Department of Radiology and Biomedical Imaging
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DEPARTMENT OF RADIOLOGY AND BIOMEDICAL IMAGING 2019–2020 Above: Transverse (top row) and coronal (bottom row) PET/CT images obtained after administration of 89Zr-DFO-VRC01, a radiolabeled broadly neutralizing antibody against the HIV envelope protein gp120, in a HIV patient on antiretroviral therapy (ART). The left panels are CT images, the right panels are PET images and the center panels are colorized PET images overlaid on the CT image. Uptake of the labeled antibody in the spine may be related to the persistent HIV reservoir. On the cover: Erika Padilla-Morales, CNMT, Nuclear Medicine Technologist, Molecular Imaging and Therapeutics, UCSF China Basin Imaging Center (photo by Marco Sanchez, UCSF Campus Life Services) Executive Editor: Christopher Hess, MD, PhD Managing Editor: Katie Murphy Editorial Consultants: Daniel Dominguez-Moncada, Rita Gaber, Clinton Louie, Hanh Ryan Editorial Assistant: Luisa Delgado Copyediting: DEF Communications Design: Laura Myers Design © 2020 The Regents of the University of California TABLE OF CONTENTSTABLE In This Issue MESSAGE FROM THE CHAIR 2 Dr. Chris Hess reflects on the department’s recent accomplishments CLINICAL AND RESEARCH NEWS 4 Molecular Imaging of the HIV Reservoir: A First-in-Human Study 6 UCSF Launches Artificial Intelligence Center to Advance Medical Imaging 10 Peripheral Nerve Ultrasound in Clinical Practice 11 Augmenting Radiology: Using Augmented Reality Tools for Education and Clinical Care 12 The Promise and Perils of Molecular Diagnosis and Therapy 13 UCSF Radiology Faculty Support Global Health Efforts DEPARTMENT UPDATE 18 New Faculty 21 Departmental Strategic Planning 22 A New Clinical Section: Molecular Imaging and Therapeutics 24 New Appointments 25 2019 Retirements 25 In Memoriam EDUCATION 29 Radiology Training Programs 2019-2020 31 PGY-2 Residents: Class of 2023 34 Goldberg Center for Medical Student Education 35 Masters of Science in Biomedical Imaging – Learning the Fundamentals of Medical Imaging 36 A Focus on Diversity and Inclusion 37 Margulis Society 38 Alumni News 40 Honor Roll of Donors 41 Radiology Continuing Medical Education PHOTO GALLERY 42 Department Highlights RESEARCH 44 Improving Care Through Research 45 Neuro Research Group 46 Body Research Group 48 Vascular and Cardiac Research Group 49 Advanced Imaging Technologies Specialized Research Group 50 The Center for Intelligent Imaging (Ci2) 51 Chemistry, Probes and Molecular Therapy Specialized Resource Group CLINICAL SECTIONS 52 Abdominal Imaging 52 Breast Imaging 52 Cardiac and Pulmonary Imaging 53 Interventional Radiology 53 Molecular Imaging and Therapeutics 54 Musculoskeletal 54 Neuroradiology 55 Neuro Interventional 55 Pediatric Radiology 56 SFVAMC 56 Zuckerberg San Francisco General IMAGES 2019–2020 1 MESSAGE FROM THE CHAIR Dear Friends: hen I wrote this letter in late February 2020, conversion of radiograph images to an electronic COVID-19 cases were relatively few in format (PACS) occurred over 30 years ago. Our W San Francisco. Much has changed in recent field has become exceptionally skilled at delivering weeks across the U.S., and the story of COVID-19 predictions and guidance for individuals. For what is still unfolding in our city and in California. While medical questions do you seek answers: The the pandemic has consumed much of our present appropriate treatment for a patient presenting with a attention and is reshaping UCSF as I write now, this stroke? Predicted response of a cancer to surgery issue of Images reflects on our accomplishments in or chemotherapy? The extent of injury or prognosis the past year, which was outstanding for the UCSF after traumatic injury? The minimally invasive treatment Department of Radiology and Biomedical Imaging. with the best outcome? The Center for Intelligent Several recent accolades illustrate the achievements Imaging will develop and apply AI to devise powerful of our faculty and trainees. Doximity once again new ways to look inside the body and to evaluate recognized our residency as a leading training program health and disease. in the country. According to the latest data from No successful endeavor comes without challenges. the Academy for Radiology & Biomedical Imaging Chief among these: how to manage the growth of Research, for the first time our National Institutes of our clinical enterprise while maintaining focus on Health funding exceeded $56M, placing us second our academic mission. To this point, exam volume is in total funding to radiology departments nationwide. growing at a rate that is rapidly exceeding radiologist Overall, US News & World Report rated our hospitals capacity. Higher spatial resolution, multiple contrasts, among the nation’s top 10 and first in Northern volumetric acquisition with standard multiplanar California, bolstered by top-ranking clinical programs in reformatting and multi-modality techniques such as radiology. We have a lot to be proud of! CT/PET and MR/PET also continue to increase the But statistics and rankings fail to recognize the information content in each exam. The number of true excellence of our department’s people and images in a single cross-sectional examination has programs. As you will read in these pages, our grown by a factor of at least 10 for most of our studies, faculty, trainees and staff represent radiology’s elite. which greatly adds to “eye time” for our radiologists. Our department’s clinical, research and educational Some of our PET/MR examinations have over 10,000 programs define the standard of practice. Decades individual images! of energy and enthusiasm for innovation, the broad Further, the clinical expansion of UCSF Health international dissemination of our brand, and a thriving fuels the growth in imaging volumes. At our Mission and inquisitive work environment make UCSF the best Bay campus, the Precision Cancer Medicine Building place in the world to learn and practice the art and opened in the spring of 2019. Construction is almost science of Radiology. complete for the Weill Institute for Neurosciences, This year, the department launched the Center for which opens in late 2020, followed soon thereafter by a Intelligent Imaging, or CI2, to accelerate the application new psychiatry building and the UCSF Center for Vision of artificial intelligence (AI) in radiology, leveraging Neuroscience. A new outpatient building is planned at advanced computational techniques and industry Mission Bay, and UCSF Health is extending its practice collaborations to improve patient diagnoses and around the Bay Area. After upgrading our CT/PET care. (See feature article on page 6.) Through years capabilities this year at our China Basin Landing facility, of evolution, Radiology has become a central hub we will begin construction for additional MR and CT/ for information in medicine, always on the forefront PET scanners to our clinical space there. At Parnassus of digital innovation. As some of us recall, the first Heights, we completed an initial renovation to create a 2 IMAGES 2019–2020 MESSAGE FROM THE CHAIR more modern, patient-friendly face for the Department; our next Parnassus project will add PET/CT and MR equipment to meet patient needs. Even as our physical footprint in San Francisco grows, the institution is also expanding its reach outside of the city. UCSF Health opened its doors for primary and specialty care across the Bay at the Berkeley Outpatient Center, a joint venture with John Muir Health. The integration with the UCSF Benioff Children’s Hospital Oakland continues, and the health system has finalized formal strategic affiliation agreements with Marin General Hospital. We look forward to working with our colleagues, many of whom are also alumni, through these new affiliations and partnerships. While growth may be perceived as a challenge, it offers major opportunities. We are at a unique point in the history of our field, a time that requires us to re-imagine the practice of radiology. We will develop innovative ways to gather and assimilate data, to interact with and interpret images and other data, to deliver treatments precisely, as well as to communicate, deliver information, and improve our work climate. Critical to achieving these goals: training the next generation of radiologists and imaging scientists, recruiting and retaining the best minds in the field, providing the best possible clinical service to patients and investing in our research programs. As you read through the pages of Images, I hope that you enjoy these glimpses into the future of our field. To see this bright future for yourself, please feel free to visit us at any of the UCSF sites across the city, at Zuckerberg San Francisco General Hospital, or at the San Francisco Veterans Administration Medical Center. Christopher Hess, MD, PhD Alexander R. Margulis Distinguished Professor, and Chair of the Department of Radiology and Biomedical Imaging IMAGES 2019–2020 3 CLINICAL AND RESEARCH NEWS Molecular Imaging of the HIV Reservoir: A First-in-Human Study Denis Beckford Vera, PhD; Henry VanBrocklin, PhD; Robert Flavell, MD, PhD; Timothy Henrich, MD cquired immunodeficiency syndrome (AIDS), caused Broadly neutralizing antibodies (bnAbs), developed by by human immunodeficiency virus-1 (HIV-1), remains the Vaccine Research Center at the National Institutes of A a serious global health threat. According to Health, interact with the HIV envelope protein gp120 at UNAIDS global statistics at the end of 2018 (https://www. the CD4 binding site (Zhou, et al., Science 329: 811-17, unaids.org/en/resources/fact-sheet),