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Eye on the future

by Krista Habermehl | November 2, 2016

Ting-Yim Lee
Ting-Yim Lee helps ensure the future of cardiac CT imaging by helping establish the Ting-Yim Lee Chair in Cardiac Computerized Tomography Imaging Research at Western, Lawson Health Research Institute and St. Joseph’s Health Care London.

At the age of 65, with a 28-year ground-breaking, life-saving imaging research program in his rear view, Ting-Yim Lee is looking to the future – and planning his succession.

The Schulich School of Medicine & Dentistry professor, whose work focuses on finding more efficient ways to use computed tomography (CT) imaging to measure blood flow in tissue in the event of stroke, cancer and cardiac events, is planning for his future retirement by ensuring the next phase and ‘final frontier’ of his research – cardiac CT imaging – is executed to the fullest.

To do so, Lee and his wife, Maggie, have helped establish the Ting-Yim Lee Chair in Cardiac Computerized Tomography Imaging Research at Western, Lawson Health Research Institute and St. Joseph’s Health Care London. The chair will develop innovative CT functional and molecular imaging techniques to advance early diagnosis and clinical care of patients suffering from cardiac events, such as heart attack.

“Over the past 28 years, the institutions have created opportunities for me and supported my research endeavours in many ways. I feel this gift is the best way to repay the help that I have received,” Lee said. “We are onto something that is worthwhile and successful. By setting up this chair, there would be a significant person – a clinician-scientist – to lead the next phase of the cardiac CT program.”

In an historic partnership announced at St. Joseph’s Health Care in London Wednesday, the gift was jointly bolstered by Western and the St. Joseph’s Hospital Foundation to create a $3-million endowment to support the chair. The establishment of the Dr. Frank Prato Research Chair in Molecular Imaging at Lawson Health Research Institute was also announced, with support from local donors, further building the City of London’s reputation as a worldwide imaging research powerhouse.

The combined value of both chairs is $6.5 million.

“These generous donations, and the new chairs they create, will strengthen our partnerships with St. Joseph’s and Lawson and help ensure that London remains at the forefront of medical imaging research and teaching,” said Western President Amit Chakma.

Through his research program, Lee pioneered the development of a software compatible with existing CT scanners that employs a method of using X-ray dye to aide doctors in assessing blood flow in the event of stroke. The software was first licensed by GE Healthcare in 1999, and again in 2015, and is now part of 70 per cent of the company’s new scanners in use in more than 8,000 hospital imaging departments worldwide. The software provides a faster, more efficient way for doctors to analyze and measure blood flow and determine the best treatment course – saving time at a juncture where every minute could change the outcome for the patient.

“Dr. Lee’s contribution to imaging research has been tremendous. Not only has his work had an impact on CT imaging globally, but it has changed the course of treatment for countless patients,” said Schulich Dean Dr. Michael Strong. “The cerebral blood flow measurements that Ting pioneered are now mainstay in the management of stroke patients. The establishment of this chair will allow us to continue this innovative work for the benefit of cardiac patients.”

With an estimated 1.3 million Canadians living with heart disease, there is a significant opportunity for cardiac imaging research to change the outcome for patients who have suffered from cardiac events.

According to Lee, the current management of a sudden onset of chest pain is to inject dye into the patient’s blood vessels – so they ‘light up’ – and take a CT picture to see which vessel is blocked. Once the blockage is found, patients undergo revascularization, a surgical procedure that restores blood circulation either by unblocking blood vessels or by implanting replacements.

In 30 per cent of cases where a person has a blockage and undergoes revascularization, Lee said, the surgery doesn’t actually provide benefit to the patient.

He continued, “It’s been found that a vessel may be blocked, but the surrounding tissue may be surviving because there are collateral vessels that will supply the surrounding tissue. The patient may still be fine even if there’s a blockage.”

In addition to being expensive for little to no benefit, there are also associated risks to the patient by undergoing a surgery like revascularization.

“The new method that we’re going to develop is while the patient is on the CT scanner table, we could measure the blood flow to the piece of tissue downstream from the blocked vessel to see if it’s really ischemic. We will have a much better idea of whether the patient will need to be revascularized or not,” he said.

The brilliance of using CT imaging for this research is scanners are commonplace in hospitals around the world.

“The methodology we develop in scanning the patient, as well as the software we develop afterwards to analyse the data, is easily translatable, not only to academic centres but to regional hospitals as well,” Lee said. “You don’t need specially-trained personnel to use it.”

The implications of this research are far-reaching and carry significant clinical and societal impacts.

“If we could develop this, we would be almost the first site in the world to prove it is really possible – and we would bring significant improvement for people with coronary artery disease,” Lee continued. “If we are the first ones in, we will be able to do a lot of ground-breaking clinical trials to prove this method works.”

For Lee, it’s all about guaranteeing his research program will continue to make an impact long after he chooses to step back.

“I am very, very happy that this has come about because it’s the last piece of the jigsaw to put the whole puzzle together,” he said. “Yes, after I retire, someone else will pick it up and carry on with it, but, if they start from nothing, the progress will be smaller than if they already have something built up to work with.”


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