Revolutionizing Disease Diagnosis with Multimodal Imaging

Albert Einstein College of Medicine

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A woman finds a lump in her breast. She visits her doctor, who sends her to get a mammogram and biopsy. The diagnosis is an aggressive cancer. Will it respond to treatment? That's a question mark today, but in the future, multimodal imaging may be able to provide an answer, sparing patients from unnecessary therapy and its harsh side effects. This noninvasive approach may even provide an alternative to biopsy.

Over the last decade, researchers across the country have pushed to make a new standard of multimodal imaging—the combination of elements of MRI and PET scans to provide richer, far more informative results. By combining optical, radioactive, and magnetic imaging techniques, this integrated approach is giving physicians information about a patient that, in the past, might have been hard to come by.

Albert Einstein College of Medicine has long been at the forefront of medical technology, and a recent gift from the EGL Charitable Foundation is allowing them to take multimodal imaging to the next level. Founded in 2012, Einstein's Integrated Imaging Program (IIP) is making a radical step forward in breast imaging. "Consider a woman who presents with a breast tumor," says project co-leader John S. Condeelis. "Right now, using MRI in the conventional way, you can see a tumor but you don't know whether it's aggressive or nonaggressive."

But images produced by the new technology will allow researchers like Condeelis to illuminate tissue across a tremendously wide imaging spectrum, from micrometers to millimeters. At this level of detail, an aggressive tumor and a nonaggressive one will not look the same, allowing a woman's physician to prescribe the appropriate treatment without resorting to biopsy. Even more incredibly, Condeelis says, it may allow oncologists to know at a glance whether or not a tumor will respond to chemotherapy. This means far greater precision in cancer treatment— and greater precision means happier patients, with far better outcomes.

"Right now, using MRI in the conventional way, you can see a tumor but you don't know whether it's aggressive or nonaggressive.

The IIP is fueled by input from across Einstein, and its benefits will be shared as well: Multimodal imaging will offer researchers and physicians at the College of Medicine unprecedented levels of detail. The Gruss Magnetic Resonance Research Center (MRRC) and the Gruss Lipper Biophotonics Center (GLBC) are already two of the finest imaging centers in the area, and they are about to become even more useful.

"Integrated imaging research is collaborative work by nature, and Einstein's highly collaborative research environment makes it an ideal setting for such a program," says Robert H. Singer, co-director of the GLBC, and one of the heads of the IIP.

Research at the GLBC and MRRC covers a wide range of pathologies and fields, including cancer, neurological disorders, liver disease, cardiology, traumatic brain injury, and hematology. The IIP promises to help Einstein's experts in those fields not just treat diseases and conditions, but better understand them. The breast imaging investigation that is serving as the IIP's test program is teaching researchers not just how to treat a tumor, but how they form. It is not difficult to imagine the same methodology being applied to tracking plaque buildup in a patient at-risk for heart disease, or monitoring the brain activity of a potential Alzheimer's sufferer.

"Images obtained through the IIP will reveal—with an astonishing level of detail—how complex diseases get started and progress in the body," says Singer. "This information will help scientists target the molecular glitches responsible for cancer, diabetes, Alzheimer's and other major health problems."

In making the IIP a reality, Singer and Condeelis' biggest challenge was securing funding for their research—an ever-present difficulty in an era of reduced federal support, and strained private pocketbooks. The generosity of the EGL Charitable Foundation, which was founded in 2011 to provide support for outstanding young Israeli scientists, was just the latest in a long line of gifts given to the College of Medicine by the family of Joseph Gruss, a prominent philanthropist who died in 1993. The Gruss Lipper Foundation was responsible for the grants that made the GLBC and MRRC possible.

"We are extremely grateful to the EGL Charitable Foundation for helping us create this vital resource at the College of Medicine," says Einstein Dean Allen M. Spiegel. "The family's support has enabled Einstein to emerge as a leader in imaging research, and this latest investment places us among a select group of institutions that offer research scientists and clinicians the tools to bring about significant medical advances."

At the MRRC, Einstein researchers continue to push the boundaries of what an MRI can do. The latest project? An MRI-guided high-frequency ultrasound system that, when focused on cancers or diseased tissue, heats it, and destroys it—completing a chain of healing begun when multimodal imaging identified the tumor in the first place.

Photo: Researchers collaborate to push the boundaries of integrated imaging.