A Q&A With Dr. Brian Pogue, Incoming Editor-in-Chief, SPIE Journal of Biomedical Optics

Dr. Brian Pogue of Dartmouth College will take the helm as editor-in-chief of SPIE’s Journal of Biomedical Optics (JBO) starting Jan. 1, 2018. The JBO publishes papers on the use of modern optical technology for improved health care and biomedical research; it is part of the SPIE Digital Library.

Further, Pogue has been an editorial board member for the Journal of Biomedical Optics since 2007. He has stated that he “aims to highlight advances at the intersection of emerging optical/photonic technologies and biomedical needs.”

Dr. Pogue graciously took time recently to speak with Photonics Online about his decision to join Journal of Biomedical Optics as editor-in-chief, his vision for the journal, and how he balances all of his interests in limited time.

1. First, what prompted you to accept this post as editor-in-chief for the Journal of Biomedical Optics?

I was asked by the SPIE search committee, not even knowing that they were looking for a new editor. But I was deeply honored to be chosen by the SPIE Board of Directors for this position. They tell me that I have published the second-most papers in JBO, and my work has been highly cited. I was not fully aware that I had such a large footprint in the journal, although I have always considered it my “home journal,” where we publish content that is squarely in the field of biomedical optics development.

While I know it is a large time commitment, I am firmly involved in biomedical optics in everything that I do professionally. I recognize JBO as being the first journal in our field, as well as the leading edge of this field, which is a hybrid of optical technology-driven and biomedical-driven research. So, I was very happy to accept SPIE’s invitation to serve as the next JBO editor-in-chief.

2. Having served on JBO’s editorial board for a decade, you have had some influence in its direction. Now that you have the helm, what is your vision for the publication?

I believe that the only reason to publish is to be part of a scientific community that exchanges ideas. We live in a world that is drowning in low-value publications, which have nothing to do with being a “community,” but rather have become conduits for getting results out, advancing the economics of the publishers, and advancing job prospects for the authors. Lost in all this have been the scientific communities that revolve around journals, and the groups of people that create them.

JBO and SPIE serve the role of a central community, where biomedical optics researchers and translators go to advance the field. I view the journal as being intimately tied into the success of the field as a whole, and associating with it is key to advancing the field. The job of the journal is to promote quality research, and to provide a conduit to publish that research in a rigorously peer-reviewed way.

The JBO editorial board is a highly accomplished group of professors, government agency leaders, and medical center leaders who choose to associate with each other and choose to be involved in ensuring that quality work is advanced through publication in the journal; this is rarer and rarer. The highest-ranked journals are now run and managed by businesses, not scientists, and the lowest-ranked journals are run by businesses that convince scientists to associate with them, but don’t really engage anyone seriously.

JBO was created at the time the field was emerging, and has created a community of researchers around it, and publishes quality work. Beyond this, the journal is affiliated with the largest biomedical optics conference in the world, BiOS — this synergy and leadership in the scientific world has got to be trumpeted and highlighted.

3. You recently were awarded a $2M grant “to further develop whole body scanning of concentrations in the sub-micromolar range,” in pursuit of a commercial prototype, high-resolution, deep-tissue imaging application. Can you speak more about that effort?

I work within a large group of faculty, staff, and students who focus on Optics in Medicine at Dartmouth. Within this group, we have a wide array of research programs, mostly all translational, with a focus on creating new techniques and tools for imaging features of cancer and cancer therapy. This new grant is a fundamentally new paradigm for imaging tissue, using therapeutic radiation beams in a diagnostic mode.

Basically, the high-energy radiation beam passing through tissue is largely unattenuated, and spins off visible light — called Cherenkov light — along the way. This Cherenkov light is then able to excite molecular probes within the tissue, and optical imaging can be achieved where the light comes from within the body and exits out to the camera. This eliminates half the problem with optical imaging, in that the exciting light is actually produced inside the body. The high-energy radiation beams can be designed to deposit minimal dose, or they can be used in the setting of radiation therapy for cancer treatment, where therapeutic doses are given, and so the signals are extremely high.

The gist of this new approach is that we can get diagnostic molecular imaging information from tissue, using biocompatible organic probes that emit in the near-infrared wavelengths. This has a significant advantage over standard fluorescence imaging, where the light attenuation really limits what we can see to the first few millimeters, in most cases. We can see down through 2-3 cm of tissue with this approach, and yet the spatial resolution can be exceptionally high — near 100 micron resolution.

This level of tissue penetration, combined with high spatial resolution, has never before been achieved with optical imaging. The closest paradigm to this is photoacoustic imaging, but with imaging through that level of tissue, the molecular contrast probes would have to be in the millimolar range for photoacoustics to work. In our case, we can image well below a micromolar concentration of molecular probe, deep into tissue. This new imaging modality has only been published in two letters papers, and we are very excited about its potential for transforming what we can do in radiation therapy imaging and diagnostics.

4. Two-parter here: 1) What other research endeavors will compete for your time in the next year, and 2) How do you proportion time between teaching, research, and now editor-in-chief responsibilities?

This is the never-ending question in academic research. I am involved in many things: I teach three classes per year, run Dartmouth’s PhD and Masters programs, advise a number of undergraduates, and have a large research group of my own, funded by multiple NIH grants.

I also am involved with a startup company, DoseOptics LLC, making commercially viable Cherenkov imaging systems for radiation therapy dosimetry. So, to be blunt, I have very little free time. I treat all of these aspects with nearly equal weight, hire very good people to work with me, and task them appropriately. I count on working with smart, well-motivated people and, together, we get a lot done.

But I view JBO as perhaps my top priority right now. It is a critical journal for our field, and the editorial board is a highly accomplished group of individuals who work tirelessly in their own research, as well as for the journal. I care a lot about this and will be spending at least a day a week working on issues for the journal.

5. You helped to establish the Center for Imaging Medicine at Dartmouth-Hitchcock Medical Center (whose mission covers multi-scale sensing tools and the interpretation of images, interventional guidance in surgery, medicine, radiology, pathology, radiation oncology, etc). Do you have a particular passion among these fields, or do your interests shift, based on the project?

I have been involved in all aspects of these research areas, but my emphasis necessarily shifts based upon what is needed, what is funded, who is working on what, and what has the largest intellectual and translational impact in our field. I have parts of each of these areas in my current grants, but I also have colleagues in the center whose research covers these areas. So, we negotiate who is working on what, and we respect each other’s scientific areas.

There are times when I defer research directions in radiology or directions in pathology to others in the group, who have more active work or a larger knowledge base in that area. Basically, it ebbs and flows over time, and we are collegial about working together. It is a real blessing to be involved with people that you get along with and you know are doing good work, to be able to rely upon them and give back to them through collaborative research.

That is the type of environment that we have been fostering in the Center for Imaging Medicine. We work weekly with a large range of translational physicians in surgery, radiology, pathology and radiation oncology, and carry out clinical trials with them, and offer new technologies to them to try out. This is all largely biomedical optics based, and ranges from fundamental discoveries in technology to cancer biology, and is carried on through human pilot trials.

6. Advanced optics / optical imaging have allowed for many procedures that once necessitated “open” surgery to become minimally invasive. What medical procedures/treatments — untouched or little affected by such technologies until now — can we expect to see benefit from these technologies over the next few years?

There are many. As I outline in an upcoming article in SPIE Professional Magazine, optical imaging is definitively larger than radiological imaging by a factor of two. The global marketplace for optical imaging technologies is near $75 billion, whereas radiological imaging — such as x-ray devices — is closer to $38 billion. I think these numbers would be surprising to most in the medical imaging community, because they show that optical imaging is much more widely practiced than radiological imaging. 

The most recent expansions in optical imaging are largely from endoscopy, ophthalmology, and surgical robotics. Each of these is a minimally invasive procedure, where the physician is able to see or do things they could not see or do before, based on having miniaturized technologies, better control, or better imaging from the devices. The range of what is possible is constantly increasing.

There is no doubt in my mind that radiological imaging with continue to grow in use, but optical imaging will continue to grow at a faster pace. This is because optical technologies are inherently applied at the point of care, where the physician is touching or seeing inside the patient. Whereas radiological procedures inherently are done by a different subspecialty, are read by a different subspecialty, and cost the medical system much more — yet they don’t always provide pertinent information.

Additionally, in low-resource settings, such as developing countries, optical tools are almost the only imaging systems available at the right price point to deal with patients. As the populations grown in these settings and their medical systems, we will see the growth of smarter diagnostic optical systems which can help this style of healthcare management work.

Taken as a whole, I see biomedical optics being the primary imaging tool used today. They come in an extraordinarily large range of sizes, shapes, and configurations, and so they are not as visible bundled as other systems, such as an x-ray CT or MRI.

7. There currently exist, for obvious reasons, numerous collaborations between optics/photonics developers and medtech. How can these two communities further build upon/improve their working relationship (e.g., corporate/academic partnerships, research initiatives, regulatory endeavors, etc.)?

This is one of the premier challenges of our time. Academic research is being driven more and more toward applied work, given our funding models. Still, we need to make space and funding available for high science in basic research, and fund and celebrate such research when it is done well. In the translational space, there is need for every translational researcher to be cognizant of how their work may or may not eventually translate. Companies, on the other hand tend to dismiss much academic research and focus on inventing within their own culture, for business protection reasons.

The best conduit that the U.S. has is its culture of startup companies and pilot funding mechanisms for entrepreneurship, such as the SBIR programs, angel funding, and early stage investment firms. It is through these mechanisms that truly innovative ideas on commercially viable technologies get advanced today, and the process de-risks the venture. Larger companies tend to work on iterative small improvements in their systems, and then look to purchase small companies that have innovative or transformative technologies. The more we can encourage this system, the better off the community will be.

Funding programs like the National Cancer Institute’s (NCI) experiment on Industry/Academic partnerships is a terrific way to push the lines closer together. Regulatory workshops and discussion panels on focused issues of healthcare technology are necessary and happen regularly, but it is critical that members of our scientific and industrial communities engage the funding and regulatory agencies to ensure these things continue to happen. I have participated in many over the years, and see their creation as critical to advancing the field. It is not easy, and at the time, the effort can seem nonlinear and time-squandering, but the final outcomes can change the shape of our field.

8. Finally, a twist on a classic question: What is the worst career advice you have ever received?

I think the worst career advice I ever got was early in my career, where I was pushed to patent-disclose every new idea that came along. I feel like I could have a patentable idea at every group meeting or discussion with colleagues. But, to be honest, patenting well takes a long time, and no one has time for frivolous patents just for the sake of pushing them out. I am extremely judicious with my time, and now I only patent when there is essentially no clear prior art.

Patents are only worth something if you can defend them, and our new approach as my institution is that patents should be advanced if you are willing to back a startup company which would utilize these patents. I think that is a good acid test of your willingness to patent, because it asks if the person patenting is willing to change the direction of their career based around the patent idea. In academic research, this should never be taken lightly, and I see it as a good measure of when to act.

I have patented and continue to be involved, but only when it could lead to a fundamentally new technology or business. Everything else, in my mind, should be left to the business world; they know how to protect their IP space very well, and how to layer patents around central core technologies.

About SPIE

SPIE is the international society for optics and photonics, an educational not-for-profit organization founded in 1955 to advance light-based science, engineering, and technology. The Society serves nearly 264,000 constituents from approximately 166 countries, offering conferences and their published proceedings, continuing education, books, journals, and the SPIE Digital Library. In 2016, SPIE provided $4 million in support of education and outreach programs. www.spie.org