Organisation:
Department:
Interests:
Graeme Houston qualified in Natural Sciences in 1983, and MB Bchir in 1987 from Cambridge University, developing an interest in Clinical Imaging and was appointed SINAPSE Professor of Clinical Imaging in the University of Dundee in 2009. A Consultant Radiologist at Ninewells Hospital and Medical School Dundee, since 1995, he has focused on developing and implementing services in MRI and Interventional Radiological techniques particularly in relation to cardiovascular disease following Clinical Fellowship in Radiology at the University of British Columbia, Vancouver, Canada. His major research interests are the improvement of non-invasive methods of assessing patient risk factors for disease, the development of new minimal invasive treatments, and the use of imaging techniques to improve understanding of the pathophysiology of cardiovascular disease.
Research Themes:
My main research interests are imaging and intervention in Cardiovascular Disease, Diabetes, and Oncology, working with colleagues in the University of Dundee, NHS Tayside and more widely through the Tayside Medical Science Centre (TASC). My current research activities are aligned with the main medical school clinical research themes:,Cardiovascular Disease, Stroke and Diabetes. My major research interests are the improvement of non-invasive methods of assessing patient risk factors for disease, the assessment of presence, site and severity of disease using MRI or CT, and the use of imaging techniques to improve understanding of pathophysiology of cardiovascular disease. Current work is in vulnerable plaque, haemodynamic analysis and overall atheroma burden using MRI.,Ischaemic Heart Disease,We have used MRI in the assessment of drug effectiveness in heart failure and hypertension (BHF,CSO, MRC, Chest Heart and Stroke), in particular Left Ventricular hypertrophy (LVH) is a strong independent CV risk factor and we are conducting a programme of research to find novel ways to regress it, since the conventional approach of achieving target BP per se leaves LVH still present in 50% of diabetics or stable angina patients. We have explored/are exploring novel approaches such as reducing oxidative stress (allopurinol) or achieving lower than normal target BPs. In addition we have undertaken a major MRI study, the TASCFORCE Project (Souter Charitable Foundation), which assesses cardiovascular risk in a large population based study (40,000 patients) using 3T MRI,Stroke,Initially my work led to an improved understanding of how stroke affects the muscles of respiration. Recent work has assessed the use of CT Angiography compared to Doppler Ultrasound in the assessment of risk of further stroke and correlation of carotid arterial plaque with MRI and Transcranial Doppler in patients with Transient Ischaemic Attacks (TMRI).,Renovascular Disease,My work has improved the understanding of MRI blood flow patterns, perfusion, assessment of renal damage and the link to tests of renal function (CSO funded). Current funded work relates to effectiveness of endovascular stenting in renal arterial disease in relation to renal, cardiac function and hypertension (ASTRAL study – MRC/NKRF and Cardiac Substudy BHF).,Peripheral Vascular Disease (PVD),Recent work has focused on blood flow haemodynamics in atheromatous disease and treatments of PVD using arterial 3-d geometries and haemodynamic wall stress predictions using computerised fluid dynamics (SE, DTI). Current work is looking at imaging and biomarker predictors of PVD progression and future work will explore the role of inflammation in diabetes.,Whole Body Atheroma Burden,A programme of grant funded research is underway (TMRC, IMI EU) to evaluate biomarkers and MR imaging markers for whole body atheroma burden assessment as a means of determining those patients at most risk for rapid disease progression and suitability for intervention trials.,Endovascular Therapy Techniques,I have developed the applications of blood haemodynamics to cardiovascular disease, particularly in relation to long term effectiveness of vascular graft, stent grafts, and stents .,Interventional Radiology Technique Development,I have particular interest in the development of interventional radiological techniques, having worked on vascular embolisation, tumour ablation, gene therapy delivery techniques. I am actively involved with the Institute of Medical Science and Technology (IMSAT), acting as advisor and PhD supervisor on cardiovascular implants and imaging.,Community/Public Health in Cardiovascular Disease,This work is aimed at improving patients understanding of clinical investigations and disease. This collaborative work with the School of Arts, Media and Imaging at Duncan University uses state of the art computer, graphics and display facilities. Displayed at the British Institute of Radiology, this work allows wide collaborative research potential in the Medical School, Dental School, the School of Life Sciences and Mathematics, with projects predominantly in cardiovascular disease (MRC, Sangster Foundation, AHRB, NESTA), stroke and diabetes. These techniques enhance patients understanding of clinical imaging, disease processes, assist in medical student and postgraduate training, and assist treatment planning and responses to therapy. By working closely with Community Health Partnerships and general practitioners, this has the potential to significantly improve the patients experience of “the patient journey” and their disease.
Key Publications:
SJ Gandy, K Armmogum, RS Nicholas, TB Mcleay, JG Houston.A clinical MRI investigation of the relationship between kidney volume measurements and renal function in patients with renovascular disease. Br J Radiol (Medium Radiology Journal IF 1.067) 2007 80:12-20.
JG Houston, R Bhat, R Ross, PA Stonebridge. Longterm results after placement of aortic bifurcation self-expanding stents: 10 year mortality, stent restenosis and distal disease progression. Cardiovasc Interv Radiol (Medium Radiology Journal IF IF 1.178) 2007; 30:42-47.
Uterine-artery embolization versus surgery for symptomatic uterine fibroids. Edwards RD, Moss JG, Lumsden MA, Wu O, Murray LS, Twaddle S, Murray GD; Committee of the Randomized Trial of Embolization versus Surgical Treatment for Fibroids. N Engl J Med (High Medical Journal IF 28.857). 2007 Jan 25;356(4):360-70.
Gandy SJ, Waugh S, Nicholas R, Milne W, Houston JG. Comparison of the Reproducibility of Quantitative Cardiac Left Ventricular Assessments in Healthy Volunteers Using Different MRI Scanners: A Multi-centre Simulation. J Magn Resonance Imaging (IF 2.106) 2008 28(2):359-65.
Gandy SJ, Waugh S, Nicholas R, Simpson HJ, Martin P, Houston JG. An MRI comparison of quantitative left ventricular structure function and measurement reproducibility in patient cohorts with a range of clinically distinct cardiac conditions. Int. J. Cardiovasc.Imaging (2008)24:627-632.
De Stefano N, Filippi M, Hawkins C; 9011 study group. Short-term combination of glatiramer acetate with i.v.steroid treatment preceding teatment with GA alone assessed by MRI-disease activity in patients with relapsing-remitting multiple sclerosis. J Neurol Sci. 2008 Mar 15;266(1-2):44-50
Wedderburn CJ, van Beijnum J, Bhattacharya JJ, Counsell CE, Papanastassiou V, Ritchie V, Roberts RC, Sellar RJ, Warlow CP, Al-Shahi Salman R; SIVMS Collaborators. Outcome after interventional or conservative management of unruptured brain arteriovenous malformations: a prospective, population-based cohort study. Lancet Neurol. 2008 Mar;7(3):223-30. Epub 2008 Feb 1.
Palmer K, Nairn M, Guideline Development Group. Management of acute gastrointestinal blood loss: summary of SIGN guidelines. BMJ 2008;337;a1832.
Levack P, Allan L, Baker L, Dewar JA, Eljamel S, Grant R, Houston JG, Mcleay T,Munro A. Co-ordinated approach to the diagnosis of malignant cord compression improves outcomes BMJ. 2009 Jan 6;338:a3151.
L Allan, L Baker, J Dewar, S Eljamel, RM Grant, JG Houston, G McLeay, A Waugh SA, Guntur Ramkumar P, Gandy SJ, Nicholas RS, Martin P, Struthers AD, Belch JJF, Houston JG. Optimisation of the Contrast Dose and Injection Rates in Whole Body MR Angiography at 3.0 T. JMRI (2009) 30:5;1059 – 1067.
The Astral investigators. Revascularization versus Medical Therapy for Renal-Artery Stenosis. NEJM (2009) 361:1953-1962.
H.J. Simpson S.J. Gandy J.G. Houston N.S. Rajendra A.D. Struthers Left ventricular hypertrophy in normaotensive individuals: Does extra reduction of blood pressure regress left ventricular mass? . Heart. 2010 Jan;96(2):148-52.
Jahrome OK, Hoefer I, Houston JG, Stonebridge PA, Blankestijn PJ, Moll FL, de Borst GJ.Hemodynamic effects of spiral ePTFE prosthesis compared with standard arteriovenous graft in a carotid to jugular vein porcine model. J Vasc Access. 2010 Nov 29.
Kao MP, Ang DS, Gandy SJ, Nadir MA, Houston JG, Lang CC, Struthers AD. Allopurinol benefits left ventricular mass and endothelial dysfunction in chronic kidney disease. J Am Soc Nephrol. 2011 Jul;22(7):1382-9. Epub 2011 Jun 30.
Matthew S, Gandy SJ, Nicholas RS, Waugh SA, Crowe EA, Lerski RA, Dunn MH, Houston JG. Quantitative analysis of cardiac left ventricular variables obtained by MRI at 3 T: a pre- and post-contrast comparison. The British Journal of Radiology, 85 (2012), e343–e347.
Stonebridge PA, Vermassen F, Dick J, Belch JJ, Houston JG. Spiral Laminar Flow Prosthetic Bypass Graft: Medium-Term Results From a First-In-Man Structured Registry Study. Ann Vasc Surg. 2012 Jun 8.
Newby DE, et al. Role of multidetector computed tomography in the diagnosis and management of patients attending the rapid access chest pain clinic, The Scottish computed tomography of the heart (SCOT-HEART) trial: study protocol for randomized controlled trial. Trials. 2012 Oct 4;13(1):184.
Collaborators:
I have academic collaborations within Scotland through the Universities of Edinburgh, Glasgow, St Andrews and Aberdeen based on clinical studies, PhD studentship supervision and examination, trial steering group activities as well as educational activities in undergraduate and postgraduate courses and seminars.
I have collaborations in the rest of the UK and Europe in multicentred clinical studies, basic science research, and pre-clinical studies
I have industrial collaborations with imaging equipment vendors, image postprocessing, medical device, pharma and biomedical imaging companies.