Taouli Lab

Cancer/Body Quantitative Imaging Group at TMII

Updated 18 March 2016

Cancer/Body Quantitative Imaging Group at TMII Cancer/Body Quantitative Imaging Group at TMII

Director: Bachir M. Taouli, MD, MS

Professor of Radiology and Medicine

Director of Body MRI

Director of Cancer Imaging

The Translational and Molecular Imaging Institute

Research Statement

The Cancer/Body MRI group is focused on the application of quantitative multiparametric magnetic resonance imaging (mpMRI) as a tool to characterize diffuse liver disease and various tumor types (such as liver and prostate cancer), and to predict early response to therapy. We investigate quantitative MRI metrics in relation to several tissue characteristics including diffusion, perfusion, tissue stiffness and oxygenation with the goal that it might clarify the complex pathophysiology behind diseases and improve upon existing tools for diagnosing and staging disease. Our methods include diffusion weighted imaging (DWI) including intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI), each of which provides insights about tissue cellularity and grade; blood oxygen level dependent (BOLD) imaging to assess tissue oxygenation, and MR Elastography (MRE) for measurement of tissue stiffness. In addition, we utilize arterial spin labeling (ASL), dynamic contrast-enhanced MRI (DCE-MRI), and 4D flow phase-contrast imaging each of which estimates tissue flow and perfusion. There are 5 major themes of investigation in our lab which include

  1. Detection of liver fibrosis/cirrhosis and assessment of portal hypertension (PH)
  2. Characterization of hepatocellular carcinoma (HCC) and response to therapy
  3. Diagnosis and characterization of renal transplant dysfunction
  4. Characterization of disease activity in Crohn’s disease
  5. Diagnosis and characterization of prostate cancer

Detection of liver fibrosis/cirrhosis and portal hypertension (PH)

Our group has been actively investigating advanced MRI techniques for evaluation of liver fibrosis/cirrhosis and PH. These include MRE, 2D/4D PC-MRI and DCE-MRI. We have established the role of MRE for the detection of advanced liver fibrosis/cirrhosis, and tested more advanced MRE techniques (2D-EPI and 3D-EPI) on the liver and spleen. We have demonstrated that the arterial buffer response can be quantified with PC-MRI and DCE-MRI in PH. By applying a mpMRI (multiparametric) approach in patients with suspected PH, we have identified stiffness, velocity and perfusion parameters to be the best performing markers of PH. We would like to generate and validate predictive models based on this approach in a large prospective study. This will validate MRI as a useful tool in clinical algorithms assessing patients with liver disease. Ultimately, the combination of different techniques will also shed light on the mechanism of pathophysiologic changes in PH.

MR Elastography of the liver and spleen
MR Elastography of the liver and spleen of a patient without portal hypertension (PH, upper row) and in a patient with PH (increased portal pressure at 18 mmHg, lower row). The liver and spleen stiffness are elevated for the patient with PH (lower row 13.2 kPa and 15.3 kPa, respectively) while in the normal range for the subject without PH (upper row 2.3 kPa and 5.1 kPa, respectively).

Characterization of HCC and response to therapy

A second theme of interest has been to validate the use of mpMRI for detection and staging of HCC and for the assessment of early response to therapy. Imaging techniques include IVIM-DWI, DCE-MRI and BOLD. Our study thus far has established significant correlations between tumor vs non-tumor tissue via measures of diffusion (D*, D, PF), perfusion/flow (Fa, Fp, ART) and oxygen uptake (R2*). Findings from mpMRI evaluation of HCC may prove useful for tumor characterization and for determining benchmarks to assess tumor aggressiveness and response. This approach may be tested for HCC drug trials, and may have a high potential impact on the clinical care of HCC patients.

Perfusion maps
Perfusion maps obtained in a patient with HCC. Different parameters are displayed including arterial fraction, permeability and interstitial volume.

Diagnosis and characterization of renal transplant dysfunction

Following renal transplantation, particularly in the early post-operative phase, a significant number of patients experience one or more episodes of graft dysfunction. Options for treatments can vary widely depending on the particular cause of parenchymal renal dysfunction. Percutaneous biopsy remains the gold standard for definitive diagnosis. However allograft biopsy has several drawbacks, including invasiveness, a challenge to repeat, susceptibility to sampling errors and inter-observer variability. We are currently examining the utility of mpMRI for the early and precise characterization of renal graft pathology, to assess disease progression, and to clarify the intricate pathophysiological processes of renal allograft dysfunction. We are utilizing the quantitative metrics obtained from DCE-MRI, DW-MRI, ASL, 4D flow phase-contrast imaging and BOLD. We believe a comprehensive approach utilizing both conventional and quantitative mpMRI offers a unique approach to elucidate the underlying causes of renal graft dysfunction by identifying confounding factors. We have only recently begun our investigation for this indication but early results are promising.

dti_tractography
DTI tractography image of a renal transplant in a 54 year old male patient with stable renal transplant function. Tract density is high in the transplanted kidney, potentially indicative of good functionality. Color codes demonstrate different flow directionality.

Diagnosis and characterization of disease activity in Crohn’s Disease

We have also recently begun investigating the use of quantitative MRI techniques to enhance our understanding of Crohn’s disease. This inflammatory bowel disease (IBD) is characterized by recurrent, chronic uncontrolled, immune mediated inflammation that can affect any part of the GI tract but predominantly affects the distal ileum and colon. The incidence of IBD is steadily increasing worldwide however the underlying etiology of this disease remains largely unknown. Although colonoscopy remains the gold standard for assessing disease activity in the colon, small bowel investigation requires MRI or computed tomography (CT) to detect involvement. MR enterography can detect active small bowel inflammation with the added advantage that it lacks ionizing radiation and offers the opportunity to acquire a comprehensive volume of information not available by CT. We are utilizing quantitative metrics from IVIM-DWI and DCE-MRI. With this study we plan to elucidate the relationship between quantitative diffusion and perfusion changes in affected small bowel segments and venous remodeling.

dwi_trace
Standard trace DWI compared to 3D diagonal DWI in a patient with prostate cancer (arrows). Equivalent image quality is observed while acquisition time is shortened by 45%.

Recent Representative Publications

  1. Wagner M, Besa C, Bou Ayache J, Yasar TK, Bane O, Fung M, Ehman RL, Taouli B. Magnetic Resonance Elastography of the Liver: Qualitative and Quantitative Comparison of Gradient Echo and Spin Echo Echoplanar Imaging Sequences. Invest Radiol. 2016 Mar 16. [Epub ahead of print] PMID: 26982699
  2. Hectors SJ, Wagner M, Besa C, Bane O, Dyvorne HA, Fiel MI, Zhu H, Donovan M, Taouli B. Intravoxel incoherent motion diffusion-weighted imaging of hepatocellular carcinoma: Is there a correlation with flow and perfusion metrics obtained with dynamic contrast-enhanced MRI? J Magn Reson Imaging. (2016) Feb 26 [Epub ahead of print] PMID: 26919327.
  3. Taouli B, Beer AJ, Chenevert T, Collins D, Lehman C, Matos C, Padhani AR, Rosenkrantz AB, Shukla-Dave A, Sigmund E, Tanenbaum L, Thoeny H, Thomassin-Naggara I, Barbieri S, Corcuera-Solano I, Orton M, Partridge SC, Koh DM. Diffusion-weighted imaging outside the brain: Consensus statement from an ISMRM-sponsored workshop. J Magn Reson Imaging. (2016) Feb 19 [Epub ahead of print]. PMID: 26892827.
  4. Bane O, Wagner M, Zhang JL, Dyvorne HA, Orton M, Rusinek H, Taouli B. Assessment of renal function using intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced MRI. J Magn Reson Imaging. (2016) Feb 8 [Epub ahead of print]. PMID: 26855407.
  5. Kihira S, Kagen AC, Vasudevan P, Jajamovich GH, Schiano TD, Andrle AF, Babb JS, Fischman A, Taouli B. Non-invasive prediction of portal pressures using CT and MRI in chronic liver disease. Abdom Radiol (NY). (2016) Jan;41(1):42-9. PMID: 26830610.
  6. Taouli B, Serfaty L. Magnetic Resonance Imaging/Elastography Is Superior to Transient Elastography for Detection of Liver Fibrosis and Fat in Nonalcoholic Fatty Liver Disease. Gastroenterology. (2016) Mar;150(3):553-6. PMID: 26820053.
  7. Dyvorne HA, Jajamovich GH, Bane O, Fiel MI, Chou H, Schiano TD, Dieterich D, Babb JS, Friedman SL, Taouli B. Prospective comparison of magnetic resonance imaging to transient elastography and serum markers for liver fibrosis detection. Liver Int. (2016) [Epub ahead of print]. PMID: 26744140.
  8. Jajamovich GH, Huang W, Besa C, Li X, Afzal A, Dyvorne HA, Taouli B. DCE-MRI of hepatocellular carcinoma: perfusion quantification with Tofts model versus shutter-speed model-initial experience. MAGMA. (2016) Feb;29(1):49-58. PMID: 26646522.
  9. Yasar TK, Wagner M, Bane O, Besa C, Babb JS, Kannengiesser S, Fung M, Ehman RL, Taouli B. Interplatform reproducibility of liver and spleen stiffness measured with MR elastography. J Magn Reson Imaging. (2015) [Epub ahead of print]. PMID: 26469708.
  10. Bane O, Besa C, Wagner M, Oesingmann N, Zhu H, Fiel MI, Taouli B. Feasibility and reproducibility of BOLD and TOLD measurements in the liver with oxygen and carbogen gas challenge in healthy volunteers and patients with hepatocellular carcinoma. J Magn Reson Imaging. (2015) [Epub ahead of print]. PMID: 26417669.
  11. Cui Y, Dyvorne H, Besa C, Cooper N, Taouli B. IVIM Diffusion-weighted Imaging of the Liver at 3.0T: Comparison with 1.5T. Eur J Radiol Open. (2015) 2:123-128. PMID: 26393236.
  12. Besa C, Bane O, Jajamovich G, Marchione J, Taouli B. 3D T1 relaxometry pre and post gadoxetic acid injection for the assessment of liver cirrhosis and liver function. Magn Reson Imaging. (2015) Nov;33(9):1075-82. PMID: 26119422.
  13. Satkunasingham J, Besa C, Bane O, Shah A, de Oliveira A, Gilson WD, Kannengiesser S, Taouli B. Liver fat quantification: Comparison of dual-echo and triple-echo chemical shift MRI to MR spectroscopy. Eur J Radiol. (2015) Aug;84(8):1452-8. PMID: 26047820.

Group Members

Faculty

Bachir Taouli, MD, MS

Bachir TaouliBachir is Professor of Radiology and Medicine, director of Body MRI, co-director of Abdominal Imaging, director of the Cancer Imaging Program at Mount Sinai, and director of the Body MRI Fellowship in the Department of Radiology and the Translational and Molecular Imaging Institute. Dr Bachir Taouli graduated in medicine from Medical University of Paris VI (France). He completed Radiology Residency in Paris VI University in 2000. After a research postdoc at UCSF, he completed a clinical Fellowship in Abdominal Imaging at UCSF. He then joined the NYU Body MRI group in 2003. Bachir moved to Mount Sinai in 2009. His research is focused on quantitative MRI methods, including diffusion, perfusion, elastography, and fat/iron quantification methods, applied for diffuse and focal liver diseases, and to liver and prostate cancer. He is a member of major professional societies (RSNA, ISMRM, ARRS, SAR, ESR, AASLD, ESGAR). He is a reviewer for Radiology, AJR, JMRI and European Radiology, and abstract reviewer for ISMRM, RSNA, AASLD, DDW, ARRS and SAR. He authored over 118 peer-reviewed manuscripts and 13 book chapters on body MRI.
Email: bachir.taouli@mountsinai.org
http://www.mountsinai.org/profiles/bachir-taouli

Sara Lewis, MD

Sara LewisSara is an Assistant Clinical Professor of Radiology in the Body Imaging/Body MRI Section at Icahn School of Medicine at Mount Sinai, where she also completed her training. Sara is actively involved in multiple areas of clinical research in abdominal imaging. Recent and current projects include evaluation of advanced MRI sequences for assessment of hepatobiliary neoplasms, renal transplant dysfunction and prostate cancer.
Email: Sara.lewis@mountsinai.org
http://www.mountsinai.org/profiles/sara-lewis

Research Scientist

Cecilia Besa, MD

Cecilia BesaCecilia received her MD from the Universidad de los Andes in Santiago, Chile and trained in Radiology in Chile. She then did a clinical fellowship in PET imaging at Mallinckrodt Institute of Radiology (Washington University) in 2011, she then joined Mount Sinai Radiology in 2012 for Body MRI fellowship followed by Cancer Imaging Fellowship in 2013/2014. She transitioned to a Senior Research Scientist position at TMII in 2015. Her work is focused on conducting clinical translational imaging research centered on the use of advanced MRI methods in characterizing abdominal and pelvic malignancies and the development of oncologic applications with the newly integrated PET/MRI scanner. This includes the application and validation of perfusion-weighted and diffusion-weighted MRI methods for focal and diffuse liver disease assessment and prediction of prostate cancer aggressiveness among others.

Current Post-Doctoral Fellows

Octavia Bane, PhD

Octavia BaneOctavia received her PhD in Biomedical Engineering from Northwestern University in 2013. Prior to her graduate degree, Octavia completed a Bachelor’s in Physics from the University of Chicago with honors. She joined the cancer/body group in 2013. She is a postdoctoral fellow in MRI physics conducting research on the non-invasive study of MR perfusion in liver and renal disease, and of intratumoral hypoxia and perfusion in hepatocellular carcinoma. She was a fellow of the NRSA Cancer Biology Training Program (T32) at Icahn School of Medicine in 2014-2015.

Stefanie Hectors, PhD

Stefanie HectorsStefanie obtained a PhD in Biomedical Engineering from Eindhoven University of Technology in The Netherlands. She joined the Cancer/Body MRI group at TMII as a postdoctoral fellow in March 2015. Her projects are on the implementation and analysis of quantitative multiparametric MRI in prostate and liver, mainly focusing on advanced diffusion and DCE-MRI methods.

Mathilde Wagner, MD/PhD

Mathilde WagnerMathilde completed her medical and Radiology training in 2012 in Paris (France), after which she completed a 2-year fellowship in abdominal imaging at Pitié-Salpêtrière Hospital in Paris. She has also completed a PhD in advanced liver imaging, from Paris Diderot University. She joined the Cancer/Body Imaging group in November 2014. Her current projects include assessment of advanced MRI sequences/post-processing in chronic liver disease, hepatocellular carcinoma, Crohn’s disease and prostate cancer.

Sonja Gordic, MD

Sonja GordicSonja completed her training in Radiology at the University Hospital of Zurich, Switzerland, and has been awarded a grant from the Swiss national Foundation. She joined the Cancer/Body Imaging group in 2015. She is involved in projects including evaluation of advanced MRI sequences for assessment of hepatic neoplasms, HCC response to locoregional therapy and renal transplant dysfunction.


Paul Kennedy, PhD

Paul KennedyPaul received his PhD in Medical Physics from the University of Edinburgh, Scotland in December 2015, and will join the Cancer/Body group in April 2016. His work is focused on data acquisition, sequence programming and image analysis to assess MRE and ultrasound elastography for the quantification of physiologic changes in flow/perfusion and stiffness in the liver and spleen in relation with cirrhosis and PH. He specifically will focus on the development of advanced elastography sequences (3D EPI) and new algorithms for processing MR elastography data in the liver, spleen and kidneys.

Past Post-Doctoral Fellows

Hadrien Dyvorne PhD (Commissariat a l’Energie Atomique, Paris VI University, France)
Guido Jajamovich PhD (Columbia University)
Suguru Kakite MD (Tottori University, Japan)
Yong Cui, MD (Peking University, Beijing, China)
Riccardo Zanato, MD (University of Padova, Italy

Clinical Fellows/Residents

Idoia Corcuera-Solano, MD

Idoia Corcuera-Solano, MDIdoia obtained her medical degree at the University Of Barcelona in 2006 and completed her Radiology Residency at the Hospital de San Pau in Barcelona in 2011. She is currently a Cancer Imaging Fellow in the Department of Radiology and TMII. Idoia is currently involved in multiple clinical research projects in the field of oncology imaging mainly focused in the evaluation of advanced DWI MRI sequences for assessment of prostate and liver cancer neoplasms.

Grace Lo, MD

Grace LoGrace is a fifth-year resident in diagnostic radiology at the Icahn School of Medicine at Mount Sinai. Grace earned Bachelor of Science degrees in Biology and in Management Science at the Massachusetts Institute of Technology and has completed medical school and an Internal Medicine internship at the Icahn School of Medicine. Currently, she is a chief resident completing her radiology residency at Mount Sinai and is involved in MR elastography research with the cancer/body imaging group. She will be pursuing an Abdominal Imaging fellowship next year at the Massachusetts General Hospital.

Research Staff

Nikki Charles, PhD

Nikki Charles, PhDNikki is the clinical research manager for the Cancer/Body imaging group at TMII. Nikki received her PhD in molecular pharmacology from Weill Cornell Graduate School of Medical Sciences. She joined the team in 2014. She has general oversight of all clinical research studies for the Cancer/Body imaging group. Her responsibilities include assisting the development of study protocols, assurance of regulatory compliance, grant submissions and overall financial management of clinical studies. Her duties also involve management of oncology trials in support of the Cancer/Body imaging core and its goals.

Nelson Chen, MA

Nelson ChenNelson Chen is the research coordinator for the cancer/body group since August 2014. Nelson has a Master’s degree in Clinical Psychology from the Teachers College of Columbia University. His responsibilities include patient recruitment, assisting with regulatory submissions along with other miscellaneous needs of the lab.

Medical students

Shingo Kihira, MD

Shingo Kihira, MDShingo was born in Nagoya, Japan and raised in Menlo Park, CA for most of his life. He graduated from Baylor University in 2011 and worked in an oncology research lab at Stanford University for two years prior to commencing his medical training at the Icahn School of Medicine at Mount Sinai. His area of focus involves assessing portal pressures non-invasively through various imaging modalities and advanced technology. He has been a part of the Cancer/Body group since November of 2013.

Martin Kang

Martin KangMartin is a first year medical student at Mount Sinai. He studied Biomedical Engineering at Johns Hopkins University. He is interested in developing algorithms for computer-aided diagnosis.

Nicholas Titelbaum

Nicholas TitelbaumNicholas is a 2nd year medical student at Mount Sinai. He graduated from Yale University in 2014 with a BS in Molecular, Cellular, and Developmental Biology. He is currently working on diagonal DWI for prostate cancer as well as image assessment of HCC with DCE and DWI compared to HCC explant.

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    NY 10029
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