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"All good things are worth waiting for," Dr. Kamil Uludag said at the official opening of the Slaight Family Centre for Advanced MRI at Toronto Western Hospital, unleashing a new future for MRI research in Canada.
Dr. Uludag is a Senior Research Scientist at the Techna Institute, UHN, and cross-appointed to the Joint Department of Medical Imaging (JDMI) and UHN's Krembil Brain Institute (KBI). He was recruited in 2018, after an extensive two-year international search and was hired as the MR Methods Lead for the centre for his unparalleled expertise in MRI research and unique vision to bridge the gap between research and patient care.
"Many advanced MRI methods, analysis and equipment that have the potential to make a big difference in diagnosis are never translated into clinical practice – not because it's not possible, but because these two worlds are separated," says Dr. Uludag. "We now have an opportunity to change that."
The centre is now open and is breaking down traditional barriers between physicians, clinician-scientists and fundamental researchers – helping to bring new technologies and imaging techniques straight to the patient.
A fleet of four new MRIs have been operationalized at the centre. The Siemens 3-Tesla (3T) Vida along with two 1.5-Tesla Sola Magnets will be dedicated to clinical care – performing approximately 2000 exams per month. The Siemens 3T Prisma is solely dedicated to research and has already started welcoming research projects.
"In my mind, it is the best brain and spine scanner on the market," says Dr. Uludag. "The sensitivity of the scanner is much higher which means we will be able to see lesions much more accurately and reliably."
Some research projects could not have been implemented effectively on the old scanners. The Prisma will enable much more research than ever before and promote cross-collaboration between teams at UHN.
"There are a lot of researchers across UHN investigating the same diseases in different ways," says Dr. Uludag. "For example, cellular and molecular biology studies on epilepsy, neurodegeneration, concussions, which we also examine. My big scientific vision is to help combine clinical research at different spatial and biological scales.
"In other words, MRI alone will not be able to solve the mysteries of the diseases but the answers will only be obtained if MRI is involved."
The Prisma will not only support research activities locally, but nationally. And, for the first time at UHN, an MR physics team has been established to help Canadian researchers get the best data out of the scanner as possible.
"It is truly exciting to see that we have acquired the top-of-the-line neuroimaging equipment," says Dr. Gelareh Zadeh, Medical Director of the KBI, Head of the Division of Neurosurgery in UHN's Sprott Department of Surgery, Dan Family Chair in Neurosurgery and Wilkins Family Chair in Neurosurgical Brain Tumour Research at UHN. "Neuroimaging and neurosciences is really what binds all of the disciplines together and if you look at the past two decades, the biggest advances have come from being able to visualize the brain, the spinal cord and the nerves."
Dr. Mary Pat McAndrews, a neuropsychologist at UHN and a Senior Scientist and Head of the Division of Clinical and Computational Neuroscience at KBI, works with both the clinical and research teams at the centre. She uses functional neuroimaging to look inside the brain and understand things such as how memory and language are organized in a healthy brain and how diseases such as Alzheimer's and epilepsy might change those networks.
She also works with UHN neurosurgeons to help evaluate the potential risks involved with complicated brain surgeries.
"Now we have all the tools we need to do absolutely the best science with the best partners and deliver the kind of care our patients need," says Dr. McAndrews. "It's the dream team for me."
This dream team and dream facility became a reality because of the remarkable work done by the KBI, the Techna Institute, JDMI, and Facilities Management – Planning, Redevelopment & Operations (FM-PRO) at UHN.
Through UHN Foundation, close to $20 million was raised for the new centre, including a transformational $10-million gift from the Slaight Family Foundation, incredible support from Myron and Berna Garron, Michael and Sonja Koerner and donors in the community. These exceptional gifts helped bring the centre to life, providing patients with ultra-high-resolution images to improve detection, diagnosis and treatment for diseases such as dementia, arthritis, brain and spinal cord injuries.
"We have teams coming together to develop, optimize and create advanced technology that will support imaging patients in ways we haven't in the past – and we have the Slaight family and all of our donors to thank for that." says Paul Cornacchione, Senior Director, JDMI.
The centre will enhance UHN's existing city-wide collaborations in the field of MRI and help develop new ones. Dr. Uludag stresses the importance of coming together as a city to help solve some of the biggest mysteries in brain structure and function.
"We are up against some very complex diseases and with limited access to patients, we require collaboration across multiple hospitals in order to get the big numbers we need to characterize and understand pathologies, make accurate evaluations, and monitor therapeutic interventions," he says.
Among his many hats, Dr. Uludag is also playing a lead role in a collaborative new research group called the Toronto Neuro-Immunology/Imaging Consortium (TONIIC). TONIIC is a partnership of the University of Toronto Temerty Faculty of Medicine and six affiliate hospital research institutions with expertise in neuroimmunology and neuroimaging.
Funded by the Canada Foundation for Innovation, the project will bring new research equipment to the city including Toronto's first 7-Tesla (7T) MRI. The scanner will be used by researchers across the network to discover innovative approaches and solutions to complex conditions of the Central Nervous System (CNS).
The 7T has a magnetic field over twice as strong as the 3T machines, meaning it can produce much sharper images of the brain and central nervous system.
"Sometimes we need the increased diagnostic quality of the ultra-high field MRI to see lesions that help evaluate conditions such as concussions or epilepsy," says Dr. Uludag. "The 7-Tesla will offer that. It is a difficult scanner to use in terms of getting good data – but the bigger the problem, the bigger the gain.
"If we do everything right, we will get the best data available. I also see a lot of synergies between MRI methods developed for the 7T and translating the advanced techniques to improve imaging using the 3-Tesla."
He hopes that Toronto's 7T scanner will become one of the top three world-leading sites for clinical research.
Toronto's top healthcare teams are coming together to bring the best possible MRI research and technology directly to patients, and UHN is emerging as the not-so-invisible driving force behind it all.
"There will be many challenges ahead: it is easy to make bad research but excellent research is difficult," says Dr. Uludag. "I am very optimistic that we at UHN, as a collaborative and a city, will rise together and be an international leader in MR research and clinical application."