Cardiac imaging took a major step forward when Elliot R. McVeigh, M.D., Ph.D., used a $90,000 RSNA GE Medical Systems/RSNA Research Scholar Grant that enabled a groundbreaking, two-year study of myocardial tissue tagging — the first noninvasive method of measuring strain in the myocardium.

Elliot R. McVeigh, M.D., Ph.D.
The Johns Hopkins University School of Medicine

Elias A. Zerhouni, M.D.
Former NIH Director

The full impact of this novel imaging technique will come into focus as more cardiac patients are referred to MR imaging. Dr. McVeigh developed the imaging technique for obtaining high-resolution estimates of strain as a function of position in the myocardium. The method involves placement of a "tag" in a thin slice of myocardium using a spatially selective radiofrequency (RF) pulse that is perpendicular to the imaging plane. The motion is then tracked.

"The primary goal of the study was to show that we could measure myocardial function at different depths within the heart wall and get endocardial versus epiocardial function," said Dr. McVeigh, Massey Professor and Director of the Department of Biomedical Engineering at The Johns Hopkins University School of Medicine since 2007. "It was a big step forward."

The 1990 study, "High Resolution MRI of Myocardial Deformation," allowed identification of myocardial deformation in previously inaccessible areas of the heart and was the springboard for an additional 15 years of National Institutes of Health (NIH)-funded research on myocardial tagging—now the gold standard for measuring cardiac function.

"Unfortunately, the analysis is so time intensive that it has not been adopted in clinical practice," Dr. McVeigh said. "But most studies that test new methods for studying myocardial function, such as echocardiography techniques using speckle tracking, will use myocardial tagging as the 'gold standard.'

"Right now, one of the primary applications for the technique is examining the asynchronous myocardial function in patients with heart failure and determining who is likely to respond to cardiac resynchronization therapy," said Dr. McVeigh.

RSNA Grant Launches Career, Funding

The RSNA Research and Education (R&E) grant served as the stepping stone for Dr. McVeigh's subsequent research, which totals more than $20 million in individual funding and approximately the same amount as a co-investigator. It also helped launch his research career at The Johns Hopkins University School of Medicine in 1988.

"It was a big deal to get that RSNA grant," he said. "It essentially secured my position at Johns Hopkins at the time. I had just earned my Ph.D., and it gave me the confidence to communicate the importance of my research to reviewers."

Although Dr. McVeigh originally planned to spend only one year at Johns Hopkins, he ended up staying a decade, starting as an instructor and assistant professor in the Department of Radiology and later becoming an assistant professor in the Department of Biomedical Engineering. In 1999, he moved to NIH, where he served as a principal investigator for the National Heart, Lung and Blood Institute until returning to Johns Hopkins in 2007.

Major highlights of his years of research include working with former NIH Director and world-renowned radiology researcher Elias A. Zerhouni, M.D., to develop a research program in cardiac MR imaging. He also founded and ran the Medical Imaging Laboratory at Johns Hopkins, a joint effort of the Biomedical Engineering and Radiology Departments, until he joined NIH in 1999.

Also at NIH, Dr. McVeigh helped develop several new MR imaging techniques including methods for performing interventions under MR guidance.

"When you're a principal investigator at NIH, your main job is to do research and publish," said Dr. McVeigh. "It's an absolutely wonderful environment. It's like nirvana."

Research Continues in Surgical Planning, Mitral Valve Repair

Today Dr. McVeigh continues to juggle research and administrative duties.

"Research and new technological innovations in imaging are what I do when I'm not being chairman of my department," he said. "I don't have as much time, but I enjoy working with younger faculty and still have graduate students. I do investigative work in interventional MR, developing techniques for surgical planning and mitral valve repair, as well as guiding bronchoscopic biopsies of cancer and helping develop techniques for making high-resolution MR from data which has motion compensation techniques applied to it," Dr. McVeigh continued. "I'm still doing a lot of research."

Zerhouni Influences Career

In his 1991 research paper, "Noninvasive Measurement of Transmural Gradients in Myocardial Strain with MR Imaging," published in the September issue of Radiology, Elliot R. McVeigh, M.D., Ph.D., and co-author Elias A. Zerhouni, M.D., presented a method for performing high-resolution strain measurements by using MR tagging. In vivo data produced with the multispectral radio-frequency pulse tagging sequence. Nine time points (25, 55, 85, 115, 145, 175, 205, 235, 265 msec) were measured through the systolic interval in the normal dog. (t = 0 was at the initial upslope of the R wave in the QRS complex.) The voxel dimensions were 0.6 x 1.2 x 5.0 mm, collected with a 256 x 128 matrix and four signals averaged. The phase-encoding direction was horizontal in these images. The total imaging time was 46 minutes. The tags were separated by 4.0 mm. To view the study, go Radiology.RSNA.org/content/180/3/677.full.pdf+html

Looking back, Dr. McVeigh feels fortunate to have spent the bulk of his career at Johns Hopkins and credits Dr. Zerhouni, who initially hired him, as being highly influential in setting him on that course. This year, Dr. Zerhouni, who spent much of his career as a professor and chairman in the Department of Radiology at Johns Hopkins, returned as senior advisor.

"Johns Hopkins is an extraordinary environment for a young person starting a research career because you have so many very experienced, generous scientists who help you launch your career," Dr. McVeigh said. "Dr. Zerhouni was one of those people. He was like my big brother in a way. He introduced me to so many good people and encouraged me to interact with them."

Dr. Zerhouni recalled his first impressions of meeting Dr. McVeigh.

"Elliot, a freshly minted Ph.D., from Toronto, was the first colleague I had in building the MR imaging research division at Hopkins," said Dr. Zerhouni. "I could not have asked for a better scientific colleague and life-long friend. Elliot brought the rigor of the physical sciences to radiology research at Hopkins and was the key to the creation of the imaging program in biomedical engineering—all with an unparalleled grace and generosity. He proved the power of interdisciplinary collaboration, and my own research would not have been possible without him."

As a Canadian, Dr. McVeigh is particularly thankful the grant was not restricted to U.S. citizens.

"The fact that it was available to someone living in the U.S. on a work visa made it possible to capture that talent and bring it to the U.S.," he said. "Which is what we want to do, right? We want to be able to work with the best minds from around the world.

"Awards like the RSNA grant are absolutely essential for launching the careers of young people," said Dr. McVeigh.