estimate the imag-

ing doses delivered to approximately 100 patients based on the kV

planar and CBCT imaging that they received during their treat-

ment. Our hypothesis is that by using phantom studies to measure

the amount of imaging dose delivered by departmental IGRT

protocols, we will be able to retrospectively estimate the amount of

imaging dose received by IGRT patients. Once the imaging dose is

quantified, future studies will focus on measures that can be taken

to adjust technique parameters in order to decrease this dose, while

producing high quality images.

Ryan Baker, BS

Radiation OncologyMoffitt Cancer Center(Ryan is enrolled at the University of South Florida College of Medicine)RSNA Research Medical Student Grant

Stereotactic Radiotherapy (SBRT) to the Lung: Quantifying the Risk of Radiation Pneumonitis

Surgery remains the standard of care for treatment of early-stage,

peripheral non small-cell lung cancers. However, many patients

are not candidates for resection due to poor baseline pulmonary

function or other co-morbidities. Traditional doses of radiation lead

to poor local control. SBRT has significantly improved outcomes

in these patients. However, given that these patients typically have

pulmonary compromise, radiation oncologists have been concerned

about radiation pneumonitis (RP) in this population. Published

guidelines regarding dose constraints or other clinical factors

which might predispose to radiation pneumonitis in SBRT patients

are scant.

From 2006 - present, we have treated approximatley 400 patients

with SBRT to the lung. We have prospectively gathered toxicity data

using CTC-AE v3 (and, more recently v4) criteria, including RP, dur-

ing treatment and at each followup. We will gather relevant clinical

information (oxygen use, smoking history, current smoking status,

history of pulmonary or cardiac comorbidity) as well as dosimetric

information for lung (V5, V13, V20, mean lung dose, minimum and

maximum lung doses) and heart (minimum, mean, and maximum

doses). Tumor location will also be annotated. We will then run

univariate and multivariate analyses to determine clinical and/or

dosimetric predictors of radiation pneumonitis.

A few dosimetric parameters have been proposed when using SBRT

to treat tumors in the lung. However, the author readily admits that

these are largely conjectural (1). We will determine hard criteria

which will further guide radiation oncologists when treating pa-

tients with SBRT.

(1) Timmerman R. An overview of hypofractionation and introduction to this issue

of seminars in radiation oncology. Seminars in radiation oncology 2008;18:215-222.



Danny Costantini, PhD

Diagnostic ImagingHospital for Sick Children, University of TorontoPhilips Healthcare/RSNA Research Medical Student Grant

Imaging Cell Proliferation with FLT PET: A Pilot Study in Pediatric Lymphoma Patients with Equivocal FDG PET Findings

Residual masses on follow-up surveillance imaging are frequently

detected in pediatric patients with Hodgkin’s lymphoma (HL).

Positron emission tomography (PET) using 3’-deoxy-3’-[fluorine-18]-

fluorothymidine (FLT) can image cellular proliferation, and may

prove useful in distinguishing fibrotic or necrotic residual mass

lesions from those that may be harboring malignancy in pediatric

patients previously treated for Hodgkin’s lymphoma.

This is a prospective pilot-scale clinical study evaluating the

clinical use of FLT PET in twenty (20) pediatric patients with HL.

Primary Measure: Our primary measure is to obtain a preliminary

estimate of the diagnostic performance (sensitivity, specificity, ac-

curacy) of FLT PET in identifying residual malignant lesions which

receive an equivocal FDG PET/CT diagnosis.

Any HL patient at SickKids who receives an equivocal post-therapy

FDG PET/CT diagnosis after completion of chemotherapy is eligible

for recruitment. The FLT PET scan will be performed 1-5 days after

FDG PET/CT. For FLT PET, each patient will receive FLT intrave-

nously (5.2 MBg/kg), and imaging will be conducted approximately

60 minutes after injection using a Phillips Gemini GXL PET/CT

scanner. FLT PET images will be analyzed in a random sequence

and evaluated in a blinded fashion. Analysis will involve comparing

the FLT PET results to the best reference standard available includ-

ing histology, if available, as well as clinical and imaging follow up.

The diagnostic performance (sensitivity, specificity, accuracy) will

be calculated retrospectively based on the information acquired

from the completed FLT PET studies.

This study will generate preliminary data to guide the design of a

larger trial of FLT PET in pediatric HL patients. In the long term,

many children with benign processes may potentially benefit by

adjunct FLT PET by avoiding lengthy follow-up evaluations, un-

necessary biopsy or aggressive chemo-radiotherapy, whereas those

children found to have residual tumor will gain precious time for

salvage therapy.

Christopher D. Corso, PhD

Radiation OncologyEmory University School of MedicineRSNA Research Medical Student Grant

Evaluation of the Heat Shock Protein 90 Inhibitor Ganetespib as a Radiosensitizing Agent in Human Breast Cancer Models in Vitro

Heat shock protein 90 (Hsp90) is a molecular chaperone that plays

a key role in the folding, stability and function of many oncogenic

signaling proteins including Akt, Her2/neu, Survivin, bcr-abl and

mutated p53, among others. Hsp90 expression is elevated in a wide

spectrum of malignancies including mammary carcinoma cells and

its activity appears to be required in order to permit accumulation

of over-expressed and mutated oncogenes. Preclinical anti-tumor

activity of Hsp90 inhibitors have been reported in several human

cancer cell lines including triple positive and triple negative breast

cancers. There are however, very limited data on the combination

of radiation with Hsp90 inhibitors in the treatment of breast can-

cers. Since radioresistance is associated with increased expression

of many of the client proteins of Hsp90 such as Akt and Her2/neu,

it is hypothesized that treatment with the novel Hsp90 inhibitor,

ganetespib, prior to irradiation will have a synergistic effect as

compared to either treatment alone.

This work aims to explore the efficacy of ganetespib in combination

with radiation in breast cancer cell lines of varying ER/PR receptor

and Her2 status. The effects of ganetespib will also be evaluated in

an inflammatory breast cancer cell line which is one of the most ag-

gressive forms of primary breast carcinoma, with poorer outcomes

correlated with ER negativity. Clonogenic survival studies, MTT

viability assays, and apoptotic studies will be performed on four

cell lines following treatment with ganetespib and radiation: BT-474

(ER/PR+, Her2+), MDA-MB-231 (ER/PR -, Her2-), MCF-7 (ER/PR+,

Her2-) and SUM190 (ER/PR -, Her2+) which is a cell line for inflam-

matory breast carcinoma. The effects of ganetespib on the levels of

Hsp90 client-proteins including Akt, EGFR, Her2/neu, and VEGF

will be studied in an effort to further understand the mechanisms

by which the Hsp90 inhibitors confer radiosensitization in breast

cancer cell lines.



Carl DeSelm, PhD

Radiation OncologyWashington University School of MedicineRSNA Research Medical Student Grant

The Role of PIKE in Cervical Cancer: a Potential Novel Therapeutic Target

Survival after treatment of cervical cancer can be predicted by

tumor metabolic response to [18F]-fluorodeoxyglucose positron

emission tomography (FDG-PET) post-therapy. In gene expression

profiling of human cervical cancer tissue, we recently identified

the PI3K/Akt pathway as significantly associated with post-therapy

FDG-PET uptake in human subjects. The mechanism of Akt regula-

tion in cervical cancer cells is unknown. PI3K Enhancer (PIKE), a

small GTPase that positively regulates Akt in glioblastoma multi-

forme and other cells, is upregulated in many cancer cells, includ-

ing cervical cancer. This proposal is designed to test the hypothesis

that manipulation of PIKE influences cancer cell response to

therapy, and that PIKE positively regulates Akt in cervical cancer

cells through GTP-dependent phosphorylation of Akt. Thus, our

aims are 1) to determine whether PIKE expression or inhibition

influences cervical cancer cell responsiveness to chemo-radiation,

and 2) to determine whether PIKE regulates cervical cancer cell

survival, proliferation, and response to treatment by GTP binding

and Akt activation. These experiments are designed to generate

preclinical data in support of the use of PIKE and Akt inhibition as

a novel therapeutic strategy for cervical cancer.

Ryan Cotter, BA

RadiologyMount Sinai School of MedicineCovidien/RSNA Research Medical Student Grant

Comparison of MR Imaging and PET/CT in Head and Neck Cancers: Developing a Clinical Rationale for Combined PET/MR Imaging

The aim of this project is to investigate the sensitivity and specific-

ity of combined FDG PET/CT and MR imaging in the detection of

squamous cell cancer of the head and neck (HNSCC) recurrence ver-

sus that of conventional MRI or PET/CT imaging alone. Currently,

there is little data evaluating the use of MRI and PET/CT compara-

tively in HNSCC recurrence, and most image-based monitoring

is currently performed by PET/CT and/or contrast-enhanced CT.

However, contemporary research suggests that combined PET/MRI

monitoring may be more advantageous. MRI is known to be better

in the characterization of tissues and may provide superior infor-

mation with respect to the extent of tumor involvement in HNSCC.

Since the acquisition of data in a combined PET-MR scanner will be

simultaneous rather than sequential as in PET-CT, there is no mis-

registration between the MR and PET images, allowing for accurate

spatial and temporal correlation between the data sets.

Consequently, FDG-PET and MRI fusion may exploit the combina-

tion of metabolic information and superior tissue definition to

avoid false readings in suspected recurrent cases. Consecutive

patient data from 2005 to 2012 will be analyzed retrospectively. Prob-

ability of malignancy of each lesion will be assessed on a 5-point

scale for both conventional MRI and conventional PET studies. MR

findings will be compared to findings from FDG PET/CT and to

contrast-enhanced CT, if available. Interpretation of the images will

be conducted independently by a board-certified nuclear medicine

physician and a neuroradiologist. The readers will be blinded to

each other and the clinical data. Given the increasing utilization

of PET-CT, if PET-MRI is at least as sensitive and specific as PET-

CT, there may be a shift of imaging towards PET-MR scanners.

However, the use of conventional MR compared to FDG PET/CT for

clinical utilization must first be validated.



Bradley Hunter, MPH

Radiation OncologyUniversity of Rochester School of Medicine and DentistryRSNA Research Medical Student Grant

The Staging and Treatment of Extranodal Hodgkin’s and Non-Hodgkin’s Lymphoma

The staging of extranodal Hodgkin’s lymphoma has been a source of

debate and controversy for over 40 years. This is troubling consider-

ing that extranodal involvement from primary nodal sites (Stage

IIE) is a relatively common finding in patients with lymphomas.

Both the implicit controversy in regards to extranodal extension in

Hodgkin’s disease, as well as the relative lack of studies investigat-

ing extranodal extension in non-Hodgkin’s disease, underscore the

contribution that research that assesses and attempts to reconcile

the possibility of inconsistency in clinical staging of an E lesion

would make to the literature.

The fundamental aims of this project are (1) to examine the fre-

quency and primary prognostic risk factors of extranodal involve-

ment from primary nodal tumors in Hodgkin’s and non-Hodgkin’s

lymphomas, (2) characterize the prognostic significance of this

extranodal involvement, and (3) assess the accuracy with which

lymphomas are staged.

The study population will consist of individuals who were diag-

nosed with Hodgkin’s or non-Hodgkin lymphoma between 1/1/2001

and 12/31/2010 and are currently registered in the Tumor Registry

Database at Strong Memorial Hospital. Using previously validated

risk stratification systems and patient records, patients will be

classified as presenting with early stage Hodgkin’s lymphoma,

advanced stage Hodgkin’s lymphoma, aggressive non-Hodgkin’s

lymphoma, or indolent non-Hodgkin’s lymphoma. These patient

classifications will be used to compare patients’ actual radiation

and chemotherapy treatment courses to those recommended based

on their assigned classification. Additionally, de facto accuracy of

the Ann Arbor designations “IIE” and “IV” will be assessed via the

results of a survey of 6 case reports which will be used for staging

by leading experts in the field. The results of this survey will be

used to identify discrete criteria used in clinical practice to differen-

tiate Stage IIE disease from that of Stage IV disease.

Caleb Graham, BS

RadiologyUniversity of Mississippi Medical CenterRSNA Research Medical Student Grant

Identifying CT Imaging Biomarkers and Criteria to Predict Disease Outcome in Locally Advanced Squamous Cell Cancers of the Head and Neck

Locally advanced squamous cell cancers of the head and neck

(LA-SCCHN) are highly vascular and often treated by a combina-

tion of chemotherapy, irradiation, and/or surgery. While concur-

rent chemoradiation is generally considered the standard of care,

neoadjuvant chemotherapy is appealing because it allows for an

assessment of tumor response and selection for organ preservation.

Because of the widespread use of CT in evaluating LA-SCCHN on

neoadjuvant chemotherapy, a predictive CT imaging biomarker

would be useful and widely applicable. Identification of poor

responders early in the course of therapy may reduce treatment-

related toxicity and cost and allow for a therapeutic intervention

before the disease burden significantly advances.

Baseline tumor volume, vascularity, and necrosis and interval

changes in tumor size/volume and vascularity after 2 or 3 cycles

of neoadjuvant chemotherapy have been independently predictive

of patient outcome in LA-SCCHN. In addition, changes in tumor

attenuation (enhancement) on contrast-enhanced CT and CT texture

analysis of target lesions, which has correlated with tumor vascu-

larity in metastatic lung cancer and renal cell carcinoma, may be

useful in predicting outcome in patients with LA-SCCHN.

We propose to retrospectively evaluate locoregional tumor size/

volume, attenuation (enhancement), and texture on the baseline

neck CT and changes in the locoregional tumor size/volume, attenu-

ation (enhancement), and texture on the initial post-therapy neck

CT (after 2 or 3 cycles of therapy) and associate these findings with

patient outcomes in 117 patients with LA-SCCHN on neoadjuvant

chemotherapy. Our goal is to identify CT imaging findings that

predict patient outcome in patients with LA-SCCHN on neoadjuvant

chemotherapy and combine the most predictive imaging findings

into a single CT imaging biomarker (or criterion).



Matthew Knecht, BS

Radiation OncologyLoma Linda University School of MedicineRSNA Research Medical Student Grant

Stereotactic Localization Accuracy in Intracranial Radiosurgery Applications

Frame-based stereotactic localization is important for radiosurgery

procedures that deliver very high doses to targets close to critical

neural structures, such as the brain stem and optic nerves. The

long-term goal of this research is to develop advanced methods of

radiosurgical targeting in the brain and spinal cord with narrow ra-

diation beams. Historical data indicate that the achievable accuracy

with existing techniques is of the order of +/- 1 mm. By combining

three dimensional (3D) regression methods in combination with

modern CT and MRI imaging equipment we hypothesize that the

accuracy of contemporary stereotactic localization methods can be

much better than 1 mm. The largest contribution to the localization

error is that of selecting the center of the fiducial rods of an exter-

nal 9-12 rod fiducial system in the CT or MRI image selected for

targeting. The 3D regression method planned for this project will

utilize data automatically extracted from multiple high-resolution

CT and distortion-corrected 3T MR images to develop the stereo-

tactic transformation equation. The improved stereotactic trans-

formation will then be tested by its ability to give the locations of

embedded markers within a stereotactic phantom (Lucy¸, Standard

Imaging) scanned with CT and MR imaging. We will also test its

ability to provide targeting information for narrow proton beams

directed at radiopaque targets embedded within a beam localization

film, which are also contained in the phantom. Analyzing mean and

standard deviation of the difference between predicted and known

(lab-inspected) coordinates of the phantom targets, and the center of

the proton beams and the desired film targets, we will test the valid-

ity of the given hypothesis. The results of this study will benefit

both clinical and scientific applications of radiosurgery techniques

requiring a very high degree of accuracy.

Ankaj Khosla, BA

RadiologyMayo ClinicCanon U.S.A./RSNA Research Medical Student Grant

Impact of Trans-endplate Cement Leakage on Vertebroplasty Outcomes

Spine augmentation is commonly performed to treat painful verte-

bral compression fractures. It is estimated that vertebroplasty, the

most common type of augmentation, is performed 48,000 times per

year in the United States. Vertebroplasty involves the insertion of

a needle into the vertebral body, usually transpedicularly, for the

placement of bone cement into the fractured vertebra. However,

no definitive evidence based guidelines exist for certain technical

aspects of vertebroplasty. For instance, no definitive studies have

shown whether cement placement near the endplate is beneficial, or

whether cement leakage from the endplates into the disc space has

any impact on outcome. Leakage through the endplate might logi-

cally be considered advantageous if it “seals” a fracture involving

the endplate. Alternatively, such leakage into the disk space might

place the patient at elevated risk for future fracture and thus worse

long-term outcome.

The aim of the study is to determine the impact of cement endplate

placement and leakage into the disc space during vertebroplasty

on patient outcomes, particularly pain and subsequent fractures.

The medical records of 590 first-time vertebroplasty patients will

be examined in close detail. Data to be collected include: presence/

absence of cement extension to the endplate edge (superior, inferior

or both), endplate leakage (superior, inferior, or both) and any sub-

sequent adjacent level fractures. The patients will be divided into

three groups: patients with no cement extension to the endplate,

patients with cement extension to the endplate but no leakage into

the disc space and patients with cement extension to the endplate

and leakage into the disc space. The changes in pain scores and sub-

sequent adjacent level fractures will be compared among the three

groups. This will enable retrospective determination of the impact

of cement placement on patient outcome, and hopefully guided

physicians as to cement placement during vertebroplasty.



Coronary artery disease remains the highest cause of morbidity

and mortality in the United States. Recently, stem cell therapy

has shown exciting promise for improving cardiac function and

minimizing disease complications. The successful derivation of

induced pluripotent stem (iPS) cells provides an unlimited source

of somatic cells such as cardiomyocytes, offering incredible new

avenues for the future of regenerative medicine. However, it is criti-

cal to validate these cells’ in vivo behavior and fate after autologous

transplantation in pre-clinical large animal models before they can

be applied to the clinical realm. First, iPS cells proliferate logarith-

mically in vitro, and can potentially cause tumors in vivo. Second,

the in vivo survival kinetics of iPS cell derivatives, such as cardio-

myocytes and endothelial cells, is currently unknown. Tracking and

monitoring of iPS cell derivatives after patient delivery is essential

for safety and an enhanced understanding of the mechanisms of

in vivo myogenesis and angiogenesis. The pig makes an excellent

anatomical and physiological model for evaluating and validating

patient-specific iPS cell-based therapies.

The aim of this proposal will be to track stem cell fate in a pre-

clinical large animal model using combined positron emission

tomography and computed tomography (PET/CT) imaging. We

propose to label pig iPS cells with a PET reporter gene using a novel

nonviral site-specific targeting vector. Cardiomyocytes derived

from individual-specific porcine iPS cells will then be subjected to

autologous transplantation. The in vivo survival, proliferation, and

engraftment of transplanted individual-specific cardiomyocytes

will subsequently be evaluated with molecular imaging techniques.

PET will provide physiological information related to cell fate and

myocardial function, while CT will provide anatomical information

regarding cell location. Using porcine iPS cells and their derivatives

to perform autologous transplanation and longitudinal molecular

imaging will provide valuable information on the ultimate clinical

translation of human patient-specific iPS cell therapies.

Marina Mityul, BS

RadiologyWashington University School of Medicine in St. LouisRSNA Research Medical Student Grant

Examining Biomarkers of Pre-Clinical Alzheimer’s Disease using MRI and PET

Kazim Narsinh, BA, (MD)

RadiologyStanford University School of MedicineRSNA Research Medical Student Grant

Longitudinal Imaging of Induced Pluripotent Stem Cell-derived Cardiomyocytes in a Large Animal Model

As the U.S. population ages, we anticipate dramatic increases in the

prevalence of Alzheimer’s disease (AD). This, in combination with

the scarcity of standardized and conclusive diagnostic procedures,

makes early diagnosis of AD a serious public health concern. Using

PIB PET, we can now detect amyloid plaques, the hallmark of AD

pathology, in the brains of asymptomatic people. It is unclear, how-

ever, which of these individuals is at highest risk for developing

AD and over what time period. It has been demonstrated that AD

patients have altered blood flow in diseased areas of their brains.

Arterial spin labeling (ASL) is an MRI measurement of cerebral

blood flow which, combined with PIB PET, may be useful in diag-

nosis of pre-clinical AD. The purpose of the study is to evaluate the

utility of ASL MRI as a biomarker of pre-clinical AD. In this project

we will correlate regional blood flow (ASL) with regional PIB PET

uptake. The hypothesis is that early in pre-clinical AD, areas of the

brain with early amyloid deposition will have inflammation and

increased cerebral blood flow compared to the same regions in age-

and gender-matched controls.



Anthony Rizzo, BA

Radiation OncologyCleveland Clinic Lerner College of Medicine of Case Western Reserve UniversityRSNA Research Medical Student Grant

Construction of an Atlas for Automatic Contouring of Stem Cell Niches in the Human Brain for Retrospective Analyses of GBM Survival

Conventional radiation therapy combined with surgery and drug

treatment, are important components of the standard of care

for glioblastoma multiforme (GBM). Despite this three-pronged

approach, the median survival for GBM patients is only about 14

months with early recurrences often found in the brain. Efforts to

decrease the recurrence, and understand the role that radiation can

have towards this end, are an important area of continued research.

Evers et al. indicated that one approach to decreasing recurrence

involves understanding of the radiation doses delivered to stem cell

niches of the adult brain. The objective of our project is to create

and test an anatomical atlas of subcortical brain structures, based

on computed tomography (CT) scans, for retrospective evaluation of

radiation dose to these stem cell niches. Using a computer-assisted

target volume delineation (CAT) system, this atlas will provide

rapid segmentation (automatic contour generation) of normal brain

structures in scans from 962 patients who were treated for GBM

with conventional radiation therapy at the Cleveland Clinic. These

treatments occurred from Jan. 2000 to December 2009, and all data

is stored in an IRB-approved database. Our study will assess the po-

tential of automatic contouring as a tool for retrospective analysis.

We will evaluate the radiation dose delivered to stem cell niches

of the adult brain and examine patient survival following conven-

tional radiation therapy. These niches include the periventricular

region of the lateral ventricles—the subventricular zone (SVZ)—and

the subgranular zone (SGZ) of the hippocampal formation. If the

dose delivered to the SVZ and SGZ is predictive of patient survival,

it could serve as a clinical parameter in the treatment planning of

GBM.

Tan B. Nguyen, BS

RadiologyUniversity of California, Los Angeles, David Geffen School of MedicineRSNA Research Medical Student Grant

Comparison of Functional Diffusion Map (fDM) Characteristics Between Different Molecular Signatures in Human Glioblastoma

Glioblastoma multiforme (GBM) is the most common and ag-

gressive primary brain tumor and is often associated with poor

response to initial treatment and poor overall prognosis. Functional

diffusion maps (fDMs), which examine voxel-wise changes in ADC

over time in diffusion-weighted images (DWI), have the potential to

serve as a valuable new imaging biomarker for brain tumors. We

believe that fDMs may provide valuable information regarding the

spatial extent and relative degree of tumor cellularity.

In order to further this claim, the proposed project will explore the

relationship between the rate of change in fDM volumes and several

important molecular/genetic signatures that are known to confer

a response benefit in patients with GBM. From empirical clinical

data, we have observed interesting patterns in fDM volume kinetics

that appear to reflect the proposed relationship. Due to the known

response benefit of temozolomide in patients exhibiting MGMT pro-

moter methylation, we hypothesize that the two distinct temporal

patterns observed in the fDM volume kinetic profiles of patients

treated with radiotherapy followed by adjuvant temozolomide may

correlate with expression of this molecular marker.

We will also examine fDM characteristics of isocitrate dehydro-

genase 1 (IDH1) mutation in glioblastoma patients after similar

cytotoxic therapy. We expect IDH1 mutation to result in increased

radiosensitivity and similarly increased cell death. Preliminary

data support these hypotheses and make a great case for evaluating

these relationships in more detail. Specific aims include determin-

ing the difference in rate of change of fDM hypocellular volume

between MGMT+ and MGMT- gliomas, and between IDH1 mutant

and wild-type gliomas, following cytotoxic treatment. The project

will involve computation of fDMs from DWI images in glioblastoma

patients with known molecular/genetic profiles. The results will

contribute important evidence that fDMs are a valuable imaging

biomarker for measuring and predicting tumor response.



Kevin Spitler, PhD

RadiologyUniversity of California, Los Angeles, David Geffen School of MedicineRSNA Research Medical Student Grant

Detecting White Matter Viability in Cervical Spondylotic Myelopathy: Prospective Analysis of Diffusion Tensor Imaging for Identification of Surgical Candidates

Degenerative disc disease (DDD) is a component of normal ag-

ing with an incidence of 10% at age 25 and 75% by age 65. The most

debilitating form of DDD, cervical spondylotic myelopathy (CSM), is

also the most common acquired cause of spinal cord dysfunction in

adults over age 50. As adults over age 65 are the fastest growing seg-

ment of the United States population, CSM is expected to increase

its already significant burden of multiple billions of dollars per year

in healthcare costs. Three quarters of patients with CSM undergo

stepwise loss of function secondary to white matter necrosis, and

this progression motivates many patients to elect decompression

surgery. Despite evaluation with somatosensory evoked potentials,

and measurement of spinal cord compression or spinal cord signal

change with T1 and T2 MR imaging, it remains unclear which

patients will benefit from decompression surgery.

At present, no accurate noninvasive method to predict potential for

neurological recovery following operative intervention exists. Ad-

ditionally, for patients that choose conservative non-operative treat-

ment, a non-invasive modality is required to monitor subclinical

disease progression, and, if needed, to determine optimal timing of

surgery. To address these deficiencies, the proposed project will test

an advanced MR imaging modality, diffusion tensor imaging (DTI),

for its potential to determine optimal timing of surgery and patient

selection for optimal outcomes from decompression surgery for

CSM. To accomplish the first goal, DTI will quantify cervical spine

integrity in subjects with severe CSM before and after decompres-

sion surgery. The improvement in DTI will be correlated with func-

tional sensory and motor function measured clinically. Secondly,

DTI will quantify cervical spine integrity in subjects with mild to

moderate CSM over time. This prospective study will evaluate the

ability of DTI to predict future clinical assessment and to identify a

threshold for recommendation of surgical intervention.

Stephanie Soriano, BS, MA

RadiologyUniversity of WashingtonRSNA Research Medical Student Grant

Radiofrequency-Enhanced Gene Therapy of Cholangiocarcinoma: Towards Intrabiliary MRI-Guided/RF-Enhanced Local Gene Therapy

The prognosis of pancreatobiliary malignances with biliary ob-

struction is very poor due to unresectable lesions at the time of pre-

sentation and rapidly evolving primary resistance to chemotherapy

and radiotherapy. Gene therapy is a frontier of modern medicine,

with nearly 1,000 gene therapy trials worldwide. Gene-directed

enzyme prodrug therapy (GDEPT) is currently the most promising

strategy for genetic treatment of cancers. GDEPT relies on the in-

tratumor delivery of a transgene to encode its enzyme, which then

activates a systemically-delivered prodrug to be toxic to kill tumor

cells via the mechanisms of inhibiting DNA polymerase and block-

ing DNA replication. Among the candidate genes, herpes simplex

virus thymidine kinase gene/gancyclovir prodrug (HSV-tk/GCV)

represents a promising example for clinical application of GDEPT.

However, a critical weakness with systemic HSV-tk/GCV therapy

is its low HSV-tk gene transfection and therefore low tumor kills

by GCV. We have recently established an intraluminal MRI/RFH

prototype system, with its key component being an FDA-approved

MR-imaging-heating-guidewire (MRIHG). The MRIHG has unique

“3-in-1” function for (i) intraluminal MRI; (ii) guiding interven-

tional procedures; and (iii) enhancing gene transfection/expression.

Based on this prototype system, we are developing a new interven-

tional oncology technique, named “Intrabiliary MRI-guided, radiofre-

quency heat (RFH)-enhanced local gene therapy.” As the initial step,

the current project focuses on establishing the “proofs-of-principle”

of this new concept. To this end, we designed two specific aims:

Aim I: In vitro evaluation of using RFH to enhance HSV-tk gene

transduction in human cholangiocarcinoma cells. Aim II: In vivo

validation of the feasibility of using RFH to enhance HSV-tk gene

therapy of human cholangiocarcimas in animal models.

The success of this project should enable us to establish the ground-

work for the next step – to develop intrabiliary MRI/RF technology-

integrated gene therapy of pancreatobiliary malignancies.



Evan Thomas, MS

Radiation OncologyUniversity of Alabama - BirminghamRSNA Research Medical Student Grant

Utilization of Dual Energy CT for Treatment Planning Scans in Patients with Metal Artifact

When a prospective radiation treatment patient undergoes a CT

scan for treatment planning, in vivo high-Z materials are notorious

for compromising the accuracy and visual integrity of the CT data.

These objects, such as dental implants, produce what are known as

metal streak artifacts in the scan. The artifacts have two important

implications which remain problematic for treatment planning.

The first and most obvious complication is the reduction in visual

quality of the images. This hinders delineation of both target and

organ-at-risk (OAR) volumes in affected CT slices. The second com-

plication is adulteration of acquired CT data which compromises

the accuracy of later dosimetric calculation.

We propose to solve this problem by utilizing a newly available CT

scanning method called dual-energy CT (DECT). DECT features

the ability to rapidly switch between 140/80 kV modes utilizing a

single x-ray tube and acquire two distinct imaging spectra. The

contribution of a designated Z material (e.g. a metallic implant)

can be subtracted from the fusion of the two spectra in a process

known as metal artifact subtraction (MARS). In this study, MARS

will be assessed in two phases for its ability to ameliorate the effects

on treatment plan quality in patients with metal artifacts. In the

first phase, we will employ MARS on planning phantoms modified

to contain metal implants. Radiation dose will be calculated and

delivered, and film and ionization chambers will assess the dosi-

metric accuracy. In the second phase, the technique will be employed

on a patient for each type of implant. Expert radiation oncologists

will contour critical structures in CT volumes of both original and

MARS-employed image sets and evaluate the improvement in their

ability to delineate relevant structures.

If this technique is demonstrated effective for the treatment planning

problems posed by metal artifacts, we will develop a protocol for its

routine clinical utilization.

Marshall Strother, BA

RadiologyWashington UniversityRSNA Research Medical Student Grant

Testing the Effectiveness of the CT Dose Check Initiative

Radiologists have long strived to optimize patient radiation expo-

sure. The risks associated with exposure are routinely cited by

clinicians as the deciding factors in decisions to forgo radiographic

studies. At the same time, it is extremely common for radiation

dose to vary significantly—sometimes up to sixfold—for identi-

cal studies, even when protocols have been put in place to reduce

such variation. In this study, we propose to implement and test

the effectiveness of a semi-automated system to reduce unjustified

variability in radiation dosage in common computed tomography

procedures.

Data from all CT exams performed at Barnes Jewish Hospital and

St. Louis Children’s Hospital will be collected using RADIANCE

and Syngo software. Data will be cleaned, and a variety of statisti-

cal analyses will be performed to identify problematic variation. A

combination of manual audit and advanced data mining techniques

will be employed to identify the circumstances responsible for

variation and to systematically categorize incidents by these failure

modes. This analysis will be used to prioritize and plan interven-

tions targeted at reducing problematic variation using the CT

Dose Check software as a supplement to organizational training

and other standard methods. When possible, these methods will be

automated using standard computational tools to assist in continu-

ous auditing, which will continue after the end of the project to

evaluate the effectiveness of interventions and assess the need for

future work.

Previous work has shown that it is possible to significantly op-

timize radiation exposure with similar interventions on smaller

scales. Automating this process and increasing its scale has the

potential to broadly affect the way patients are protected from ex-

cessive and sub-diagnostic radiation exposure during CT scans.



Patrick Tyler, BS

RadiologyNorthwestern University Feinberg School of MedicineRSNA Research Medical Student Grant

MRI-Guided Nanoembolization for Liver Cancer

For patients with unresectable hepatocellular carcinoma, there

are few treatment options currently available. Advancements in

transarterial chemoembolization (TACE) have emerged that may

provide some benefit to these patients, but optimal dosing regimens

remain unknown. The purpose of this project is to use MR imaging

to optimize and quantify the local delivery of therapeutic nanopar-

ticles to VX2 liver tumors in rabbits. Doxorubicin (DOX) will be

coupled to supraparamagnetic iron oxide nanoparticles (SPIOs).

Methods: 20 rabbits will be used in this study. VX2 tumors will be

surgically implanted in the liver according to previously published

protocols. For intra-tumoral delivery, rabbits will be assigned to a

low dose group (0.5 mg/kg) and a high dose group (1.5 mg/kg) with

DOX dosages calculated based on current TACE protocols. Rabbits

will undergo X-ray digital subtraction angiography (DSA) to place a

catheter in the left hepatic artery (LHA), and will then be trans-

ferred to a Bruker 7T ClinScan MRI horizontal bore scanner.

A baseline Multi-Echo GRE scan will be performed, followed by

infusion of the entire dose volume and a post-infusion Multi-Echo

GRE scan to obtain an R2* pulse sequence map of targeted tis-

sues. Tumor and surrounding hepatic parenchyma samples will be

obtained at necropsy for inductively-coupled plasma mass spec-

trometry analysis (ICPMS), which allows quantification of the NP

in tissue. ?R2* will be calculated from pre-treatment and post-treat-

ment MRI scans and correlated with the ICPMS tissue concentra-

tion. This project will contribute to developing the next generation

of TACE by devising a new system of dosimetry for locally delivered

nanotherapies that employs MRI.

Allison Tillack, MA

RadiologyUniversity of Colorado Denver (Allison is enrolled at the University of California, San Francisco)Fujifilm Medical Systems/RSNA Research Medical Student Grant

An Evaluation of the Impact of Clinically Embedded Reading Rooms on Radiologist-Clinician Communication

In the era of Picture Archiving and Communication Systems

(PACS), there are fewer opportunities for radiologists to interact

face-to-face with their clinician colleagues. As an attempt to address

this problem and to promote in-person consultation of radiologists

by referring physicians, some health care facilities have embedded

radiology reading rooms in clinical areas. This study investigates

whether locating reading rooms in clinical areas at a large, tertiary

care academic hospital in the US is in fact associated with increased

rates of direct communication between radiologists and clinicians.

Results of this research will suggest whether reading room location

significantly impacts the patterns and the character of interperson-

al clinician-radiologist communication. Because better communica-

tion among medical specialists presumably translates into improve-

ments in patient care, the results of this study will be of importance

not only to the field of radiology, but also for efforts to augment the

quality of health care.



Stephen Brown, MD

RadiologyChildren’s Hospital Boston and Harvard Medical SchoolGE Healthcare/RSNA Education Scholar Grant

Program to Enhance Relational and Communication Skills for Radiologists (PERCS-Radiology)

Expectations are rapidly evolving for how radiologists commu-

nicate with patients, requiring radiologists to convey cognitively

complex information under emotionally charged conditions. Few

educational opportunities exist to help radiologists acquire the

skills to approach these conversations effectively. The Program

to Enhance Relational and Communication Skills for Radiologists

(PERCS-Radiology) seeks to fill this gap and to enhance radiology

trainees’ confidence and skills when communicating with patients

about difficult topics.

The objectives of the proposed program are to: 1) improve radiol-

ogy trainees’ preparedness to communicate with patients about a

new, unexpected or difficult diagnosis; 2) help radiology trainees

effectively disclose radiological errors to patients and families; and

3) enhance trainees’ success in discussing radiation safety with

patients.

The proposed daylong workshops will combine didactic and

educational media presentations with realistic improvised enact-

ments and feedback between workshop participants and profes-

sional actors. Radiology trainees are the core learning group.

Participants will also include attending radiologists, technologists,

nurses, clinicians, and patient representatives. Faculty facilita-

tors include experts in healthcare communication pedagogy. The

learning model emphasizes collaboration among professionals from

varying disciplines and levels of experience, integration of patient/

family perspectives, and a safe environment that respects multiple

viewpoints.

The main outcome measure will be participants’ self-assessments of

preparation, communication skills, confidence, and anxiety when

holding difficult conversations on questionnaires administered

before, immediately after, and 6 months after the workshops.

We anticipate that PERCS-Radiology can be developed into self-

sustaining workshops for radiologists and affiliated professionals

nationally. Workshops could provide CME and risk-management

credits, and fulfill ACGME requirements for proficiencies in Profes-

sionalism and Communication.

Julia Fielding, MD and Alfred D. Llave, MD

RadiologyUniversity of North Carolina at Chapel HillRSNA Education Scholar Grant

Meeting the Challenges of Radiology Resident Education in the 21st Century: Redefining the Radiology Classroom through RAD-SHARE, Radiology (See, Hear And Respond Education)—A Collaborative Pilot Endeavor

The aim of Radiology: See, Hear And Respond Education (RAD-

SHARE) is to create a robust, novel, and unique interactive online

learning community among training institutions for mutual benefit.

The objectives of RAD-SHARE will be accomplished through the cre-

ation of lecture modules called “radactics” which will be authored by

various contributors from different programs who share the vision of

the project. The “radactics” will emphasize the use of adult learning

principles, and the inculcation of new core competencies and stan-

dards of practice. The latest interactive learning technologies will be

integrated in the portal to facilitate group and self-directed learning.

RAD-SHARE will be implemented in two phases through a concerted

multi-institutional effort. During the pilot phase, initial learning

experience of residents from participating institutions will be evalu-

ated objectively. According to a pre-defined format, a lecture module

in uroradiology (the initial representative example) will be created

and uploaded onto the portal. To assess learning among residents,

standardized tests will be administered following completion of the

module. Subjective feedback regarding ease of use and functionality

will be obtained from module contributors and learners, respectively.

The second phase will focus on systems adjustments based on the

initial experience, progressive completion of the lecture curriculum,

and evaluation of interactive learning features.

This RAD-SHARE initiative will be an opportunity to assess the effec-

tiveness of a novel interactive resource for learning and the feasibil-

ity of multi-institutional sharing of educational resources for mutual

benefit. The RAD-SHARE project may serve as a model to establish

collaborative knowledge sharing that would potentially benefit other

academic communities. to establish collaborative knowledge sharing

that would potentially benefit other academic communities.

education grant programseducation scholar grant


Mannudeep K. Kalra, MD

RadiologyMassachusetts General HospitalGE Healthcare/RSNA Education Scholar Grant

CT Virtual Autopsy for Radiation Dose Reduction and Radiological-Pathological Correlation Training Programs

Postmortem examinations generally show an error rate for clini-

cally significant conditions in approximately 20 - 30% of postmor-

tem examinations in most studies. Despite this, there has been a

continuing decline in the rate of autopsies, with academic institu-

tions having an autopsy rate of 10 - 20% and community hospitals

having an autopsy rate in many cases bordering on zero. This error

rate has occurred despite modern laboratory and radiology testing

including cross-sectional imaging techniques. Because postmortem

radiographic examination may be more acceptable to next of kin of

deceased and possibly also to attending physicians may be one step

in reversing the decline of information that could be obtained only

by autopsy. Correlation with assistance from imaging techniques

after death.

Recently, use of CT and MRI has been described for postmortem

imaging (virtopsy) in conjunction with autopsy. Virtopsy can add

information to the autopsy and enable a more focused autopsy. Yet

in most academic institutions, benefits of virtopsy have not been

exploited. Our proposal seeks to address this discrepancy, by devel-

oping two model training programs for radiologists, residents and

medical students. The first program will use imaging data acquired

from CT virtopsy at different radiation dose levels through different

body regions to develop a training module for educating radiology

personnel on perception of pathologically proven abnormalities at

different levels of radiation doses. Unlike antemortem CT, postmor-

tem CT can be repeated several times without risks to the body and

would not require simulated low dose images, which are not ideal

in our experience. The second program will create a teaching mod-

ule of 2- and 3- dimensional CT and MR imaging data with relevant

photographic documentation from gross and microscopic autopsy

examinations. The latter module will help enhance understanding

of the radiologic and pathologic correlation of different disease

processes leading to death.

Sharad Goyal, MD

Radiation OncologyUMDNJ/Robert Wood Johnson Medical School, UMDNJ/New Jersey Medical School & The Cancer Institute of New JerseyRSNA Education Scholar Grant

COntouring in Radiation Oncology Education (CORE)—A Self-Assessment Module (SAM) for Radiation Oncologists

Maintenance of Certification (MOC) is a process where a practicing

physician provides evidence to peers and the public that he or she

continually gains knowledge, maintains quality of care, and im-

proves his or her practice. The American Board of Radiology (ABR)

strongly encourages all radiation oncologists with time-limited and

lifetime certificates to participate.

We hope to create the COntouring in Radiation Oncology Education

(CORE); a Self-Assessment Module (SAM) that fulfills MOC require-

ments set forth by the ABR. Following breast conserving surgery

for early stage breast cancer, visualization of the postsurgical exci-

sion cavity can be difficult and target volume delineation practices

of radiation oncologists can vary widely. It is important to accu-

rately contour target volumes given the increased research into,

and clinical use of, accelerated partial breast irradiation (APBI),

where only the tumor bed with margin is irradiated. Previous stud-

ies have shown that without guidelines, practicing physicians have

substantial variations in target volume delineation which can have

significant dosimetric and clinical impact. Cavity visualization can

be difficult given post-surgical changes and lack of surgical clips or

implanted fiducial markers to aid visualization.

Our goal is to create a SAM whereby trainees or physicians in the

MOC program can learn or refresh skills and knowledge in critical

postsurgical breast changes, postsurgical cavity visualization, and

target volume delineation with requisite expansions. Immediate

feedback will be provided as physicians are able to practice con-

touring on sample CT images overlaid with standard contours from

leading academic radiation oncologists who specialize in breast

radiotherapy.

The outcome of this project will give physicians more educational

options when re-certifying as a diplomate of the ABR in radiation

oncology and assist trainees to learn this new technique which may

become an important treatment option for women with early stage

breast cancer.

education scholar grant


Jie Li, MD and Elizabeth A. Morris, MD

RadiologyBeijing Cancer Hospital & Beijing Institute for Cancer Research, Peking University School of OncologyDerek Harwood-Nash/RSNA Education Scholar Grant

Developing an Educational Program on Breast Imaging for the Chinese Radiology Society with International Cooperation

Knowledge of breast imaging has grown dramatically over the past

decade, and the field is changing rapidly. However, breast imaging

in China has not developed in step with the field. Limited educa-

tional resources, a lack of specialty training in breast imaging, and

language barriers have opened up a large gap between Chinese

radiology and the international breast imaging community with

regard to knowledge and information, interpreting skill and clinical

research.

The objective of this project is to disseminate updated knowledge

in the field of breast imaging to the Chinese Society of Radiology

(CSR), provide special training and educational resources on breast

imaging in China, and enhance Chinese radiologists’ experience in

the use of BI-RADS¸ in order to improve their clinical practice and

research in breast cancer imaging.

The scholar will develop a breast imaging educational program

in collaboration with Memorial Sloan-Kettering Cancer Center

(MSKCC). The goals of the program will be to implement BI-RADS

in medical practice, create a quality assurance system, establish

a clinical fellowship training program, and ultimately develop a

clinical training center for breast imaging in China. As part of the

educational program, a nationwide continuing medical education

program on breast imaging will be instituted, with invited experts

from the U.S.A., to provide updated knowledge and workshops for

Chinese radiologists. In addition, an educational website on breast

imaging will be set up, providing free, unlimited learning resourc-

es, links and information on breast imaging to Chinese radiologists.

It is expected that the program will strengthen the clinical skills

of Chinese radiologists in breast cancer detection and diagnosis,

help to build up quality assurance systems for breast imaging in

China, stimulate research and international communication, and

ultimately improve clinical practice and research in breast cancer

care in China.

Lonie R. Salkowski, MD

RadiologyUniversity of Wisconsin—Madison, School of Medicine and Public HealthPhilips Healthcare/RSNA Education Scholar Grant

A Paradigm Shift in Teaching Anatomy: Development of New Educational Methods for Health Care Professionals to Learn Anatomy through Radiology Correlation

The goal of my proposal is to become more efficient and effective in

teaching the complexities of radiology anatomy and radiation safety

to healthcare students.

Class hours are being cut as the wealth of information to be taught

is increasing. New and developing concepts are being taught often

at the expense of the fundamentals. Anatomy education is vital in

the technical, undergraduate and graduate fields of healthcare rang-

ing from radiology technologists, PT/OT students, medical students

and radiology residents. Each group of students requires specific

and different levels of understanding of anatomic principles and

how they relate to radiologic imaging. The introduction of radiology

early into the anatomy curriculum provides a means of demonstrat-

ing the human anatomy with the relevance and importance of the

anatomic principles in the healthcare sciences.

I am devoted to teaching and curriculum development in radiologic

anatomy to diverse groups of students. The changes in classroom

time and restrictions require me to gain additional competence and

expertise beyond the scope of what I currently possess. Gaining

additional knowledge and skill sets by acquiring my masters degree

in education and leadership will provide me with the tools to be

more effective and innovative in the classroom and beyond. These

skills will prepare me to optimally engage the student learner

within the limited resources of education hours.

I am passionate about teaching fundamentals that serve as a solid

framework that students can develop and expand upon. I am

interested in developing programs to challenge student thinking

beyond memorization. The programs I have developed thus far have

progressed without any formal training. I believe that given the

opportunity to attain additional training in education concepts, I

will become a more effective leader and scholar in health profession

education.

education scholar grant


education scholar grantXiaoming Yang, MD, PhD

RadiologyUniversity of Washington School of MedicineRSNA Education Scholar Grant

Toward Clinical Translation of Interventional Molecular Imaging: An Educational Program for New Generations of Interventional Radiologists

Molecular imaging is an emerging technology for in vivo detection

of biological events at molecular/cellular levels. It has demonstrated

great promise in early diagnosis of diseases and precise guidance of

advanced treatments, such as gene and cell therapies. Recent com-

mon interest in molecular imaging among diagnostic and interven-

tional radiologists has led to a new concept, called interventional

molecular imaging. This concept, by combining interventional radi-

ology (IR) with molecular imaging, aims to fully apply the advantag-

es of both imaging fields. Specifically, interventional radiology can

extend the capabilities of currently-available molecular imaging

techniques in (i) reaching deep-seated targets; (ii) getting a close

look at small targets; (iii) precisely guiding delivery of non-targeted

imaging tracers/therapeutics; and (iv) super-selectively enhancing

the effectiveness of targeted imaging and treatment.

To prompt successful translation of interventional molecular imag-

ing from benches/animal labs to clinical practice, one of crucial

steps is to get the new generations of interventional radiologists

prepared for application of this new technology. To this end, we

have designed an educational program that will provide IR trainees

with hands-on experience in interventional molecular imaging.

Through practicing a relatively complex IR procedure, transjugular

intrahepatic portosystemic shunt (TIPS), with subsequent mo-

lecular MRI-guided intraTIPS agent delivery on near-human-sized

pigs, the trainees will not only gain understanding of the concept

of interventional molecular imaging but also become familiar with

the necessary techniques. We propose a 3-phase program, including

(i) a 2-hour theory course on TIPS and interventional molecular

imaging; (ii) a pre-clinical hands-on training on the TIPS procedure

and subsequent MRI-guided intraTIPS agent delivery; and (iii) a

hands-on experience in confirming successful agent delivery using

various laboratory methods.

Our long-term goal is to attract the interest and attention of new

IR generations to molecular imaging-integrated interventional

technologies, and thereby facilitate the translation of interventional

molecular imaging to clinical practice on humans.

My RSNA R&E funding will

help fast-track my studies of novel therapeutic targets to alter

bio-chemical signaling in breast cancer, and advance my long-

term career goal—a position in an academic radiation oncol-

ogy department which couples clinical practice with basic and

translational research.

Carmen Bergom, MD, PhD



Supriya Gupta, MBBS, MD

RadiologyMassachusetts General HospitalRSNA/AUR/APDR/SCARD Radiology Education Research Development Grant

Education in International Radiology Outreach: Development of Multi-language Web-based Modules and Providing Training for Diagnosing Acute Clinical Conditions Using Ultrasound

Advancement in imaging modalities has boosted and complemented

radiologist’s diagnostic skills. Nevertheless, ultrasound continues

to be the prime imaging modality for evaluating acute conditions in

emergency department in many resource-poor rural settings and is

the imaging modality of choice for some diseases even in developed

countries. Importance of this modality is amplified in resource-poor

countries where it proves to be easily available, easy to perform,

rapid, accurate and repeatable even if it is being performed by

non-radiologist physicians. Our objective for developing a training

curriculum, including web-based multi-language lectures, video

demonstrations, hands-on training workshop and developing an

(OSCE) Objective Structured Clinical Examination for medical

personnel at Butaro Hospital, Rwanda, would serve as a benchmark

for developing similar and more effective programs in other devel-

oping countries. Such a training course would enhance imaging

utilization in these countries while developing quality standards for

diagnosing acute abdominal and pelvic emergencies in rural areas.

Joshua Dowell, MD, PhD

RadiologyNorthwestern University Feinberg School of MedicineRSNA/AUR/APDR/SCARD Radiology Education Research Development Grant

A Pharmacopeia iPhone/iPad Mobile Communication Application for the Interventional Radiologist

Interventional radiology (IR) is becoming increasingly indepen-

dent as a clinical discipline. An understanding of commonly used

medications is pivotal to patient safety and efficiency. The purpose

of this project is to pilot the practicality of a handheld, mobile soft-

ware solution to assist the interventional radiologist. This mobile

application may make medications encountered in daily IR practice

more readily accessible, increase one’s comfort and knowledge in

selecting appropriate medications and dealing with adverse effects,

and ultimately reduce medical dosing errors.

The current literature of commonly used drugs for the manage-

ment of disease treated by the interventionalist will be reviewed

and guidelines compiled. An IR pharmacopeia application will be

developed for the iPhone/iPad, a mobile communications device

platform. IR personnel will then be surveyed on the functionality,

usage, and opinion of the application in daily practice. This mobile

application will promote patient safety and may aid in reducing

medical dosing errors.

rsna/aur/apdr/scard education research development granteducation grant programs


rsna/aur/apdr/scard education research development grant

Carolyn Wang, MD

RadiologyUniversity of WashingtonRSNA/AUR/APDR/SCARD Radiology Education Research Development Grant

Prospective Randomized Study of Contrast Reaction Management Curricula: High-Fidelity Hands-on Simulation Versus Computer-based Interactive Simulation

In phase 1, high-fidelity simulation-based training was compared

to standard didactic lecture, which demonstrated equal results on

written tests, but improved performance during a high-fidelity se-

vere contrast reaction scenario. Unfortunately high-fidelity simula-

tion laboratories are not widely available and are expensive. There-

fore we created a computer-based interactive module for teaching

contrast reaction management and want to prospectively compare

its effectiveness to hands-on high-fidelity simulation-based training.

Subjects will be randomized to either curriculum based on their

experience questionnaire responses. They will take written exams

before and after the intervention to establish baseline knowledge

and immediate learning. Six months later, all participants will take

a different written exam to assess knowledge retention and undergo

performance testing with a different high-fidelity severe contrast

reaction scenario. If the computer-based interactive simulation is

equally effective, it may be a more cost-effective widely available

means to standardize contrast reaction training for trainees and

academic and community practicing radiologists.

The peer review process

is competitive, but it is an excellent training ground for NIH grant

writing. My funding will help me determine which second-line

treatment is more likely to improve liver fat in patients with type 2

diabetes, and promote the adoption of MR-based fat quantification

techniques, potentially alleviating the need for liver biopsy.

An Tang, MD


r&[email protected]

Amir Abdelmalik, MDSaint Louis University

Asif Abdullah, MDUniversity of Toledo Medical Center

Bryan G. Allen, MDUniversity of Iowa Hospitals and Clinics

Laura M. Allen, MDUniversity of California, IrvineRadiological Sciences

Mu’taz Morshed Abdallah Alnassar, MBBSUniversity of TorontoMedical Imaging

Nila Alsheik, MDUniversity of Wisconsin School of Medicine and Public Health

Hebert Alberto Vargas Alvarez, MDMemorial Sloan-Kettering Cancer Center

Asim K. Bag, MDUniversity of Alabama at Birmingham

Mohammad Bahador, MDUniversity of Missouri- Columbia

Richard L. Barger Jr., MDWilliam Beaumont Hospital

Ranjit Bindra, MD, PhDMemorial Sloan-Kettering Cancer Center

David Bonekamp, MD, PhDJohns Hopkins

Daniel J. Boulter, MDMedical University of South Carolina

Ashley Bragg, MDUniversity of Arkansas for Medical Sciences

Olga R. Brook, MDBeth Israel Deaconess Medical Center

Ilene Burach, MDHahnemann University Hospital Drexel University College of Medicine

Alissa J. Burge, MDNorth Shore University Hospital

Mark Burshteyn, MDTemple University Hospital

Sherwin Chan, MD, PhDUniversity of Washington

Arindam Rano Chatterjee, MDUT/Methodist Healthcare

Leslie Chatterson, MDUniversity of Saskatchewan

William Chen, MDUniversity Hospitals Seidman Cancer Center

Praveena Cheruvu, MDUniversity of Rochester Medical Center

Francis Cloran, MDSan Antonio Uniformed Services Health Education Consortium

Randi J. Cohen, MDFox Chase Cancer Center

Rivka R. Colen, MDDana-Farber Cancer Institute

Andrew C. Cordle, MD, PhDMetroHealth Medical Center

Andreu Costa, MDUniversity of Ottawa

Kelly Lynn Cox, DOCleveland ClinicImaging Institute

Ildiko Csiki, MD, PhDVanderbilt University Medical Center

Megan Daly, MDStanford University

Sherwin Danaie, MDGeorge Washington University

Shadpour Demehri, MDBrigham and Women’s Hospital, Harvard Medical School

Robert Benjamin Den, MDThomas Jefferson University & Hospitals, Inc.

Matthew D. Dobbs, MDVanderbilt University Medical Center

John Dufton, MDQueen’s University

Neal Dunlap, MDUniversity of Virginia

Siobhan M. Flanagan, MDUniversity of Minnesota

Carl Flink, MDAllegheny General Hospital

Shira Galper, MDYale-New Haven Hospital/Yale University School of Medicine

Xavier Garcia-Rojas, MDUniversity of Texas Health Sciences Center San Antonio

Amol J. Ghia, MDUniversity of Utah

Peter Ghobrial, MDBaystate Medical Center

Saurabh Guleria, MDChildren’s Hospital of Wisconsin, Medical College of Wisconsin

Ajay Gupta, MDNewYork-Presbyterian Hospital, Weill Cornell Medical College

Jagan Dewan Gupta, MDTulane University School of Medicine

Shiva Gupta, MDNew York Medical College

Ihab Haddadin, MDUMDNJ-Robert Wood Johnson Medical School

Amer Hanano, MDSUNY Downstate Medical Center

Robert F. Hanna, MDColumbia University Medical Center

Matthew Hardee, MD, PhDNew York University

Cameron Hassani, MDLong Island College Hospital

roentgen resident/fellow research award

Laura M. Allen, MD, Recipient, with Arash Anavim, MD, Program Director

r&[email protected]


Michael D. Hasselle, MDUniversity of Chicago

Meredith L. Hayes, MD, MSMayo Clinic-Rochester

Robert G. Hayter, MDHospital of Saint Raphael

Jeremy J. Heit, MD, PhDMassachusetts General Hospital

Mack P. Hendrix, MDMedical College of Virginia/VCU

Kristin Higgins, MDDuke University Medical Center

David Hirschl, MDMontefiore Medical Center

Nickoleta Hoefling, MDUniversity of Michigan

Anastasia Hryhorczuk, MDChildren’s Hospital-Boston

Albert Hsiao MD, PhDStanford University

Zain Husain, MDUniversity of Maryland Medical Center

Benjamin Hyman, MDTexas A&M HSC COM Scott & White Hospital

Joseph Ippolito, MD, PhDMallinckrodt Institute of Radiology

Jason N. Itri, MD, PhDUniversity of Pennsylvania Hospital

Paul M. Jaffray, MDUniversity of Massachusetts Medical School

Ramin Javan, MDBaptist Memorial Hospital

Alisa Johnson, MDUniversity of Vermont/Fletcher Allen Health Care

Bhishak Kamat, MDCooper University Hospital

Aaron P. Kamer, MDIndiana University School of Medicine

Alisa Kanfi, MDHartford Hospital

Mohammad K. Khan, MD, PhDCleveland Clinic

Rachel Anne Lagos, DOWest Virginia University

David Lee, MDWilliam Beaumont Hospital

Joanne S. Lee, MDAlbert Einstein Medical Center

Stefanie Lee, MDThe University of Western Ontario

Forrester D. Lensing, MDBaylor University Medical Center at Dallas

Marie-Hélène Lévesque, MDUniversity Laval

Ruby J. Lien, MDSt. Luke’s-Roosevelt Hospital Center

Dorota Linda, MDMcMaster University

Heng-Hsiao E. Liu, MDThe University of Texas Medical School at Houston

Yuxin Li, MD, PhDVA Greater Los Angeles Healthcare System

Chikaodili I. Logie, MDUniversity of Maryland Medical Center

George Emmett Lynskey, MDBeth Israel Medical Center

Daniel J. Ma, MDWashington University School of Medicine

Anton Mahne, MDBryn Mawr Hospital

Richard H. Marshall Jr., MDOchsner Clinic Foundation

Heath McCullough, MDWake Forest Baptist Health

Scott McNally, MD, PhDUniversity of Utah

Jeet Minocha, MDNorthwestern University

Monika Misra, MDJacobi Medical Center

Lex Mitchell, MDTripler Army Medical Center

Anoushiravan Montaserkoohsari, MDAultman Hospital

Benjamin Mou, BSc, MDCancerCare Manitoba

Waleed Fouad Mourad MD, MScUniversity Of Mississippi Medical Center

Kambiz Nael, MDDavid Geffen School of Medicine at UCLA

Xuan V. Nguyen, MDUniversity of Kentucky

Brandon W. Nichols, MDUniversity of South Alabama

Josef R. Noga, MDEastern Virginia Medical School

Krisha J. Opfermann, MDMedical University of South Carolina

Hansel J. Otero, MDTufts Medical Center

Christopher A. Parham, MD, PhDUniversity of North Carolina School of Medicine

Biraj M. Patel, MDUniversity of Cincinnati

Jay Patel, MDEmory University

Parul Patel, MDUniversity of Rochester

Sohil H. Patel, MDNYU School of Medicine

Peter Paximadis, MDWayne State University

Ben E. Paxton, MDDuke University Medical Center

Paul Gabriel Peterson, MDNational Capital Consortium


Monika Misra, MD, Recipient (middle), with Jill Leibman, MD (left) and Melvin Zelefsky, MD, Department Chair


44 r&[email protected] r&[email protected]

Jake Pirkle, MDUniversity of Tennessee Medical Center

Benjamin E. Plotkin, MDLos Angeles County-Harbor-UCLA Medical Center

Ryan Alexander Priest, MDOregon Health & Science University

M. Reza Rajebi, MDUpstate Medical University

Anand Dorai Raju, MDLe Bonheur Children’s Hospital- University of Tennessee Health Science Center

Taruna Ralhan, MDSt. Joseph’s Hospital and Medical Center

Vinay Ravi, MDDartmouth-Hitchcock Medical Center

Sapna Rawal, MDMcGill University

Amar Rewari, MD, MBACancer Institute of New Jersey/UMDNJ

Jared R. Robbins, MDHenry Ford Health System

Nicholas Roman, MD, PhDVirginia Commonwealth University

Paul Saconn, MDWake Forest University Baptist Medical Center

Parmbir Singh Sandhu, MDUniversity of California, Davis

Jorge Luis Sarmiento, MDTexas Tech University Health Sciences Center, Paul L. Foster School of Medicine

Ambreen Sattar, MDDetroit Medical Center/Wayne State University

Jacob Scott, MDMoffitt Cancer Center

Fabio Settecase, MDUniversity of California San Francisco

Salman S. Shah, MDMount Sinai School of Medicine

Mohammed Bilal Shaikh, MDSUNY-Stony Brook University

Richard E. Sharpe Jr., MD, MBAThomas Jefferson University Hospital

Joseph Shelton, MDEmory University

Sindu Sheth, MDUniversity of Southern California

Nasir Siddiqui, MDUniversity of Pittsburgh Medical Center

Charles B. Simone II, MDNational Cancer Institute, National Capital Consortium, Bethesda

Heath Skinner, MD, PhDMD Anderson Cancer Center

John G. Stewart, MDUniversity of Alabama at Birmingham

Teerath Peter Tanpitukpongse, MDWinthrop University Hospital

Ajay Tejwani, MDNew York Methodist Hospital

Vincent Timpone, MDDavid Grant USAF Medical Center

Mitesh Trivedi, MDChristiana Care Health System

Venu Vadlamudi, MDMSU Flint Area Medical Education

Vladimir Valakh, MDAllegheny General Hospital

Kalyani Vallurupalli, MDSIU School of Medicine

Artur Velcani, MDSt. Vincent’s Medical Center

Franco Verde, MDGeisinger Medical Center

Nicholas L. Walle, MDRhode Island Hospital Brown Medical School

Danny Wang, MDAlbany Medical Center

Tony J. Wang, MDColumbia University Medical Center

Rodney Wegner, MDUniversity of Pittsburgh Medical CenterRadiation Oncology

Terence Williams, MD, PhDUniversity of Michigan Health Systems

Onalisa Winblad, MDUniversity of Kansas Medical Center

Michal Wolski, MDUniversity of Texas Medical Branch at Galveston

Joseph H. Yacoub, MDUniversity of Chicago

Hooman Yarmohammadi, MDUniversity Hospitals Case Medical Center

Takeshi Yokoo, MD, PhDUniversity of California San Diego

Jennifer Young, MDMemorial University

Jennifer Yu, MD, PhDUniversity of California San Francisco

Jing Zeng, MDJohns Hopkins School of Medicine

Joseph Zikria, MDLenox Hill Hospital

Xavier Garcia-Rojas, MD, Recipient, with Rajeev Suri, MD, Program Director


the RSNA Research & Education Foundation has enabled

the brightest minds in radiology and related sciences to

discover new methods to fight disease, devise sophisticated

new technologies, improve the patient care process and

cultivate the workforce of the future.

For more information or to apply

for a grant, please contact:

Scott Walter

630-571-7816

[email protected]

Diane Georgelos

630-590-7789

[email protected]

Since 1984

Improving patient care by supporting research and education in radiology and related scientific disciplines through funding grants and awards to individuals and institutions that will advance radiologic research, education and practice.

Bright Ideas Get Funded

2011rsna grants and awards


donate. volunteer. get funded.


820 Jorie Blvd

Oak Brook, IL 60523

1-630-368-7885

r&[email protected]

RSNA.org/Foundation

2011 grant-and-award-booklet web

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