Precision Imaging: The Backbone of Modern Cancer Medicine

July 3, 2018 | by Alison Shore

Ammar Chaudhry Ammar Chaudhry, M.D.
Ammar Chaudhry, M.D., is a full-plate kind of person, which begs the question: When does he sleep?
Chaudhry, the director of City of Hope’s precision imaging lab, and associate director of research in radiology and imaging informatics, aims to implement a “gold-standard program” for diagnosing and treating cancer using precision imaging.
It’s just one way in which Chaudhry hopes to further our understanding of cancer and other life-threatening diseases.

Early Excellence

At City of Hope, Chaudhry works with a team of heavy hitters (Behnam Badie, M.D., chief of neurosurgery; Andrea Bild, Ph.D., professor in the Department of Pharmacology; Michael Caligiuri, M.D., president of City of Hope National Medical Center and the Deana and Steve Campbell Physician-in-Chief Distinguished Chair; Sumantha Pal, M.D., co-director of the Kidney Cancer Program; Steven T. Rosen, M.D., director of the comprehensive cancer center and the Irell & Manella Cancer Center Director's Distinguished Chair; and Vijay Trisal, M.D., chief medical officer and the Dr. Norman & Melinda Payson Professor in Medicine).
In addition to his collaborations with former colleagues at Johns Hopkins and Stanford, Chaudhry is embarking on new research endeavors involving the Oncology Research Information Exchange Network, studying ways to optimize imaging equipment and methods.
I want to help City of Hope become the star of imaging,” he said.

A Vision for the Future

The seemingly indefatigable Chaudhry is also assistant cinical professor in the Department of Diagnostic Radiology at City of Hope, as well as at the University of California Riverside College of Medicine, where he recently received the Research Mentor of the Year (2018) award.
With the support of a four-year K-12 Paul Calabresi grant, he is currently investigating imaging biomarkers and a new imaging contrast agent for the assessment of CAR (chimeric antigen receptor) T cell therapy, an immunotherapeutic approach in which a patient’s own immune system is trained to fight cancer.
So, when does he sleep? “At night,” he quipped. “I get only four hours of sleep right now, but it’s solid, uninterrupted sleep. Still, when I wake up, it feels like only a second has gone by!”
We spoke with Chaudhry about his work and his vision for the future of precision imaging.
Tell us about your primary responsibilities as director of the precision imaging lab.
It’s a team effort, with multiple institutions and team leaders contributing. In this regard, I am directly involved in developing a state-of-the-art imaging core at City of Hope that will make us the leaders in cancer and diabetes diagnostics and therapeutics and redefine standards of care. We want to develop the next generation of diagnostic imaging sequences, which provide information about a tumor's genetics, metabolomics and its microenvironment, an understanding of which is integral to patient care. Finally, we are trying to develop new targeted MRI and PET imaging agents that can be used for both diagnosis and therapy, a field known as theranostics.
Can you go into more detail about the goals of the lab?
The optimal goal of our imaging equipment is to add specificity to a diagnosis. For example, current technologies are sensitive in detecting a lesion, but they fail to tell us about the genetic makeup of a tumor. The “next-gen” techniques are intended to add specificity to cancer diagnoses. This is the definition of precision imaging and it is what I envision as the backbone of precision medicine — treatment that employs genetic-mutation-specific agents. You can’t have precision medicine without precision imaging.
Are institutions required to follow general standards regarding the updating of imaging equipment/facilities?
The American College of Radiology (ACR) sets the standards. Every facility in the United States must be approved by the ACR. Although the gold standard has yet to be defined, anything older than four years should not be termed “state of the art.” These days, state of the art would encompass equipment that can detect genetic mutations by finding the genetic information behind the imaging pixels.
Tell us something about your education and what got you where you are today.
A lot of people in med school felt their undergraduate education was a waste of time. I didn’t feel that way at all! I was a double major at St. John’s University — biology and physics — with a minor in chemistry. All of these help me now: The physics behind magnetism and quantum theory help in developing imaging techniques, biology lends understanding to humans and disease mechanisms, and chemistry is invaluable in my current efforts to develop both an MRI contrast agent that is less toxic than the one currently used and will target cancer more specifically and a theranostics agent.
You’ve published extensively — any recent research you’re particularly proud of?
The results of a trial evaluating the use of a new imaging technique, CISS MRI (a more sensitive imaging method than MRI alone), have been published in The American Journal of Neuroradiology. We were able, for the first time, to identify stellate ganglion and the sympathetic chain using CISS MRI, a finding that will be instrumental in managing various conditions, especially lung cancer in patients with Pancoast tumors.

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