Chapter 15: Developing and Opening the Center for Advanced Biomedical Imaging: Challenges and Complexities
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Description
In this segment, Dr. Podoloff explains why it took ten years to open the Center for Advanced Biomedical Imaging, despite strong support from the institution and partners. He explains legal issues that emerged between MD Anderson and GE Health. He describes the process of finding a location for CABI.
Dr. Podoloff observes that the centers are located on South Campus for synergy: he lists the departments with strong connections to CABI.
Identifier
PodoloffD_02_20150423_C15
Publication Date
4-23-2015
City
Houston, Texas
Interview Session
Tacey A. Rosolowski, PhD, Oral History Interview, April 23, 2015
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the Institution; Building the Institution
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey A. Rosolowski, PhD:
OK, thank you. OK. And we were talking about your deputy chair role. And what would you like to say about that?
Donald A. Podoloff, MD:
Well, I was running a very busy Nuclear Medicine Department, the clinical aspects of a very busy Nuclear Medicine Department. I think we used to do fifty or sixty bone scans a day. We used to do forty or fifty liver scans. Maybe thirty or forty brain scans. But all that changed when CT came out. The liver scan went down to zero almost overnight, so did the brain scans. And we filled that void with cardiac scans and other tumor imaging that we hadn’t done before. And then of course PET and PET/CT came along. So during all that time I was involved, like if new technology came in that was clinically approved, one of my responsibilities would be to evaluate it and put it in place. I was also responsible while working with the technical support people to develop protocols. If we had a new imaging technique that we’d not done before, let’s say we’d never imaged the adrenal glands before and we wanted to, and there was an FDA-approved agent to do it, I would have to help set up that protocol. And then I was responsible for the quality control or quality assurance. So I ran a conference that we did once every two weeks I think.
Tacey A. Rosolowski, PhD:
And the purpose of that was to?
Donald A. Podoloff, MD:
To go over cases where there were either errors or where there was a teaching point that others could learn from. While we read, if we came across a mistake or something of concern, we turned that in. And those turn-ins were evaluated by me and by a technical person. And if they were of significant import, we presented them at the conference, blinded to who had done it. That’s all done electronically now. We used to have to do it by hand.
Tacey A. Rosolowski, PhD:
(laughter) And was that a new thing?
Donald A. Podoloff, MD:
No, it was fairly standard. Peer review has always been part of medicine.
Tacey A. Rosolowski, PhD:
Right. I was curious. In addition to the various technological advances that you approved, do you recall any significant technologies coming to your attention that you did not approve, that were not appropriate for use here at MD Anderson, and why?
Donald A. Podoloff, MD:
I don’t think so. I don’t recall. Normally when a new technique, let’s say a new instrument, is being developed, the appropriateness for it in a particular clinical setting is usually defined by a research group. And by the time they got to me as the practicing clinician, they had already been—those that weren’t mustering were out. So it wasn’t something that I would be concerned with in that role. If I were doing technical development work, or if I was working closely with a physicist, that might be where those kinds of things would come up. So what came to us in the clinical realm, although it was new, it was scientifically pretty mature.
Tacey A. Rosolowski, PhD:
OK. Also from our conversation last time about some of the transformations that took place in practice when the combined PET scan/CT came about, I can see how new technology would come in and there’s a cascade effect that it not only affects clinical work, it affects research, which then affects development. So there’s a whole—
Donald A. Podoloff, MD:
Well, this whole building is a very good example of that. The original thought behind the Center for Advanced Biomedical Imaging Research, CABI, as we called it when it started, was that we would partner academically with the medical school, with GE Healthcare, and with MD Anderson, the three of us as three equal partners. And GE’s skin in this game was to provide us with equipment that we would then use to develop new technologies that GE could use and sell commercially.
Tacey A. Rosolowski, PhD:
Interesting. When were those conversations first taking place?
Donald A. Podoloff, MD:
In 2000 maybe, fifteen years ago. So that began as a little seed amongst John Mendelsohn, myself, and the head of GE Medical, who at that time was somebody whose name I’ve forgotten. (laughter) Jeff Immelt, who was the original guy that I worked with, went on to become the head of GE after Jack Welch retired. So Jeff took over the whole company. And this young man became the medical person. Joe Hogan was his name.
Tacey A. Rosolowski, PhD:
So not Jeff Immelt, but it was Joe Hogan.
Donald A. Podoloff, MD:
No. Joe Hogan. Jack Welch in his book wrote a very funny thing about Hogan. He said he must get carded in every bar that he goes into because he looks like he’s nineteen years old. He did when he was in his mid thirties.
Tacey A. Rosolowski, PhD:
That’s funny.
Donald A. Podoloff, MD:
Yeah. So it was the three of us that forged the original deal about doing this. The CABI was actually part of my recruitment package to be the division head.
Tacey A. Rosolowski, PhD:
Oh. Really. Huh. That’s information I didn’t—
Donald A. Podoloff, MD:
It’s not anywhere that you would ever see it.
Tacey A. Rosolowski, PhD:
Yeah. Wow. So this was really so—
Donald A. Podoloff, MD:
Well, I had a vision of molecular imaging. And that’s what I wanted. That’s what wasn’t here when I became the division head that I wanted to make sure was here. So that’s why we restarted the PET program.
Tacey A. Rosolowski, PhD:
And what was your vision?
Donald A. Podoloff, MD:
That by the time a tumor gets to be a lump or a bump and you can see it on an X-ray it’s too big. It’s gone through too many replications and there’s too much cancer around. What we have to be able to do is see things before they become that large, or before hundreds of millions of cells are there. And the way to do that is to do it through molecular imaging. Now nobody’s ever imaged a molecule yet as far as I know, except by X-ray diffraction and other things. But no radiologist has ever seen a molecule. But we do look at molecular events and subcellular events. And the reason that’s important—since I’m a radiologist I’ll show you something visually.
Tacey A. Rosolowski, PhD:
And I’m going to of course e-mail you and ask you for this image.
Donald A. Podoloff, MD:
I think I should be able to do that.
Tacey A. Rosolowski, PhD:
That’s great, yeah.
Donald A. Podoloff, MD:
So that’s what fighting cancer looks like. We do surgery, we do chemotherapy, we shoot radiation. And that’s the tumor, that’s what we can see. But what the etiology of this tumor is, it’s all this stuff going down here.
Tacey A. Rosolowski, PhD:
So you’re using an image of an iceberg basically. And the surgery and chemo is all above water. And what’s below—
Donald A. Podoloff, MD:
Right. And after you get through—after you destroy the top part of it, you still have all this stuff back there. That’s why cancer comes back. So the idea is you got to see what’s going on down here. That’s what molecular imaging is all about.
Tacey A. Rosolowski, PhD:
Now when did you first have the idea for this?
Donald A. Podoloff, MD:
It started to appear in the literature in the late 1990s. People started to talk about it. It wasn’t an original idea with me. It was people began to realize that anatomy wasn’t everything.
Tacey A. Rosolowski, PhD:
But when did you feel that you had a special purpose to take action about it in this way?
Donald A. Podoloff, MD:
I think in the context of when they offered me the job as division head I said, “Well, if I’m going to be the division head, what am I going to do that warrants me to take that position? I mean it’s wonderful and I’ll make a lot more money than I was making. But what am I going to do for myself and the institution and for cancer care?” I suspect all of our leaders have epiphanies like that if they’re good leaders.
Tacey A. Rosolowski, PhD:
Yeah. It’s the grander purpose.
Donald A. Podoloff, MD:
Well, it’s a different purpose. And I always used to tell people the difference between my practice in private practice and at MD Anderson. In private practice my mission was to practice high quality medicine and make a profit. And my mission at MD Anderson is to eliminate cancer as a public health problem. Both of them are adequately good missions, they’re noble. But I think the elimination of cancer as a public health problem is a more noble one.
Tacey A. Rosolowski, PhD:
Certainly has more impact.
Donald A. Podoloff, MD:
Well, it may, yeah. So when it came time to negotiate, well, if you’re going to give me this job what are you going to give me with it, CABI was what came out of that. And without Dr. Mendelsohn’s support and without the willingness of GE to be part of that, without the buy-in of a lot of people in the division who were going to help put it together, it never would have happened. No one person does something like this.
Recommended Citation
Podoloff, Donald A. PhD and Rosolowski, Tacey A. PhD, "Chapter 15: Developing and Opening the Center for Advanced Biomedical Imaging: Challenges and Complexities" (2015). Interview Chapters. 743.
https://openworks.mdanderson.org/mchv_interviewchapters/743
Conditions Governing Access
Open
