Vanderbilt Radiology Society, February 2017
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What is Radx?


In his recent State of the Department address, Reed Omary, M.D., M.S., introduced Radx, a novel healthcare innovation and entrepreneurship incubator within the Department of Radiology. Radx will be modeled along the lines of successful Silicon Valley technology incubators, but will be tailored for the needs of an academic medical department. Its mission is to foster and support the development and commercialization of creative healthcare technology solutions.
Radx will evolve over time and be positioned to provide a number of resources for would-be innovators, including training, workshops, mentorship, business plan development, grant writing support, workspace, prototyping equipment, and funding.  It will also provide networking opportunities and will maintain close relationships with the Wond’ry, the Center for Technology Transfer and Commercialization (CTTC), other departments at VU and VUMC, and the business community outside Vanderbilt.
Radx’s inaugural activity will be a four-month Innovation Challenge, co-sponsored with the Wond’ry and the CTTC, and with support from the Evelyn Selby Stead Fund for Innovation. Contestants will be invited to generate an idea, assemble a team, build a prototype, and develop a preliminary business concept. At the conclusion of the Challenge, the winning teams from each of two tracks will receive a $10,000 award, to be used for further prototyping and business plan development, with the aim of taking a new product or process to a licensing or start-up opportunity. 
Radx will stand as a tangible symbol of the Department’s commitment to innovation as a long-term strategic policy. It will reinforce the Department’s brand identity as creative and entrepreneurial, enhance our recruitment efforts, and strengthen our collaborative relationships with other departments and other schools within the Vanderbilt community. Our ultimate goal is to encourage entrepreneurship and support commercialization efforts into order to propel discoveries into real-world application.
Click here for details.

A New Faculty's Experience

My first visit to Vanderbilt University Medical Center was in 2011 when my son was a freshman at Vanderbilt University. At the time, as the radiology residency Program Director at the University of Florida (UF), I had heard terrific things about the Vanderbilt radiology program. I decided to stop by the hospital, out of my own curiosity, to catch a glimpse of the clinical training environment first hand. I had no idea that I would someday join the Vanderbilt faculty.
Three years later my husband, Mark Rice, M.D., an anesthesiologist, and I had the opportunity to join the faculty at Vanderbilt. Although it meant leaving behind friends and colleagues at UF, the decision to join forward-thinking departments with tremendous resources was absolutely the right one. During the months leading up to my start date, our Chairman, Reed Omary, M.D., M.S., went out of his way to send email updates on educational and departmental activities at Vanderbilt and made "virtual" introductions to School of Medicine education leaders. I similarly connected with members of the Body Imaging/Ultrasound section and departmental education leaders.
The start date finally arrived: March 30, 2015. Everyone welcomed me to the department and helped with my transition. I remember one of my first conversations with Dr. Omary, where he expressed his passion for creativity and innovation, which truly got me excited as I took on my new role as Vice Chair of Education. Over the next several months, Dr. Omary helped me connect with education leaders and members of the informatics team to discuss innovative teaching strategies and tools to integrate into our department. This led to the development of QuizTime, a web-based app for texting or emailing daily questions to learners. The Department of Radiology partnered with the Department of Anesthesiology to pilot QuizTime with our residents and faculty. We subsequently received an inaugural FAME (Fellowship to Advance Medical Education) award from the School of Medicine for innovative educational program development.
 Dr. Deitte, Dr. Ahmad and Dr. Magarik
Lori Deitte, M.D., (back left), Asma Ahmad, M.D., (back right) and
Meaghan Magarik, M.D., Ph.D., (front) developing Quiz Time. 

As the Vice Chair of Education, I meet with new faculty members to discuss faculty development resources within our department and the institution. Dr. Omary, Ed Donnelly, M.D., Ph.D., and I work together to nominate our faculty and residents for leadership and development programs at national meetings, such as the Association of University Radiologists (AUR) annual meeting. "Team Vanderbilt" regularly competes in the AUR film interpretation session and took third place in 2015. My national involvement with the AUR and other professional societies reinforces my perspective that our department is at the forefront of radiology innovation. When recently asked about my decision to join Vanderbilt, I replied "It's one of the best decisions I ever made; it's fun to be in a high-energy, creative and supportive environment doing what I love to do."
My husband and I really enjoy working at Vanderbilt. The professional and leadership opportunities are outstanding, and we find our clinical practices very rewarding. Living in Nashville has been an added bonus. It is great to live in such an "up and coming" city with fantastic outdoor activities, music, and restaurants. Our experience thus far has been nothing but positive, and we are excited and honored to be members of the Vanderbilt Radiology family. 

Resident Life: RSNA

By: Karthik Sundaram, M.D., Ph.D.

Dr. Karthik SundaramI was recently afforded the opportunity to present my graduate thesis work (which I completed at the University of Chicago) and represent Vanderbilt Radiology at this year's RSNA in Chicago. In my scientific presentation, I described a novel molecular imaging strategy to detect ovarian cancer by magnetic resonance imaging (MRI). Briefly, we discovered that greater than 98% of ovarian cancers over-express the prolactin receptor regardless of grade, stage, or histology. We took advantage of this finding to conjugate gadolinium-based chelators to proteins that bind the prolactin receptor. Intravenous injection of this protein-gadolinium conjugate allowed for the increased sensitivity and specificity to detect ovarian cancer in mouse models of ovarian cancer using contrast-enhanced MRI. This work has been accepted by Cancer Research for publication and will appear in an upcoming issue.

It was a daunting task to try to summarize over 4 years of work into a presentation that was only 7 minutes long. Instead of describing the more technical aspects of our research, I tried to focus on some of the key concepts and potential future clinical applications of our work.

During the question and answer period, audience members asked thoughtful questions that sparked ideas for future research. One of the moderators even suggested we form a collaboration between our institutions, with the goal of translating our method for clinical application. It was a great connection to make, and I am hopeful to continue to build these kinds of relationships as I continue to pursue scholarly work at Vanderbilt.

I spent the remainder of my time at the conference attending scientific presentations on prostate MRI and dual energy CT, touring McCormick Place with other Vanderbilt Radiology residents, and networking with colleagues from other institutions. I was impressed by the large educational exhibit hall and vendor space. The vendor space had thousands of exhibitors promoting their cutting-edge technology, ranging from artificial intelligence by IBM Watson to 3D printing and augmented reality.

I am grateful for the opportunity to represent Vanderbilt at RSNA 2016. I highly encourage anyone interested in presenting their scientific or educational work to submit their projects to future RSNA meetings.

3D Printing Program

3D printing has emerged as an exciting technology, poised to make a big impact in the healthcare field. The utilization of 3D printing has grown exponentially over the past few years, – being used not only by radiologists, but also by clinicians across many different medical specialties. It has been used with great success to plan and navigate complex medical procedures, to provide training/education models for medical students, residents and fellows, and to print patient specific custom devices and instruments. 
Based on the potential of this technology in clinical applications, many hospitals are beginning to adopt 3D printing service lines to support the growing level of interest. The Department of Radiology and Radiological Sciences is pleased to announce that we have launched a 3D printing program, which will serve the entire VUMC. With the guidance of Reed Omary, M.D., M.S., I have been tasked to lead a core team consisting of members from different medical sub-specialties. We have recently completed the pilot phase of the program and are now expanding to offer wider availability throughout VUMC.
During the pilot phase, we successfully printed a few normal anatomical models, as well as some clinical cases. Building clinically useful 3D models is a challenging process. It begins with acquisition of high spatial and temporal resolution imaging data. Multiple imaging modalities can be used to supply the imaging data needed to create 3D models, including CT, MRI, and 3D ultrasound. CT was the most commonly used modality during our pilot phase.
Once the data has been collected, we perform advanced post-processing and convert our imaging data into data files. This is the most crucial and rate limiting aspect of the 3D printing process. Vanderbilt has been fortunate enough to have leading, state-of-the-art, and FDA approved software tools (Mimics Innovation Suite), which has been an advantage as we get this project off the ground.

After the data files are complete, we utilize high-resolution 3D printing equipment - located both on and off campus - to print the models. The time required to print a particular model varies depending on the anatomy being printed, the complexity of the design (size, resolution), the material used for printing, and the type of printer used. It can take anywhere from a couple of hours to a day to print a model.

Our initial cases were geared toward pre-surgical planning, education and training, but we expect to eventually print customized and patient specific implants and prostheses. In addition to impacting patient care, one of our ultimate goals is that our program, and our department, will continue to drive new innovation within the hospital. 

Example Case: 
Cloacal anomalies are rare and treatment requires complex multidisciplinary care. Accurate anatomic measures, including the length of common channel, Mullerian structure development, and bladder size, are essential for operative planning and family counseling. We present our experience with the use of 3-dimensional (3D) reconstruction cloacagram and 3D printing for a patient with cloacal anomaly.


Figures 1-4. Illustrates a 3D model printed from patient CT cloacagram. This model effectively demonstrates the length of the common channel, and the complex relationship between the bladder, colon, the two hemivaginas, and the distance of the common channel from pubic symphysis. 

VUIIS Human Imaging Research -
Growth and Impact in 2017

By: Seth Smith, Ph.D.

Vanderbilt University Institute of Imaging Science (VUIIS) is a trans-institutional initiative within Vanderbilt University that brings together physicians, scientists, students and corporate affiliates. It focuses on providing advanced imaging research and outreach to Vanderbilt and the greater scientific community. One of the core programs within VUIIS, the Center for Human Imaging (CHI), is dedicated to developing tools that can be utilized in studies of patient populations, and works to ensure these technologies and tools are accessible to the clinical community. It has been exciting to watch emerging scientific collaborations between the clinical and research faculty develop into full-scale translational projects that have significant impact on patient care. For example, VUIIS and Clinical Radiology partnerships have provided advanced methods to study stroke, spinal cord injury in adult and pediatric patients, peripheral nerve injury, and breast cancer.
One project that gained momentum this year was an initiative to improve the quality of MRI for evaluation of the spinal cord in the pediatric population. In collaboration between the VUIIS and the radiology department, we were able to develop a new set of protocols that improved our image quality and assessment. The results have been met with great enthusiasm, and there is discussion about implementing our protocol design for all future Philips MRI scanners. Most importantly, our successes have generated new projects, fostering close relationships between PhD students, radiology residents and their advisers. This lays groundwork for even greater successes and collaborations between the VUIIS and the radiology department in 2017.

newly upgraded MR scanner

In addition to our growing collaborative efforts, CHI had many technology upgrades in 2016, and more planned for 2017. We currently have two 3T and 7T MRI units.  One of our 3T units has been upgraded to the latest Ingenia platform, which is a fully digital MR unit capable of simultaneous multi-slice acquisitions, improved SNR and opportunity for improved patient comfort and faster scan times. Our other 3T scanner will be replaced with a wide-bore 3T Ingenia platform, which is the current Philips flagship MR unit. This wider bore magnet provides an opportunity to study patient populations that may otherwise have difficulty being scanned; however, image quality is maintained. Other recent and planned additions include a High Intensity Focused Ultrasound (HIFU) device to explore MR-guided ultrasound treatments, and a new digital PET/CT system.
As exciting as this year has been, we are even more excited about what 2017 holds for the research community at VUIIS, and are optimistic about the growing opportunities for research studies that will have potential clinical application.

Upcoming Events

  • Radx Kick-off Party: February 16, 4 to 5:30 p.m. at the Wond’ry (2414 Highland Ave #102, Nashville, TN 37213)
  • Alumni Night: Early Fall 2017
  • Vanderbilt Medical Alumni Association Reunion Weekend: Late Fall 2017
  • Alumni Reception at RSNA: November 2017

We recently welcomed the following faculty to our department:

Clinical Faculty
Ryan Muller, M.D.

Research Faculty
Nellie Byun, Ph.D.
Jacob Houghton, Ph.D.
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Vanderbilt Radiology · Medical Center North · Nashville, TN 37203 · USA

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