Research and Development Scientist and Engineer, Department of Orthopaedic Surgery
Stanford University, Stanford CA, PI Dr. Constance Chu
Undergraduate Degree, University: BS Aerospace Engineering, University of Colorado – Boulder BA Dance, University of Colorado – Boulder
Graduate Degree, University: MS in Electrical Engineering & Computer Science, Massachusetts Institute of Technology
Past Employers: Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, Prometheus Dance, Cambridge, MA Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh PA Attack Theatre, Pittsburgh, PA
Could you describe the path you’ve taken in meniscus research? How did it evolve?
My research began and mostly remains in cartilage compositional imaging with MRI. But as a neighboring tissue with many similar compositional properties, I also examine meniscus. And in clinical studies, the functional integrity of meniscus has a huge influence on overall joint health, so it comes up often in our clinical trials. My first close look at meniscus composition came when I was in Dr. Constance Chu’s lab at the University of Pittsburgh and we began a fabulous collaboration with Dr. Yongxian Qian. Dr. Qian is an MRI physicist who developed the Acquisition Weighted Stack of Spirals (AWSOS) sequence for ultrashort echo time imaging. He developed that sequence to look at short-T2 tissues in the brain. But the knee has short-T2 tissues, too (e.g., meniscus, deep cartilage, tendons, and ligaments). Through our collaboration with Dr. Qian, we applied the AWSOS sequence to knees to capture and quantitate fast-relaxing (i.e., short-T2) signals from meniscus tissue. In conventional MRI, the meniscus appears black a signal void – because the highly aligned collagen fibrils have fast-relaxing T2 signals that typically decay completely away before an image can be collected. But with the AWSOS sequence, we could see and measure(!!) signal in meniscus tissue that was previously invisible. That allowed us to detect clinically occult intra-substance meniscus degeneration in patients at risk of osteoarthritis but without (yet) clinical evidence of meniscal pathology.
When you started in meniscus research, what was your biggest question? Do you think its answered?
Sadly, but a goal for us all, my biggest question remains largely unanswered: How do we get the meniscus to heal?
What collaboration was the most unexpected of your career? How did it impact your work today?
When I was just starting my career, I don’t think I expected to get to work closely with biomechanics experts. Seeing the knee tissues through the lens of forces and moments and alignment – many of which can be modified – has changed my sense of purpose in the field from that of studying to understand cartilage and meniscus physiology to wanting to be able to manipulate it to help people preserve and protect their joints.
In your opinion, what is the current open question in the meniscus field right now?
There are many, but I still go back to: How might we get the meniscus to heal? Figuring this out would be transformative to so many people with pain or functional limitations due to meniscus injury or degeneration.
What advice would you give investigators who are just starting out in the field?
Try to find experts outside your discipline to work with on a common problem. Multi-disciplinary collaborations are incredibly exciting and can lead to the development of new tools (or new applications for existing tools), new ways of thinking, and a much richer understanding of the problem.
When you’re not in the lab, what do you like to do for fun?
I used to dance professionally, so for fun and to try to maintain a psychological connection to my younger self, I take dance classes 3 or 4 days a week. I also enjoy losing to my husband at basketball (even though he’s a foot taller than me), trying to beat him at Scrabble (he’s great), slow-speed chases with my really old pug, Samson, and hiking at dusk.
Great overview — clear and interesting. Quick question: based on your work with AWSOS and biomechanical collaborators, do you think early detection of short-T2 meniscal changes could realistically guide non-surgical interventions (like targeted loading modifications or bracing) to delay degeneration? Curious whether there are pilot trials planned or underway. Thanks for sharing.
Hi Isolde –
Thanks for reading about my meniscus work. I’m not a clinician, so I’m not in the position to say whether or not short-T2 changes r should guide clinical practice. That said, none of our studies to date support using elevated meniscal UTE-T2* alone to determine appropriate treatment. At most at this time, I think meniscus UTE-T2* could be included as additional information for doctors to consider alongside other more standard symptomatic or functional assessments when determining treatment plans. While we don’t have any trials currently underway specifically focused on meniscus, we do track both cartilage and meniscal UTE-T2* values in response to various interventions and we expect to have several publications out in the coming year.
Cheers!
Ashley