Francisco Contijoch, Ph.D.
Assistant Professor of BioengineeringEmbedded Files
CONTIJOCH RESEARCH LAB | $3.14M NIH GRANT
CONTIJOCH RESEARCH LAB | $3.14M NIH GRANT
Improved MRI Guidance of Pediatric Catheterization via Autonomous Multi-Beat Data Synthesis
Improved MRI Guidance of Pediatric Catheterization via Autonomous Multi-Beat Data Synthesis
Interview by Ben Smarr, Ph.D., Assistant Professor in Bioengineering and Halicioğlu Data Science Institute.
Engineers and physicians at the University of California San Diego have received a $3.14 million, five-year grant from the National Institutes of Health to help make MRIs a viable option for imaging during heart procedures in children. The team includes Francisco Contijoch, an assistant professor of bioengineering at the UC San Diego Jacobs School of Engineering, and Dr. Sanjeet Hegde, an associate professor of pediatrics at UC San Diego Health and Rady Children’s Hospital.
Heart disease remains one of the leading killers around the world. Despite its reputation as being full of fit surfers, San Diego also serves large populations of elderly, Hispanics, and others with higher risk of cardiac ailments. At UC San Diego, clinicians and researchers strive to develop new technologies that will stack the deck for better outcomes while integrating into the already complex routines of hospital medicine.
UC San Diego Professor Francisco Contijoch of the Department of Bioengineering recently received a major award from the National Institutes of Health for such an endeavor. Cardiac procedures, such as placing a stent in a blood vessel, often use x-ray imaging to guide the procedure. This delivers radiation to the patient which is particularly worrisome when treating young children, as they are more vulnerable to radiation, and may need multiple treatments throughout their lifetime. Rady Children’s Hospital San Diego recently created the Dickinson Image-Guided Intervention Center, the nation’s first state-of-the-art image-guided center for children. This facility houses an MRI scanner which can serve as an alternative approach for guidance of procedures. In contrast to x-ray imaging, MRI imaging does not deliver ionizing radiation but quickly making high quality MRI pictures is challenging.
Luckily, Prof. Contijoch and his clinical collaborators at Rady Children’s Hospital have developed new data processing techniques that could get more information – a clearer image – out of the MRI by continuously analyzing a patient’s heart and breathing motion. Similar to a self-driving car, which constantly analyzes the road ahead, Prof. Contijoch believes this approach can make the images crisper – enough so that they could help guide clinicians during sensitive cardiovascular procedures on children.
UC San Diego hosts experts at the forefront of both imaging technology and clinical practice. By working directly with Rady and faculty members in the Department of Pediatrics, Prof. Contijoch convinced the NIH that his was the right team to bet on. With the major award now in hand, he and his team are ready to begin testing what could prove to be a paradigm shift in safe childhood care for cardiovascular medicine.
As a junior faculty in Bioengineering with an interest in clinical translation, I got to sit down with Prof. Contijoch to ask him about how this all came together.
The research team on the new NIH grant to improve imaging during heart procedures in children: from left: Dr. Howaida El-Said, from Rady Children's Hospital and UC San Diego, UC San Diego Jacobs School bioengineering professor Francisco Contijoch and Dr. Sanjeet Hegde, from Rady Children's and UC San Diego.
Thanks for meeting with me Francisco. Congratulations on your award. How did you come up with this project?
Hi Ben. Sure. We actually came up with the technical solution when we were trying to solve a different problem: how to better image people with irregular heart beats. The lack of a consistent heart rhythm makes it hard to anticipate the next beat. So we came up with a method using cross-correlations that is pretty robust. It figures the patterns out pretty quickly, and you don’t need a pre-defined template.
How did you know this could help the imaging done at Rady’s?
Drs. Sanjeet Hedge and Dr. Kanishka Ratnayaka worked for several years to build the Dickinson Image-Guided Intervention Center and came to campus to talk about potential projects from the beginning. They had a vision to work with MR physicists to improve the MRI imaging components and as a result, we’ve been having weekly meetings for several years. The center took longer than we expected to build, like everything through COVID; but in the end, the Center really prioritized supporting research like ours.
I’ve never worked on imaging kids. By studying younger patients, we will also get to discover whether the patterns we see in adults change more with age than others realize yet. That could be a big help for getting better treatment outcomes for kids. That’s really motivating.
Advanced Flow Evaluations using MRI
Contijoch Lab ResearchI’ve also never worked on imaging where you are guiding a procedure in real time. When you are guiding someone as they move a device through a blood vessel, you don’t want a laggy video game, you know? Doing this – using MRI to guide cardiac procedures in kids in real time – really brings some new technical challenges. We need to make an image, process it, and send it back reliably within at most 100ms.
Is there a longer horizon here? Once this works, what is it building towards for you?
There’s a clinical bar that we want to hit that is currently set by X-rays. But MRI can also add new information that isn’t available with X-rays. For example, both X-ray and MRI can help us see where the devices are, but MRI is also great for measuring how blood is flowing. That lets a clinician see if things are healthy, or they closed a wound correctly – things that might let us do much better for the patient once we get over that initial bar.
Also, with a system like this, we can imagine building more features into the “self-driving” systems. We’re interested in making the instruments easy to see. At 100ms, you can’t draw an outline around the probe frame by frame like you can in the lab. But we could try to build those features into our tool.
It’s great that you and the Rady team found each other, but it sounds like a lot of pieces came together to make this possible. Am I seeing that right?
Yeah, it’s definitely true. This wouldn’t work without support from the folks at Siemens’ Advanced Cardiac MRI and the MRI Image Guidance teams. You can build something in the lab and say “hey, it works really well”, but getting it into an MRI system in the hospital where people can really use it is another leap. They have so much experience getting things translated quickly in hospital settings for real world use. We couldn’t hope to move as fast without their efforts.
The whole project is a really great example of a mutli-disciplinary collaboration. There’s industry, clinical, and bioengineers all coming together. Our Bioengineering Department has a history of collaborating with clinicians at Rady and I think that collaborative spirit lets us take on more challenging problems here, and it’s one of the great things about being at UC San Diego.
On a bittersweet note, the center was the vision and brainchild of Kanishka Ratnayaka, but he never got to see the Center operating [Dr. Ratnayaka passed away from cancer in December 2021]. His vision for what the Center could be and his work fund raising and designing the space made the current clinical work and our project possible. The other investigators and I can do all this work, but the ultimate credit really falls on Knishka. He left big shoes for us all to try to live up to filling.
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