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Published in Alumni Publications on January 15, 2014

Research Roundup

Catch up on the latest findings from UMMC scientists

RADIOLOGIST’S SOFTWARE PROMISES TO AID MILLONS WITH LIVER DISEASE

Dr. Andrew Smith
Dr. Andrew Smith

New software by a UMMC radiologist that detects liver disease on CT scan images could lead to earlier detection and treatment of cirrhosis in potentially millions of patients.

Dr. Andrew Smith, assistant professor of radiology, got the idea during downtime on a flight for a radiology conference a couple of years ago.

“We know that the liver gets nodular in cirrhosis, and this is most obvious at the surface,” said Smith, director of radiology research and an abdominal imaging specialist. “I thought if we can define the edge in an existing CT image of the liver, we can look for and measure nodularity.

“I wanted something like the tool in Photoshop that can recognize and outline the edge of an object against a different background. Once we learned to detect the liver surface, we developed tools to measure the amount of nodularity.”

Scientists and physicians have long known that liver nodules, especially as they approach 1-2 millimeters in size, signal cirrhosis. But there was no way to accurately and reproducibly detect and measure them on routine CT scan images, so patients currently need an invasive liver biopsy to make the diagnosis.

“A liver biopsy is the bronze standard for diagnosing cirrhosis right now,” Smith said. “We call it bronze, not gold, because livers are heterogeneous and a biopsy is a tiny sample, so they don’t always accurately show what’s going on across the organ.

“Detecting and measuring liver surface nodularity on CT scan images offers a much less invasive test and allows us to screen for varices and liver cancer, common complications of cirrhosis.”

To write the software, he enlisted Ohio-based software development firm ImageIQ, a spin-off of the Cleveland Clinic. The team incorporated algorithms to detect the liver surface and measure nodularity.

Smith and developers at ImageIQ have been fine-tuning the program since March, putting it through multiple revisions so it can be ready for clinical trials.

Smith is processing hundreds of scans to validate the program, comparing the results with biopsies taken from the same patients.

Beyond screening general patient populations, radiologists could use the program to stage patients with known hepatitis risks. In follow-up, physicians could use it to tell how well therapies for liver disease work.

It’s a research tool, too.

“It could be used in drug clinical trials, which would move us away from doing multiple biopsies on participants,” Smith said. “The fact that UMMC supports innovation like this is very important.”

He spun off Radiostics LLC, his technology startup, from UMMC in 2013. With it, he plans to further develop the liver surface nodularity quantification software, launch prospective clinical trials and work on other ideas for advanced CT image processing he’s got cooking for detecting stroke, osteoporosis and cystic kidney and liver disease.

The company joins a growing list of biotech spinoffs at UMMC.

HEART STUDIES TIE BODES WELL FOR IMPROVED TREATMENT

Jones
Jones

A coalition announced in mid-November by the American Heart Association establishes formal research ties between the University of Mississippi and Boston University and their renowned population studies of cardiovascular disease.

The AHA-sponsored collaboration, with a placeholder name of Heart Studies v2.0, will add breadth to the two major population investigations, the Jackson and Framingham heart studies. It will allow researchers to more deeply analyze information collected in the studies’ extensive databanks.

Such research holds the promise of more effective and personalized medical treatments based on an individual’s genetic makeup, environment, history, particular disease sub-type and other variables.

“Thanks to the American Heart Association, this collaboration will allow the continued development of the science to better understand the causes of heart disease and stroke,” said Dr. Dan Jones, University of Mississippi chancellor and former Jackson Heart Study principal investigator.

“It moves us closer to the day when this leading cause of death can be prevented in more people.”

The coalition will be funded for five years at approximately $5-6 million annually with a five-year extension possible. In general, the funds will be invested in a combination of specific grant programs, infrastructure and a challenge program.

The Framingham Heart Study, founded in 1948 at Boston University, is the nation’s longest-running cardiovascular disease investigation. Its researchers have collected massive amounts of health data over the years from thousands of participants.

The Jackson Heart Study is the largest study in history to focus on the genetic factors related to cardiovascular disease in African Americans, a group which faces increased risk for heart disease and stroke.

The JHS draws together UMMC, Jackson State University and Tougaloo College. It has followed 5,300 African-Americans in Jackson for 13 years, while also analyzing the effects of lifestyle factors.

Jones helped establish the JHS in the late 1990s and served as AHA president from 2007-08. JHS researchers have identified links between social conditions and specific risk factors for diseases, uncovered differences in metabolic syndrome between blacks and whites, and identified how location of fat in the body affects African Americans – a topic previously characterized mainly in white people.

NORQUIST LEADS GROUP SEEKING TO BETTER HEALTH CARE

Norquist
Norquist

Dr.  Grayson Norquist, professor and chair of psychiatry, was named chair of the Patient-Centered Outcomes Research Institute (PCORI) Board of Governors by the U.S. Government Accountability Office on Sept 19.

The PCORI is an independent, nonprofit organization authorized by Congress that funds research to provide patients, their caregivers and clinicians with the evidence-based information needed to make better health-care decisions.

Norquist, whose appointment became effective Sept. 23, has been a member of PCORI’s board since it was first appointed by the GAO in 2010.

“Gray has dedicated his career to researching and improving health care for society’s most vulnerable populations,” said Dr. Joe Selby, PCORI executive director.

“The board, and the communities they represent, will be well served by his leadership in engaging patients and stakeholders and commitment to funding rigorous research.”

Norquist’s research focuses on the use of telemedicine to reduce disparities in mental health treatment for those living in the Mississippi Delta and to improve the quality of care they receive at local community health centers.

ANCIENT ALGAE TREATMENT COULD BOOST SENIORS’ HEALTH

Dr. Gailen Marshall displays immulina in its capsule form.
Dr. Gailen Marshall displays immulina in its capsule form.

If the algae spirulina built better health for centuries across ancient cultures, it might improve immune systems in today’s seniors.

A clinical trial still enrolling participants is under way in the Division of Allergy and Immunology to test the theory.

Spirulina is a type of blue-green algae rich in linoleic acids, B vitamins and a variety of minerals. While many recognize spirulina’s overall benefits for health, the UMMC study focuses on a more defined and at-risk group.

The pilot study at UMMC aims to identify whether and how much of the spirulina extract immulina it takes to improve the immune response of adults 60 and older. Seniors stand a greater risk for complications from colds, flu and other common infections.

“As people age, their susceptibility to mortality from influenza increases,” said Dr. Gailen Marshall, professor and R. Faser Triplett Sr. M.D. Chair in Allergy and Immunology. “Even the flu vaccine becomes less effective for them.”

Similarly, people’s immune systems weaken with age.

“If we can improve people’s immune system response with immulina, they may respond more robustly to the vaccine, which would better prepare their bodies to fight off the actual, live flu virus,” Marshall said.

He plans to enroll 50 people into the study. He began taking volunteers in August and will accept more on a rolling basis.

“I’ve collaborated for a couple years with Dr. Larry Walker and Dr. David Pascoe at Ole Miss,” Marshall said. “They’d been working with immulina for a while and have considered it for use in cancer patients.”

If the results show promise, Marshall will apply to the National Institutes of Health to fund an investigation of immulina’s abilities to boost the effectiveness of flu vaccines in seniors.

“That study would also consider whether immulina’s effects are different based on gender and race,” he said.

Those interested in the immulina pilot study can call the Division of Allergy and Immunology at 601-815-5374.