May 1, 2013
With regards to our article “Apolipoprotein E (ApoE) ε4 Does Not Modulate Amyloid-β–Associated Neurodegeneration in Preclinical Alzheimer Disease,” we researched this topic because there is a need to better elucidate the pathobiologic changes underlying the earliest stage of Alzheimer disease (AD). Specifically, we wanted to better understand howApoE ε4, tau, and amyloid together modulate the earliest neurodegenerative process in cognitively normal older adults. Clinically, our findings suggest the need for examining entities besides amyloid, such as ApoE and tau, when designing anti-amyloid therapeutic trials. Our findings also support the hypothesis that the Alzheimer disease process may involve an amyloid-dependent and an amyloid-independent stage. However, it is still not known whether there exist tau-dependent and tau-independent stages of the disease process, and current work from our laboratory is investigating this issue. That is, there is a need to further understand whether additional entities besides tau modulate β-associated neurodegeneration in preclinical and very mildly symptomatic AD. Taken together, these findings illustrate that the Alzheimer neurodegenerative process starts very early and is extremely complex, involving interactions between numerous genetic and cellular factors. Only by better understanding this complexity, can we identify meaningful therapeutic targets that will prevent this disease.
Our other manuscript, "Temporoparietal MR Imaging Measures of Atrophy in Subjects with Mild Cognitive Impairment That Predict Subsequent Diagnosis of Alzheimer Disease," was one of the first papers to evaluate the use of semi-automated/automated MRI-based morphometric tools for predicting time to progression from mild cognitive impairment to AD. Specifically, our work demonstrated that semi-automated/automated measures of regional neocortical volumes can predict which individuals with cognitive impairment would progress to AD. Our findings suggest the importance and feasibility of using structural MRI-based tools in the clinical evaluation of memory impairment. Current work from our laboratory has been expanding upon this work to demonstrate that MRI-based measures can be combined with cellular and genetic measures to identify presymptomatic and very mildly symptomatic older individuals at increased risk for AD.
April 10, 2013
Congratulations to Dr. Tudor H. Hughes, Department of Radiology, as the 2013 Attending Physician of the Year, and Dr. Joshua Alexander, Department of Neurosciences, was named 2013 House Officer of the Year. The physicians were nominated by their UC San Diego Health System faculty physician colleagues with final selection made by the Medical Staff Executive Committee.
March 13, 2013
SAN DIEGO — An injectable drug that was developed from scratch at UC San Diego has just been approved by the FDA. It's an imaging agent that will help doctors locate cancerous lymph nodes.
One of the ways to see if cancer has spread is to check the lymph nodes.
For years, doctors have had to inject cancer patients with blue dye to find out if a lymph node is harboring cancer. It's a painful injection, and it often doesn't work.
Clinical trials showed the new drug, Lymphoseek, was much more effective.
The drug was developed by two UC San Diego practioners: Dr. David Vera, professor of radiology, and Dr. Anne Wallace, director of plastic surgery.
"It's going to allow me to find the lymph node in the operating room that drains these cancers much faster, much more reliably, and the other thing with this agent is, it really doesn't cause any pain when you inject it," Wallace said.
The drug will be used with patients who have breast cancer or melanoma.
Only one out of every 5,000 new drugs actually make it to the market. Wallace said she's overwhelmed.
"It's actually kind of breathtaking, because I just wanted good science and something good for the patient," she explained. "And now, in the end, it's also going to be good for healthcare and everyone else. So, I haven't actually completely embraced the whole thing yet, that's it's come this far."
Wallace said she has no financial stake in the drug. It will be sold by Navidea Biopharmaceuticals.
March 13, 2013
Researchers at the University of California, San Diego School of Medicine have shown that a new imaging dye, designed and developed at UC San Diego Moores Cancer Center, is an effective agent in detecting and mapping cancers that have reached the lymph nodes.
The radioactive dye called Technetium Tc-99m tilmanocept, successfully identified cancerous lymph nodes and did a better job of marking cancers than the current standard dye. Results of the Phase III clinical trial published online today in the Annals of Surgical Oncology.
"Tilmanocept is a novel engineered radiopharmaceutical specifically designed for sentinel lymph node detection," said David R. Vera, PhD, the drug's inventor, who is a professor in the UCSD Department of Radiology. "The molecule, developed at UC San Diego School of Medicine, offers surgeons a new tool to accurately detect and stage melanoma and breast cancers while in the operating room."
On March 13, 2013, tilmanocept received U.S. Food and Drug Administration (FDA) approval.
After a cancer diagnosis, surgeons want to be sure that the disease has not spread to a patient's lymph nodes, especially the sentinel nodes that may be the first place that a cancer reaches. The lymphatic system is a network of vessels and ducts that carry disease-fighting cells throughout the body, but can also act as a way for cancer cells to access the bloodstream. By surgically removing and examining the sentinel nodes that drain a tumor, doctors can better determine if a cancer has spread.
"Tilmanocept advances the molecular targeting in breast cancer. It's the first agent that is binding to a lymph node because it is a lymph node that plays an important role in metastasis," said Anne Wallace, MD, professor of surgery, UC San Diego School of Medicine and principal investigator of the study. "Tilmanocept's ability to identify more cancer containing nodes will lead to better post-operative care for patients, especially those patients who had more than one positive sentinel node."
Doctors compared injections of tilmanocept, also called Lymphoseek, and the standard blue dye into the tumor area. Then, using a handheld radiation detector, they found the lymph nodes that had taken up the drugs radioactivity. The researchers found that more than 99 percent of sentinel lymph nodes containing blue dye also contained tilmanocept. Of these nodes, 18 percent were positive for cancer. Ninety-four percent of the malignancies were detected by the new radiopharmaceutical whereas the blue dye only detected 76 percent.
"Tilmanocept is just as accurate as current techniques, simple to use, takes less time to find lymph nodes and is cleared faster from the body. This could standardize the process of lymph node mapping and make the process easier, particularly for less experienced surgeons," said Wallace, chief of plastic surgery at UC San Diego Health System and director of the Breast Care Unit at UC San Diego Moores Cancer Center.
Tilmanocept was originally developed at UC San Diego by Vera. Wallace advanced the agent through Phase 1 clinical trials with funding provided by the Susan G. Komen Breast Cancer Foundation and the American Cancer Society. The Phase III study was supported by Navidea Biopharmaceuticals, Inc. based in Dublin, Ohio.
Lymphoseek's safety and effectiveness were established in two clinical trials of 332 patients with melanoma or breast cancer. The Phase III clinical trial took place at 13 medical centers involving 148 patients who had both melanoma and breast cancer. The most common side effects identified in clinical trials was pain or irritation at the injection site reported by two patients.
Study collaborators include: Linda Han, MD, Indiana University Simon Breast Center; Stephen P. Povoski, MD, Wexner Medical Center; Kenneth Deck, MD, South Orange County Medical; Schlomo Schneebaum, MD, Sourasky Medical Center; Nathan Hall, MD, PhD, Wexner Medical Center; Carl K. Hoh, MD, and Karl Limmer, MD, UC San Diego; Helen Krontiras, MD, University of Alabama; Thomas Frazier, MD, Bryn Mawr Hospital; Charles Cox, MD, University of South Florida; Eli Avisar, University of Miami Hospital; Mark Faries, MD, John Wayne Cancer Institute; and Dennis King, PhD, and Lori Christman, PhD, STATKING Clinical Services.
February 24, 2013
Our new CEO Paul Viviano attended the Radiology Faculty Meeting on February 20, to guide the faculty through his vision of UCSD, addressing our strengths, weaknesses, and obstacles. He then took formally prepared and ad hoc questions from the group. Growth in imaging will be an important part of future UCSD expansion.
February 1, 2013
A new study, to be published in the Feb. 7, 2013 issue of the American Journal of Human Genetics, expands and deepens the biological and genetic links between cardiovascular disease and schizophrenia. Cardiovascular disease (CVD) is the leading cause of premature death among schizophrenia patients, who die from heart and blood vessel disorders at a rate double that of persons without the mental disorder.
“These results have important clinical implications, adding to our growing awareness that cardiovascular disease is under-recognized and under-treated in mentally ill individuals,” said study first author Ole Andreassen, MD, PhD, an adjunct professor at the University of California, San Diego School of Medicine and professor of psychiatry at the University of Oslo. “Its presence in schizophrenia is not solely due to lifestyle or medication side effects. Clinicians must recognize that individuals with schizophrenia are at risk for cardiovascular disease independent of these factors.”
Led by principal investigator Anders M. Dale, PhD, professor of radiology, neurosciences, psychiatry and cognitive science at UC San Diego School of Medicine, an international team of researchers used a novel statistical model to magnify the analytical powers of genome-wide association studies or GWAS.
These are studies in which differing bits of sequential DNA – called single nucleotide polymorphisms or SNPs – in persons and groups are compared to find common genetic variants that might be linked to a trait or disease. The researchers boosted the power of GWAS by adding information based on genetic pleiotropy, the concept that at least some genes influence multiple traits or phenotypes.
“Our approach is different in that we use all available genetic information for multiple traits and diseases, not just SNPs below a given statistical threshold,” said Dale. “This significantly increases the power to discover new genes by leveraging the combined power across multiple GWAS of pleiotropic traits and diseases.”
The scientists confirmed nine SNPs linked to schizophrenia in prior studies, but also identified 16 new loci – some of which are also associated with CVD. Among these shared risk factors: triglyceride and lipoprotein levels, waist-hip ratio, systolic blood pressure and body mass index.
“Our findings suggest that shared biological and genetic mechanisms can help explain why schizophrenia patients have a greater risk of cardiovascular disease,” said study co-author Rahul S. Desikan, MD, PhD, research fellow and radiology resident at the UC San Diego School of Medicine.
“In addition to schizophrenia, this new analysis method can be used to examine the genetic overlap between a number of diseases and traits,” Desikan said. “Examining overlap in common variants can shed insight into disease mechanisms and help identify potential therapeutic targets for common diseases.”
Co-authors include Srdjan Djurovic, University of Oslo and Oslo University Hospital, Norway; Wesley K. Thompson, Andrew J. Schork, J. Cooper Roddey and Linda K. McEvoy, UC San Diego; Kenneth S. Kendler, Virginia Commonwealth University; Michael C. O’Donovan, Cardiff University; Dan Rujescu, University of Halle-Wittenberg, Germany; Thomas Werge, University of Copenhagen; Martijn van de Bunt, Andrew P. Morris and Mark I. McCarthy, University of Oxford; The International Consortium for Blood Pressure GWAS; the DIAGRAM Consortium and the Psychiatric Genomics Consortium Schizophrenia Working Group.
Funding for this research came, in part, from the National Institutes of Health (grants RC2DA029475, R01HD061414 and T32 EB005970), the Research Council of Norway, the South East Norway Health Authority, the Unger-Vetlesen Medical Fund and the Robert J. Glushko and Pamela Samuelson Graduate Fellowship.
January 21, 2013
Dr. David Karow received a Department of Defense Research Grant for his application, "MRI-Derived Cellularity Index as a Potential Noninvasive Imaging Biomarker of Prostate Cancer”. David's application received an "Outstanding" overall score. Of 704 applications, only 32 were funded (9%). David's grant will provide him research funding for two years.
November 9, 2012
Dr. Brenner, Dean of UCSD Health Sciences, sent the following email:
I am especially proud to share that several of our outstanding faculty members were recognized by the San Diego Business Journal at this year’s “Women Who Mean Business” awards luncheon on November 6. In fact, six of the 27 awards were to women from the UC San Diego School of Medicine. Winners included Drs. Sarah Blair, Sheila Gahagan, Bess Marcus, Sonia Ramamoorthy, Mia Savoia and JoAnn Trejo. The awards program, now in its 19th year, is a showcase for the region’s dynamic women leaders in business, civic and cultural organizations.
Please join me in congratulating all of the deserving nominees:
Giovanna Casola, MD, is a professor in the Department of Radiology and a practicing clinician at UC San Diego Health System. She has 30 years of experience as a diagnostic radiologist with expertise in body imaging. She is the radiology representative for our trauma service and is the leading clinical expert in GU radiology. Dr. Casola was the principal investigator for the ACRIN CT Colonography trial and has established the CT Colonography Clinical Program at UC San Diego Health System.
Sarah Blair, MD, is an oncological surgeon and professor at Moores Cancer Center. Currently, she and her team are testing an innovative surgical method to remove breast cancer tumors utilizing biodegradable nanoparticles, with the goal of ensuring that all tumor cells are removed during surgery. Her work is supported with $250,000 in funding from the Innovative Molecular Analysis Technologies (IMAT) program, which is designed to support novel and potentially transformative, next-generation technologies in cancer research.
Pamela Deak, MD, is an obstetrician/gynecologist with the Department of Reproductive Medicine at UC San Diego Health System, where her role is to guide women through the stages of their reproductive lives, from adolescence through childbearing and menopause. She has been honored by multiple patients through our Clinical Advancement and Recognition of Excellence in Service (CARES) program, which offers our patients the opportunity to support excellence in quality and compassionate patient care by making a donation in honor of one of our health care providers who has made a difference in their lives.
Sheila Gahagan, MD, MPH, Martin T. Stein Endowed Professor and chief of the Division of Academic General Pediatrics, Child Development and Community Health, was recognized for her work to create relationships between UC San Diego’s Department of Pediatrics and community clinics, particularly Vista Community Clinic and San Ysidro Health Center. She heads several of the Division’s important community outreach programs, including projects designed to prevent obesity and encourage a healthier lifestyle among pregnant women, young mothers and children.
Beatrice Golomb, MD, PhD, associate professor of medicine, is one of UC San Diego Health Sciences’ most prolific and visible researchers whose studies cover issues ranging from statin’s adverse effects to Gulf War Syndrome to the benefits of eating chocolate. This year alone, she published several studies in major journals – resulting in stories that were picked up by hundreds of major media outlets – while continuing her clinical work at UC San Diego Health System and Veterans Affairs San Diego Healthcare System.
Bess Marcus, PhD, is professor and chair of the Department of Family and Preventive Medicine. She has spent 25 years conducting research on physical activity behavior, publishing three books and more than 175 articles and book chapters on physical activity behavior. Dr. Marcus is currently principal investigator on three National Institutes of Health grants, and has mentored more than 20 individuals who have gone on to successful careers as independent medical investigators.
Sonia Ramamoorthy, MD, is an associate professor of surgery who specializes in surgery of the colon and rectum. She is also dedicated to elevating and promoting the role of women in health care, and is the founder of the Women in Surgery Lectureship Series at UC San Diego Health System, a public platform to highlight the achievements and struggles of women in health care. Now in its fourth year, the program attracts prominent female surgeons and doctors from across the U.S. to share their career path and observations with young medical students and the public.
Sharon Reed, MD, is a professor of pathology and medicine, and director of the Microbiology Laboratory at UC San Diego Medical Center in Hillcrest. A physician-scientist whose primary passion is the understanding and treatment of parasitic disease, her research emphasizes finding new drug targets for neglected tropical diseases. For more than a decade, she has worked to upgrade hospital laboratories in Ethiopia with modern equipment, and develop new and effective tests for blood, viruses and tuberculosis.
Mia Savoia, MD, is dean of Medical Education for our School of Medicine, and also serves as the outpatient infectious diseases physician at UC San Diego Health System. She has been active nationally in all of the important organizations and groups that deal with medical education – as national chair of the Group on Student Affairs of the American Association of Medical Colleges (AAMC), on the Governing Council of the Women in Medicine group of the AAMC, and on numerous task forces and boards. Her strong leadership style and perseverance has made her a role model for generations of women in academic medicine.
JoAnn Trejo, PhD, is a professor of pharmacology who studies the function of receptors on cells sometimes involved in spurring breast cancer growth, invasion and metastasis. These receptors also play a role in inflammation related to cardiovascular disease. Understanding how these receptors work is a fundamental step toward controlling their dysfunction and reducing the incidence and mortality of heart disease and cancer. She has been honored for her research and related efforts to improve and expand the role of minorities in science.
August 10, 2012
Hospitals run by the University of California, San Diego will soon only receive 80% of their typical supply, said William Bradley, chairman of its radiology department. That will likely force the school to pay a premium to keep its 10 magnetic resonance imaging, or MRI, machines operating.
"Ultimately the costs go up to patients and insurance companies," Dr. Bradley said.
[ Read Full Article ]
Dr. Bradley was one of 3 Gold Medal winners this year at the ACR.
April 30, 2012
William G. Bradley, Jr., MD, PhD, FACR, chairman of the Department of Radiology, was awarded the ACR Gold Medal, the highest honor of the American College of Radiology on April 22, during the ACR annual meeting and Chapter Leadership Conference held in Washington, D.C. The ACR said of Bradley, "(He) is renowned for his endless dedication…to advance the science and cause of radiology locally, nationally and internationally." He founded the ACR's MR Accreditation Program in 1992 and served as its chair for seven years. He also chaired the ACR Commission of Neuroradiology and MRI from 1999 to 2005, and was vice president of its Board of Chancellors in 2005-06. ACR noted his many accomplishments in pioneering developments in MR and publications, especially his influential co-editorship of Magnetic Resonance Imaging.
March 15, 2012
This award was established to honor one of the pioneers in neuroradiology, and is given to a trainee or junior faculty member in neuroradiology for excellence as demonstrated in a paper that represents original, unpublished research in some aspect of neuroradiology.
Rahul S. Desikan, M.D., Ph.D., was awarded the prestigious 2012 Cornelius G. Dyke Memorial Award for his paper, "Phospho-tau not APOE ε4 modulates amyloid-β associated neurodegeneration in cognitively normal older individuals."
Warm congratulations, to Dr. Desikan!
March 1, 2012
Myanmar's healthcare system is in dire need of medical supplies, modern diagnostic equipment and money, but is persevering despite the odds, according to three radiology professors who visited the nation through RSNA’s International Visiting Professors program.
February 1, 2012
Inconsistency in interpreting and reporting of suspected hepatocellular carcinoma (HCC) led to the creation of Liver Imaging Reporting and Data System (LI-RADS).
September 16, 2011
Nearly 130 physicians with UC San Diego Health System were named in San Diego Magazine’s "Physicians of Exceptional Excellence" survey. Congratulations to the 13 physicians from the Department of Radiology!
July 21, 2011
An article from Scientific American discusses research where functional MRI was used to determine how the brain 'constructs' the experience of subjective time providing insight into how time can seem to fly by or stretch on forever.
[ Read article ]
June 28, 2011
Congratulations to Giovanna Casola, MD for her recognition in the Chicago Museum of Science and Industry. The exhibit opened 1.5 yrs ago in the technology area of the "your body" section in the museum is an interactive exhibit on whole-body CT scanning. Out of >500,000 people that have voted on the topic, Dr. Casola was one of the top 2 speakers rated most influential in the audience's decisions (they both had about 26% of the votes), with ~73% voting against whole-body CT screening.