Interview with Professor Odd Helge Gilja

Background Odd Helge Gilja became interested in photography, imaging and technology already in his childhood. Inspired by the pioneering nature photographer Sverre M. Fjelstad, who had very popular weekly programs at the only Norwegian TV channel at that time, Odd Helge purchased his first single-lens reflex camera (Konica T3) as a confirmation gift. Later, when he was a pupil at Fana highschool, Odd Helge joined the photography club “Spektrum”. Already in secondary school, he chose electronics as optional topic, demonstrating also an emerging interest in technology. -So, these early interests in technology and photography have also inspired you in your professional career as medical doctor? -Yes, I believe there is a link between my joy of observations in nature, where you have to use both your eyes and ears actively, and my observations of patients in the clinic. We do not only depend on instruments in the clinic, but are also aware of visible symptoms, e.g. skin spots or lesions, and the patient’s behavior and state. However, the ultrasound (US) scanner is a wonderful supplementary technology and gives the physicists many opportunities in both diagnosis and treatment. Actually, I had an early aspiration for studying at NTH in Trondheim before I decided to start my medical studies in Bergen. After my internship at SSSF in Førde in 1989 and following an initial resident period at Dept. of Medicine at HUS, I worked as research fellow at Christian Michelsen Research AS in 1993, financed by a fellowship from NTNF, to focus on the development of 3D US. This was indeed, a true combination of medicine and technology, and gave me further motivation for convergence and trans-disciplinary research between different areas of competence, Odd Helge tells.

Professor Odd Helge Gilja in action in the gastroenterology clinic at HUH.

Background for MedViz -Based on my previous good experience with CMR, I later was matched with Christopher Giertsen, who had been working on applications of 3D technology in oil wells. We joined forces in 2005, during the 75th anniversary of CMR, with the scope to establish a new concept in Bergen within advanced visualization and medicine, Odd Helge memorizes. -We talked to a huge number of potentially interested colleagues at UiB and HUS and decision makers (Kåre Rommetveit, Anne Kverneland Bogsnes, Odd Søreide, Stener Kvinnsland, Torleiv Kløve, Petter Bjørstad, Arvid Nøttvedt, Alfred Halstensen and others) and potential industrial partners (Nordic NeuroLab, GE Wingmed, Statoil, Norsk Hydro). Based on this idea phase, we published the report “Skisse til en ny Bergensbasert FoU- satsing innen analyse og visualisering av medisinske data” (Gilja & Giertsen, October 2005). The report gave an overview of several R&D groups dealing with research and development within analyses and visualization of medical data in Norway, with particular attention to groups in Bergen. We listed a number of work tasks to be carried out in order to develop a strong and coordinated Bergen research consortium, and concluded that an annual financing of 10 mill. NOK per annum in five years would be needed. We also established the vision: Å fremskaffe endtydige visuelle beslutningsgrunnlag for diagnostikk og behandling. Or in the English short version: From vision to decision.

Professor Odd Helge Gilja was one of the founders of MedViz and has since the establishment in 2007 been its chairman and scientific director. -Through good support from Arvid Lundervold, Elin Myhrvold Riple, Dag Magne Ulvang, Torfinn Taxt, Paul Ludvig Muren, Anfinn Mehus, Eduard Gröller, Knut Matre, Erlend Hodneland, Antonella Zanna Munthe-Kaas, Yngve Kvinnsland, Svein Ødegaard, Ola Øye and Renate Grüner, MedViz was established in 2006 and the first gathering was around a Christmas dinner, a tradition that still is alive. Ole Amundsen from the HUH Communication Dept. helped us in designing the MedViz logo. Our slogan From Vision to Decision can also be illustrated by the bird bearded vulture (Gypaetus barbatus, or ‘lammegribb’ in Norwegain) from Eastern Africa and Eurasia, with a wingspan up to 2,8 m. The bearded vulture has learned to crack bones too large to be swallowed by carrying them in flight to a height of 50–150 m above the ground and then dropping them onto rocks below, which smashes them into smaller pieces and exposes the nutritious marrow. This is the only living bird species that has specialized in feeding on marrow, and by help of its sharp vision, it takes quick and smart decisions, Odd Helge explains.

The MedViz slogan From Vision to Decision can be illustrated by the bird bearded vulture (lammegribb) Photo: OH Gilja.

-The first MedViz Conference was arranged at Villa Skjoldnes at Nordåsvannet in 2007, so in 2016 we arranged the 10th MedViz Conference. In 2008 we arranged theMedViz Opening Conference at Vil Vite Centre, formally opened by Stener Kvinnsland and including 72 participants. In June 2009 the Consortium Agreement was signed by our three mother institutions UiB, HUH and CMR. In the beginning, we had more focus on software development, however, this activity never grew to the expected heights, Odd Helge says.

Highlights and achievements by MedViz during the past 10 years -We have not succeeded in attracting really big funding to MedViz, even though we have applied for both SFF and Horizon 2020 financing. It seems like networking is a less valuated activity for the funding agencies. We are happy that Bergens forskningsstiftelse now is providing more funding to the visualization activities in Bergen by supporting a new medical visualization centre at the Radiology Department at HUH, a MedViz phase II one may say. -The monthly seminars and annual conferences have been the foundation of MedViz, as it created important meeting places for the visualization and imaging community. In this respect, I would particularly like to mention the EuroVis Conference (2011) and the combined MedViz + VCBM Conference (2016) as great international events in Bergen. We have also organized three Euroson schools in Bergen, which represent the highest accredited courses in ultrasonography. When it comes to project activity, we have previously established and financed 13 scientific projects from the seed money that we received from Helse Vest and from our mother institutions. Three of these projects have been further financed and developed into MedViz Lighthouse projects in the period 2014 – 2016. From these MedViz based platforms, the principal investigators and their teams have been able to achieve new financial support from various funding agencies. This demonstratedthat the basic MedViz funding was useful for further research funding and new innovation activities. The bridging money that we have given to support students in their intermediate phase between studies and PhD- or postdoc.-positions has also been a great success in order to withhold their competence in an academic environment in competition with industry during critical periods. 27 PhD students have furthermore carried out their studies in close association with MedViz and many of them have received direct economic support from MedViz in the period 2007 – 2016, Odd Helge tells.

-A highlight from 2013 is worth mentioning, namely when researchers from MedViz won the biannual, international competition organized by Eurographics Association, to acknowledge the contribution that computer graphics is playing in the medical field, and to encourage further development. In that year the Eurographics Medical Prize was renamed to honor Dirk Bartz who passed away in 2010. The 1st prize of the Dirk Bartz Prize for Visual Computing in Medicine 2013 was achieved by the contribution High-Quality 3D Visualization of In-Situ Ultrasonography, by the cooperative partners Ivan Viola, Åsmund Birkeland, Veronika Šoltészová, Linn Helljesen, Helwig Hauser, Spiros Kotopoulis, Kim Nylund, Dag Magne Ulvang, Ola Kristoffer Øye, Trygve Hausken & Odd Helge Gilja, Odd Helge adds.

-Another significant highlight in MedViz has been that we carried out the first study ever on the application of contrast microbubbles in therapy of patients with pancreas cancer. The vision of this concept was one of the cornerstones already in the early phase of MedViz. Now, we have received new financing through a prestigious project from NIH (USA): Optimizing US enhanced delivery of therapeutics (2016-2020), Odd Helge tells.

-I would also like to mention a few other initiatives, besides the success of the three MedViz lighthouse projects, where MedViz has been involved:

 Installation of PET-CT at the PET & Nuclear Medicine Center  NorBioImaging and EuroBioImaging networks  MedIm PhD research school where MedViz contributed with the chairman of the steering board

-A great challenge for the MedViz virtual research cluster is that we lack a physical localization in close vicinity of the different instrumental modalities in the clinic. This point was also concluded by a Nordic Evaluation Committee in 2013. Hopefully, the new Medical Visualization Centre at the Radiology Department at HUH will give opportunities for researchers to meet daily over a cup of coffee and deal with the future challenges in the hospital related to Man & Machine. It is a great pleasure for me, looking back and now handling the baton over to new Centre leader, Renate Grüner. I believe she will be able to build on the various resources in the MedViz network, most importantly the personal competences, and I wish her the very best, Odd Helge says.

Your main focus in the near future

-Now, that you have retracted from the position as Scientific Director of MedViz, what will be your main focus in the coming years?

-Research and medical aid in developing countries is a focus area close to my heart. I have been nine times in Ethiopia so far, to teach in ultrasound, endoscopy and clinical gastroenterology, and to carry out research activities on liver diseases and malignant hepatic carcinomas, predominantly caused by hepatitis B or C. A new treatment is based on a fungi extract (Andosan) that has shown promising results on animals by researchers from Oslo and Japan, and now also in Addis. Furthermore, we have given many courses both in Africa and in Europe, based on the unique competence in Bergen on gastrointestinal ultrasound, Odd Helge tells.

Professor Odd Helge Gilja gives lectures in ultrasound in Addis Ababa.

-However, my main activity will be here at Haukeland University Hospital as Director at National Center for Ultrasound in Gastroenterology, Department of Medicine, combined with my work in BRUSE – Bergen Research Group for Gastroenterology, an activity anchored at K1, UiB, where we are dealing with diseases in the liver, the pancreas and the gastrointestinal tract. There are many functional aspects of the bowel and the intestines that need more dedicated research. Ultrasound helps us in discriminating between organic and functional disorders. Contrast- enhanced ultrasound and elastography are also important areas of research. The contrast agents are not only used as diagnosticum but also as therapeuticum. Our activity in this area has given us international attention and recognition because we are in the forefront of research. As President of EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) I also have the opportunity to disseminate information about ultrasound to a wide audience and form European policy on important aspects of education. A significant part of my continued activity will also be devoted to running courses at national and international levels for medical students, where the new and small handheld ultrasound scanners have stimulated my combined interest for medicine and technology. The strength of the Bergen ultrasound milieu is the great spectre of competence in methods, cell lines and both preclinical and clinical aspects, or in short, we contribute to better images for better patient treatment, Professor Odd Helge Gilja concludes.

Professor Odd Helge Gilja also teaches in colonoscopy in Addis Ababa .