Radiology Department Report 2015–2017 Contents Letter from the Chair 2 Clinical Divisions 70 In Memoriam 6 Research Divisions 78 Canary Center at Stanford for Cancer Department Leadership 10 Early Detection 80 Feature: Medical ImageNet 85 Radiology Faculty 12 Integrative Biomedical Imaging Informatics at Stanford (IBIIS) 86 New Faculty Appointments 16 Molecular Imaging Program at Stanford (MIPS) 90 Faculty Retirements 28 Feature: The Richard M. Lucas Center for Imaging 103 Faculty Departures 30 Radiological Sciences Laboratory (RSL) 104 Feature: 52in52 31 Feature: The Project Baseline Study 111 Faculty Honors and Awards 32 Precision Health and Integrated Future Faculty and Staff 34 Diagnostics (PHIND) Center at Stanford 112 Equipment and Facilities 36 Active Sponsored Research 114 Feature: Cyclotron and Radiochemistry Facility 39 Translational Research 40 Radiology Snapshot 124 Microbubbles and Early Detection of Cancer 42 Illuminating Pain Generators with PET-MR 44 Thank You to Our Colleagues 126 Fluorescence Imaging 46 Stroke and Neuroendovascular Surgery 48 Donor Acknowledgement 128 Annual Report Team This Page 2017 Department of Radiology Group Photograph Executive Editor Training Programs 50 Supporting the Department 129 Clinical Training Programs 52 Sanjiv Sam Gambhir, MD, PhD Cover Research Training Programs 58 Canary Challenge 132 Top to Bottom: Editors Graduating PhDs 64 Susan Kopiwoda, MS, MPH 3D printed, high resolution, solid representation of airway; intended to demonstrate Trainee Honors and Awards 68 Rajan Munshi, PhD, MSIS bronchoscopic pathway to lesion (red). Hans Ringertz, MD, PhD Image courtesy H. Henry Guo, MD, PhD. Feature: 3DQ Lab 69 Deep learning model automatically detects and outlines tiny retinal hemorrhages, Copy Editors color coding suspected areas in color (red = suspicious), with the suspicious areas Judy Schwimmer, MBA, MA matching well that determined by an expert physician. Karen Aguilar Image courtesy the Rubin lab. Jim Strommer A coronal view of the brain showing color-coded orientations of white matter fiber pathways measured by diffusion MRI (blue:S-I; green: A-P; red: L-R). Design & Production Image courtesy the McNab lab. Amy Thomas Thin-slab volume-rendered image of CT Angiography heart and great vessels. Image courtesy Dominik Fleischmann, MD. Printing Lahlouh http://radiology.stanford.edu/about/annualreport/ From the Chairman THE STANFORD DEPARTMENT OF RADIOLOGY The second initiative, With the opening of many new facilities, and the expan- faculty. Each new faculty addition not only fills a par- continues to thrive in an ever-changing and challenging another major mile- sion of existing ones, our growth in space and facilities, ticular gap in a specific area in the department, but also world. In my last message to you through the 2014–15 stone in 2017, was in particular for our clinical needs, has been remarkable. brings fresh energy and an enriched perspective to the Annual Report, I shared examples of the department’s the launch of Project In recent years, we have experienced high growth of our team. Please see pages 16–27 for information about each achievements in multiple new areas of clinical, educa- Baseline, a collabora- Dr. Sanjiv Sam Gambhir clinical imaging capabilities. With the anticipated open- new faculty member—and be sure to keep an eye out Chair, Department of Radiology tional, and research expansion. This growth matches our tion between Verily/ ing of the Lucile Packard Children’s Hospital Expansion for them throughout your day and welcome them to our most aggressive expectations and positions the depart- Google (Alphabet), Stanford Medicine, and Duke in December 2017, the planned construction comple- Radiology family! ment to be an outstanding clinical and research entity University School of Medicine (page 111). The project will tion of the new Stanford Hospital in early 2019, the With a need to increase effi- at Stanford. gather comprehensive health information on 10,000 par- newly added outpatient sites, ciencies for a rapidly expand- ticipants to better understand health and the transition to and a commitment to keep- Implemented through our truly outstanding faculty, ing department, we have disease, including cancer and heart disease. ing our imaging sites up-to- staff, and trainees, we continue to push the boundaries restructured leadership as of date, we have purchased more . we continue to of what radiology, as a field, will offer in the years ahead. We have made remarkable progress in key research areas August 1, 2017: (1) Dr. Garry imaging equipment than ever Key themes of my chairmanship have included “Science that we believe are important to healthcare in the long- push the boundaries of Gold named Vice Chair of before (pages 36–37). During Without Borders”, which creates significant bridges to term. These areas include: (1) Early disease detection as what radiology, as a Research and Administration. the last three years alone, we scientific and clinical activities throughout the medi- one of our strategies for moving from precision medicine “ (2) Dr. David Larson named have acquired 15 new clinical field, will offer in the years cal school, affiliated hospitals, and across the Stanford towards precision health (e.g., early lung cancer screening). Vice Chair of Education and MRIs. Our ability to use the campus. Earlier this year, we formally announced two (2) Theranostics through the use of technologies such as ahead. Clinical Services. (3) Dr. most cutting-edge equipment important new initiatives: (1) The Precision Health and MR-high intensity focused ultrasound (MR-HIFU) and Juergen Willmann named Vice ensures that we can achieve Integrated Diagnostics (PHIND) Center at Stanford, through radiochemistry with imaging agents that serve SANJIV SAM GAMBHIR, MD, PHD Chair of Strategy, Finance and our commitment to the high- and (2) Project Baseline. While distinctly different ini- as both diagnostics and therapeutics. (3) Multimodality Clinical Trials. This newly est levels of patient care. ” tiatives, the PHIND Center and Project Baseline both imaging through strategies that combine the best of what formed leadership model will introduce new concepts to healthcare and build on the each modality has to offer (e.g., MR + PET; ultrasound + Regarding research space: We are in the process of share department responsibilities to begin a new era of long-held belief that precision health can help us move photoacoustics). (4) Bringing together in vitro diagnos- updating several sites, including the Lucas Center, the partnership with me in leading a radiology department away from the position of being more reactive to being tics with in vivo diagnostics for improved patient care Clark Center, and the Porter/Canary Center facility that is rapidly expanding on all fronts. There are sev- more proactive. Unlike precision medicine, precision (e.g., lung cancer detection and management through with upgrading, or siting new equipment (that is micro- eral other changes as well, including the naming of Dr. health focuses on risk assessment, prevention, and early the use of CT, PET-CT, and circulating tumor cells). (5) scopes, a microCT scanner, and magnetic particle imag- Heike Daldrup-Link, Associate Chair for Diversity; Dr. disease detection. We need to move the entire healthcare Increased clinical trials bringing new instrumentation and ing (MPI)). At the Canary Center facility, we are siting Wendy DeMartini, Division Chief of Breast Imaging; field towards a precision health strategy, and both the new imaging agents to the clinic. (6) Breast tomosynthe- new equipment ranging from imaging to mass spectros- Dr. Payam Massaband, Associate Chair and Chief of PHIND Center and Project Baseline will help us to do sis for improved breast imaging. (7) Pediatric oncologic copy to stereomicroscopy. To manage these very active Radiology at the VA Palo Alto Health Care System just that. imaging strategies with PET-MR that reduces radiation facilities, Dr. Heike Daldrup-Link, who was recently (VAPAHCS); and Dr. Christopher Beaulieu, Associate burden relative to PET-CT while still providing similar appointed to lead all Radiology small animal imaging Chair of Education (taking over for Dr. Michael Federle The new PHIND Center (page 112–113) is dedicated accuracy. (8) Novel strategies for improving cardiovascu- sites, works closely with Drs. Doyle, Pisani, and Habte effective January 2018). As we have further discussions to longitudinal monitoring and improvement of over- lar imaging including 4D visualization and 3D printing to keep all facilities operating at the highest level and on department leadership throughout this calendar year, all human health by studying the fundamental biology for improved patient care. (9) Imaging informatics/arti- to accommodate many users’ schedules and their varied there are likely to be additional changes announced later underlying early transitions from health to disease and ficial intelligence for extracting more useful information research needs. in 2017 and early 2018. the biomarkers of health and early disease. The long- from medical data/images as well as combining informa- term goal of the Center is to develop, test, and dissemi- The growth in our faculty is a reflection of the depart- Ten faculty searches are currently in progress and tion from different disciplines (e.g., genomics, pathology, nate the next generation of healthcare strategies and ment’s commitment to excellent patient care and advanc- include: (1) Three positions in Pediatric