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Research involving radiology is being conducted in almost every field of medicine, and IU School of Medicine faculty and students are deeply involved with the work to improve clinical diagnostics and patient care. Within the department, most radiology faculty members are deeply involved in research projects. The focus of their work includes diagnosis of pulmonary emboli with computed tomography; FDA IDE trials, clinical trials and animal studies; data analysis and research with the National Heart Lung and Blood Institute as well as the Agency for Health Care Policy and Research; and development of workflow software to improve reporting turnaround and quality.
Research in the field of radiology and imaging sciences has generated critical technologies, including magnetic resonance imaging (MRI), computed tomography (CT), and nuclear medicine as well as honed modern techniques for using equipment to identify abnormalities and disease to be treated. Today’s research is seeking discoveries to contribute to advances in the treatment of diseases such as cancer and Alzheimer’s disease. Faculty of the Department of Radiology and Imaging Sciences and the Imaging Sciences Division are taking a proactive role in the advancement of new medical technology that will provide novel methodologies for the detection and treatment of human disease. These new technologies will eventually displace or minimize the need for conventional anatomically based imaging procedures.
Specifically, the Imaging Sciences Division works to develop imaging techniques to noninvasively characterize human physiology and its disruption by disease; to provide infrastructure support to implement and maintain state-of-the-art technology employed in the practice of radiology; and the dissemination of knowledge to students, faculty, scientific community and the public.
Many more specially funded programs center on cooperative efforts between IU School of Medicine and segments of the private industry. The School of Medicine annually receives more than $110 million in grants from national organizations and government agencies to conduct research projects.
Strong Research Support
IU School of Medicine offers an ideal environment for medical research that leads to major advancements in medicine. With a strong tradition of achievement, expertise of faculty, state-of-the art equipment and facilities, and access to a large and diverse patient population with complex conditions, the working and learning environment at IU School of Medicine inspires innovative diagnostic and therapeutic techniques.
Innovation in Imaging Sciences drives optimal patient care. It is our mission to develop and translate novel imaging technologies to addresses unmet patient needs. The vision of National and Institutional (IU School of Medicine and IU Health) Precision Health/Medicine initiatives is to revolutionize patient care by applying treatments that are optimized for specific characteristics of the patient, taking into consideration genetics, environment, and lifestyle. A central feature of our research activities is in alignment with the goals of Precision Health/Medicine and broad base of research within the IU School of Medicine. We are positioned to play a major role in the transformation of patient care through innovative new technologies that move beyond detection to non-invasive evaluation of disease.
Radiology Subspecialty Research
Kumar Sandrasegaran, MD, Division Chief
The two major foci of research in the abdominal section are Radionomics, i.e. the use of quantitative information from MRI/CT to predict patient outcomes, and Improving Patient Safety by reducing CT radiation and intravenous contrast doses to the absolute minimum necessary.
Together with the pancreatologists, the Abdominal Section is performing prospective research studies on chronic pancreatitis and pancreatic cancer. We also collaborate with hepatologists and oncologists to perform research on the liver as well as with urologists by using multiparametric MRI to image features of prostatitis using T2-weighted images, diffusion (DWI) and perfusion (DCE MRI).
Katherine Patterson, Division Chief
The breast imaging subspecialty team has several studies open in collaboration with medical and surgical oncology to continue to improve the diagnosis and treatment of breast cancer. One study allows women who may otherwise need to have their breast removed to pursue breast conservation therapy. Another study evaluates the diagnostic accuracy of magnetic resonance imaging in the extent of disease evaluation in patients with ductal carcinoma in situ. At Eskenazi Hospital, a study is being performed to evaluate the effects of an educational video to reduce patient anxiety prior to ultrasound guided biopsy, and the team is preparing to participate in two national multicenter trials: Tomosynthesis Mammographic Imaging Screening Trial (TMIST) and Comparison of Abbreviated Breast MRI and Digital Breast Tomosynthesis in Breast Cancer Screening in Women with Dense Breasts.
Stacy Rissing, MD, Division Chief
As the cost of healthcare escalates, the value of screening exams for early detection and treatment becomes essential. The cardiothoracic, or chest imaging, team at IU School of Medicine remains committed to patient screening exams and have made tremendous strides in the lung cancer screening program. This program is expected to reduce lung cancer-specific mortality by 20 percent.
The seven radiologists on this team work closely with their thoracic surgery colleagues to ensure the quality and accessibility of this program at IU School of Medicine clinical facilities. The team also offers coronary calcium score screening CT scans, which have received attention in the popular press and continue to be valued by patients and referring clinicians. Many lives are saved by early cancer detection, early diagnosis of coronary artery disease, and early treatment for these pathologies, and the teams is motivated to continue to offer and improve these services.
Radiology fellows and residents engage in medical research and publish papers on a wide range of topics, including post-operative CT in the setting of trauma, the potential for streamlining emergent hand and wrist radiography in the ED setting, the incidence of facial fractures in the setting of whole-body CT, urinary leaks in the setting of renal trauma, CT of blunt mesenteric injuries, CT image reconstruction algorithms and image quality in the setting of solid organ injuries, and more.
In addition, Dr. Steenburg is collaborating with orthopedic trauma surgeons to quantify the magnitude of soft tissue injury in polytrauma and its relationship to multi-organ failure and systemic inflammation. Five peer-reviewed manuscripts have been accepted or published based on this work. Over 70 patients have been prospectively enrolled to date, and the team was recently selected for Department of Defense funding support.
Thomas Casciani, MD, Division Chief
The Interventional Radiology group at IU School of Medicine is one of the top three programs in the country performing Yttrium-90 radioembolizations for treatment of primary and secondary liver cancers. The liver tumor working group includes physician specialists from interventional radiology, oncologic surgery, transplant surgery, hepatology, medical oncology and radiation oncology, providing an outstanding example of the power of interspecialty collaboration in treatment for this challenging area of medicine. Faculty physicians in this specialty area now offer advanced therapy for liver cancers that promises to significantly improve quality and length of life.
By working closely with colleagues at Northwestern University, the IU School of Medicine’s Department of Radiology Interventional Radiology team has doubled procedure volume for radioembolization every year since its introduction at IU School of Medicine in 2006.
Trenton D. Roth, MD, Division Chief
The musculoskeletal radiology team includes six musculoskeletal fellowship-trained radiologists and one physician assistant as well as two musculoskeletal imaging fellows per year and three to four diagnostic radiology residents rotating each month on the musculoskeletal service. The team’s clinical service base is IU Health Methodist Hospital but also provides musculoskeletal imaging expertise for multiple hospitals and outpatient facilities throughout the IU Health system as well as Eskenazi Health, Center for Orthopedic Surgery and Sports Medicine, and Central Indiana Orthopedics.
The musculoskeletal radiology team cares for patients with trauma, sports- and work-related injuries, arthritis, metabolic bones diseases, tumors, infections and other problems. With advanced equipment, the team offers interpretive expertise in musculoskeletal radiography, computed tomography, magnetic resonance imaging, ultrasonography, and fluoroscopy as well as procedural expertise in arthrography, bone and soft tissue biopsy, and image-guided joint or tissue aspiration and injection.
Musculoskeletal Radiology at IU School of Medicine has included testing and analysis for MRI sequences for metal artifact reduction around orthopedic hardware and also for fast imaging of diabetic feet for osteomyelitis. The section has been involved with collaborative projects with bone endocrinology for investigating atypical femur fractures, pediatric radiology for fast MRI screening of hip pain in children, and orthopedic surgery for MRI diagnosis of lateral meniscus tears in patients with ACL tears.
James W. Fletcher, MD, Division Chief
The Nuclear Medicine/Molecular Imaging and Therapeutics specialists provide supervision, interpretation and reporting for nuclear-medicine-imaging procedures, PET/CT exams, and radiopharmaceutical therapies across the IU Health enterprise. These physician educators also participate in many research programs at IU School of Medicine. For example, ongoing programs look at radiation dose and dose distribution in 90Y radio embolization of the liver. These programs are focused on efforts to assess the radiation dose to the liver tumors per se as well as to the adjacent uninvolved hepatic parenchyma. These efforts have illustrated that the currently used empiric methods for determining 90Y dose can under- and overestimate radiation burden to the liver and targeted tumor in association with radio embolization of hepatic malignancies.
Two projects recently received NIH funding that encompass a 12- month study of the feasibility of labeling a neuropeptide (DOTA-TATE) with short-lived 62Cu and secondly, further refinement over a five-year funding period for modeling and validation of a “chemical microsphere” that can provide unique information on tumor and tissue blood flow throughout the body. The second project is an Academic-Industrial partnership for translation of technologies for cancer diagnosis and treatment (1-RO1 CA202695-01A1) using novel 62Cu-ETS and 62Cu-PTSM labeled ligands. A previous NIH-NCI funded RO1 in this division laid groundwork for further funded studies of this unique radiopharmaceutical. This will be a collaborative project between Nuclear Medicine and the Radiologic Sciences divisions involving both animal and human PET/CT imaging studies.
Matthew Cooper, MD, Division Co-Chief
The Pediatric Radiology subspecialty team is working to improve the quality of skeletal surveys performed for child abuse around the State of Indiana. With the help of physicians on the child abuse team at Riley Hospital for Children, hospitals and imaging centers who do not follow the ACR–SPR Practice Parameter for Skeletal Surveys in Children are identified and receive a phone call and follow-up email from one of the pediatric radiologists at IU School of Medicine. The radiologist provides information which includes an informational poster that that reviews the required views and proper patient positioning and can be hung up in technologist for easy reference.
The Department of Radiology’s pediatric radiology team includes eight general pediatric radiologists. Most of the general pediatric radiologists have an area of specialized interest:
- pediatric musculoskeletal imaging
- child abuse
- fetal magnetic resonance imaging
- cardiac imaging
- thoracic imaging
- urologic imaging
- oncologic imaging
Each member of this team is board-certified by the American Board of Radiology and meets all ACR accreditation requirements. All of the pediatric radiologists are fellowship-trained and five of the eight radiologists have achieved their Certificate of Added Qualification in Pediatric Radiology from the American Board of Radiology. The other three will become eligible to receive this certification within the next several years. The radiologists are supported by tremendous physician assistants, sonographers, fluoro and X-ray techs, and support staff who work together to provide care to some of the sickest patients in Indiana.