Neuroradiology Research Overview
The neuroradiology specialists in the UCSF Department of Radiology and Biomedical Imaging are focused on developing new diagnostic techniques and cutting edge therapies for diseases of the brain, spinal cord and neck in both adults and children. Research in these areas has had, and continues to have, enormous positive impact on treatments and care for patients.
Adult Imaging Research
UCSF neuroradiologist physician scientists have a broad range of research interests. We are currently involved in developing and assessing new magnetic resonance techniques such as perfusion imaging, MR spectroscopy and diffusion MR that hold the promise of new, more specific and precise diagnostic and therapeutic results for patients with brain and spine lesions. We are also conducting studies of dynamic brain function, looking for new approaches for the diagnosis of epilepsy, stroke, autism, Parkinson’s disease, traumatic brain injury, and nerve and spine disorders. We are constantly looking to transfer our research advances into clinical protocols for better diagnosis and treatment of our patients.
The UCSF pediatric neuroradiology group, led by A. James Barkovich, MD, is studying normal and abnormal brain development, neonatal brain injury, brain anomalies, fetal abnormalities and diseases afflicting premature infants. Dr. Barkovich and Orit Glenn, MD work closely with UCSF’s outstanding teams of child neurologists, pediatric neurosurgeons, and pediatric intensive care doctors to guide the care of sick infants and children. These research efforts are funded by multiple grants from the National Institutes of Health for the study of normal and abnormal brain development of premature newborns, term-born neonates, children with brain malformations, children with epilepsy, and children who suffer strokes.
Spinal and Peripheral Nerve Research
The UCSF Precision Spine and Peripheral Nerve Center spine neuroradiology team is applying the use of advanced imaging tools to better diagnose and treat spinal and peripheral nerve disorders.
Neuroradiology Research in Detail
Below, are additional details regarding UCSF neuroradiology research and laboratory programs. Contact information is included as a convenience for physicians who may wish to discuss their patients or to refer for an opinion or a consultation with a UCSF radiology specialist.
- Brain Tumor Imaging Research Laboratory
- Advanced Imaging for the Study of Neurodegenerative Disease
- Biomagnetic Imaging Laboratory
- Molecular Imaging Research
- Mapping the Structure and Function of the Brain
- Pediatric Neuroradiology Research
- Fetal Neuroimaging Program
- Spine Research and Treatment Program
- Quantitative Image Processing Center (QUIPC)
Top row: A patient suffering a right brain stroke as shown on CT, CT perfusion, CT Angiography.
Bottom row: MR diffusion, MR Flair, and gradient echo MR (hemorrhage sensitive exam).
Brain tumors, called Glioblastoma Multiforme (GBMs) are the most common adult primary brain tumors. They can occur at any age, but are more common in older patients. These tumors are diagnosed with imaging studies and a tumor biopsy. Currently the use of a contrast-enhanced MRI is a sensitive means of delineating anatomic and structural features of brain tumors. This technology, however, often fails to detect subtle tumor infiltration beyond the contrast-enhancing margin of the tumor, or differentiate the active tumor from therapy-related brain injury.
MR perfusion and map of brain tumor.
At UCSF’s Neuroradiology Research Laboratory, Director, Dr. Soonmee Cha and her colleagues are studying the potential of anatomic and physiologic MRI as useful tools for improved GBM classification, benefits for cancer therapy monitoring, and more accurate surgery planning to help surgeons and their patients.
Dr. Cha and her team have validated physiologic variables by directly correlating them with the study of microscopic changes or abnormalities in tissues of the tumor specimen obtained through image-guided stereotactic biopsy. The team is also exploring the benefits of combining imaging with genetic analysis of GBM. Researchers are trying to better understand the possible implications for apparent self-renewing brain tumors.
|MR images of a Glioblastoma Multiforme:
A) Fluid-attenuated inversion recovery image shows a bright tumor adjacent to the right lateral ventricle.
B) Post-contrast SPGR T1-weighted image shows heterogeneous enhancement within the tumor.
C) Dynamic susceptibility-weighted contrast-enhanced perfusion MR image shows markedly increased vascularity (red) within the tumor due to underlying angiogenesis.
D) Dynamic contrast-enhanced permeability image shows marked increase in vessel leakiness (red and yellow) within the central aspect of the tumor.
The hypothesis is that neural stem cells in the subventricular zone (SVZ) of the human brain, where self-renewing neurons in the adult brain are located, may be the cellular origin of GBM brain tumors. To explore this hypothesis, the features of GBM tumors in specific relation to the SVZ have been analyzed, and this research is continuing with an analysis of genetic markers, such as methylation and mRNA.
Physicians are welcome to contact Dr. Soonmee Cha for further information at (415) 353-9301 or by email at email@example.com.
Standard anatomical imagin in degenerative disorders of the brain, including dementia, which affect a growing number of patients across an aging population. With 20 years experience in MRI engineering, Dr. Hess and his group develop and employ new MRI techniques to study the process of neurodegeneration in disorders including Huntington's disease, Alzheimer's disease, and parkinsonian disorders. Ultra-high field 7 tesla MRI, diffusion MRI, quantitative susceptibility mapping, and mathematical morphometry techniques are currently being explored in his laboratory. Through multi modality imaging and advanced image analysis techniques, the goal of this work is to make possible more accurate diagnosis and to monitor the effect of treatments under development using imaging. Dr. Hess' group excels at translating state-of-the-art research techniques to practical imaging in clinical patients, and the advanced imaging techniques developed by his group are also currently being used to more accurately characterize brain tumors, to study neurovascular disorders and to understand plasticity in the newborn brain.
|High resolution imaging using 7 tesla MRI. Images on the left show atrophy and iron accumulation within the right basal ganglia of a patient with an atypical movement disorder compared to a normal control subject. Images on the right compares the right hippocampus of a patient with epilepsy acquired using 7 tesla (left) and 3 tesla (right) MRI.|
Physicians are welcome to contact Dr. Christopher Hess for further information at (415) 514-4385 or by email at firstname.lastname@example.org.
Functional Brain Imaging
The Biomagnetic Imaging Laboratory (BIL) is a shared clinical and research facility in the Department of Radiology and Biomedical Imaging at UCSF. The program is focused on improving non-invasive functional brain imaging methods to develop a better understanding of the dynamics of brain networks associated with complex human behaviors, such speech, language, memory and attention. The laboratory conducts basic and clinical research on brain function using multiple brain imaging modalities including magnetoencephalographic imaging (MEGI), functional magnetic resonance imaging (fMRI), transcranial magnetic stimulation (TMS) and psychophysics.
Ongoing Functional Brain Imaging research projects include:
- Imaging the plasticity of the brain associated with learning, disease, recovery and therapeutic interventions
- Ongoing clinical studies are in patients with autism, brain tumors, dementias, dystonia, epilepsy, neurodevelopmental disorders, Parkinson’s disease, schizophrenia, stroke, tinnitus and traumatic brain injury
- Imaging speech and language processing and speech motor control of speech
- Developing machine learning algorithms and tools for:
- Multimodal functional brain imaging,
- Imaging structural and functional connectivity
- Brain computer interfaces (BCI)
- Developing novel clinical applications for MEGI and TMS
Functional Brain Images:
Patient experienced word finding and word production difficulties. The MEGI study at BIL found a lesion located close to auditory cortex in the right hemisphere and in close proximity to brain regions that process speech and language (red icon).
Patient experienced facial twitching, numbness and arm spasms, with some word finding difficulties. MEGI found a tumor located in the vicinity of auditory cortex, close to somatosensory cortex for the lip (red icon).
Cinical Services Offered in the Biomagnetic Imaging Lab
Our laboratory provides clinical services for referring physicians and their patients including:
- Functional brain mapping in patients with brain tumors and arteriovenous malformations (AVMs),
- Epileptic zone localization in patients with epilepsy
The functional brain mapping services are important and clinically useful for mapping sensory, motor, and language areas prior to neurosurgical procedures. The team offers and conducts epileptic zone localization studies in patients with seizure disorders or epilepsy in order to identify causes for epileptic activity and potential seizure triggers, to evaluate patients and contribute to preparations for epilepsy surgery.
Physicians seeking more information or wishing to order a study for a patient, please call the Biomagnetic Imaging Laboratory at (415) 476-6888. Physicians are welcome to contact Dr. Nagarajan at (415) 476-4982 or email him at email@example.com.
More information is available at the Biomagnetic Imaging Laboratory site.
The research goal within the Molecular Imaging Research group, led by Dr. David Wilson, is to better understand the molecular mechanisms of the brain, in both health and disease. Cells within the brain communicate with each other using simple molecules, and maintain normal functioning by accumulating large quantities of antioxidants including Vitamin C.
The UCSF team has developed methods to make images of brain antioxidants, which are depleted in aging, stroke, and neurodegenerative diseases including Alzheimer's disease.
Dr. Wilson’s team also has the goal of developing new ways to detect harmful pro-oxidant molecules themselves, using positron emission tomography (PET), a technology commonly used in cancer detection. These methods will allow us to detect oxidative damage in patients non-invasively, and therefore monitor the therapeutic efficacy of our interventions. As we develop more methods to detect the basic chemistry of the normal and abnormal brain, our approaches to treatment will be increasingly patient-centered.
Physicians are welcome to contact Dr. David Wilson for more information, at firstname.lastname@example.org or telephone (415) 514-6229.
Dr. Pratik Mukherjee's research focuses on technical development of advanced imaging methods and their application to cognitive neuroscience for mapping structure and function in the human brain. In particular, diffusion tensor imaging (DTI) is a cutting edge MRI technique proven useful for assessing the development and integrity of white matter and for mapping axonal fiber pathways. Dr. Mukherjee made many of the initial observations of human white matter development in newborns and children using this technique. He also led the development of more advanced methods known collectively as “high angular resolution diffusion imaging” (HARDI) for surmounting the limitations of DTI for characterizing regions of complex white matter architecture.
Traumatic Brain Injury
Currently, Dr. Mukherjee's primary clinical research effort is the study of traumatic brain injury (TBI) using advanced MR imaging techniques, including DTI. Dr. Mukherjee has also made novel scientific findings about the organization of white matter in the normal adult brain using multivariate statistical analyses of group DTI data. More recently, Dr. Mukherjee has also employed functional connectivity mapping based on resting state fMRI and MEG for basic and clinical neuroscience applications. Diffusion tractography and resting state fMRI/MEG technology have been used in Dr. Mukherjee’s lab to map the structural and functional “connectome” of the human brain, both to study normal brain organization as well as pathologic conditions such as brain malformations and brain injury.
A) Initial resting state MEG scan after mild TBI.
B) Resting state MEG scan 26 months later showing improved connections with time.
Pediatric Neuroradiology Research is led by Dr. A. James Barkovich. The team studies the process of normal brain development to better understand abnormalities seen on MR studies of infant patients. Suspected abnormalities of myelination, (the development of myelin sheaths around nerve fibers of the central nervous system), is one area of particular research interest. The processing speed of a brain is determined, in large part, by the myelination around the nerves in the brain. When nerves are myelinated properly, messages and neuronal signals are transmitted through the brain more effectively. Various diseases may demyelinate the white matter resulting in brain dysfunction.
Pediatric neuroradiology research includes:
|Abnormal brain development||
High resolution MRI and diffusion tensor MR imaging (DTI) are used to investigate the anatomy of brain anomalies. Brain malformations being studied include anomalies of the corpus callosum, malformations of cortical development, and malformations of the midbrain and hindbrain.
Neonatal brain injury
Standard MR imaging (MRI), MR spectroscopy (MRS), and diffusion tensor MR imaging (DTI) are utilized to assess encephalopathic neonates in order to precisely locate neonatal brain injury (these are infants less than a month old who have difficulty with respiration, depressed tone and reflexes, subnormal level of consciousness and may have seizures); imaging findings are correlated with neurodevelopmental outcomes.
Prematurely born neonates
Many prematurely born infants ultimately have neurodevelopmental disabilities. UCSF Pediatric Neuroradiology researchers use state of the art MRI, MRS, and DTI to assess the brains of prematurely born neonates in order to detect subtle abnormalities that can impact development and provide information to primary care and neonatal specialists and parents.
Physicians please feel free to call Dr. A. James Barkovich for further information, at (415) 353-1668 / 1537 or e-mail email@example.com.
The Fetal Neuroimaging Program is led by Dr. Orit Glenn, M.D. This program develops advanced imaging techniques to study normal and abnormal fetal brain development. Fetal MR imaging is used to help answer questions about fetal anatomic structure before birth when it can be a helpful in making medical decisions or planning critical care. The clinical scientists use specialized real–time MR techniques to detect various congenital (inherited) abnormalities and correlate these with childhood development.
These imaging studies can help parents and doctors make decisions during pregnancy and prepare in advance for challenges that the child and family may face. The Fetal Neuroimaging Research Program is a collaborative effort of MR scientists working with obstetricians, perinatologists, child neurologists, geneticists, pediatric neurosurgeons, fetal treatment surgeons, and neonatologists. By developing new and improved fetal MR techniques, (such as the generation of 3D high resolution images, fetal diffusion weighted imaging, and fetal diffusion tensor imaging,) changes in brain measurements, shape, and dimension as well as changes in the microstructure of white matter can be quantified. These techniques contribute to understanding and clinical decision-making regarding a wide range of neuro-developmental disorders.
More information about Fetal Neuroimaging available at: http://www.radiology.ucsf.edu/research/labs/baby-brain/fetal-mri
For physicians to discuss further please email Dr. Orit Glenn, MD at Orit.Glenn@ucsf.edu.
Spine Research and Treatment Program (Doctors Cynthia Chin, MD, William Dillon, MD, Christopher Hess, MD, PhD, and Sharmila Majumdar, PhD)
The Spine Research and Treatment Programis led by Doctors Cynthia Chin, MD, William Dillon, MD, Christopher Hess, MD, PhD, and Sharmila Majumdar, PhD. This program focuses on research to advance the practical utility of CT and MR imaging of the spine and peripheral nerves.
The UCSF Spine Neuroradiology team is continuously exploring the use of advanced imaging tools to better diagnose and treat spinal cord and peripheral nerve disorders and to better diagnose these disorders and assess their clinical implications.
Another focus of the group is the use of MR in the evaluation and treatment of patients with peripheral nerve disorders.
Physicians are also welcome to discuss a patient with one of our neuroradiologists by contacting Erin Harrison at (415) 353-3717 or by email at firstname.lastname@example.org. She will quickly arrange a call with one of our neuroradioiologists experienced in performing these studies.
More information is available about treatment at The UCSF Precision Spine and Peripheral Nerve Center.
Right cervical rib causing C7 neuropathy.
The Quantitative Image Processing Center (QUIPC) at UCSF focuses on providing the latest image processing technologies for use in qualitative and quantitative assessments and additional refinement of imaging studies. The QUIPC is led by Vivek Swarnakar, PhD. The Quantitative Image Processing Center provides comprehensive image analysis and data management services, for clinical and pre-clinical research needs. This includes reformatting image studies, registration, segmentation, ROI analysis, image post-processing for parametric data (fMRI, DTI, T1, T2, T1rho), and novel algorithm development.
Post-processing ensures highest quality, consistent and efficient image analysis. Post-processing services allow sub-specialties in Radiology to provide faster and more effective diagnosis for referring physicians and their patients.
QUIPC data management supports PACS (Picture Archiving and Communication System) to manage and archive images.
Services include Co-Registration, Segmentation, ROI Analysis, RECIST Measurements, Perfusion Analysis, Volumetry and Morphometry, DTI Post-Processing, Customized Research Management, Clinical and Pre-Clinical Trial Support, and Multi-Center Trial Support.
Research Trial Workflow Support
Services in support of research trials include development of web-based report forms, data analysis and statistics, multi-center data management, security and curation (including the selection, preservation, maintenance, collection and archiving of digital assets.)
More information about QUIPC is available at: http://www.radiology.ucsf.edu/research/coreservices/quipc
For consultation or to request services please contact Director, Vivek Swarnakar, at (415) 353-9455 or email email@example.com.