As technology charges forward and science offers more avenues for exploration, new applications are often more limited by creativity than by basic knowledge. Creative minds thrive in all fields that require science’s application, and translational medicine is very much the same. Such creativity can be found in Sean Fain’s lab as he explores ways to enhance and create new imaging technologies to improve patient care.

As technology charges forward and science offers more avenues for exploration, new applications are often more limited by creativity than by basic knowledge. Creative minds thrive in all fields that require science’s application, and translational medicine is very much the same. Such creativity can be found in Sean Fain’s lab as he explores ways to enhance and create new imaging technologies to improve patient care.

“There’s the science of designing the technique, and for me that has to do with the engineering of the imaging method. But the art of understanding the biology means we use our creativity to understand how to apply the technology to make useful measurements,” says Fain, associate professor of medical physics in the University of Wisconsin School of Medicine and Public Health (SMPH).

The Five (current) dimensions of imagination

Such combinations of art and technology have produced once-amazing, now-commonplace technologies like magnetic resonance imaging (MRI). And as technology advances, so do the medical applications and assorted techniques.

We’ve long been familiar with 3-D imaging, visualizing tissues in three spatial dimensions to capture a whole volume of the body to better cover tissue of interest. But what about 4-D or even 5-D imaging?

“The concept of 4-D imaging is very simple; it’s imaging in three spatial dimensions. But we’re also interested in how that region and the disease are changing with time. That’s the fourth dimension,” says Fain. “4-D imaging is sort of a fancy term that has ‘gee-whiz’ impact, but we actually do 5-D imaging now. We add new dimensions of measurement it seems like every year.”

The fifth dimension Fain and fellow scientists are exploring is “functional” space. The way lung and diseased tissues respond to treatment and disease, like the inside of your lungs, is mostly gas space that looks black on an MRI.

To better visualize that space, something visible has to fill it up. Fain is experimenting with hyperpolarized gases - specially treated gases like helium or xenon that are up to 100,000 times more detectable under magnetic resonance imaging than normal gases.

By incorporating the three dimensions of spatial imaging over time with how these gases fill the lungs and dissolve in the blood (5-D), imaging specialists can visualize airways and lung function that have been impossible to see with standard MRI and other imaging technologies.

“We have these five degrees of freedom, and how do we use those degrees of freedom to understand disease mechanisms and disease progression? There’s the art. We know something about how cells and tissues respond to environmental challenges, such as allergic reactions in both disease and normal function,” he says. “How do we expect these signal changes to reflect lung disease such as asthma? That’s where we bring in the biology; we bring more creative aspects to bear.”

Bringing advances to the clinic

“What I like about the Wisconsin Institutes for Medical Research and what I like about how the School of Medicine and Public Health structures itself is that it tries to encourage new technology in the clinic,” says Fain. “They try to encourage people to translate techniques and move then into the clinic, and I think that’s the right direction.”

The challenge of translational research that’s maybe not fully appreciated is that scientists have to take a new method, show that it works in a preclinical trial, make sure it scales up the same way to a human subject, make sure the technique is safe, and make it integrate well into a clinical workflow.

This process takes time and effort and adds new expectations and dimensions the traditional research role to include financial, compliance and regulatory aspects.

Chronic diseases have a huge financial and time cost, and sometimes it’s hard to put a number on that cost in terms of patient quality of life, their ability to be productive, and how these diseases affect our society as a whole. But the question of what treatment costs is on the minds of not only patients, but also researchers.

“Can it be cost effective, as opposed to just saying, I can do this. Does it make sense financially? That’s a legitimate question. I think accountability is good, too,” says Fain, who is also vice chair for research in medical physics and director of the Image Analysis Core Facility within the SMPH.

“How is my taxpayer money being spent on research? I think this focus on transparency is great and I think that’s improving and a very good trend, but I also think you need to trust the system because the system itself has worked well in the past and it will work well in the future if we give people the space and time to be creative.”