About

Dr. Smith is currently a Professor of Neuroradiology and Director of Faculty Advancement for the Department of Radiology. He served as the UNC Radiology Department Interim Chair from September 2019 through January 2021. Prior to this leadership position, he was the Department’s Executive Vice Chair (April 2018 to September 2019). His other past departmental leadership roles include: Director of Clinical Faculty Development (2018-2019); Vice Chair of Diagnostic Services (2015-2018); Director of Clinical Research (2015-2018); Vice Chair of Clinical Research (2011-2015); and Residency Program Director for the Diagnostic Radiology residency program at UNC (2007-2011). Dr. Smith completed a two-year Neuroradiology fellowship in 1995 and was recruited to join our faculty in 1998. He holds a PhD in physiology from Louisiana State University. His areas of research interest include normal brain development, physiologic imaging, and brain tumors. He is board-certified in Diagnostic Radiology and Neuroradiology. Dr. Smith is a Fellow of the American College of Radiology (FACR).

Contributions to Science

1. The study of normal and abnormal early human brain development represents a substantial technical challenge. We use high-resolution anatomic imaging, diffusion tensor imaging, and BOLD resting state fMRI to improve our understanding of early human brain normal and pathologic development and the relationships between structural and functional development. We extended these techniques to study disease states in humans with Autism, Fragile –X syndrome, the risk for schizophrenia, aging, and early dementia.

• Gilmore JH, Kang C, Evans DD, Wolfe HM, Smith JK, et al. Prenatal and neonatal brain structure and white matter maturation in children at high risk for schizophrenia. Am J Psychiatry. 2010 Sep;167(9):1083-91. PubMed PMID: 20516153; PubMed Central PMCID: PMC3105376.
• Gao W, Gilmore JH, Giovanello KS, Smith JK, Shen D, et al. Temporal and spatial evolution of brain network topology during the first two years of life. PLoS One. 2011;6(9):e25278. PubMed PMID: 21966479; PubMed Central PMCID: PMC3179501.
• Alcauter S, Lin W, Smith JK, Goldman BD, Reznick JS, et al. Frequency of spontaneous BOLD signal shifts during infancy and correlates with cognitive performance. Dev Cogn Neurosci. 2014 Nov 4;12C:40-50. PubMed PMID: 25459875. PMCID: PMC4830279
• Gao W, Alcauter S, Smith JK, Gilmore JH, Lin W. Development of human brain cortical network architecture during infancy. Brain Struct Funct. 2015 Mar;220(2):1173-86. PubMed PMID: 24469153. PMCID: PMC4850360

2. One of the challenges in the diagnosis and treatment of brain tumors is that many brain tumors appear similar on clinical CT and MRI images. It is difficult in many cases to distinguish between tumor recurrence following treatment, and some of the common post treatment effects, such as radiation or chemotherapy induced necrosis. We have used advanced imaging techniques, such as MR spectroscopy, MR perfusion, and diffusion imaging to improve pre-operative brain tumor diagnosis, and to assess tumor treatment response and distinguish between tumor recurrence and treatment effects such as radiation necrosis.

• Kwock L, Smith JK, Castillo M, Ewend MG, Collichio F, et al. Clinical role of proton magnetic resonance spectroscopy in oncology: brain, breast, and prostate cancer. Lancet Oncol. 2006 Oct;7(10):859-68. PubMed PMID: 17012048.
• Bullitt E, Lin NU, Smith JK, Zeng D, Winer EP, et al. Blood vessel morphologic changes depicted with MR angiography during treatment of brain metastases: a feasibility study. Radiology. 2007 Dec;245(3):824-30. PubMed PMID: 17954616; PubMed Central PMCID: PMC2615672.
• Huang BY, Kwock L, Castillo M, Smith JK. Association of choline levels and tumor perfusion in brain metastases assessed with proton MR spectroscopy and dynamic susceptibility contrast-enhanced perfusion weighted MRI. Technol Cancer Res Treat. 2010 Aug;9(4):327-37. PubMed PMID: 20626199.
• Anders C, Deal AM, Abramson V, Liu MC, Storniolo AM, et al. TBCRC 018: phase II study of iniparib in combination with irinotecan to treat progressive triple negative breast cancer brain metastases. Breast Cancer Res Treat. 2014 Aug;146(3):557-66. PubMed PMID: 25001612; PubMed Central PMCID: PMC4112043.

3. Many diseases cause damage or dysfunction in the brain in which the brain pathology is primarily or partially mediated through injury to the blood vessels and microvasculature. Examples include hypertensive encephalopathy, eclampsia, ischemic injury in aging, sickle cell disease and others. We have used advanced neuroimaging techniques such as high resolution MR angiography, MR perfusion and MR microvascular permeability estimates to improve diagnosis and understanding of these entities, and to allow for improved treatment monitoring. I use my background in cardiovascular physiology (PhD Thesis microvascular injury in ischemia reperfusion) and neuroradiology. 

• Brubaker LM, Smith JK, Lee YZ, Lin W, Castillo M. Hemodynamic and permeability changes in posterior reversible encephalopathy syndrome measured by dynamic susceptibility perfusion-weighted MR imaging. AJNR Am J Neuroradiol. 2005 Apr;26(4):825-30. PubMed PMID: 15814928.
• Bullitt E, Rahman FN, Smith JK, Kim E, Zeng D, et al. The effect of exercise on the cerebral vasculature of healthy aged subjects as visualized by MR angiography. AJNR Am J Neuroradiol. 2009 Nov;30(10):1857-63. PubMed PMID: 19589885.
• Vichinsky EP, Neumayr LD, Gold JI, Weiner MW, Rule RR, et al. Neuropsychological dysfunction and neuroimaging abnormalities in neurologically intact adults with sickle cell anemia. JAMA. 2010 May 12;303(18):1823-31. PubMed PMID: 20460621; PubMed Central PMCID: PMC2892214.
• Marks BL, Katz LM, Styner M, Smith JK. Aerobic fitness and obesity: relationship to cerebral white matter integrity in the brain of active and sedentary older adults. Br J Sports Med. 2011 Dec;45(15):1208-15. PubMed PMID: 20558529.

Personal Statement

I have clinical training in neuroradiology, with a basic science Ph.D. in physiology. My thesis work was related to the microvascular injury and response to ischemia-reperfusion injury. My clinical and translational research has focused in these areas: the study of normal and abnormal brain development, use of imaging techniques to improve diagnosis and treatment of brain tumors, and disease processes that cause brain injury mediated through damage to the brain vasculature. I also use my clinical training in medicine, radiology and neuroradiology to help non-clinical investigators assure studies are relevant to clinical human disease, insure human subject safety during imaging, assist with scan protocol selection and design, and to review images to identify and measure studied pathology and clinically significant incidental abnormalities in subjects at risk.

Ongoing and recently completed projects

5R01MH111944-05 Gilmore (PI) Role: Co-Investigator 07/01/2017-05/31/2022 The Origins of Preadolescent Risk for Psychiatric Disorders in Early Childhood Brain Development RDNN2017704/452056220 Lin (PI), Role: Co-Investigator 02/27/2017-09/30/2021 Interrelationships of Nutrition, Gut Microbiota, as well as Brain & Cognitive Development in Early Life Unassigned HU (PI), Role: Co-Investigator 06/01/2020-05/31/2022 A Study of Prostatic Artery Embolization for Benign Prostate Hyperplasia 5R01EB008374 Yap (PI), Role: Co-Investigator 04/01/2008-01/31/2021 4D Software Tools for Longitudinal Prediction of Brain Disease 5P30CA016086 Earp (PI), Role: Co-investigator 06/01/1997-11/30/2020 Cancer Center Core Support Grant