Accomplishments 2017-2018

Abdominal Imaging

Abdominal Imaging

  • The promotion of evidence-based abdominal imaging, including systematic validation of commonly held opinions and assumptions
  • Developing MRI and CT techniques to optimize assessment of hepatobiliary, GI tract, and GU diseases
  • Optimizing multiparametric MRI scanning for detection and staging of prostate cancer
  • High-intensity focused ultrasound of uterine fibroids and prostate cancer
  • Advanced hepatic imaging, including multi-detector CT, CT cholangiography, new hepatobiliary MR contrast agents, and MR cholangiopancreatography
  • Radiological evaluation of diffuse liver disease, including cirrhosis, pseudocirrhosis, and nonalcoholic steatohepatitis
  • Dynamic contrast-enhanced MRI and CT for assessment of solid organs and tumors in the abdomen and pelvis
  • 3D rendering of CT and MR images, including projectional and volumetric applications, and CT colonography
  • Expanding image-guided percutaneous thermal ablation applications in the abdomen

Breast Imaging

Breast Imaging

  • MRI, optical imaging and X-ray mammography for breast cancer screening and surveillance, diagnosis and tissue characterization for risk assessment, cancer staging, and treatment response assessment
  • New techniques in MRI-guided biopsy and imaging protocols
  • Quantitative assessment of breast density and breast cancer risk models
  • Digital breast tomosynthesis
  • MRI/MRS for assessing tumor response to neo-adjuvant chemotherapy for patients with locally advanced breast cancer
  • Biomarker development using advanced breast MR techniques

Cardiac & Pulmonary Imaging

Cardiac & Pulmonary Imaging

Cardiac CT

  • Use of cardiac CTA for emergency room evaluation of atypical chest pain
  • Evaluation of coronary atherosclerosis in patients with HIV infection
  • Evaluation of pulmonary venous anatomy in atrial fibrillation
  • Characterization of myocardial ischemic injury by contrast enhanced MRI and CT

Chest CT/High-resolution CT

  • High-resolution CT of interstitial lung disease
  • Predictors of poor outcome in patients with acute PE diagnosed by helical CT

Cardiac MRI

  • Use of novel cardiac MRI techniques and computational modeling for the quantitative assessment of ventricular performance in congenital heart disease
  • Use of multidimensional flow techniques for quantitative assessment of flow dynamics in congenital heart disease
  • MRI to assess cardiac function after repair of tetralogy of Fallot; correlation with clinical outcomes
  • T1 mapping techniques for assessment of pulmonary hypertension cardiomyopathy

 

Interventional Radiology

Interventional Imaging

  • Joint project with Transplant Service for implantation of pancreatic islet cells
  • Joint project with Transplant Service for down staging hepatocellular carcinoma in potential transplant candidates
  • Joint project with Abdominal Imaging using MR diffusion imaging to differentiate flow abnormalities from hepatocellular carcinoma
  • Joint project with Pediatric Surgery to create gastrojejunostomies and percutaneous jejunostomies using magnets
  • Assessing the role of interventional radiology in managing complications related to the creation of ileal pouches following proctectomy
  • Use of expandable metallic stents in the airways
  • Joint project with Urology on RF ablation of small renal masses
  • Assessing the safety of transdiaphragmatic drainages

 

Musculoskeletal Radiology

Musculoskeletal Imaging

Imaging of Osteoarthritis and Cartilage

  • New morphological pulse sequences for cartilage imaging
  • Biochemical, quantitative imaging of the cartilage matrix
  • Analysis of the Osteoarthritis Initiative Cohort
  • Osteoarthritis, obesity, and physical activity
  • Cartilage imaging of marathoners and physically active individuals
  • Assessing menisci and cartilage with matrix-sensitive MRI sequences

Bone Marrow Imaging

  • Monitoring the progress of the treatment of Gaucher’s disease
  • MRI of bone marrow changes in osteoarthritis
  • Disuse osteopenia related bone marrow changes

Osteoporosis Imaging

  • Evaluating insufficiency fractures of the pelvis, CT vs. MRI
  • Contrast-enhanced, multi-slice-spiral CT for assessing bone density and structure
  • Diabetic bone disease: cortical porosity and increase in fracture risk
  • Imaging of the Shoulder
  • Optimizing MRI for visualizing metal-on-metal surface replacements
  • Evaluating fatty infiltration of muscles of the rotator cuff
  • Imaging of the Spine
  • Imaging at 1.5T and 3T
  • Clinical implications of lumbosacral segmentation abnormalities MR Arthrography
  • Evaluating the complications of MR arthrography 57
  • High-field MRI for musculoskeletal applications
  • In vitro and in vivo comparison of cartilage imaging at 1.5T, 3T, and 7T
  • Comparing 1.5T with 3T MRI for the evaluation of smaller joints
  • Optimizing MR protocols for the knee at 3T and 7T

New MRI Techniques

  • Use of CUBE and IDEAL sequences at 3T to image the knee
  • Application of metal suppression MAVRIC sequences for assessment of total joint replacements
  • In vitro and in vivo assessment of metal suppression sequences at 1.5 and 3T MR neurography

 

Neuro Interventional Radiology

Neuro Interventional Radiology

Advances in the field of Neuro Interventional Radiology require the constant development of new skills and techniques, and the Neuro Interventional Radiology researchers within the UCSF Department of Radiology and Biomedical Imaging have been involved in designing, conducting, and publishing research regarding current trends and techniques for patient care. In particular, we are focused on developing new and innovative techniques to treat a variety of neurovascular disorders including aneurysms, vascular malformations, tumors, and vasospasm in animal models and in active clinical practice within the interventional neurovascular radiology section at UCSF.

We work closely with the Institutional Review Board at UCSF Medical Center to oversee new products and procedures. We are working with several sponsor companies to assess the use and outcome of new intravascular stents. We have been involved in a multicenter study regarding outcomes after placement of carotid artery stents to treat carotid artery atherosclerotic disease. We conduct translational research in remote-controlled catheter guidance, percutaneous ablation, intra-arterial chemotherapy, and endovascular biopsy. We are working closely with other collaborators at UCSF in MRI modeling of unruptured cerebral aneurysm and MRIassisted embolization of brain tumors. In addition, we conduct long-term clinical research on pediatric neurovascular diseases.

 

Neuroradiology

Neuroradiology

Neuropediatrics

  • Cause of cerebellar hypoplasia in some prematurely born neonates and the effects of brain cooling on CNS injury in term neonates suffering hypoxic-ischemic injury
  • Embryogenesis of disorders of the midbrain and hindbrain
  • Normal and abnormal development of the cerebral cortex
  • Fetal MR Neuroimaging: development and application of advanced MRI techniques to study normal and abnormal fetal brain development Traumatic Brain Injury
  • DTI and fiber tractography, fMRI, 3D MRSI, and deformation morphometry as imaging biomarkers for mild TBI to predict clinical outcomes in post-concussive syndrome, with correlation to neurocognitive testing and genomic analysis for TBI susceptibility genes such as ApoE
  • DTI and fiber tractography processing for a multi-center consortium study of mild TBI

Cardiovascular Disease and Stroke

  • Use of 64-slice CT to detect cardiovascular disease and stroke and a functional mapping and scoring system for predicting the outcome of ischemic stroke
  • Use of perfusion and CTA imaging to detect ongoing hemorrhages in the brain of patients presenting with acute intracerebral hematoma
  • Use of permeability image mapping to detect stroke patients at risk of subsequent hemorrhage
  • Automated software for the outcome classification of patients with acute subarachnoid hemorrhage

Cardiovascular Disease and Stroke

  • Use of 64-slice CT to detect cardiovascular disease and stroke and a functional mapping and scoring system for predicting the outcome of ischemic stroke • Use of perfusion and CTA imaging to detect ongoing hemorrhages in the brain of patients presenting with acute intracerebral hematoma
  • Use of permeability image mapping to detect stroke patients at risk of subsequent hemorrhage
  • Automated software for the outcome classification of patients with acute subarachnoid hemorrhage

Brain Tumors

  • Use of permeability and perfusion imaging to guide operative biopsy
  • Correlation of genetic markers and imaging markers from tissue obtained by image guided biopsy

Head and Neck

  • The utility of PET/CT in follow-up of patients with head and neck cancer
  • The use of advanced imaging techniques in the detection of recurrent head and neck cancer

Spine

  • CT-guided back pain management
  • Use of image guidance to improve the accuracy of injections
  • Utility of gadolinium MR myelography to detect CSF leaks
  • MR neurography for peripheral nerve diagnosis • Neurodegenerative Diseases
  • New imaging biomarkers for neurodegenerative diseases using
  • 7T MRI
  • 7T imaging of patients with intractable epilepsy
  • Characterization of multimodal diffusion data using highangular, resolution-diffusion imaging

 

Breast Imaging

Nuclear Medicine

Cardiac and vascular applications of clinical SPECT-CT, PET and PET-CT

  • Applications of SPECT-CT for cardiac synchrony
  • Dementia imaging with SPECT-CT
  • Clinical PET and PET-CT studies of cancer, cardiovascular, and neurological diseases
  • Feasibility of PET and MRI to characterize myocardial metabolism and flow
  • Use of PET to monitor therapy for breast and ovarian cancers
  • Conformal radiation treatment planning with PET-CT
  • Imaging structure and function in small animals with CT/ SPECT
  • Molecular probe development for SPECT and PET

Pediatric Radiology

Pediatric Radiology

The mission of the Pediatric Radiology section is to improve the health of children through advanced clinical imaging and research. The section studies pediatric disease through the lens of imaging and is focused on the development of new imaging technologies. Several ongoing basic science and clinical studies are underway with collaborations with MRI physics, pediatric oncology, pediatric gastroenterology and pediatric surgery.

  • Study of novel diffusion weighted imaging (DWI) techniques to better identify inflammation and monitor treatment changes in children with inflammatory bowel disease (ulcerative colitis and Crohn disease)
  • Testing and improving motion-resistant MRI with pulse sequences such as PROPELLER for use in infants and nonsedated children
  • Examining the strengths and limitations of high-resolution, 3D MRI sequences such as CUBE and SPACE for complex pediatric diseases in the chest, abdomen, and pelvis, including diseases of the liver, bile ducts, kidneys, and pelvic organs
  • Studying bowel motion (peristalsis) of bowel and the changes in motion that occur in disease using MRI pulse sequences such as real-time CINE FIESTA.

Pediatric Imaging - Fetal MRI

Ultrasound

  • Prenatal diagnosis of CNS anomalies with ultrasound and MRI
  • Further investigation of clinical manifestations and treatment of twin transfusion syndrome
  • Prospective, randomized trial of repair of fetal myelomeningocele
  • Prospective, randomized trial for selective ablation of connecting vessels in twin transfusion syndrome

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