• Physicians
• Arnab Chakravarti, MD
• Nina Mayr, MD
• John Grecula, MD
• Edward Kim, MD
• Simon Lo, MD
• Douglas Martin, MD
• Joseph Montebello, MD
• Residents, Fellows & Physican Assistants
• Physicists
• Dosimetrists
• Nurses
• Therapists
• Administration & Support

Specialty

• Board Certified in Radiation Oncology

Hospital Affiliation

• James Cancer Hospital
• University Hospitals
• University Hospitals East

Joined OSU

• 2004

Clinical Interests

• Imaging-Based Radiation Therapy
• Functional Imaging
• Neuro-Radiation Oncology
• Women's Cancers
• Proton-Particle Therapy

Research Interests

• Gynecologic radiation oncology
• Tumor imaging, Functional imaging
• MR imaging of early outcome prediction for women with cervical cancer

One of the greatest questions on the minds of our cancer patients when they face their cancer therapy is:  “Will the treatment work for me?”  Most commonly our answer is that we cannot predict therapy response, tumor control or survival in the individual patient.

In many tumors, we also have no real second chance at cure, once first-line therapy has failed.  Cervical cancer is such a disease, and there is no reliable means to assess therapy success until well after all radiation and chemotherapy has been completed.  If ultimate tumor control could be predicted early during the course of therapy, a window of opportunity would open to modify treatment strategy upfront and to individualize patient care. 

The goal of my research group is to develop and validate outcome predictors for ultimate outcome of radiation/chemotherapy, that are non-invasive and widely applicable, so they can be integrated into routine patient care.

Our predictors are based on radiobiological principles of hypoxia, tumor perfusion and on quantitative early tumor responsiveness determined by high-precision 3D tumor measurements.  In cervical cancer and many other tumors, blood perfusion and hypoxia during treatment are powerful factors influencing, how responsive the tumor is  to radiation and how effectively chemotherapy is delivered to the tumor.  Blood perfusion and hypoxia therefore critically affect the success of radiation and chemotherapy however, these parameters have been very difficult to measure in real patients and therefore have not been used in clinical decision making. 

Over the past decade, our Laboratory has developed non-invasive magnetic resonance imaging (MRI) methods to assess tumor perfusion and predict tumor responsiveness.  Our preliminary work shows that tumor perfusion parameters, assessed by our MRI methods, can predict primary tumor control and long-term survival in cervical cancer patients.  This predictive information is available as early as 2 weeks after initiating the 2-month radiation /chemo therapy course. 

The goal of our work is to develop a comprehensive non-invasive in vivo predictive assay and to determine the most powerful parameters from dynamic contrast enhanced MRI and 3D volumetric MRI, as well as non-imaging parameters, for prediction of long-term therapy outcome, and to integrate these methods effectively into the therapy regimen.

If prediction of ultimate treatment failure can be achieved sufficiently early, critical adjustments in first-line therapy can be made:  More intense therapy (e.g. higher dose of radiation, novel chemotherapies of clinical trial therapy) can be implemented in patients with a high risk of treatment failure.  Conversely, when therapy success is predicted, side effects from unnecessarily intense therapies can be avoided, treatment-related morbidity and health care cost may be reduced.  Early outcome prediction through refined predictive assays and therapy adaptation brings us closer to the goal of personalized cancer medicine.

Education

Selected Publications