Any practice within an academic medical center provides best patient care only through keeping up with the latest in its respective specialty. UNC Radiology has done just that … for decades. The Department’s late Chairman Emeritus (1966 – 1991) Dr. James H. Scatliff acquired emerging US, CT and MRI technology in the 1970s and 1980s, redefining how present-day UNC Medical Center (UNCMC) provides Diagnostic Radiology services. World-renowned Body CT expert and Immediate Past Chair Dr. Joseph JKT Lee (1991 – 2006) created specialty-specific divisions, established subspecialty training and acquired significant clinical space during UNCMC’s years of fast-expanding imaging clinical programs.
Over my 12 years as Chair, I’ve upheld duty to my post in ways such as guiding the Department’s shift to informatics-driven imaging access and storage in the era of EHRs. When appointed UNC Faculty CEO in 2015, I had to balance overseeing imaging care with medical practice itself across UNC Health Care’s enterprise. Over the past few years, I’ve been accountable for sustaining quality imaging practice across our system’s 10 affiliates. Nonetheless, leading UNC Radiology’s growth in clinical practice remains at the fore. Our Department found answers in two distinctive areas in 2018: 1) advancing faculty procedural expertise to boost UNC Health Care’s referral care; and 2) immersion in outcomes-driven clinical trials.
For the 2018-2019 academic year, Associate Professor Dr. Kyung Kim is a Clinical Fellow on Boston Children’s Hospital (BCH) Interventional Radiology (IR) team. Over 12 months, Dr. Kim has significant training opportunity in treating rare pediatric vascular anomalies from BCH’s huge referral case load, both from institutions worldwide and New England-area states. He is also gaining leadership experience presenting case findings at BCH’s weekly vascular anomalies conference. Dr. Kim will return to UNC able to advance what our IR division offers in vascular anomaly care to families of pediatric patients at UNC’s Vascular Anomalies Clinic.
Recently launched industry-sponsored and federally-funded clinical trials are also keeping our Department strong in producing evidence-based procedural and technological answers that benefit our interests and the field itself. Currently, 13 Department clinical trials are open to patient accrual, with total accrual already at 1,130 enrollees. Six more are opening in the coming months. Not only has our team grown, but even more faculty members are starting to conduct funded clinical trials.
In early 2018, a successful pilot geniculate artery embolization (GAE) study to treat knee pain secondary to osteoarthritis earned Clinical Research Director Dr. Ari Isaacson an investor-initiated award from Medtronic, Inc. The pilot phase’s very positive results showed a significant decrease in patient pain and skin rash as the most common complication following the GAE procedure. Through the end of 2019, Dr. Isaacson is Sponsor-Investigator of a multi-institution, randomized trial examining use of GAE. Dr. Isaacson received additional industry funding in 2018 to conduct separate retrospective analyses studying effectiveness of radiopaque embolic beads (LCBead LUMI™) in: 1) interventional treatment of hepatocellular carcinoma; and 2) prostatic artery embolization (PAE) treatment for BPH.
In November 2017, a National Cancer Institute (NCI)-funded, five-year randomized mammography trial – Tomosynthesis Mammographic Imaging Screening Trial (TMIST) – comparing standard digital (2D) with tomosynthesis (3D) launched across 100 U. S and Canadian sites. In the year+ since launch, institutional PI and Breast Imaging Division Chief Dr. Cherie Kuzmiak has facilitated UNC’s success in becoming the lead TMIST recruitment site through enrolling over 1,000 subjects. Investigators will collectively continue to enroll subjects for the next several years until reaching approximately 165,000 women.
In late 2018, Dr. Yueh Z. Lee and multi-disciplinary colleagues received a collaborative, three-year Department of Defense (DoD) Defense Medical Research and Development Program Precision Trauma Care Research Award ($1.27M+/year). For multi-national military airfields lacking CT scanning, this team has produced solid-state, no-rotation carbon nanotube X-ray CT technology to test in battlefield triage of traumatic brain injury (TBI). Through Dr. Lee’s study involvement, UNC Radiology is contributing to imaging solutions for modern-era military medical research. Given the tremendous upswing in TBI research, we’re pleased one of our top clinical investigators is collaborating across the disciplines to generate neuroimaging solutions for improved diagnosis and triage of battlefield TBI.
Amidst all that Department Chairs have instituted over several decades, Dr. Lee’s 1990s creation of our Division of Research cannot go unmentioned. An immense base of biomedical imaging, epidemiology and radiochemistry funding has branded UNC Radiology’s top-tier reputation in pre-clinical research. Countless basic science accomplishments translationally pave the way for clinical successes. We must remember that imaging research itself is an equal pillar to patient care in how our Department upholds the University of North Carolina’s institutional reputation.