Three decades ago, engineers at GE research labs in Niskayuna, NY, built one of the first magnetic resonance machines and peered inside a colleague’s head. The result was the world’s first MRI image of the human brain. “This was an exciting time,” says John Schenck, a lead scientist on the project and also the test’s subject. “We worried that we would get to see a big black hole in the center. But we got to see my whole brain.”
That revolutionary picture may soon feel like a silent movie in the age of Avatar. A few doors down from Schenck’s office, who still works at the lab, is a new MRI system that could one day probe the microstructure of the brain with unprecedented resolution.
One group of researchers is looking at imaging the mobility of water molecules in the brain to better understand how the organ is wired, as well as the health and function of these connections, sort of a wiring diagram of the brain.
In the future, medical scanners could be used to study diseases ranging from stroke to Alzheimer’s, as well as depression. Take a look at some of the images captured by the team so far.
Scientists at GE Global Research are developing magnetic resonance methods to image the brain’s white matter tissue and study the organ’s structural connectivity. Today, 25 to 30 percent of all MRI scans are brain scans. As disease modifying drugs for neurodegenerative diseases become available, the use of these drugs is likely to require more frequent monitoring through repeated scans.
Top Image and GIF: This image shows complex patterns of connectivity of the human cortex measured in vivo with MRI via diffusion of water molecules in axons in the white matter. The colors depict average directional anisotropy of white matter voxels (fractional anisotropy of a diffusion tensor model) - blue: more anisotropic, yellow: less anisotropic. The data was acquired and processed on a GE MRI scanner at 3 Tesla (MR750), using diffusion spectrum imaging accelerated with compressed sensing, a technique developed at GE Global Research. Credit: Luca Marinelli, Ek Tsoon Tan
Bottom Image: Diffusion tractography of the brain, displaying some of the long white matter bundles (red: left-right, green: anterior-posterior, blue: head-foot). Visible are the cortico-spinal tract fanning out in the corona radiata (blue/purple), the long cortico-cortical association bundles (green), and ponto-cerebellar fibers (orange/red). The data was acquired and processed on a GE MRI scanner at 3 Tesla (MR750), using diffusion spectrum imaging accelerated with compressed sensing, a technique developed at GE Global Research.
“We’re looking at trying to decode the signals the brain sends and receives in controlling limb movement,” Ashe says. “If you can understand the brain’s language, you’ll be able to understand the nature of how one particular disease has affected a certain function.”
Ashe, an electrical engineer, reached out to Brown because of the university’s decades-long experience with brain implants. His team is contributing expertise in microelectronics and non-invasive, wearable and wireless medical devices. “Our sensor designs will be tiny, and they will be able to record the electrical signals coming from the individual neurons,” Ashe says. “Being able to record and separate the signals from the individual neurons, we can then interpret the information the neurons are creating and the functions their circuits should be producing.”
Ashe believes that scientists are on the cusp of understanding how groups of neurons work together to control brain function. “We know a lot about individual neurons, how they function and how they carry electrical and chemical signals, but we don’t know how they are all interconnected,” Ashe says.
The team will develop sensors that will allow scientists to record more neurons from more parts of the brain than ever before. They strive to develop a more complete understanding of how the brain communicates and, ultimately, devise improved ways to correct lost function. “We want to take that outside the body via an external device that can mimic these signals and restore motor control,” Ashe says.
A scientist works with a microelectromechanical systems (MEMS) wafer in the cleanroom at GE Global Research in upstate N.Y. GE innovations in micro-electronic design and fabrication has led to the development of tiny switches that could be a key component of implantable devices for the brain. Implants could benefit patients suffering from neurodegenerative disease as well as Alzheimer’s, Parkinson’s, and even depression.
Worldwide, there are over 450 million people living with neuropsychiatric and neurodegenerative diseases.1 The costs of caring for 14 million Alzheimer’s victims will likely exceed $1 trillion in the US annually over the next 40 years.2
GE has been working with universities, hospitals as well as the National Football League to better understand the brain.
For example, GE and the Icahn School of Medicine at Mount Sinai are developing technologies that blend neuroscience with new biomarkers and bio signatures. The objective is to eventually detect underlying cellular changes that lead to degenerative diseases like Alzheimer’s, so diagnoses happen earlier and treatments can be developed more effectively.
In March 2013, GE Healthcare and the NFL entered into a $60 million collaboration to speed diagnosis and improve treatment for mild traumatic brain injury for the benefit of athletes, members of the military, and society overall. The partners are also investing up to $20 million in an open innovation program called the Head Health Challenge to generate ideas for new and improved safety equipment.
Treating mental illness can be as difficult as it is living with it. Typically, finding the right drugs requires a hefty dose of trial and error, and arriving at the correct therapy can be a long journey that lasts for months or years.
Now a company called Assurex Health is trying to change that. It developed a set of diagnostic tools that could help doctors prescribe the right medication faster and more accurately. The technology is using patients’ own genetic material to study how they will respond to different drug treatments.
Assurex Health, which is based in Mason, Ohio, is a pioneer in a field of research called pharmacogenomics. Doctors use Assurex Health testing kits to swab and collect cells from inside of the patient’s cheek and analyze the DNA information for variants of genes that may affect a patient’s response to antidepressant, antipsychotic, analgesic and attention deficit hyperactivity disorder (ADHD) medications.
Assurex Health was formed to commercialize patented DNA testing technology from Cincinnati Children’s Hospital Medical Center and Mayo Clinic in 2006. The company is licensing the technology.
According to a story in the Cincinnati Enquirer, Assurex Health’s antidepressant and antipsychotic medication test called GeneSight Psychotropic now analyzes how 38 FDA-approved drugs will interact with eight genes. The resulting patient-specific report analyzes 785,000 possible gene variant-drug combinations to help doctors offer the right medicine.
More accurate prescriptions could significantly improve the lives of many patients. The National Institute of Mental Health estimates that about one in four Americans over the age of 18—more than 57 million people—suffer from a diagnosable mental disorder in any given year. These illnesses cost the economy around $300 billion annually. The Centers for Disease Control says that 11 percent of Americans 12 years and older take an antidepressant medication.
GE Capital sees Assurex Health’s potential. The GE financial arm acted as agent in a $25 million credit facility for the company to increase clinical adoption of its products. GE Capital says the funds will help develop the emerging personalized neuropsychiatric medicine market. “Our combination of healthcare knowledge and structuring expertise means our customers have access to the capital they need to fund growth and other strategic initiatives,” said Neil Bonanno, senior vice president of Life Sciences for GE Capital, Healthcare Financial Services.
Assurex secured a total of $32 million in financing in the latest round. Existing investors in the company include Sequoia Capital, Claremont Creek Ventures and others.
A powerful magnetic resonance imaging (MRI) machine developed by GE is using a magnet that can generate a magnetic field that’s 140,000 times stronger than the Earth’s magnetic field. It could be used by researchers to investigate diseases and disorders ranging from cancer and amyotrophic lateral sclerosis (ALS) – also known as Lou Gehrig’s disease – to brain trauma, epilepsy and autism.
At 7 Tesla (7T), the ultra-powerful magnet is almost five times stronger than magnets found in the majority of MRI machines used by doctors today. In fact, it is almost as strong as the 8T magnets guiding beams of high-energy particles zipping near the speed of light inside CERN’s Large Hadron Collider in Geneva. “We are pushing the limits of medical science,” says Baldev Ahluwalia, magnetic resonance manager at GE Healthcare. (Tesla is a unit of magnetic field strength.)
A side-to-side comparison of brain images generated by a 3T and a 7T machines.
Magnetic resonance is still a relatively young imaging technology, compared to, say, X-ray, which has been around for more than a century.
The first MRI machines appeared in the late 1980s and Ahluwalia says that advancements and improvements in MR are helping with medical diagnosis and disease evaluation. “There are a fantastic number of opportunities to be explored.” He says researchers can focus the 7T machine, called the GE Discovery MR 950*, to study tissues and anatomical differences in a way that they could not do before.
Dr. Michela Tosetti is the leader of a team of MR scientists at the IMAGO7 Research Foundation in Pisa, Italy, the home of the first European GE 7T machine. Her group has been using it to look for markers of neurodegenerative diseases like ALS and Parkinson’s and to study epileptic patients. They will start soon to look for brain tumor lesions in children.
Right now, there are no radiologic techniques to study Parkinson’s, a progressive disease with symptoms that include shaking, stiffness and impaired coordination. Clinicians must rely on medical history and neurological examination, which can lead to the wrong diagnosis. “With this technology, we can explore pathologies that we could not see before,” Tosetti says.
Dr. Mirco Cosottini, Tosetti’s colleague at the University of Pisa, used the 7T machine to study brains of 38 people, including 17 Parkinson’s disease patients and 21 healthy controls, as well as specimens from diseased individuals, to help determine the scanner’s accuracy. The team reported that they were able to distinguish a three-layered organization of the substantia nigra, a crescent-shaped mass of cells in the midbrain.
Parkinson’s disease results from the loss of cells producing the neurotransmitter dopamine located in this region of the brain. Cosottini believes the results show promise for earlier disease detection and treatment.
GE’s Ahluwalia says clinical research with the 7T could also help GE engineers and their research collaborators to optimize existing 1.5T and 3T scanners used by doctors all around the world. “The 7T gives us the ability to distinguish brain tissues at a significantly higher level of differentiation,” he says. “Since the 7T machines and standard clinical scanners share many of the same of components and electronics, we could then leverage the experiences and learnings from the high-performance 7T machines and optimize the 1.5T and 3T systems to look for the same tissue and disease differences - this could be a very powerful tool.”
This week, GE Healthcare and UK’s Tesla Engineering Ltd. announced an agreement to collaborate on the production of 7T magnets at the joint meeting of the International Society of Magnetic Resonance in Medicine (ISMRM) and the European Society of Magnetic Resonance in Medicine and Biology (ESMRMB).
Richard Hausmann, president and CEO of GE Healthcare, MR, said that the agreement with Tesla would allow GE to “deepen and broaden our collaborations with leading MRI academics and visionaries. The GE 7T community in the US, Europe and Asia has already demonstrated breakthrough observations and understanding of Alzheimer’s disease, traumatic brain injury and cognitive physiology. Together, we will continue to push the frontiers of MRI for neuroscience and other applications,” Hausmann said.
Tesla’s Dr. Simon Pittard says a 7T magnet, which is 11 feet long and weighs 40 tons, employs the same basic technology as a standard clinical magnet, but uses about 10 times more wire and stores approximately five times more energy than a 3T magnet.
Engineers must cool the 7T’s wiring to just 4 degrees Kelvin above absolute zero, the coldest temperature possible, to achieve superconductivity and generate the device’s powerful magnetic field. It takes at least two weeks and 10,000 liters of liquid helium to cool the magnet down. Dr. Pittard says it then takes about 40 hours to charge the magnet for use.
*GE Discovery MR 950 7T is an investigational medical device under the US Federal Food, Drug, and Cosmetic Act
Two days before Christmas 1895, shortly after Wilhelm Röentgen discovered X-rays by experimenting with a cathode tube in his laboratory, he invited his wife to experience the phenomenon. Anna Bertha Ludwig put her left hand inside his apparatus and became the first human to be X-rayed. But when she saw her wedding ring slipped over the bones of her fourth finger, her reaction was far from jubilant. “I have seen my death,” she exclaimed.
Röentgen became immediately famous but it was not until 1913 that X-ray imaging took off. That year physicist William D. Coolidge, a longtime director of the GE Research Laboratory in Schenectady, NY, invented the X-ray Tube.
A print of one of the first X-rays by Wilhelm Röntgen (1845–1923) of the left hand of his wife Anna Bertha Ludwig. It was presented to Professor Ludwig Zehnder of the Physik Institut, University of Freiburg, on 1 January 1896. Source: NASA
Coolidge kept perfecting his tube and received 83 patents for the technology. The tube effectively started radiology as a medical discipline and launched a series of innovations raging from the X-ray machine to computed tomography.
The latest in that line is GE’s Revolution* CT scanner, which was just cleared for use in the U.S. Where Roentgen and Coolidge could see just shadowy outlines of bones and organs, the new machine can image the heart in just one heartbeat.
In 1939, GE medical scanners produced X-ray images of mummies for the New York World’s Fair (above). Image courtesy of the New York Public Library.
The system uses high-resolution and motion correcting technology similar to the image stabilization features in personal cameras. The blend of speed and clarity is important because it allows doctors to retrieve sharper images with higher resolution at lower radiation doses.
Cardiologists can use the Revolution to image patients with high heart rates, oncologists can use its low-dose settings to study liver, kidneys, pancreas and other organs, and neurologists can quickly assess brains of stroke patients. “This will be the first CT scanner that’s right for physicians in every clinical specialty and provides answers from one CT exam,” said Steve Gray, president and CEO of GE Healthcare MICT.
On October 7, biologist James E. Rothman received the 2013 Nobel Prize in Physiology and Medicine together with colleagues Randy W. Schekman and Thomas C. Südhof. Rothman is a professor of biomedical sciences at Yale. Over the last decade he has served as a senior advisor to GE Global Research in Niskayuna, NY. He is also a former chief scientist at GE Healthcare. GE Reports managing editor Tomas Kellner talked to Rothman last week about his discovery, innovation, and GE.
Nobel laureate James Rothman worked as chief scientist at GE Healthcare. “In the university we talk a lot about collaboration, discovery through bringing together disciplines,” he says. “I have never seen it work anywhere as well as at GE Global Research.”
The Nobel committee is known in the U.S. for what may be the world’s most exhilarating wake up call. Where were you when you learned the news that you won a Nobel?
I was at home and I was in bed. The phone rang and there was a very pleasant Swedish voice bringing good news. It turned out that I had met the gentleman who was calling, Göran Hansson, at a scientific conference a couple of years ago. He is the Secretary of the Nobel Assembly at the Karolinska Institute in Stockholm.
The Nobel committee recognized you and your two colleagues for “solving the mystery” of how cells transport molecules like insulin to the right place in the cell and at the right time. Why is that important?
The body is made up of many different types of cells that make up your muscle, your liver or the nerve cells in your brain. These cells need to communicate with each other, otherwise they get out of synch and the liver won’t function like a liver.
Adding even more complexity, the different organs need to talk to each other. For example, when you eat a meal, your intestines are digesting the food and producing sugar that goes into the blood. The pancreas is detecting the sugar and secreting insulin to control and distribute the sugar throughout the body. There have to be signals or information flowing between the components of the system in order for it to function in a coherent way. Every electrical engineer will understand this. The work we have done has elucidated how those signals are produced and passed between cells.
It is interesting that you mention engineering. Your Nobel is in physiology and medicine, you studied medicine, but you left medical school and trained as a physicist.
I am not a physicist in any professional sense. But like many people at GE who are engineers, my initial education was in math and physics. I later moved toward molecular biology.
You said in an interview that what attracted you to molecular biology was the opportunity to find simplicity. Can you explain it? Biology seems inherently messy.
I’ve observed that biologists fall into two camps. There are those who seek simplicity and find it, and then there are those who seek complexity and revel in it. I know that sounds a little odd, but I think it’s true.
The goal of a complex system can actually be very simple. Its core function could be almost mechanical, like a little machine. In fact, we found that this is the case. Most of cell biology is carried out by proteins that are very complex on one level, but when you look at them through an electron microscope, they behave just like little nanomachines. So you have something than can be very complex, involving interactions of tens of thousands of atoms in multiple combinations and a complex interface between two proteins, or it can be conceptualized for example as a hammer hitting a nail, because one of the proteins looks like a hammer and the other looks like a nail.
You cannot get a simpler system than that.
If you have orientation to physics, where you always expect some simplicity and generality as distinct from the way biology is usually approached, it’s possible to make better progress in a complex field and cut through the fog more easily.
You could use these simple building blocks to create a much more complex picture and gain a deeper understanding.
That’s exactly right. The very complex behaviors of healthy and diseased organs are now being modeled increasingly using tools similar to what electrical engineers use. This approach extracts the essence and represents a profound simplification. This so called systems biology is becoming an important tool for example in the pharmaceutical industry. It will be an important clinical tool down the road for qualifying patients for treatments.
Such personalized medicine is a goal that GE is also pursuing. When did you start working at GE?
My history with GE goes back to early 2000s when GE acquired Amersham. That company brought to GE a great strength in life sciences. This truly differentiates GE from major industrial companies. I served for several years as chief scientist at GE Healthcare, which was then a new business formed by the combination of Amersham and GE’s imaging unit, GE Medical. I also started working in a high-level advisory role at GE Global Research (GRC). We essentially moved the Amersham research group from New Jersey to GRC and we’ve seen so many rewards from that move over the years.
Why was this move so important?
At first, the biologists were out in the left field and the GRC engineers didn’t really know how to relate to them even. They were working on two completely different sets of projects. But over the years we’ve seen the biology culture infuse and inform almost every aspect of research across the healthcare business. The development of digital pathology is an important example. Ten years ago we were not in digital pathology at all. If you think about it, that’s kind of interesting, because GE is a predominant company in the imaging space.
Can you explain the connection between medical imaging and pathology?
Pathologists use a microscope, rather than an MRI or ultrasound machine, to analyze a large numbers of cells. It’s subjective, it’s not digital, it’s qualitative, it’s all the things that radiology is not. But we were able to develop digital pathology because of the infusion of biology in the engineering.
Digital pathology paves the road for digitizing the pathology department. Once the environment is digital, data are created and stored in an archive in instantly manageable and accessible forms. This creates the platform for personalized medicine.
But this is just the first step. Step two is the development of molecular pathology at GRC, and that still continues. The acquisition of Clarient a few years ago was a major step in this direction. This is a big deal in clinical medicine and, eventually, cancer treatment. While digital pathology purely concerns capturing and storing microscope images of samples like tumor biopsies, molecular pathology images numerous potential cancer causing genes within the tumor, allowing pinpoint diagnoses and targeted treatments.
How often do you visit GRC?
I am usually in Niskayuna two days a month. I work very closely with the scientists and the advanced technology there, particularly John Burczak and Nadeem Ishaque, who are great leaders. I have the privilege of working with a great number of very talented people, including Mike Idelchik [vice president for advanced technologies] and Mark Little [GE senior vice president and chief technology officer], whose leadership is really quite extraordinary.
You have a busy academic career as chair of the cell biology department at Yale. What makes you go back to GRC?
Having had the experience of working with other companies as an adviser, I can tell you that there is no greater company in the world. It is absolutely my privilege to be a part of GE. The value system, the business focus, the innovation that goes on at GRC are all astonishing.
In the university we talk a lot about collaboration, discovery through bringing together disciplines. I have never seen it work anywhere as well as at GRC. The needs of the various business segments way outside of healthcare are appreciated by the people at GRC through the very nature of the lab. That sort of non-quantifiable knowledge has a way of leveraging across the whole of GE.
People who do not really understand GE describe us as a conglomerate. Sure, we are very broadly based. But what I see from the standpoint of GE Global Research is a company that has technology platforms that add enormous value that goes way beyond the conglomerate [label]. I see it every time I am at GRC and it excites me because I learn so much from my colleagues there.
How do you compare university research, or blue-sky research, and the type of research that goes on at GRC, which is looking for commercial applications? Are there benefits to having a product in mind?
Absolutely. GE does that so impressively.
Academia is largely supported by the public because of what you call the blue-sky aspect, with the hope that some of that will translate it into outcomes that benefit the society broadly. That of course happens.
GE Global Research has many, many tentacles and connections into the academia. GRC has labs all over the world and we have excellent relationship with excellent investigators at the top universities. We go to meetings, we publish, and we are understood to be leaders. That’s very important because it gives us visibility and it gives us access. It allows us to be part of the ecosystem in the way that we function, which is synthesizing the blue sky developments, the best of them, that occur anywhere in the world.
We take those developments, the best of them and we infuse them with the shorter term needs of the various businesses. Out of that ferment emerge projects that have perhaps a longer term timeline than what the business would ordinarily be excited about. It’s very powerful. I am not aware of any other large industrial that has the kind of leverage that we have.
Have you started working on your Nobel lecture? Do you have a topic in mind?
That’s a good question. The ceremony is scheduled for early December in Stockholm. I have not started working on my Nobel Lecture, which is a special lecture of more than average importance. This week there has been a lot of interest from the press. I trust that it will go away by next week as we become fish wrap.
I am also trying to get some sleep. I’ve been going on three to four hours of sleep all week. If I conveyed any measure of coherence today, that in itself should be worth of a Nobel Prize.
The technology, called Integrated Blast Effects Sensor Suite (I-BESS), uses vehicle and body sensors and computer analytics to record and time-tag information like blast force and direction from explosions caused by improvised explosive devices (IEDs). The Army plans to use the information to better diagnose brain injuries and choose the best treatment.
GE’s Intelligent Platforms unit is supplying the Georgia Tech team with a rugged, off-the-shelf computer system the size of a six-pack that can process large amounts of raw sensor data. The system gathers information from accelerometers, pressure sensors and other devices placed on the soldiers’ bodies and inside the vehicle. Such off-the-shelf systems help the Army to reduce development time and risk, and create a robust system that can quickly accommodate new devices and sensors.
The I-BESS sensors and computers have been designed to operate in harsh conditions. They can power through shock waves, vibrations, high G-forces, and extreme temperature swings. The sensors communicate with each other over standard wireless protocols like Bluetooth and RFID. They feed the information into the GE computer.
REF first approached the Georgia Tech Research Institute in 2011. The Army started deploying the first 1,000 I-BESS sensors last year.
This is not the first GE effort to better understand the brain. This spring, GE, the National Football League, and Under Armour launched a $60 million partnership designed to speed up the diagnosis and treatment for mild traumatic brain injuries and stimulate new research and innovation in the field.
In 1953, Russian archaeologist A. D. Stolyar excavated a group of 14 skeletons from a Mesolithic cemetery near Kiev, Ukraine. One of the skulls found at the 7,000 year-old site showed signs of trepanning, the surgical removal of a small piece of bone from the cranium. Some historians consider trepanation the oldest form of surgery and doctors today still drill holes in the skull to obtain and monitor essential information about brain pressure, also known as intracranial pressure (ICP). High ICP is a serious medical condition that can cut off blood supply into the brain and sometimes cause permanent damage to the nervous system and brain function.
ICP can rise due to the build-up of fluid or blood around the brain caused by head trauma, brain tumor, or swelling inside the brain. Monitoring pressure requires placing a catheter in the brain through a burr hole in the skull. But because of the risk of infection, doctors use such “invasive” monitoring only in the most severe cases even though more patients could benefit from the information. “Right now the main challenge with ICP is that the only good way to monitor it accurately and continuously is the invasive way,” says Guy Weinberg, chief executive officer of HeadSense, an Israeli startup that decided to put the drill aside and obtain ICP with sound waves.
HeadSense developed a set of disposable earbuds that emit a series of low-pitch beeps and record changes to the signals after they cross the brain. The headphones feed the data over a Bluetooth link to a tablet app that converts signal modulations to units of intracranial pressure in seconds. “This non-invasive system will allow doctors to monitor pressure continuously, determine whether medication is effective, and steer the course of treatment,” Weinberg says.
The HeadSense system is designed to listen for sound modulations caused by blood flow in the brain. As ICP goes up, blood vessels narrow to compensate for the rise in pressure, and send the pitch of the beeps higher. “It’s kind of like a pipe organ,” Weinberg says. “A pipe organ has pipes with different diameter that produce sounds with different pitch. This is exactly the same case.” The system also listens for bumps in ICP caused by breathing and feeds the data into a proprietary algorithm.
HeadSense tested and calibrated the system in human investigational trials in India, Armenia and Italy. The company just received financing by Pontifax, a leading Israeli venture capital fund, GE Ventures of Menlo Park, California, Everett Partners from Akron, Ohio, and JuMaJo, an investment group from Hamburg, Germany.
This 5,500 years old skull of was trepanned with a rock. The patient survived. Source: Natural History Museum, Lausanne Credit: Rama
Weinberg says that HeadSense will use the proceeds to obtain the necessary regulatory authorizations and bring the device to market. He estimates that in the U.S. alone there are over 3 million patients suffering from traumatic brain injury, stroke, and brain tumors, but only 200,000 receive invasive ICP monitoring due to high cost and the lack of neurosurgeons to perform the procedure. “High pressure [in the brain] is one of the most significant adverse outcomes that derive from head trauma, and one of the most serious conditions for US soldiers in Iraq and Afghanistan,” Weinberg says. “That’s why it’s so important to monitor it and measure it.”
Weinberg says that doctors are still looking at the brain like a black box. “With our device they can get a better understanding of the conditions inside and provide better and lower-cost treatment”.
Innovative headphones use sound to monitor pressure inside the brain. A tablet app then decodes the data. Obtaining the information would normally require drilling a hole in the skull.Innovative headphones use sound to monitor pressure inside the brain. A tablet app then decodes the data. Obtaining the information would normally require drilling a hole in the skull.Innovative headphones use sound to monitor pressure inside the brain. A tablet app then decodes the data. Obtaining the information would normally require drilling a hole in the skull.
Late one October night 30 years ago, GE scientist John Schenck was lying on a makeshift wooden platform inside a GE lab in upstate New York. Surrounding his body was a large magnet, 30,000 times stronger than the Earth’s magnetic field. Standing at his side were a handful of colleagues. They were there to peer inside Schenck’s head and take the first magnetic resonance scan (MRI) of the brain.
The 1970s were a revolutionary time for medical imaging. Researchers at GE and elsewhere improved on the X-ray machine and developed the computed tomography (CT) scanner that could produce images of the inside of the body. Other groups were trying to adapt nuclear magnetic resonance (NMR) for medical imaging, a technology that already used powerful magnets to study the physical and chemical properties of atoms and molecules. But their magnets were not strong enough to image the human body.
At the time, GE imaging pioneer Rowland “Red” Redington (he built the first GE CT scanner) also wanted to explore magnetic resonance and hired Schenck, a bright young medical doctor with a PhD in physics. Schenck spent days inside Redington’s lab researching giant magnets and nights and weekends tending to emergency room patients. “This was an exciting time,” Schenck remembers.
Heady Times: John Schenck (standing) and Bill Edelstein at the front opening of the first whole-body 1.5 tesla magnet in 1983.
Schenck’s unique background allowed him to quickly grasp the promise of MRI. Unlike CT and X-ray machines that generate radiation which travels into the body, the strong magnetic field produced by MRI machines tickles water molecules inside body parts and makes them emit a radio signal that travels out of the body. Since every body part contains water, MRIs can recognize the source of the signal, digitize it, and apply algorithms to build an image of the internal organs.
It took Schenck and the team two years to obtain a magnet strong enough to penetrate the human body and achieve useful high-resolution images. The magnet, rated at 1.5 tesla, arrived in Schenck’s lab in the spring of 1982. Since there was very little research about the effect of such strong magnetic field on humans, Schenck turned it on, asked a nurse to monitor his vitals, and went inside it for ten minutes.
The field did Schenck no harm and the team spent that summer building the first MRI prototype using high-strength magnetic field. By October 1982 they were ready to image Schenck’s brain.
Many scientist at the time thought that at 1.5 tesla, signals from deep tissue would be absorbed by the body before they could be detected. “We worried that there would only be a big black hole in the center” of the image, Schenck says.
But the first MRI imaging test was a success. “We got to see my whole brain,” Schenck says. “It was kind of exciting.”
The 1.5 tesla magnet has since become the industry standard for MRI. Today, there are some 22,000 1.5 tesla MRI machines working around the world and generating 9,000 medical images every hour, or 80 million scans per year.
>Schenck, now 73, still works at his GE lab and works on improving the machine. “When we started, we didn’t know whether there would be a future,” he says. “Now there is an MRI machine in every hospital.”
Making people healthier does not always involve developing a more potent pill or building a better body imaging machine. Sometimes it pays to keep your eyes open and listen. A few years ago a group of care delivery professionals from GE Healthcare noticed that some hospitals were getting much better results than others. “Their ideas were new and innovative, but they were also incremental and did not turn the facility upside down,” says Denise Kruzikas, a healthymagination director at GE Healthcare. “They made care smoother, faster, and more efficient.”
What were these hospitals doing right and could it serve as a “best practice” for others? “We started looking for the true pioneers,” Kruzikas says. GE’s first visit was to Saint Luke’s Neuroscience Institute in Kansas City, Missouri, a leading stroke treatment center. Doctors at Saint Luke’s, a long-time GE customer, were using GE imaging technology to diagnose stroke patients. They were getting better results than others and the GE team wanted to know why.
Typically, no more than 5 percent of stroke patients receive “interventional treatment,” where doctors remove the blood clot in the brain that blocked an artery. This is because patients were not diagnosed properly or did not arrive at the hospital in time. However, Saint Luke’s developed an innovative stroke treatment protocol and increased this number to 40 percent, say Dr. Marilyn Rymer, medical director at the Neuroscience Institute. When stroke patients leave her hospital, they are doing better, have lower stroke severity scores, and stand a better chance to resume their lives. “Saint Luke’s combines education, outreach, and coordination with efficient care,” Kruzikas says. “They’ve got people, process and technology working together.”
Starting in 2005, Dr. Rymer’s team turned stroke treatment at the hospital into a series of interconnected steps, each with a measurable outcome. The steps ranged from teaching regional hospitals and EMT personnel to recognize stroke, performing a CT scan on suspected stroke patients to help inform treatment, and also starting physical, occupational and speech therapy a lot sooner to speed up the recovery and the quality of life. “It is critical for us to be as fast as we can at all times,” says Bridget Brion, a “Code Neuro” nurse at Saint Luke’s intensive care unit. “Every minute of a stroke one million brain cells die.” “Code Neuro” ICU nurses like Brion work directly with emergency room staff to care for a stroke patient. “Instead of having the emergency room acting as an independent silo taking care of stroke, we have a continuity of care that starts immediately when a stroke patient arrives until they go home,” Dr. Rymer says.
The GE team came in 2009 and took a “full download” of Saint Luke’s stroke data since the beginning of the new program. The researchers looked at patient volumes and outcomes, stroke education, time to diagnosis and treatment, length of stay, and costs.
The analysis showed that between 2005 and 2010, the hospital increased the amount of stroke patients by 23 percent and boosted transfers by 17 percent. Around 40 percent of stroke patients at Saint Luke’s receive interventional stroke treatment such as clot-dissolving medication deployed directly at the site of a blood clot in the brain. The average across the healthcare system is only 3 to 5 percent. Given the important stroke related information it provides in a relatively short time, nearly all stroke patients at Saint Luke’s receive a CT scan followed by specialized post-processing analysis. “The bottom line was that patients were doing better and they were able to get discharged earlier,” Kruzikas says.
Last June, Dr. Rymer traveled to GE’s training and education center in Crotonville, New York, and presented the results as “best practice” steps to stroke doctors from the U.S. and abroad. “Every hospital around the country should be stroke ready and stroke able,” Dr. Rymer says. “That just hasn’t happened.” Stroke is the leading cause of disability among adults in the U.S. Approximately 795,000 strokes occur in the U.S., costing $25 billion in 2007.
The Saint Luke’s study was part of GE’s healthymagination program, whose goals include finding innovative solutions to healthcare and improving access to treatment. The GE team is already seeking out facilities that excel in treating breast cancer, Alzheimer’s disease, and low-dose radiation management. “It’s about using what’s out there in a more efficient and productive way,” Kruzikas says. “We want to address our customer’s need and support best practice models that can be replicated around the world.”