SUMMARY
The importance of biomarkers in clinical practice and regulatory science is difficult to overstate. The ultimate
goal for clinical care of the future is to determine the most appropriate therapy for each patient’s unique version
of a particular disease. This concept of precision medicine has been identified as a national priority in the USA,
leading to a need for biomarkers that can provide objective and reproducible information. In addition, regulatory
science for the approval of new qualified drugs and medical technologies has an urgent need for qualified
biomarkers to report on the success or failure of these drugs and technologies. Imaging biomarkers, providing
in situ “biopsies”, have the potential to provide such specific information and, ultimately, to improve routine
clinical care and speed up development of new treatments. The overall goal of this Resource therefore is to
develop novel noninvasive MRI candidate biomarkers that can ultimately be used for: (i) personalized
assessment of patients for diagnosis, prognosis, and treatment monitoring; (ii) monitoring of the development
of new medical technologies and drugs, i.e. for better guiding of clinical trials. The significance of our proposed
developments lies in providing the fundamental design and initial testing (i.e. not clinical trials itself) of new MRI
candidate biomarkers with the potential to provide surrogate quantitative imaging endpoints that are as close
as possible to clinical endpoints. As such, this Resource will focus on designing, calibrating and standardizing
new magnetic resonance (MR) technologies to provide reliable measures across sessions, scanners, and
raters. This technology will then be disseminated for larger scale patient studies to allow clinical validation.
The MRI Resource for Physiologic, Metabolic and Anatomic Biomarkers is an interdepartmental and
interdisciplinary consortium combining facilities and expertise of the F.M. Kirby Research Center at Kennedy
Krieger Institute (KKI), the Department of Radiology at Johns Hopkins University (JHU) School of Medicine, the
Center for Imaging Science at the JHU Whiting School of Engineering, and the Department of Biostatistics at
the JHU Bloomberg School of Public Health. We propose 4 TRD projects, 3 on MR acquisition approaches and
one bringing them together with advanced multi-scale data analysis methods that include machine learning. To
assure a proper choice of technologies, we will interact closely with a group of clinical and research experts in
a push-pull relationship through collaborative projects (CPs) that focus on brain diseases, disorders, and
injuries that have a need for new quantitative MR technology to better and noninvasively assess them. These
include anemia/ischemia and related white matter hyperintensity lesions (CPs 1,5), aging, cerebrovascular
disease, and dementia (CPs 2,7,10), traumatic brain injury (CP4), glymphatic function (CP6), pain (CP8) and
addiction (CP9). As an initial testbed for our methods, we also have a group of service projects (SPs) to which
we will provide both data acquisition methods and data analysis software. Finally, we will train investigators in
their use and disseminate methods nationwide and to MRI manufacturers for even broader application.