Clifford R. Weiss, MD, an interventional radiologist from Johns Hopkins University, Baltimore, Md., received a Dr. Ernest J. Ring Academic Development Grant from SIR Foundation in 2009 for his project, “MR-guided Transplantation of Magneto-encapsulated Human Pancreatic Islet Cells in a Diabetic Swine Model.” He has recently been awarded a National Institutes of Health (NIH) R01 based in part on preliminary work funded by the Ring Grant. Dr. Weiss and his co-primary investigator on the R01, Dara L. Kraitchman, VMD, PhD, FACC, recently joined me for an interview.
Clifford R. Weiss, MD
Collins: Can you briefly summarize your research that was funded by SIR Foundation’s Ernest J. Ring Academic Development Grant?
Weiss: Its purpose was to demonstrate the possibility of encapsulating islet cells in magnetocapsules that are visible on MRI and then delivering them into the livers of pigs. Our work showed that we could indeed have those cells survive and produce insulin.
Collins: Excellent research ideas often grow out of clinical practice. Did an initial IR experience lead to this research idea?
Weiss: About five or six years before my Ring Grant was awarded, Jeff W.M. Bulte, PhD, and Aravind Arepally, MD, FSIR, originated the idea of encapsulating islets using MRI-visible particles, for which they received an R01 grant. Dr. Arepally was my mentor when I was a medical student, and he was my research mentor on the Ring Grant. I was focusing on a piece of their project.
Collins: Was there anything in your clinical practice that led you to want to pursue this topic under the Ring Grant?*
Weiss: It was more my view of the role of the interventional radiologist and interventional radiology scientist to bridge the translational gap between basic and clinical science, as it relates to minimally invasive procedures. I was very interested in developing MR-guided interventions in clinical practice. The Ring Grant project was a great way to bring some advanced MRI techniques into the clinic.
Collins: How did you turn your idea into preliminary data to support an application for the SIR Foundation Ring Grant?
Weiss: My mentors and collaborators, Drs. Arepally, Bulte and Kraitchman, had performed extensive work in this area. In terms of the Ring Grant, there was a lot of data that had been collected already by our group, under the leadership of Dr. Arepally. I was very lucky to have a strong clinical and research mentor to guide me through the process of applying for grants and make sure that we had enough data to apply for a Ring Grant. I cannot underscore enough the need for great mentorship as a junior faculty member.
Collins: Congratulations on your recently funded R01 application! Applying for an R01 grant is a substantial undertaking. Did you find the application process for and research support enabled by the SIR Foundation Ring Grant helpful in the NIH R01 application process?
Weiss: The Ring Grant is essentially in the format of an NIH grant, whether it’s an R01 or R21. The Foundation’s application process is designed to prepare you to go for the [NIH] grant process. The application process provides feedback and experience in a less competitive environment, where you know that your grant is being reviewed by colleagues rather than by a committee of people who may not understand your work. The concept of how to approach the R01 application— how to keep ideas focused and clear—that really came from the Ring Grant application process.
Kraitchman: Also, as a result of the Ring Grant, Dr. Weiss had some publications that were directly relevant for the R01 that we applied for and that gave him more standing as well for his first R01. Of the awards that I see that are for young or early investigators, it seems to me that the Ring Grant provides a particularly excellent opportunity to obtain preliminary data for subsequent grants.
Weiss: I agree. SIR Foundation is the best place to go as an interventional radiologist to obtain preliminary data that you are going to need to apply for the next round of grants.
Collins: I understand that Ben E. Paxton, MD, a recent SIR Foundation pilot grant and resident research award recipient, is a collaborator on your R01 grant. Can you describe how such collaboration has advanced your research?
Weiss: In any modern research program where you are trying to get funding, the more expertise you bring to the table from different players the better, so collaboration is absolutely essential. The close collaboration of the obesity research programs at Duke University and Johns Hopkins University has been crucial to the success of the recent R01 application.
Kraitchman: We are very thankful for our collaboration with Dr. Arepally, Dr. Paxton and Charles Y. Kim, MD, because some of the data from our collaborators at Duke University and specifically data from Dr. Paxton’s SIR Foundation Resident Research Grant provided additional data to answer questions we knew would be posed on our R01 application. Subsequently, our preliminary data as well as data from Dr. Paxton’s resident grant assisted with his pilot grant application.
Collins: Would you like to share with IRQ readers anything regarding the unique components of the no vel embolic agent you are studying for the treatment of obesity?
Kraitchman: We’re pretty excited. We weren’t looking to make an embolic; my work is primarily cardiovascular where we are not trying to cause ischemia. This work originated from a focus on individual cell encapsulation and we were trying to miniaturize that technology. It was developed using a device similar to a computer chip, but instead of moving electrons it allows you to move fluids and create uniformsized embolic particles, with a very high throughput. On top of that we applied our expertise to improve bead X-ray visibility. We are pretty excited about it since it lets us see where we are putting the beads initially, but we can also follow up with cone beam CT, c-arm CT, conventional CT, to see if that embolic is still there.
Weiss: I think the concept of knowing where you are embolizing and knowing where you embolized previously is critical to this grant and critical to the embolic treatment of obesity knowing that these are otherwise healthy patients.
Collins: What other applications do you foresee for this embolic technology in IR?
Weiss: I think that this agent would be useful for any embolic application. Rather than looking at the dynamic state during particle embolization using contrast, you can look at a static state of where this embolic is sitting in the body. When you think about it, there aren’t many applications where an X-ray- and MRI-visible, highly precisely sized agent wouldn’t be very useful. To be fair, the concept of a visible embolic agent is the holy grail of embolics. These beads are unique in that they, themselves, are the contrast agent.
Kraitchman: We could use X-ray for bead delivery and then monitor their location over time with nonionizing radiation imaging such as MRI.
Collins: How do you balance a busy clinical practice with your research program?
Weiss: That’s a difficult dilemma commonly faced in academic practice. Realistically, early research success requires a division that supports research and is willing to let you take the time to do it. At this point I pay for my time. The Ring Grant helped to pay for my time to be able to do this research. Now my R01 and my other duties in research and administration pay for my time. Otherwise, even if your time is paid for it can be a challenging balance. Reed A. Omary, MD, MS, FSIR, gave me a very useful piece of advice: “When you have an academic day, it’s an academic day. Academic time is for academic pursuits; clinical time is for clinical pursuits.”
Collins: What advice would you give to residents and fellows considering an academic research career in interventional radiology?
Weiss: First, don’t hesitate to get involved in research. Ask what research is going on in or outside of your department. Second, take time to do research, with dedicated time without or outside of your training program. Finally, the most important thing I can say to any young physician looking to get involved with research is to find a mentor who has the perspective to guide you along the steps of your career. Mentorship involvement and time gets you 90 percent of the way there.
