October 2009

Dr. William Kuo and Colleagues Reveal Lifesaving Treatment for Pulmonary Embolism

Dr. William Kuo was recently featured in a Stanford Medicine News article and national press release entitled "Study Reveals Life-Saving Treatment for Pulmonary Embolism." Dr. Kuo discussed the results from his study published in the November 2009 issue of the Journal of Vascular and Interventional Radiology (20(11):1431-1440). Analyzing global data regarding the use of catheter-directed therapy for massive PE, he and his colleagues discovered that the therapy was life-saving in 86.5% of the 594 cases they studied. Dr. Kuo published his findings along with co-authors Lawrence Hofmann, MD, associate professor and chief of cardiovascular-interventional radiology; Daniel Sze, MD, associate professor of radiology; John Louie, MD, assistant professor of radiology; Jarrett Rosenberg, PhD, statistician; and Michael Gould, MD, associate professor of pulmonary and critical care medicine. The full Stanford press release can be accessed here: http://med.stanford.edu/ism/2009/october/embolism.html.

MIPS/RSL/ISIS Retreat 2009

By Julie Ruiz, PhD

MIPS
Sharing the Asilomar Conference Grounds, this year's retreats for the Molecular Imaging Program at Stanford (MIPS) (above) and the Radiological Sciences Laboratory (RSL)/Information Sciences in Imaging at Stanford (ISIS) (below) overlapped by one day.
Beginning on Tuesday, September 15th, 128 people from . . .

MIPS attended the two-day 5th annual MIPS retreat. Ninety-three people attended the two-day 11th annual RSL/ISIS Retreat, which ended on Thursday, September 17th. Agendas for both retreats are available on the retreat website at http://stanfordradretreat.pbworks.com/Agenda.

MIPS
After meeting on the beach for lunch on Tuesday, MIPS retreat attendees began an extensive photo treasure hunt, which lasted until the following day. Participants were required to take photos that were humorous, creative, and appropriate as well as that included the most number of strangers and team members as possible in the picture. Please see the winning photos below.

Opening remarks were delivered by Sam Gambhir, MD, PhD, the Virginia and D.K. Ludwig Professor of Radiology and Bioengineering followed by "MIPS Faculty Words of Wisdom" given by Drs. Craig Levin, Michael Lin, Michael Moseley, David Paik, Brian Rutt, and Michael McConnell. Based on each speaker's personal experiences, these 10 minute talks addressed topics such as the work-life balance and how to succeed on the job. The retreat also included Breakout Sessions with 11 different groups, which discussed topics including mentorship, social networking, space issues, and professional growth. Other highlights included remarks by Keynote Speaker Steve Haddock, PhD, a marine biologist studying bioluminescence and zooplankton at the Monterey Bay Aquarium Research Institute who spoke about bioluminescence in marine life. Through videos, he demonstrated how marine life use their natural bioluminescence in the deep sea to avoid predators and attract prey.

MIPS/RSL/ISIS
On Wednesday, all three groups overlapped and shared in several retreat activities followed by a bonfire, karaoke/music jam, and jeopardy game, with categories specific to Stanford Radiology. There was also an RSL/ISIS photo contest in which participants submitted photos in three categories: special effects with no manipulation; unusual; and nature. The three winners' photos are included below. Retreat attendees participated in "Pie in the Sky" presentations, sharing their ideas regarding the future challenges, solutions, and directions of Radiology, as well as in "Elevator Pitches," 60 second talks explaining their research. Highlights included the State of the Department presentation by Dr. Gary M. Glazer, chair of Stanford Radiology and Emma Pfeiffer Merner Professor in the Medical Sciences.

RSL/ISIS
On Thursday, Keynote Speaker Fei-Fei Li, PhD, assistant professor in the Department of Computer Science, gave a talk entitled "Telling Stories of the Visual World: Perception and Computation" in which she described some goals of her research such as understanding human visual intelligence by applying computational tools as well as building intelligent visual algorithms for machines and robots. Other retreat events included a presentation by Dr. Shreyas Vasanawala, assistant professor of radiology, entitled, "A Day in the Life of a Radiologist" and workshops by Dr. Brian Hargreaves, assistant professor of radiology (research), "Making Meetings Effective"; Drs. Gary Glover, professor of radiology, and Kim Butts Pauly, professor (research) of radiology, "How to Write and Read a Recommendation Letter"; and Drs. Rebecca Fahrig, associate professor (research) of radiology; Kim Butts Pauly; and Norbert Pelc, professor of radiology and bioengineering, "Finding a Work/Life Balance."

The retreat ended with the judging of the RSL/ISIS photo contest (please see winning photos below); and a tour of the Stanford Hopkins Marine Laboratory.

WINNING MIPS PHOTOS

WINNING RSL/ISIS PHOTOS
"Nature" Category Winner (Wendy Baumgardner, RVT, LATg)

"Special Effects" Category Winner (Norbert Pelc, ScD)

"Unnatural" Category Winner (Wendy Baumgardner, RVT, LATg)

For prior blog retreat articles, please access the following:
Molecular Imaging Program at Stanford (MIPS) Retreat 2008 ; Radiological Sciences Laboratory (RSL) Retreat 2008; 2007 MIPS Retreat ; 2007 RSL Retreat; and 2007 RSL Post-Retreat Update .

Pediatric Musculoskeletal Interventional Program at Lucile Packard Children’s Hospital (LPCH)

CT guided imaging at LPCH for treatment of juvenile idiopathic arthritis. The arrow shows the trajectory of the needle for placement of steroid medication into the temporomandibular joint.

By Julie Ruiz, PhD

“I was hoping my scar would be bigger,” remarked one of our pediatric patients with some disappointment as she undid her bandage. Several days earlier her bone tumor had been successfully treated through a CT-image guided ablation procedure at Lucile Packard Children’s Hospital (LPCH).

To treat children with bone tumors, our Chief of Pediatric Musculoskeletal Imaging at LPCH, Dr. John MacKenzie, has teamed up with Drs. Larry Rinsky, James Gamble, and Meghan Imrie, pediatric orthopedics at LPCH. Because CT-guided RF ablations for osteoid osteoma tumors require a very small incision and leave virtually no scar, other parents have also

expressed their gratitude for the work done through our Pediatric Musculoskeletal Interventional Program. One mother was ecstatic that her daughter had the first "good night’s sleep in years" the day after the team had eliminated her bone lesion with CT-guided RF ablation.

These are just a few of the many success stories from the Pediatric Musculoskeletal Interventional Program at LPCH, which is helping to expand the minimally invasive options for our smallest patients. Dr. MacKenzie says he enjoys the interventional part of his work at LPCH because it gives him a chance to work directly with the patients, "Often the role of the pediatric radiologist is as the doctor's doctor, seeing the patient for the most part by how they look on the imaging study." But he says the interventional component of his work is very rewarding because he gets a chance to do something that may help while meeting the kids and family at the same time.

Along with the pediatric orthopedists, Dr. MacKenzie has also teamed up with rheumatologists and oncologists at LPCH in order to offer other image-guided diagnostic and treatment procedures to children, such as bone and soft tissue biopsies, joint aspirations, and diagnostic and therapeutic joint arthrograms.

Prior to the Pediatric Musculoskeletal Interventional Program, children were treated with a larger incision or transferred to the adult hospital. The smaller body parts of pediatric patients present a particular challenge for successful image-guided procedures, but the Program is adapting smaller tools made to fit children as well as special techniques to minimize the CT dose delivered to radiosensitive tissues.

These image-guided therapies help shorten the recovery time, reduce pain, and increase the chance for recovery. Since the Program began two years ago, they have treated over 60 children for various minimally invasive procedures with excellent response. Imaging guidance includes fluoroscopy, CT, and ultrasound and the approach varies depending on what imaging strategy works best for an individual child.

Stanford Radiology Voted "Best Radiologist Training Program"

Voted the 2009 "Best Radiologist Training Program" by AuntMinnie.com, Stanford Radiology was recently recognized for excellence in radiological education.

Dr. Sam Gambhir Named the Virginia and D.K. Ludwig Endowed Professor in Cancer Research

Sanjiv "Sam" Gambhir, MD, PhD, professor of radiology and bioengineering, was appointed the Virginia and D.K. Ludwig Endowed Professorship in Cancer Research in June of 2009. At Stanford, he leads several large NCI-funded programs and serves as chief of the Nuclear Medicine Division; director of the Molecular Imaging Program at Stanford (MIPS); and head of the new Canary Center for Cancer Early Detection. To read more about his selection for this endowed professorship, please access Stanford University news at http://news.stanford.edu/news/2009/june17/med-endow-061709.html.
The Ludwig Institute for Cancer Research (LICR) was established in 1971 by Mr. Daniel K. Ludwig, who also established the Virginia and D.K. Ludwig Fund for Cancer Research. In 2006, funds from this trust created Ludwig Centers "for the pursuit of basic science and research into the advancement of knowledge regarding the causes, origin, prevention and cure of cancer and other neoplastic diseases" at six leading academic institutions in the United States: University of Chicago, Pritzker School of Medicine; Dana-Farber Cancer Institute/Harvard Medical School; Johns Hopkins University; Massachusetts Institute of Technology; Memorial Sloan-Kettering Cancer Center; and Stanford University Medical Center. At Stanford, these funds support two professorships.

Dr. Gary M. Glazer and Colleagues Use Image-Guided Insonification for Tumor Biomarker Detection

Emma Pfeiffer Merner Professor in the Medical Sciences and chair of the Department of Radiology, Gary M. Glazer, MD, led a team of researchers in a ground-breaking study recently published in Proceedings of the National Academy of Sciences (PNAS), "A Strategy for Blood Biomarker Amplification and Localization Using Ultrasound," in which they apply low-frequency ultrasound directly to tumor cells, causing the release of significant amounts of biomarker measurable in the blood. Simultaneously, they provide a method for the localization of biomarker production by showing that this release of biomarkers is specific to the direct application of ultrasound to the tumor. Their research is featured in a recent Stanford news article by Bruce Goldman, "Researchers Use Ultrasound to Better Detect Tumor Biomarkers."

Dr. Glazer published his study along with co-author, Sanjiv "Sam" Gambhir, MD, PhD, Virginia & D.K. Ludwig Professor of Radiology & Bioengineering; chief of the Nuclear Medicine Division; and director of the Molecular Imaging Program at Stanford (MIPS), as well as first author Aloma D'Souza, PhD, research scientist and member of the Multimodality Molecular Imaging Lab. Other co-authors include Kim Butts Pauly, PhD, professor of radiology; Samira Guccione, PhD, assistant professor of radiology; and staff scientists Jeffrey Tseng, MD (now at Santa Clara Valley Medical Center in California) and Jarrett Rosenberg, PhD, of the radiology department.

New Staff Hires and Promotions: October 16, 2009

Kim Ko joined our Department on August 24, 2009, as our new human resources administrator. Born and raised in O'ahu, Hawai'i, Ms. Ko moved to California a few months ago. "I knew I always wanted to move to the Bay Area," she said. "So, I was really excited when this opportunity to work at Stanford came up. There are certain comforts of home that I miss, of course, like my family and friends, but I'm really excited to begin this new chapter in my life."

For her undergraduate education, Ms. Ko attended . . .

the University of Hawaii, graduating in 2004 with a bachelor's in business administration and with majors in both the management of information systems and marketing. After graduation, she worked briefly as a communications analyst for Linda Lingle, the current governor of Hawai'i. Lacking a passion for politics, Ms. Ko left after five months and began working at Norwegian Cruise Line America (NCLA) as an administrative assistant in the Honolulu land office. On her first day, she was placed in the human resources department (HR) and began her career by conducting phone interviews and hiring crewmembers to staff NCLA's second cruise ship, the Pride of America.

Working her way up the ranks at NCLA, Ms. Ko held many different positions in the HR department, which included working as an HR manager onboard each of the three American-flagged ships (the Pride of Aloha, Pride of America, and Pride of Hawai'i). "Each position was a very interesting and different experience," Ms. Ko commented. "Ship life definitely created some very interesting stories to tell! Through my employment with NCLA, I was able to take a 19-day cruise last year from San Francisco down to South America. I visited Mexico, Guatemala, Costa Rica, Ecuador, Peru, and Chile. I was able to go to Machu Picchu for a three-day adventure, and it is one of the most amazing and beautiful places I have ever been. I have also traveled to different parts of China, and visited the Great Wall and the Forbidden City. One of my life's goals is to travel to all seven continents."

Ms. Ko's spare time is mostly devoted to surfing on the Internet, which includes keeping in touch with people on social networking sites, shopping, and learning things through Wikipedia. Back in her home state, she also used to participate in a modern dance group called Giinko Marischino, which performed at various venues across the state of Hawai'i. She hopes to find a similar group in the near vicinity to continue in the performing arts, and to refine her skills in belly dancing.

Let the Good Times Roll . . . RSNA Awards Continue

2009 RSNA Gold Medalist
Dr. Gary M. Glazer has been named the 2009 Radiological Society of North America (RSNA) Gold Medalist, which is the Society’s highest honor. As an RSNA Gold Medalist, Dr. Glazer is a member of a very select group of individuals who have deeply impacted radiology and the imaging sciences. At the forefront of research in cancer staging breakthroughs, he has profoundly influenced the science of using cross-sectional imaging in lung cancer staging and noninvasive tissue characterization of liver and adrenal tumors. His most recent investigations are in noninvasive cancer therapy monitoring and image-guided tumor insonification.

During his twenty years as chair of Stanford Radiology, Dr. Glazer has repeatedly led the Department in generating noteworthy advances in the field. Under his leadership, the Department has established four NIH Centers and has created the Richard M. Lucas Center for Imaging, which serves as a unique international resource. As a second generation radiologist, Dr. Glazer is also devoted to developing patient-centered radiology by optimizing the communication between the radiologist and the patient to improve the quality of healthcare.

Gary M. Glazer, MD, Emma Pfeiffer Merner Professor in the Medical Sciences, will receive the Gold Medal during a special awards ceremony in December at the 2009 Radiological Society of North America (RSNA) Annual Meeting in Chicago. To read more about his award, please access the following links: SUMC in the News and RSNA Gold Medal Announcements.

2009 RSNA Outstanding Researcher
In addition to Dr. Glazer’s award, Sam Gambhir, MD, PhD, has been chosen as the 2009 Outstanding Researcher by the Radiological Society of North America (RSNA) for his unique contributions to the field of radiology. A world-renowned leader in the field, Dr. Gambhir is transforming the imaging sciences and patient treatment through his expertise and leadership in cellular and molecular imaging. He is the second scientist from our Department to be honored with this award in the past 8 years; Dr. Gary Glover won this honor in 2001. This award is given to only one physician and/or scientist each year, and only 15 such awards have ever been given out by the RSNA.

Dr. Gambhir has over 20 years of experience in molecular imaging in both animal models and patients. At Stanford, he serves as chief of the Nuclear Medicine Division; director of the Molecular Imaging Program at Stanford (MIPS); and head of the new Canary Center for Cancer Early Detection. He also leads several large NCI-funded programs, such as the In Vivo Cellular Molecular Imaging Center (ICMIC); the Center for Nanotechnology Excellence Focused on Therapy Response (CCNE-TR); and the Stanford Molecular Imaging Scholars (SMIS) Program. Currently, he is advancing "the merger of in vitro and in vivo diagnostics using novel nanotechnology for earlier disease detection and individualized patient management" (from Inside Stanford Medicine).

Sam Gambhir, MD, PhD, the Virginia and D.K. Ludwig Professor of Radiology and Bioengineering, will receive his award at the opening session of the 2009 RSNA Scientific Assembly and Annual Meeting. For Dr. Gambhir’s RSNA Award announcement, please access the following URLs:
http://www.rsna.org/Foundation/OutstandingResearcherAward.cfm as well as "Inside Stanford" at http://med.stanford.edu/ism/people/index.html#gambhir.

2009 RSNA Trainee Award Winners
Stanford Radiology Residents Bao Do, MD, and Pejman Ghanouni, MD, PhD,
have also been honored with 2009 RSNA Trainee Awards for their outstanding research projects.

Dr. Do (on left) developed his project, "A Natural Language Processor to Detect Uncertainty and Recommendations in Radiology Reports," under the mentorship of Dr. Daniel Rubin, assistant professor of radiology (diagnostic), while Dr. Ghanouni (on right) pursued his research, "Minocycline Prevents Development of Neuropathic Pain by Mitigating Macrophage Recruitment to Site of Nerve Injury as Shown with USPIO-MRI," mentored by Dr. Sandip Biswal, assistant professor of radiology (musculoskeletal).

Center for Advanced Magnetic Resonance Technology Receives a Perfect "10"

The Stanford Radiological Sciences Laboratory (RSL) and the Department of Electrical Engineering's Magnetic Resonance Systems Research Laboratory (MRSRL) received renewal of their NIH P41 Grant for the Center for Advanced Magnetic Resonance Technology at Stanford (CAMRT). In its fifteenth year of existence, the CAMRT’s perfect grant score extends its funding through its twentieth year.

Awards and Honors II: October 9, 2009

Kim Butts Pauly, PhD, associate professor of radiology and of Bioengineering (by courtesy), was recently elected to the board of the International Society for Therapeutic Ultrasound (ISTU) for a period of three years. The ISTU is a non-profit organization "founded in 2001 to increase and diffuse knowledge of therapeutic ultrasound to the scientific and medical community, and to facilitate the translation of therapeutic ultrasound techniques into the clinical arena for the benefit of patients worldwide." Dr. Butts Pauly's current research interests are focused on image-guided minimally invasive therapies, including MR-guided high intensity focused ultrasound and MR-guided cryoablation. She has published her work in over 75 peer-reviewed publications. When Dr. Butts Pauly is not working, she enjoys gardening, traveling with her family, and reading with her kids.

Awards and Honors I: October 9, 2009

Joseph Wu, MD, PhD, assistant professor of medicine (cardiology) and radiology, was one of four Stanford scientists to receive a National Institutes of Health (NIH) Transformative R01 Award designed to "support exceptionally innovative, high risk, original and/or unconventional research projects that have the potential to create or overturn fundamental paradigms."

According to a recent Office of Communication & Public Affairs article, Dr. Wu's award will support his research regarding "ways to keep the body from rejecting human embryonic stem cells. For many years, researchers assumed that these undifferentiated building blocks would be ignored by the body's defense system. Wu's recent research in mice shows that this is not the case. 'It's getting harder and harder to believe that these cells are immunoprivileged,' said Wu. 'Now we need to know what to do about it.'" He will use his award to devise ways to "coax the immune system to tolerate the foreign cells, allowing them to regenerate or heal damaged tissues" (from "Stanford Nabs 13 Top NIH Awards for High-Stakes Research" by Krista Conger, Erin Digitale, Bruce Goldman, David Orenstein, Ruthann Richter, and Tracie White; download PDF at Stanford Nabs 13 Top NIH Awards for High-Stakes Research.pdf). To learn more about Dr. Wu's research, please access the Cardiovascular Gene and Cell Therapy Lab website at http://mips.stanford.edu/research/lab?lab%5fid=2883.

Oldest Person Scanned at Stanford by Dr. Fahrig

(Images courtesy of Mark Riesenberger)

By Julie Ruiz, PhD

On August 20th, Rebecca Fahrig, PhD, directed the CT scanning of a 2,500-year-old mummy of the Egyptian Priest Iret-net Hor-irw. The high resolution CT scans were taken of the mummy in the AxiomLab and will be used . . .

to construct three-dimensional images of his skeleton to learn more about the mummy's life and death.

To acquire more information about the mummy's amulets, a second scanning procedure was completed at Stanford Medicine Imaging Center, Palo Alto, (SMIC) with a dual-energy CT scanner that differentiates between different materials. Through these scans, scientists hope to learn more about the substances used in the mummification process as well as in the composition of the amulets.

The mummy has been a resident of the Fine Arts Museums of San Francisco since 1917 and will be part of an upcoming show at the Legion of Honor Museum in an exhibition entitled, "Very Postmortem: Mummies and Medicine," which opens on Oct. 31, 2009. This exhibition is organized by the Fine Arts Museums of San Francisco with the cooperation of the Akhmim Mummy Studies Consortium, Stanford Radiology, and Stanford Medicine Imaging Center. Additional project assistance has been provided by the Stanford Division of Anatomy, eHuman Inc., and Fovia Inc. To read more about the mummy, please access "The Mummy Speaks: Detailed Scans at Stanford Help Reveal the Secrets of an Ancient Egyptian Priest" and "Mummy to Be Scanned at Stanford at Aug. 20."

This is Dr. Fahrig's second time scanning a mummy. In 2005, she led the team who scanned a 2,000-year-old mummy of a four- or five-year old girl (nicknamed Sherit, or "little one") from the Rosicrucian Egyptian Museum in San Jose. To read more about Dr. Fahrig's work, please access "Radiologists as Artists: Critics Love Mummy Scans"; "Mummy's Inner Secrets Revealed"; "The Latest in X-Rays: A 'Mummogram'?"; and "It's a Girl: Digital Unwrapping Reveals a Little Mummy's Secrets."

Awards and Honors: October 1, 2009

Arundhuti Ganguly, PhD, research associate in the Radiological Sciences Laboratory (RSL), received an NIH K99/R00 Pathway to Independence Award for her research proposal entitled "High Performance CMOS Based X-Ray Detector for C-Arm CT Imaging." The objective of this award is to "prepare qualified individuals for careers that have a significant impact on health-related research." Her proposal aims to improve image-guided interventions for the treatment of stroke by using a novel solid-state X-ray detector, which is based on CMOS technology that will allow faster imaging at an increased resolution. Dr. Ganguly plans to use the detector in conjunction with a conventional angiographic C-arm system to provide high frame rate projection images as well as 3D image volumes. Beginning in June of 2009, this grant will enable Dr. Ganguly to complete two years of mentored research with Professor Rebecca Fahrig, followed by three years of independent research.

Research by Dr. Wu and Colleagues Induces Fat Cells to Become iPS Cells

In a recently published paper, "Feeder-Free Derivation of Induced Pluripotent Stem Cells from Adult Human Adipose Stem Cells," senior author Joseph Wu, MD, PhD, assistant professor of medicine (cardiology) and radiology, and his colleagues describe how they reprogrammed fat cells (collected from adults undergoing liposuction) to become pluripotent stem (iPS) cells for use in tissue regeneration and disease research. According to Dr. Wu, "Fibroblasts, or skin cells, must be grown in the lab for three weeks or more before they can be reprogrammed. But these stem cells from fat are ready to go right away"(from "'Liposuction Leftovers' Easily Converted to iPS Cells, Study Shows" by Krista Conger http://med.stanford.edu/ism/2009/september/fat-cells.html or Download file.

Please click here to access the full research article "Feeder-Free Derivation of Induced Pluripotent Stem Cells from Adult Human Adipose Stem Cells," (published in Proceedings of the National Academy of Sciences (PNAS) 2009;106(37):15720-15725 http://www.pnas.org/content/106/37/15720.full.pdf) by Dr. Wu and his colleagues, which include co-author Michael Longaker, MD, professor of surgery (plastic/recon surgery) and (by courtesy) of bioengineering and first author Ning Sun, PhD, postdoctoral scholar in the Cardiovascular Gene and Cell Therapy Lab.