(provided by candidate): The Mentored Clinical Scientist Development Award will support the program outlined in this proposal, a program that will enable the Principal Investigator, an Interventional Radiologist, to combine his clinical skills and training with interventional magnetic resonance imaging (MRI) research and become an independent clinical scientist in the field of interventional MR (iMR). Research will be focused on the development of an innovative, minimally invasive mesocaval shunt that will not only provide safe and accurate implementation of the new shunt, but also serve as a vehicle for delivery of therapeutics to the liver, spleen, and pancreas. The candidate's immediate goal is to gain expertise and knowledge of Magnetic Resonance Imaging techniques as they relate to vascular imaging, as well as research methodology. The candidate's long-term goal is to become an independent biomedical researcher who is focused on translational research in iMR. To achieve these goals, the candidate and his mentor, Ergin Atalar, Ph.D., have developed a career development plan that includes: a) protected research time (75 percent); b) didactic coursework on MR vascular imaging and research techniques; and c) an advisory panel of established multidisciplinary investigators, with expertise in several fields related to this proposal. As a clinician trained in interventional procedures, the candidate has had experience with the interventions required as a result of complications from cirrhosis of the liver. Due to the development of portal hypertension, decompression of the portal venous system has traditionally been accomplished with either a surgical shunt or a percutaneous transjugular intrahepatic portosystemic shunt (TIPS). In addition, minimally invasive access to the spleno-meso-portal venous system creates the opportunity for the development of novel therapies for diseases of the pancreas, liver, and spleen. Using only real-time MR guidance, the candidate will work closely with his assembled team to create a minimally invasive meso-caval shunt The following specific aims will support these goals: (1) Develop a novel intravascular needle system to perform MR-guided vena cava punctures; (2) Develop and implement an MRI protocol that will provide complete real-time 3D anatomical definition of devices and target vessels in order to safely perform MR-guided interventions; (3) Demonstrate that a ,meso-caval shunt can be constructed and implemented safely under MR guidance using a novel anastomotic device; and (4) Determine that injection therapies can be delivered accurately to the pancreas, liver, and spleen under MR guidance. The Department of Radiology, with its long history of groundbreaking achievements in Radiology research, will provide a supportive and nurturing environment in which the Principal Investigator can establish a future as an independent clinical scientist.
