Dr. Wladyslaw "Wady" Gedroyc, MBBS, MRCP, FRCR is a Consultant Radiologist at St. Mary's Hospital, Imperial College NHS trust and has been a champion of focused ultrasound for 16 years. He has treated more than 600 patients, mostly women with uterine fibroids, at St. Mary’s. The center now treats about one uterine fibroid patient per week, and they are continuing to explore other uses of the technology.
We interviewed Dr. Gedroyc to find out more about his current projects and future plans:
Q. When and how did you get interested in FUS?
I was first involved with MR-guided interventional work using an MR scanner carrying out a variety of thermal ablation percutaneous procedures. The work we were doing in this area in fibroids was obviously applicable to the newly emerging field of MR-guided focused ultrasound (FUS), and it was our original work in percutaneous thermal ablation of fibroids that led me to suggest that FUS could be utilized for this purpose. Having seen first-hand the potential of FUS to replace a great deal of conventional invasive therapeutic procedures for the great benefit of our patients, I became deeply engaged in this field.
Q. What are your areas of interest in FUS?
Fibroid treatment, facet joint treatment, liver treatment, and brain applications along with using FUS in the activation of drugs at local sites within the body.
Q. What mechanisms and clinical indications do you study?
Most of my initial work in FUS has involved studying thermal ablation procedures and their clinical results, and this still remains a primary goal and interest. Over the last five years, however, I have been deeply involved in a variety of projects looking at the early in vitro and then in vivo animal work assessing FUS for local drug applications and in using FUS to increase the uptake of drugs within tumors. This work has led to the patenting of several new drug formulations that have been developed within my group and the evolution into first in-human work, which will happen over the next few years followed by commercialization of these developments.
Q. What is the goal of your work?
My goal is to convert many currently utilized surgical and interventional procedures into completely non-interventional outpatient procedures, which would immensely benefit our patients in terms of greatly reduced morbidity and mortality. This will also benefit patients by keeping them out of hospitals, and reduce the cost and burden on our financially strapped health services.
Q. What are your funding sources?
Funding comes from multiple sources, including government organizations, industry, UK charities, and the Focused Ultrasound Foundation. I have had a long-term relationship with FUS equipment manufacturer, Insightec, which has funded many of our early developmental projects. The UK Engineering and Physical Science Research Council and Cancer Research UK have funded our extensive work in developing methods of activating drugs using FUS. Imperial College NHS trust charity has very generously funded the purchase of a brain system. Part of our ongoing fibroid clinical work is now funded in certain age groups directly by the National Health Service.
Q. Who are your team members and your internal and external collaborators?
Brain applications: Dr. P. Bain and Mr. D. Nandi
Fibroid work: Prof. L. Regan at Imperial and Dr. S. Quinn at Imperial
Drug activation: Dr. M. Thanou at Kings College in London; Prof. A. Miller at King's College in London; Prof. Y. Xu at Imperial College; Prof. J. Stebbing at Imperial College; and Prof. S. Thom at Imperial College.
Q. What are your grea achievements? Any major disappointments?
Initiating the fibroid FUS work has been immensely gratifying because it has been taken up and expanded on a worldwide basis. Equally exciting is our immensely promising work in drug activation, which will potentially change the way we deliver therapy to patients with malignancies. We have encountered our share of disappointments along the way as well. Our center faced a difficult internal political situation for a few years, which decreased the size of my research team, tightened financial constraints, and stalled our work in using FUS to treat facet joint pain. These challenges stifled innovation and creativity, but the situation has evolved, and we are now poised for progress.
Q. What do you see as impediments to your success?
Ongoing financial constraints have led to a complete change in the environment in which many of us develop new procedures. An overwhelming and increasingly intrusive bureaucracy has been created both locally and nationally that has made all aspects of research more difficult. Research has become much more expensive, and more competition for fewer resources has created a vicious cycle that impedes development of medical devices and their applications. A simple example would be that the costs to undertake a randomized device trial are so high that they deter investment from both independent funding bodies and device manufacturers.
Q. What is your research wish list?
My main research goal is to develop an effective method of carrying out MR-guided FUS ablation of the liver so that many more patients with liver tumors can be treated in a simple manner. I would like to combine this approach with the use of new FUS-activated drugs to improve the results of this process even further.
Q. Does the Foundation play a role in your work?
The Focused Ultrasound Foundation has been key in the continued evolution and promotion of FUS on a worldwide platform. On a personal level, the Foundation has funded some of the projects that allowed me to develop FUS as a treatment for facet joints. The Foundation has often provided the infrastructure to allow me to network with many invaluable colleagues around the world who have helped the progress of my work.
Q. How many patients have you treated?
I have treated more than 600 patients with FUS. The majority have been women with fibroids, but a substantial minority has been in other areas, including facet joint, liver, bone, and miscellaneous soft tissue masses.
Q. Do you have any clinical or clinical research highlights?
We recently performed a first-in-the-world treatment on a 6-year-old girl with a large, benign, slow growing, and inoperable pelvic tumor.
Wladyslaw Gedroyc Named Editor of the Journal of Therapeutic Ultrasound, Which Is Now Indexed on PubMed
Focused Ultrasound Pioneer, Wladyslaw Gedroyc, MD, Named Honorary President of FUS Foundation’s 2012 International Symposium (September 2011)
Patient with Benign Pancreatic Tumor Experiences Pain Relief After MR-guided Focused Ultrasound Treatment