In this issue we interviewed WCMM Clinical Researcher Elin Trägårdh, professor and chief physician in clinical physiology and nuclear medicine at Lund University and Skåne University Hospital. Elin's research in in the field of nuclear medicine, a well-established and increasingly used modality in modern healthcare that generates images for the diagnosis and follow-up of disease.
The focus of Elin's research is to optimize nuclear medicine and the research projects covers areas from technical and clinical validation of novel digital positron emission tomography (PET) to automatic quantification of images using AI technology for prognostication and evaluation of treatment response in cardiology and oncology. Crucial for this work is multidisciplinary collaborations between researchers from the fields of mathematics, physics, radiology, nuclear medicine, oncology, urology and cardiology.
The overall aim of her projects is to increase sensitivity and specificity for diagnosing different diseases as well as improve patient outcome. Also, that development and evaluation of automatic quantitative measurements from images can be used as predictive and prognostic imaging biomarkers in patients with cardiac disease and cancer.
| We would love to hear about your academic and professional journey. What first sparked your interest in this field, what key experiences shaped you as a researcher, and how did you arrive at your current role at WCMM?
-The first key experience was that I had a brilliant lecturer in medical school who sparked my interest in Clinical Physiology. I asked him if he had a small research project that I could perform in my spare time, and that’s where it started. I continued as a PhD student after finishing medical school.
Another key experience was when I started my residency in Malmö and one of the professors asked if I was interested in continuing doing research, which I was. He helped me to establish a new research line. When this professor moved to Gothenburg I became the new PI for the research group. I think these stories highlight the importance of having role models and people around you who believes in you and that are willing to help and mentor a young researcher.
I applied for, and got, one of the imaging positions at WCMM, which has been crucial for my career. I suddenly found myself in a very inspiring research environment with time dedicated to research and secure funding for several years. During the first WCMM years, I had several PhD students who successfully defended their theses, had time to take pedagogical courses and time to write several publications. All of this made me qualified to apply for a position as full professor of Clinical Physiology and Nuclear Medicine, which I am for 1.5 years.
| Can you share success stories where your work has had direct clinical implications or influenced patient care?
-Funnily, it is the simplest studies that so far has had the most direct impact on patient care. Before, we used the radiopharmaceutical 18F-choline for detecting metastases in patients with prostate cancer. The literature supported its use. However, when one of my former PhD students conducted a simple study to verify its use in detecting lymph node metastases using histopathology as reference method, we found that it was no better than tossing a coin! This study made it very easy for us to quickly switch to the new radiopharmaceutical 18F-PSMA for the same indication. This performs much better (and yes, we have verified its accuracy in our own studies as well, not only relying on other studies).
|You have research projects that use AI technology to improve cancer imaging diagnostics. What reactions do you typically encounter when you mention that you're working in this field?
-Out of all my different research projects, the AI projects interest the most people. I guess this is a hot topic that many people are curious about and many also want to learn. Even highly educated people in technical fields realise that they know quite little about AI and there is an urge to be more familiar with the technique and to understand its potential.
| What do you see as the biggest challenge currently facing your field?
-I see several challenges. For our AI projects, finding good, annotated data from several centres is difficult and takes time. If you want the AI methods to be included in the clinical work, they need to be CE marked. This is something that the industry is used to doing, but not academia. For the medical area in general (Nuclear Medicine), the main challenge is rising prices on radiopharmaceuticals due to poor competition in the market (almost monopoly situation) and legislation.
| Looking back on your career so far, which discovery or project stands out to you as your proudest achievement?
-I would say that I am most proud of our AI projects, especially in prostate cancer, since we were really pioneering in trying to create AI for detecting and quantifying tumours in PET-CT images. This work has led to us being involved in a huge EU funded research project on the use of PET-CT in metastatic breast cancer. For the AI studies, I have also recently been awarded the 2024 medical award from the LMK Foundation!
| Could you highlight some key collaborations with WCMM Fellows or researchers, either in Lund or at other centres, and describe how they’ve expanded the scope or impact of your work?
-I have a great collaboration with Andreas Josefsson at WCMM in Umeå. He currently got a large funding, with me as well as several others as co-applicants, for a project on prostate cancer called the SPRINTR study. This will be a large national study with several hospitals and universities in Sweden being involved. Being part of such a large study will be very educative and we are currently in the process of putting together all different work packages, including a steering committee, a committee for data handling etcetera.
