Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Lancet, Lung Cancer, Medical Imaging, Technology / 07.09.2022

MedicalResearch.com Interview with: Raymond H. Mak, MD Radiation Oncology Disease Center Leader for Thoracic Oncology Director of Patient Safety and QualityDirector of Clinical Innovation Associate Professor, Harvard Medical School Cancer - Radiation Oncology, Radiation Oncology Department of Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What is the algorithm detecting? Response: Lung cancer, the most common cancer worldwide is highly lethal, but can be treated and cured in some cases with radiation therapy.  Nearly half of lung cancer patients will eventually require some form of radiation therapy, but the planning for a course of radiation therapy currently entails manual, time-consuming, and resource-intensive work by highly trained physicians to segment (target) the cancerous tumors in the lungs and adjacent lymph nodes on three-dimensional images (CT scans). Prior studies have shown substantial variation in how expert clinicians delineate these targets, which can negatively impact outcomes and there is a projected shortage of skilled medical staff to perform these tasks worldwide as cancer rates increase. To address this critical gap, our team developed deep learning algorithms that can automatically target lung cancer in the lungs and adjacent lymph nodes from CT scans that are used for radiation therapy planning, and can be deployed in seconds. We trained these artificial intelligence (AI) algorithms using expert-segmented targets from over 700 cases and validated the performance in over 1300 patients in external datasets (including publicly available data from a national trial), benchmarked its performance against expert clinicians, and then further validated the clinical usefulness of the algorithm in human-AI collaboration experiments that measured accuracy, task speed, and end-user satisfaction. (more…)
Author Interviews, Breast Cancer, JAMA, Mammograms, Medical Imaging, UCSF / 15.06.2022

MedicalResearch.com Interview with: Karla Kerlikowske, MD. Professor, Departments of Medicine and Epidemiology/Biostatistics, Cancer Center Program Membership. Breast Oncology UCSF MedicalResearch.com:  What is the background for this study?  Response: Digital breast tomosynthesis (DBT) was developed with the expectation it would improve detection of breast cancer in women with dense breasts and decrease false-positive results. DBT is now available at most breast screening centers. (more…)
Author Interviews, Autism, Medical Imaging / 02.04.2022

MedicalResearch.com Interview with: Alpen ORTUĞ, PhD Postdoctoral Research Fellow​ Massachusetts General Hospital Department of Radiology Martinos Center for Biomedical Imaging Boston, MA   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Finding the earliest diagnosis possible for autism spectrum disorder (ASD) is one of the main goals for researchers studying ASD. This study aimed to investigate the critical abnormalities in prenatal brain development in ASD using structural magnetic resonance imaging (MRI). We hypothesized that volumetric analyses of brain segmentations are useful to identify such abnormalities before birth. We have retrospectively analyzed fetal MRI based on the knowledge that the same individuals were later diagnosed with autism spectrum disorder. We have evaluated developmental abnormalities in brain structures of prospective ASD fetuses using volumetric segmentation. The current study is still preliminary, but the ‘insula’ of the brain showed statistically significant volumetric enlargement in prospective ASD patients, compared to the other three control groups.  (more…)
Author Interviews, Education, Medical Imaging, Technology / 13.08.2021

MedicalResearch.com Interview with: Ryan C. Gibbons, MD, FAAEM, FACEP Associate Professor of Emergency Medicine Director of the Emergency Ultrasound Fellowship Associate Director of the Division of Emergency Ultrasound Department of Emergency Medicine Director of Ultrasound in Medical Education Lewis Katz School of Medicine at Temple University MedicalResearch.com: What is the background for this study?  How was the gift funded? Butterfly needle visualizatioResponse: Point-of-care ultrasound is one of the most significant advances in bedside patient care, and its use is expanding across nearly all fields of medicine. In order to best prepare medical students for residency and beyond, it is imperative to begin POCUS training as early as possible. At the Lewis Katz School of Medicine at Temple University, we introduced POCUS education over a decade ago and have expanded it since then. By providing each student with a Butterfly iQ device, we can augment our curriculum significantly. In addition to our robust pre-clinical sessions, now we will expand into the clinical years highlighting the utility of POCUS with actual patients. This gift was made possible by the incredible generosity of Dr. Ronald Salvitti, MD ’63.  (more…)
Author Interviews, Brigham & Women's - Harvard, Medical Imaging, Neurological Disorders / 02.07.2021

MedicalResearch.com Interview with: Michael Ferguson, PhD Instructor in Neurology | Harvard Medical School Lecturer on Neurospirituality | Harvard Divinity School Center for Brain Circuit Therapeutics Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: Over 80% of the global population consider themselves religious with even more identifying as spiritual, but the neural substrates of spirituality and religiosity remain unresolved. MedicalResearch.com: What are the main findings? Where is this circuit located in the brain? What other effects does this circuit control or influence? Response: We found that brain lesions associated with self-reported spirituality map to a human brain circuit centered on the periaqueductal grey. (more…)
Alzheimer's - Dementia, Author Interviews, Medical Imaging, Mental Health Research / 01.12.2020

MedicalResearch.com Interview with: Maria Vittoria Spampinato, MD Neuroradiology Division Director Department of Radiology and Radiological Science Medical University of South Carolina Charleston, SC 29425-3230 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alzheimer’s disease (AD) represents a major public health crisis worldwide. More than 5 million people currently have AD in the United States. AD is a slowly progressing neurodegenerative brain disorder with a long preclinical phase. Many people with AD first suffer from mild cognitive impairment (MCI), a decline in cognitive abilities like memory and thinking skills that is greater than that associated with normal aging. A person with MCI is at an increased risk of developing AD or another dementia, although some individuals with MCI remain cognitively stable or improve. Anxiety is frequently observed in individuals with MCI. The reported prevalence of anxiety in MCI patients varies between 10 and 50%.  In this study we evaluated a cohort of 339 individuals with MCI participating in the Alzheimer’s Disease Neuroimaging Initiative study (ADNI2). During the five years of study participation, 72 patients experienced cognitive decline and were diagnosed with AD. We did not find difference in age, gender and education among patients with and without AD conversion. Patients who progressed had greater atrophy of the hippocampi and entorhinal cortex on their MRI scan, as expected (hippocampal atrophy is often used as a marker of neurodegeneration in AD), as well as greater prevalence of APOE4 is the strongest known genetic risk factor for AD.   Patients who progressed to Alzheimer’s disease also had greater severity of anxiety during the study, as measured using the Neuropsychiatric Inventory-Questionnaire. Next we determined the effect of the MRI findings (hippocampal and entorhinal cortex atrophy), of the genetic risk factor (APOE4) and of the severity of anxiety on the time to progression to AD. We found that higher levels of anxiety were associated with faster progression from MCI to AD, independently of whether they had a genetic risk factor for Alzheimer’s disease or brain volume loss. We still need to understand better the association between anxiety disorders and cognitive decline. We do not know whether increased levels of anxiety are a consequence of cognitive decline or if anxiety exacerbates to cognitive decline. If we were able to find in the future that anxiety is actually contributing to cognitive decline, then we should more aggressively screen for anxiety disorders in the elderly population.  (more…)
Author Interviews, COVID -19 Coronavirus, Medical Imaging / 27.08.2020

MedicalResearch.com Interview with: Bruce G. Haffty, MD FACR FASTRO FASCO Associate Vice Chancellor Cancer Programs Rutgers Biomedical and Health Sciences Professor and Chair, Dept. Radiation Oncology Rutgers Robert Wood Johnson and New Jersey Medical Schools Rutgers Cancer Institute of New Jersey MedicalResearch.com: What is the background for this study? : What are the main findings? Response: That at peak times of COVID in NJ, in a tertiary care hospital with lots of COVID patients, where cancer patients still need to get treated, there was no evidence of surface COVID contamination, which should be reassuring to patients requiring radiation treatment in a busy hospital with a high in patient population of COVID patients. It should be noted that patients and staff were routinely mask wearing, observing social distancing and routinely hand washing as well as screening patients as they came in to the department with temperature checks and questions regarding symptoms. (more…)
Author Interviews, COVID -19 Coronavirus, CT Scanning, Global Health, Medical Imaging / 13.03.2020

MedicalResearch.com Interview with: Soheil Kooraki  MSR MS, MD on behalf of Dr. Ali Gholamrezanezhad MD and co-authors Department of Radiological Sciences, David Geffen School of Medicine, University of California at Los Angeles Los Angeles, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: COVID19 is a novel strain of the coronavirus family causing pneumonia. Two similar strains were discovered in 2003 and 2012 to cause the so-called SARS and MERS outbreaks, respectively. Radiologists need to be prepared for the escalating incidence of COVID-19. We reviewed the literature to extract the epidemiologic and imaging features of SARS and MERS in comparison with known imaging features of COVID-19 pneumonia to have a better understanding of the imaging features of the COVID19 pneumonia in acute and post-recovery stages. (more…)
Alzheimer's - Dementia, Author Interviews, Brain Injury, Medical Imaging, UCSF / 06.01.2020

MedicalResearch.com Interview with: William G. Mantyh, MD Clinical Fellow, UCSF Memory and Aging Center Weill Institute for Neurosciences UCSF MedicalResearch.com: What is the background for this study? Response: Similar to Alzheimer’s disease (AD) and other dementing illnesses, Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative condition associated with abnormally folded tau protein in the brain. CTE is thought to be caused by exposure to repetitive head trauma, and recently has been the subject of intense media coverage given the frequency of CTE found in brains of deceased former American professional football players. CTE is almost impossible to confidently diagnose during life as the symptoms are diverse and vary from patient-to-patient. Symptoms can include impairments in memory, multi-tasking, behavioral/mood regulation, and movement. As there are no blood, imaging, or other tests for this disease, one active area of research is developing a test to help doctors diagnose this condition. As tau tangles in CTE are similar in many respects to those in Alzheimer’s disease, there was hope that PET tracers that detect tau in AD might also work in CTE. Flortaucipir (FTP) is probably the most widely used tau tracer in AD. Recent work has reported some signal from FTP-PET in symptomatic former NFL players and other patients at risk for CTE (Stern et al. New Engl Jour Med 2019; Lesman-Segev et al. Neuroimage Clinical 2019). The overall signal was lower than that observed in Alzheimer’s disease, and, in lieu of correlations with post-mortem findings, it was unclear how well FTP binds to tau pathology in CTE. (more…)
Abuse and Neglect, Alzheimer's - Dementia, Autism, Medical Imaging, Mental Health Research, MRI, Multiple Sclerosis, Neurology, Technology / 23.12.2019

MedicalResearch.com Interview with: Sebastian Magda, Ph.D Director of Science & Engineering CorTechs Labs, Inc MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that the changes of brain structure volume and/or metabolic activity are associated with various neurological diseases. We have created an artificial intelligence clinical decision support tool based on brain volumetric and PET metabolic activity measurements as well as other clinical measurements. (more…)
Author Interviews, Medical Imaging, Technology / 11.12.2019

MedicalResearch.com Interview with: Dr. David Steiner, MD PhD Google Health, USA MedicalResearch.com: What is the background for this study? Response: Advances in artificial intelligence raise promising opportunities for improved interpretation of chest X-rays and many other types of medical images. However, even before researchers begin to address the critical question of clinical validation, there is important work to be done establishing strategies for evaluating and comparing different artificial intelligence algorithms. One challenge is defining and collecting the correct clinical interpretation or “label” for the large number of chest X-rays needed to train and evaluate these algorithms. Another important challenge is evaluating the algorithm on a dataset that actually represents the diversity of the cases encountered in clinical practice. For example, it might be relatively easy to make an algorithm that performs perfectly on a few hundred or so “easy” cases, but this of course might not be particularly useful in practice. (more…)
Author Interviews, Cost of Health Care, JAMA, Medical Imaging, UCSF / 05.09.2019

MedicalResearch.com Interview with: Rebecca Smith-Bindman, MD Professor, Department of Radiology and Biomedical Imaging, Epidemiology and Biostatistics Philip R. Lee Institute for Health Policy Studies University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Medical imaging increased rapidly from 2000 to 2006. The rise in imaging can be attributed to improvements in technical aspects of imaging, strong physician and patient demand, and strong financial incentives. While imaging contributes to accurate disease diagnosis and improved treatment, imaging can also increase costs and patient harms, such as incidental findings, overdiagnosis, anxiety, and radiation exposure associated with increased risk of cancer. Potential overuse of diagnostic testing has been addressed by the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign and initiatives by payers to reduce imaging through payment reductions, but there remains uncertainty in the impact of these initiatives on imaging rates.The objective of our study was to evaluate recent trends in medical imaging. Our study assessed imaging from 2000 through 2016 among individuals enrolled in diverse U.S. integrated healthcare systems and among individuals residing in Ontario, Canada and assessed changes in medical imaging utilization over time by country, health system, and patient demographic factors. (more…)
Author Interviews, Cost of Health Care, Heart Disease, JAMA, Medical Imaging / 17.06.2019

MedicalResearch.com Interview with: Quinn R Pack, MD Assistant Professor of Medicine University of Massachusetts Medical School - Baystate Adjunct Assistant Professor of Medicine Tufts University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Because echocardiograms are non-invasive, very low risk, and nearly universally available, it is easy to over-use this technique.  In myocardial infarction, echo is also recommended in guidelines. However, in our lab, we frequently find echocardiograms that are ordered purely out of routine, without any thought as to the likelihood of finding an abnormality.   Prior studies also suggested that as many as 70% of echocardiograms provide no additional diagnostic value. When spread across the approximate 600,000 patients in the United States each year, this low diagnostic yield represents an opportunity to reduce costs by reducing echocardiograms.  (more…)
Author Interviews, Emergency Care, JAMA, Medical Imaging, Pediatrics / 04.06.2019

MedicalResearch.com Interview with: Eyal Cohen, MD, M.Sc, FRCP(C) Professor, Pediatrics University of Toronto Co-Founder, Complex Care Program The Hospital for Sick Children   MedicalResearch.com: What is the background for this study? Response: Minimizing care that provides little benefit to patients has become an important focus to decrease health care costs and improve the quality of care delivery.  Diagnostic imaging in children is a common focus for campaigns designed to reduce overuse both in Canada and the US. There are some suggestions that there may be more overuse of care in the United States than Canada, but there has been little study in children. We compared the use of low-value diagnostic imaging rates from four pediatric emergency departments in Ontario to 26 in the United States from 2006 to 2016.  We defined low-value imaging as situations where children are discharged from an emergency department with a diagnosis for which routine use of diagnostic imaging may not be necessary, like asthma or constipation.  (more…)
Author Interviews, Medical Imaging, Mental Health Research, UCSD / 13.05.2019

MedicalResearch.com Interview with: Dr. Mingxiong Huang, PhD Professor, Electrical and Computer Engineering University of California, San Diego MedicalResearch.com: What is the background for this study?   Response: Combat-related mild traumatic brain injury (mTBI) is a leading cause of sustained impairments in military service members and Veterans. Yet, conventional neuroimaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) are typically insensitive to physiological alterations caused by mild and some moderate TBIs. With funding from the VA, we have pursued in developing sensitive imaging markers based on magnetoencephalography (MEG) for mTBI. This paper reflects the news MEG findings in this research field.  (more…)
Author Interviews, Biomarkers, CT Scanning, JAMA, Lung Cancer, Medical Imaging / 01.03.2019

MedicalResearch.com Interview with: Martin C. Tammemägi PhD Senior Scientist Cancer Care Ontario | Prevention & Cancer Control Scientific Lead Lung Cancer Screening Pilot for People at High Risk Professor (Epidemiology) | Brock University Department of Health Sciences Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Some prediction models can accurately predict lung cancer risk (probability of developing lung cancer during a specified time). Good model predictors include sociodemographic, medical and exposure variables. In recent years, low dose computed tomography (LDCT) lung cancer screening has become widespread in trials, pilots, demonstration studies, and public health practice. It appears that screening results provides added valuable, independent predictive information regarding future lung cancer risk, aside from the lung cancers directly detected from the diagnostic investigations resulting from positive screens. (more…)
Author Interviews, FDA, JAMA, Medical Imaging / 04.12.2018

MedicalResearch.com Interview with: Aldo Badano, Ph.D. Deputy Director, Division of Imaging, Diagnostics, and Software Reliability Office of Science and Engineering Laboratories Center for Devices and Radiological Health Silver Spring, MD 20993 Aldo Badano, Ph.D. Deputy Director, Division of Imaging, Diagnostics, and Software Reliability Office of Science and Engineering Laboratories Center for Devices and Radiological Health Silver Spring, MD 20993  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Expensive and lengthy clinical trials can delay regulatory evaluation of innovative technologies, affecting patient access to high-quality medical products. Although computational modeling is increasingly being used in product development, it is rarely at the center of regulatory applications. Within this context, the VICTRE project attempted to replicate a previously conducted imaging clinical trial using only computational models. The VICTRE trial involved no human subjects and no clinicians. All trial steps were conducted in silico. The fundamental question the article addresses is whether in silico imaging trials are at a mature development stage to play a significant role in the regulatory evaluation of new medical imaging systems. The VICTRE trial consisted of in silico imaging of 2986 virtual patients comparing digital mammography (DM) and digital breast tomosynthesis (DBT) systems. The improved lesion detection performance favoring DBT for all breast sizes and lesion types was consistent with results from a comparative trial using human patients and radiologists.  (more…)
Alzheimer's - Dementia, Author Interviews, CT Scanning, JAMA, Medical Imaging / 20.09.2018

MedicalResearch.com Interview with: PET scanner Wikipedia imageRik Ossenkoppele -PhD Lund University & VU University Medical Center Oskar Hansson - Lund University MedicalResearch.com: What is the background for this study? What are the main findings? Response: [18F]flortaucipir is a relatively novel PET tracer that can be used to detect tau pathology in the living human brain. Previous studies have shown a robust signal in patients with Alzheimer’s disease, but in patients with other types of dementia the signal was more variable. We aimed to assess the ability of [18F]flortaucipir PET to distinguish Alzheimer’s disease from other neurodegenerative disease in more than 700 study participants. T he main finding was that [18F]flortaucipir discriminated Alzheimer’s disease patients from patients with other neurodegenerative diseases with high accuracy. Furthermore, [18F]flortaucipir PET outperformed established MRI markers and showed higher specificity than amyloid-β PET.  (more…)
Author Interviews, Breast Cancer, Cost of Health Care, Mammograms, Medical Imaging / 29.07.2018

MedicalResearch.com Interview with: Michal Horný PhD Assistant Professor Emory University School of Medicine, Department of Radiology and Imaging Sciences Emory University Rollins School of Public Health Department of Health Policy and Management Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? Response: Increased breast tissue density is a common finding at screening mammography. Approximately 30-50% of women have so-called “dense breasts” but many of them are not aware of it. The problem is that the increased tissue density can potentially mask early cancers. In other words, if there is cancer hiding in dense breast tissue, it could be difficult to spot it. To improve the awareness of breast tissue density, a patient group called Are You Dense Advocacy, Inc., started lobbying state and federal policymakers to pass laws mandating health care providers to notify women about their breast density assessments. As a result, 31 states have already enacted some form of legislation regarding dense breast tissue. (more…)
Author Interviews, Emergency Care, Heart Disease, JACC, Medical Imaging / 21.06.2018

MedicalResearch.com Interview with: Jeffrey M. Levsky, M.D., Ph.D. Associate Professor, Department of Radiology Associate Professor, Department of Medicine (Cardiology) Albert Einstein College of Medicine Montefiore Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Millions of Americans are evaluated each year for acute chest pain in the Emergency Department.  There are multiple modalities that can be used to triage these patients and there have only been a few studies comparing different imaging methods. We chose to study Stress Echocardiography and Coronary CT Angiography, two exams that have not been compared directly in this population.  We found that Stress Echocardiography was able to discharge a higher proportion of patients in a shorter amount of time as compared to Coronary CTA.  (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Medical Imaging, Memory / 12.06.2018

MedicalResearch.com Interview with: Arno de Wilde, MD / PhD candidate Department of Neurology & Alzheimer Center Amsterdam Neuroscience VU University Medical Center Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies assessing the clinical utility of amyloid imaging used very selected research populations, limiting the translatability to clinical practice. In contrast, we used an unselected memory clinic cohort, offering amyloid PET to ALL patients visiting our memory clinic, and for the purpose of this study, we implemented amyloid PET in our routine diagnostic work-up. Our results demonstrate that amyloid PET has important consequences, in terms of diagnosis and treatment changes, for a significant number of patients within a situation that closely resembles clinical practice. I think that these results are an important step in 'bridging the gap' between using amyloid PET in a research setting versus daily clinical practice. (more…)
Author Interviews, JAMA, Medical Imaging, Prostate Cancer, Technology / 17.05.2018

MedicalResearch.com Interview with: Andrew J. Armstrong, MD ScM FACP Associate Professor of Medicine, Surgery, Pharmacology and Cancer Biology Associate Director for Clinical Research in Genitourinary Oncology Duke Cancer Institute Divisions of Medical Oncology and Urology Duke University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Men with prostate cancer commonly develop bone metastases and undergo nuclear medicine bone scans. However, these scans are non-quantitative, and disease burden has been challenging to assess over time and to relate to clinical outcomes. We developed a software program and measurement called the automated bone scan index that essentially reads a standard of care nuclear bone scan, provides a quantitative metric, and demonstrate in a phase 3 trial that this aBSI is highly associated with clinical outcomes including survival, time to symptomatic progression, and prostate cancer specific survival. We accomplished this within a prospective phase 3 international trial of men with metastatic hormone resistant prostate cancer who were followed over a long period of time.  All bone scans were read and measured using the aBSI at baseline, and we found that the aBSI was highly prognostic.  This work validates prior smaller phase 2 BSI studies, and demonstrates both the feasibility and clinical utility for incorporating the aBSI into clinical practice to provide this important prognostic information to patients and providers. (more…)
Abuse and Neglect, Hematology, Lancet, Medical Imaging, Transplantation / 07.03.2018

MedicalResearch.com Interview with: Kirsten Williams, M.D. Blood and marrow transplant specialist Children’s National Health System  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study addressed a life-threatening complication of bone marrow transplantation called bone marrow failure. Bone marrow transplantation has provided a cure for patients with aggressive leukemias or acquired or genetic marrow dysfunction. The process of bone marrow transplantation involves giving chemotherapy and/or radiation, which removes the diseased blood cells from the bone marrow. After this, new bone marrow stem cells are infused from a healthy individual. They travel to the bone marrow and start the slow process of remaking the blood system. Because these new cells start from infancy, it takes upwards of four to five weeks for new mature healthy cells to emerge into the blood, where they can be identified. Historically, there has been no timely way to determine if the new cells have successfully repopulated unless they can be seen in the blood compartment. This condition of bone marrow failure is life-threatening, because patients don't have white blood cells to protect them from infection. Once bone marrow failure is diagnosed, a second new set of stem cells are infused, often after more chemotherapy is given. However, for many individuals this re-transplantation is too late, because severe infections can be fatal while waiting cells to recover. We were the first group to use a new imaging test to understand how the newly infused bone marrow cells develop inside the patient. We have recently published a way to detect the new bone marrow cell growth as early as five days after the cells are given. We used an investigational nuclear medicine test to reveal this early cell growth, which could be detected weeks before the cells appear in the blood. This radiology test is safe, does not cause any problems and is not invasive. It is called FLT (18F-fluorothymidine) and the contrast is taken up by dividing hematopoietic stem cells. The patients could even see the growth of their new cells inside the bone marrow (which they very much enjoyed while waiting to see recovery of the cells in their blood). We could use the brightness of the image (called SUV) to determine approximately how many weeks remained before the cells were visible in the blood. Finally, we actually could see where the new cells went after they were infused, tracking their settling in various organs and bones. Through this, we could see that cells did not travel directly to all of the bones right away as was previously thought, but rather first went to the liver and spleen, then to the mid-spine (thorax), then to the remainder of the spine and breastplate, and finally to the arms and legs. This pattern of bone marrow development is seen in healthy developing fetuses. In this case, it occurs in a similar pattern in adults undergoing bone marrow transplant. (more…)
Author Interviews, Cognitive Issues, Genetic Research, JAMA, Medical Imaging, Mental Health Research / 25.01.2018

MedicalResearch.com Interview with: “The Fourth Sex: Adolescent Extremes” by Victor Soto is licensed under CC BY 2.0Dag Alnaes, PhD Norwegian Centre for Mental Disorders Research KG Jebsen Centre for Psychosis Research Division of Mental Health and Addiction, Oslo University Hospital Oslo, Norway  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The transition from childhood to adulthood is characterized by swift and dramatic changes, both in our environment and in our brains. This period of life also coincides with the onset of many mental disorders. To gain a better understanding of why, the clinical neurosciences must attempt to disentangle the complex and dynamic interactions between genes and the environment and how they shape our brains. The ultimate goal is to be able to predict which individuals are at risk before clinical symptoms appear. Advanced brain imaging has been proposed to represent one promising approach for such early detection, but there is currently no robust imaging marker that allows us to identify individuals at risk with any clinically relevant degree of certainty. Our study shows that self-reported early signs of mental illness are associated with specific patterns of brain fiber pathways in young people, even if they may not fulfill criteria for a formal diagnosis or are currently in need of treatment.  (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Medical Imaging, Weight Research / 22.11.2017

MedicalResearch.com Interview with: Miriam Bredella, MD Associate Professor of Radiology Harvard Medical School Department of Radiology Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that body composition differs between men and women, with women having proportionally more fat and men more muscle mass. But not the amount of fat but its distribution is an important determinant of cardiometabolic risk, with certain ectopic fat depots, such as visceral adipose tissue, fat within muscle cells - intramyocellular (IMCL), and liver fat, being more detrimental than others, such as femorogluteal subcutaneous adipose tissue. We therefore wanted to study sex differences in body composition and cardiometabolic risk in men and women with obesity. We found that at the same BMI, men had relatively higher visceral adipose tissue, IMCL, liver fat, muscle and lean mass, while women higher percent fat mass and higher subcutaneous adipose tissue. This female anthropometric phenotype was associated with a better cardiometabolic risk profile at similar BMI compared to men. However, ectopic fat depots were more strongly associated with adverse cardiometabolic risk factors in women compared to men (more…)
Author Interviews, JAMA, Lung Cancer, Medical Imaging, Surgical Research, Vanderbilt / 10.11.2017

MedicalResearch.com Interview with: Amelia W. Maiga, MD MPH Vanderbilt General Surgery Resident VA Quality Scholar, TVHS MedicalResearch.com: What is the background for this study? What are the main findings? Response: Positron emission tomography (PET) combined with fludeoxyglucose F18 (FDG) is currently recommended for the noninvasive diagnosis of lung nodules suspicious for lung cancer. Our investigation adds to growing evidence that FDG-PET scans should be interpreted with caution in the diagnosis of lung cancer. Misdiagnosis of lung lesions driven by FDG-PET avidity can lead to unnecessary tests and surgeries for patients, along with potentially additional complications and mortality. To estimate FDG-PET diagnostic accuracy, we conducted a multi-center retrospective cohort study. The seven cohorts originating from Tennessee, Arizona, Massachusetts and Virginia together comprised 1188 nodules, 81 percent of which were malignant. Smaller nodules were missed by FDG-PET imaging. Surprisingly, negative PET scans were also not reliable indicators of the absence of disease, especially in patients with smaller nodules or who are known to have a high probability of lung cancer prior to the FDG-PET test. Our study supports a previous meta-analyses that found FDG-PET to be less reliable in regions of the country where fungal lung diseases are endemic. The most common fungal lung diseases in the United States are histoplasmosis, coccidioidomycosis and blastomycosis. All three fungi reside in soils. Histoplasmosis and blastomycosis are common across much of the Mississippi, Ohio and Missouri river valleys and coccidioidomycosis is prevalent in the southwestern U.S. These infections generate inflamed nodules in the lungs (granulomas), which can be mistaken for cancerous lesions by imaging. (more…)
Alzheimer's - Dementia, Author Interviews, Medical Imaging, MRI / 06.10.2017

MedicalResearch.com Interview with: Dr. Sanja Josef Golubic, dr. sc Department of Physics, Faculty of Science University of Zagreb, Croatia MedicalResearch.com: What is the background for this study? Response: Our study was aimed to search the topological biomarker of Alzheimer’s disease. A recent evidences suggest that the decades long progression of brain degeneration that is irreversible by the stage of symptomatic Alzheimer’s disease, may account for failures to develop successful disease-modifying therapies. Currently, there is a pressing worldwide search for a marker of very early, possibly reversible, pathological changes related to Alzheimer’s disease in still cognitively intact individuals, that could provide a critical opportunity for evolving of efficient therapeutic interventions. Three years ago we reported the discovery of the novel, fast brain pathway specialized for rapid processing of the simple tones. We named it gating loop. Gating loop directly links auditory brain areas to prefrontal brain area. We have also noticed the high sensitivity of the gating loop processing on AD pathology. It was inspiration to focus our Alzheimer’s disease biomarker search in the direction of prefrontal brain activation during listening of simple tones. (more…)
Author Interviews, Medical Imaging, Prostate Cancer / 19.06.2017

MedicalResearch.com Interview with: Dr. Susanne Lütje Ärztlicher Dienst Universitätsklinikum Essen (AöR) Klinik für Nuklearmedizin Essen Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer (PCa) is the most common cancer in men and accounts for a significant amount of morbidity and mortality. At present, the curative treatment option of choice for localized stages of PCa is radical prostatectomy, which may include extended lymph node dissection. Unfortunately, surgical procedures can be accompanied by complications such as urinary incontinence. Most importantly, small tumor deposits may not be seen by the surgeon during surgery and could ultimately lead to disease recurrence. To overcome these issues, new and innovative treatments are needed. The prostate-specific membrane antigen (PSMA) is a surface protein that is overexpressed in prostate cancer and can be used as a target to guide new therapies. Photodynamic therapy (PDT) is an ablative procedure in which tumor cells can be destroyed effectively by irradiation of light of a specific wavelength, which activates previously administered photosensitizers. The photosensitizers can respond by emitting fluorescence or emitting oxygen radicals which can cause cellular damage. Coupling the photosensitizer to an agent that targets PSMA on the tumor surface offers the possibility to selectively and effectively destroy prostate tumor remnants and micrometastases, while surrounding healthy tissues remain unaffected. In our study, the PSMA targeting antibody D2B was coupled to the photosensitizer IRDye700DX and radiolabeled with 111In. In a mouse model, this multi-modality agent was used to preoperatively visualize tumor lesions with SPECT/CT to allow rough localization of the tumors. During surgery, the fluorescent signal originating from the photosensitizer facilitates visualization of tumors and residual tumor tissue, so the surgeon can be guided towards accurate resection of the entire tumors and metastases. In addition, the PSMA-targeted PDT can be applied to destroy small tumor deposits in cases where close proximity of the tumors. (more…)
Author Interviews, Heart Disease, JACC, Medical Imaging, MRI / 19.04.2017

MedicalResearch.com Interview with: Pr. Juerg Schwitter MD Médecin Chef Cardiologie Directeur du Centre de la RM Cardiaque du CHUV Centre Hospitalier Universitaire Vaudois - CHUV Suisse  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coronary artery disease (CAD) is still one of the leading causes of death in the industrialized world and as such, it is also an important cost driver in the health care systems of most countries. For the European Union, the estimated costs for CAD management were 60 billion Euros in 2009, of which approximately 20 billion Euros were attributed to direct health care costs (1). In 2015, the total costs of CAD management in the United States were estimated to be 47 billion dollars (2). Substantial progress has been achieved regarding the treatment of CAD including drug treatment but also revascularizations procedures. There exists a large body of evidence demonstrating myocardial ischemia as one of the most important factors determining the patient’s prognosis and reduction of ischemia has been shown to improve outcome. On the other hand, techniques to detect CAD, i.e. relevant myocardial ischemia, were insufficient in the past. Evaluation of myocardial perfusion by first-pass perfusion cardiac magnetic resonance (CMR) is now closing this gap (3) and CMR is recommended by most international guidelines for the work-up of known or suspected CAD (4,5). Still, a major issue was not clarified until now, i.e. “how much ischemia is required to trigger revascularization procedures”. Thus, this large study was undertaken to assess at which level of ischemia burden, patients can be safely deferred from revascularization and can be managed by risk factor treatment only. Of note, this crucial question was addressed in both, patients with suspected CAD but also in patients with known (and sometimes already advanced) CAD, thereby answering this question in the setting of daily clinical practice. (more…)