Databanks of the Future

To expand the size of the DNA databank—and thus expand the related research opportunities—Vanderbilt is reaching out to other academic medical centers that are compiling their own DNA databanks. "If everyone asks the same questions, you can then connect the aggregate information and achieve much greater statistical power."

Project: Institute for Advanced Biomedical Imaging
Host: National Jewish Medical and Research Center

Earlier this year, Denver-based National Jewish Medical and Research Center announced the formation of its Institute for Advanced Biomedical Imaging. "It reflects our commitment to personalized medicine," explains Greg Downey, MD, executive vice president of academic affairs. Personalized medicine, he continues, means "using all available information—genetic, proteomic, and metabolomic, as well as traditional information from the physician encounter—to help in diagnosis, prognosis, and individualized treatment." At NJM, imaging will play a big role in the effort, as the 47-licensed-bed academic medical center, which primarily serves as an outpatient facility, recently signed a multiyear deal with Siemens Healthcare to outfit its new imaging center. The imaging center's work will complement personalized medicine projects underway in NJM's Integrated Bioinformation and Specimen Center and its Center for Genetics and Therapeutics, also led by Downey.

As imaging technology matures, its capacity to understand metabolic functions increases. Using advanced technologies such as CT and PET-CT, researchers at NJM can understand how diseases function at the molecular level. The facility is creating a repository of radiological images that are linked to other data in a patient's electronic medical record. Like Vanderbilt, NJM has taken steps to ensure the privacy of patient data, as all records are de-identified. Matching brain functions to a patient's DNA sequence may help explain disease states and processes, Downey says.

NJM's effort has been supported by federal research grants. It will be creating a reference database of CT scans and developing algorithms to distinguish between benign and malignant tumors. As part of the grant, NJM is working with 16 other medical centers that will funnel CT images to the repository. One early project is the development of "phantoms," or surrogate human forms used to calibrate imaging equipment before the scan occurs. Having all the hospitals use the same surrogate to calibrate the imaging technology leads to a more standardized image and valid analysis, Downey explains.

Much of the research will delve into the mysteries of DNA composition. Researchers at NJM will analyze single nucleotide polymorphisms or SNPs (pronounced "snips"). These are tiny variations in an individual's genomic sequence that may predict certain diseases. Researchers may be able to determine who is at risk for chronic obstructive pulmonary disease before it occurs.

Personalized medicine, Downey concedes, may sound improbable. However, he notes that using genetic information to predict responses to certain treatments is already in play in cancer therapy and in blood thinners. "Personalized medicine, while controversial, is here to stay," he says. "It has the chance to revolutionize the way we do business."