Christian Medical College, Vellore
Don’t dare to just dream, dare to live your dream. This is what Dr. ECG Sudarshan told a group of us, young graduating physicists in 2003 which made me contemplate on my own dream of becoming a scientist. While I remained undecided about being ready to face the challenges of being a researcher and the pressures of being a woman scientist, I worked for a year to fund my further studies. I went back to college for my Masters in physics and for the thesis decided to work with Dr. Gautam Menon, an established scientist in biological modeling at the Institute of Mathematical Sciences. My masters dissertation in 2005 on numerical simulation of the motion of a protein molecule gave me an insight into the world of inter-disciplinary research.
I got introduced to Medical Imaging in 2006 when I joined Dr. Paul Ravindran’s lab in Christian Medical College Vellore on a DRDO funded project to develop reconstruction software for megavoltage-cone beam computed tomography (MV CBCT). In the next 3 years I implemented the acquisition and reconstruction software for megavoltage images. The information from the MV CBCT images was integrated into the radiotherapy planning and found feasible in adaptive therapy, palliative treatment and in patients with metal implants. In 2009 I joined the department of Bioengineering in CMC Vellore with Dr Suresh Devasahayam to help set up the imaging lab for MTech clinical engineering and man the lab.While there I got trained in image segmentation with Dr. Michael Downes, a visiting faculty from Columbia University. As part of the course I initiated a study with Dr. Joy Mammen Professor and Head, Department of Transfusion Medicine and Immunohaematology to automate the segmentation of white blood cells, in order to calculate the differential count in peripheral blood smear images in malaria and tuberculosis. This project paved the way for my PhD as I realised that my heart was truly in medical imaging and the next decade was in training to become a clinical imaging scientist, a role not known or popular in India.
In oncology imaging I realized that anatomical imaging does not always provide the complete picture and that the functional or metabolic changes can and do occur in the tumors even without a corresponding anatomical correlate. For my PhD with Dr James Jebaseelan as my Guide from VIT University and Dr Devakumar as academic supervisor from Nuclear Medicine, Christian Medical College Vellore I worked extensively on improving delineation methods for positron emission tomography (PET) based biological tumor delineation. At the time very few centers used functional images for planning purpose in India and those using employed manual segmentation method which is both time consuming and had large inter-observer variability. The focus of my thesis was to improve the clinician’s ability to localize and delineate the extent of the tumor by improving the available PET delineation methods and incorporate it for routine clinical use. I worked with Dr. Ari Chacko, senior neurosurgeon who expressed his difficulty in determining the residual pituitary tumor from a postoperative MRI that he planned to treat with a stereotactic radiation. PET imaging provided the necessary surrogate since the pituitary tumors had metabolic uptake. The segmentation method is still in use and there were instances anatomical imaging shows the extent of the tumor to a larger extent; but the functional imaging helps in restricting the limit of the tumor to only the areas which were active; hence sparing of the surrounding normal tissues and limiting the side effects from irradiation. To better delineate heterogeneous lung tumors, I worked alongside Dr Balu Krishna, Professor of Radiation Oncology to improve the GrowCut segmentation method to use for clinical research for functional imaging-based treatment planning and treatment response assessment. In 2014 I received the Fulbright-Nehru Doctoral Fellowship to do a part of my PhD in the US. I worked with Dr. Paul Kinahan, one of the founding fathers of PET imaging and Dr Stephen Bowen at the Imaging Research Lab, University of Washington to study the impact of segmentation and respiratory-induced tumor motion on the boost volumes for PET-based dose escalation for non-small cell lung cancers. Overall, my thesis not only brought new knowledge, it also improved the oncology imaging workflow from acquisition to treatment planning for some of the major disease sites.
Following the completion of my PhD in 2016 I worked briefly with Dr Beena Koshy, a developmental Pediatrician on morphometric analysis for Autism where I was responsible for implementing the imaging acquisition protocols for the MRI studies and the Freesurfer pipeline for cortical reconstruction and volumetric segmentation of the pediatric brain. In 2017 Dr Stephen Bowen brought me on board to University of Washington(UW), Seattle on his FLARE clinical trial as his post-doctoral fellow. The next two and half years I worked towards various studies to characterize the spatially evolving function of the tumor and normal tissues of the lung from SPECT images for a personalized dose delivery based on early treatment. This experience provided me an outstanding environment to see the clinical implementation of research methods in translational medicine and clinical research. I trained with Dr Janet Rasey, Professor emeritus in Radiology at UW in grant writing which led to my successful India Alliance fellowship in 2019.
After spending more than 13 years in imaging research that includes my PhD training, I have affirmed that I love the challenge of finding practical applications to clinically relevant problems. Quantitative imaging field is constantly developing and growing and is relatively new in India. Hence, there is limited domain expertise and I realize the need for imaging data scientists who both trained in medical imaging and also are interested in leading the effort for the development of quantitative imaging tools and workflow that are aimed at clinical implementation. I chose India Alliance as the fellowship provides a platform for mentored growth and the research conducted is with an integrated goal of training to facilitate my career development and help me transition to becoming an independent researcher. Since the fellowship is prestigious it also provides scope for future collaborative work. I draw inspiration from past India Alliance fellows who have established themselves as world-class experts in their chosen fields and it resonates with my own goals. I am grateful to India Alliance for this opportunity and hope to deliver to the best of my ability.