Sunday 7th September 2008
Elliot R. McVeigh
Massey Professor and Director
Department of Biomedical Engineering
Johns Hopkins University School of Medicine
Dr. McVeigh received his undergraduate degree in Physics from the University of Toronto in 1984. In 1988 he obtained his PhD doing MRI research in the Department of Medical Biophysics at University of Toronto. Immediately following his PhD, Dr. McVeigh joined the faculty of Radiology at Johns Hopkins University School of Medicine, working with Elias Zerhouni to develop a research program in cardiac MRI.
In 1991 Dr. McVeigh founded the Medical Imaging Laboratory in the Department of Biomedical Engineering as part of a Whitaker Development Award. Many novel MR imaging techniques were developed during this period: myocardial tagging for evaluating local muscle contraction, myocardial perfusion estimates with dynamic imaging of contrast injections, and late enhancement imaging to clearly image myocardial infarction. These techniques form the foundation of the modern cardiac MRI exam. Dr. McVeigh's laboratory also demonstrated the ability of MRI to evaluate the benefit of Cardiac Resynchronization Therapy (CRT) in the failing heart; these studies were seminal in understanding how CRT should be used.
In 1999, Dr McVeigh joined the Laboratory of Cardiac Energetics at the NIH in Bethesda to develop a research program in cardiovascular interventional MRI. Working with clinical colleagues Dr. McVeigh's laboratory demonstrated numerous novel applications for the first time, three of which were: the first MRI guided injections of therapeutic agents directly into the myocardium, the first simultaneous electrical and mechanical measurements of cardiac function with MR, the first MR guided aortic valve replacement in the beating heart.
In 2007 Dr. McVeigh was appointed Massey Professor and Director of the Department of Biomedical Engineering. His vision for the department is to produce new knowledge from outstanding laboratories and facilitate the transfer of that knowledge into patient care at the fastest pace possible.
Using MRI to Understand and Treat the Heart
Elliot McVeigh, PhD
Over the past two decades MRI has contributed enormously to the progress in understanding the structure and function of the normal and diseased heart. MRI has the ability to measure morphology, blood and tissue velocities, myocardial strains, infarcted vs. edematous vs. normal tissue, dynamic uptake of contrast, dynamic imaging of interventions, …, and the list goes on. There is no other diagnostic or therapeutic modality that covers such a broad range of measurements.
High resolution MRI has been used to characterize cardiac fiber structure, microvascular structure, and the morphological shape of the heart. Dynamic imaging coupled with contrast injections have been used to identify regions of low perfusion; delayed enhancement is now the gold standard imaging technique for identifying myocardial infarction. Flow imaging has been used to characterize pressure gradients within the heart and vessels, and to investigate the response to stress. Numerous methods for characterizing the motion and contraction of the myocardium, and how that motion is related to electrical activity, have been developed. One application of these techniques is the investigation of the asynchronous heart; this has lead to a rational approach for the application of Cardiac Resynchronization Therapy (CRT). Realtime interactive MRI has been developed with the specific goals of measuring cardiac function in the unstable heart, and directing therapies such as myocardial injections, myocardial ablations, and valve replacement and repair.
The next phase of development in cardiac MRI will be the construction of a coherent approach to all of these measurements using a system that can perform these measurements without gating in breathing patients with little or no supervision from an imaging technician.