The Importance of Translational Research in Medical Imaging

1. The Importance of Translational Research in Medical Imaging Beau Pontré • Lecturer • Medical Imaging Discipline • School of Medical Sciences • NZIMRT Conference, Invercargill • 16th August 2014

2. What is Research?

3. What is Research?

4. What is Research? “Eureka” moments are quite rare Most research is incremental in nature Translational research aims to make findings from basic science useful for practical applications

5. ?

6. Translational Research The bridge between basic and applied science - Many steps - Time-consuming - Often incremental - Multi-disciplinary

7. Translational Research Drug development Computers • Images!

8. Translational Research in Medical Imaging Most protocols used in medical imaging today are a direct result of translational research Scanning equipment is updated incrementally

9. Two Examples… People from physiology, audiology, engineering, optometry, computer science, medical imaging, physics • Using MRI facilities at the University of Auckland • 1. Cochlea • 2. Eye

10. Our facilities 4.7T pre-clinical MRI • 3T clinical MRI

11. Example One - Cochlea MRI performed on the cochlea in guinea pigs • Axial turn • Medial turn • Basal turn • Le Floc’h, J. et al. (2014) JMRI 39:150-161

12. Baseline • T2-weighted MRI following injection of USPIO contrast agent • - Taken up by macrophages • - Reduced signal on T2-weighted images • Day 2 • Control • Inflamed

13. Baseline • Day 2 • Normal • Inflamed • Le Floc’h, J. et al. (2014) JMRI 39:150-161

14. Pre Contrast • 15min • 60min • Normal • Inflamed • Le Floc’h, J. et al. (2014) JMRI 39:150-161

15. Le Floc’h, J. et al. (2014) JMRI 39:150-161 • Le Floc’h, J. et al. (2013) JMRI (in press)

16. Day 4 • Day 7 • Day 10 • p<0.0001 • Le Floc’h, J. et al. (2014) JMRI 39:150-161

17. The next step… Ménière’s Disease - Inner ear disorder affecting hearing and balance - Thought to be caused by disturbances to inner ear fluids - Mechanism is largely unknown Normal volunteer scans - Develop and refine protocol Ménière’s patients - Assess BLB permeability - First in patient in September

18. The next step… Challenges - Human vs animal tissues - Motion - … A better understanding of the mechanisms behind Ménière’s disease could lead to better treatment options

19. Example Two - The eye MRI performed on bovine eyes and isolated bovine lenses • T1-wt scan • 3D Model • T1 map (lens)

20. Lens placed in D2O and scanned at different times • 10 min • 20 min • 30 min • Normal • Disrupted • 40 min • 240 min Vaghefi, E. et al. (2011) Am J Physiol Regul Integr Comp Physiol 301:R335-R342

21. Diffusion tensor imaging (DTI) Vaghefi, E. et al. (2009) Physiol Meas 30:1061-1073

22. T2 and refractive index maps of the lens • 1.45 • 25 • 1.35 • 0 • Control • High-K+ • Ouabain • T2 (ms) • Control • High-K+ • Ouabain • Refractive • index

23. - Disruptions to microcirculation affect visual acuity - Myopic shift is a strong predictor for cataracts • 1.45 • Control • High-K+ • Ouabain • 1.35 • Refractive • index • Original

24. The next step… Need a technique for performing reliable MRI scans on the human eye in vivo Currently testing similar techniques (DTI) in the retina to assess macular degeneration Challenges - resolution - scan duration - motion

25. Summary Translational research is the bridge between basic and applied science Requires a lot of patience and people from many disciplines Future everyday protocols in medical imaging may result from translational research being done right now! • Science is like being in a dark room and looking for a black cat using a flashlight

26. Acknowledgements Cochlea Study Johann Le Floc’h Jerome Plumat Peter Thorne RavindraTelang Lens Study EhsanVaghefi Marc Jacobs Paul Donaldson