Established Technologies

The Department of Laboratory Medicine at the National Institutes of Health is a large modern laboratory, fully equipped with state-of-the-art instrumentation. The laboratory employs 170 people and operates 24 hours per day, 365 days per year.

The Department of Laboratory Medicine includes five services: Chemistry, Hematology, Immunology, Microbiology, and Phlebotomy.

The department provides laboratory testing for all Clinical Center inpatients and clinic outpatients. This translates to more than 1 million test results per year. A hospital-wide information system is used for ordering and reporting laboratory tests. There is also a stand-alone laboratory information system (LIS) that interfaces with the hospital information system. Because many of the instruments in the department are interfaced, test results are available to the nursing units as soon as they are certified. Reports are printed on the nursing units and clinics for tests that are ordered in the hospital information system as STAT or Priority. All other reports are printed as cumulative reports every six months.

Established Technologies

The three research arms of FAB are Neuromotor Assessment and Recovery, Virtual Functional Anatomy, and Rehabilitation Robotics. Beyond movement analysis using infrared cameras or magnetic resonance imaging (MRI), FAB has expanded its expertise to areas that include state-of-the-science balance assessment, a robotics laboratory, and ultrasound. In addition, FAB has begun a program that uses brain imaging technologies (EEG and fNIRS) to assess and train motor coordination and capabilities.

Instrumentation

• Motion capture Vicon MX system with ten T40 cameras (Vicon Motion Systems, Inc; Denver, CO)
• Three AMTI OPT464508-2000 force plates (Advanced Medical Technology, Inc; Watertown, MA)
• Split-belt instrumented treadmill (Bertec Corporation; Columbus, OH)
• 16 channel Trigno wireless EMG (Delsys Inc; Boston, MA)
• 10 channel MA300 wired EMG system – surface and fine wire (Motion Lab Systems, Inc; Baton Rouge, LA)
• ZeroG dynamic body-weight support system (Aretech, LLC; Ashburn, VA)
• SMART EquiTest and long forceplate (NeuroCom International, Inc; Clackamas, OR)
• Custom virtual reality system (HeadRehab, LLC; Chicago, IL)
• SonixTOUCH ultrasound machine (Ultrasonix; Richmond, B.C., Canada)
• iU22 Philips ultrasound machine (Koninklijke Philips Electronics N.V.; Eindhoven, the Netherlands)
• System 3 Biodex dynamometer (Biodex Medical Systems; Shirley, New York)
• 32 channel Near-Infrared Spectroscopy (NIRS) system – noninvasive optical brain monitor (TechEn, Inc; Milford, MA)
• 64 channel MOVE wireless EEG system with actiCAP electrodes (Brain Products; Germany)
• 64 channel Mindo Coral wireless EEG system with dry electrodes (EEE Holter Technology; Taiwan)

Established Technologies

• Body Composition
  • DXA (450-lb capacity)
  • Bod Pod
  • Bioelectical Impedance (single and multi-frequency)
  • Stable isotopes

• Physical Activity and Fitness Assessments
  • Exercise testing lab
  • Accelerometers
  • Continuous heart rate and blood pressure

• Dietary
  • Metabolic kitchen
  • Computerized vending machines
  • Food preference/array

• Whole-body Energy Metabolism
  • Three whole-room indirect calorimetry suites
  • Metabolic carts
  • Doubly-labeled water

• Nursing (inpatient and outpatient)​​​​​

Established Technologies

CIPS can process most modern imaging modalities such as MR, CT, PET and Ultrasound in anatomical regions from the hand to the heart. The CIPS lab currently offers services in seven exam categories.

IP Dynamic Enhancement
Dynamic Enhancement MRI (DEMRI) is a type of MRI study in which intravenous contrast is administered to a patient and the pattern of contrast uptake and washout within a lesion is observed. IP exam provides pharmacokinetic analysis for region of interest, lesion, and whole image.

IP Perfusion
IP perfusion is a technique whereby the physiologic parameters of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) are estimated based on the kinetics of a bolus passage of contrast through the brain. MRI perfusion provides relative measures of these parameters.

IP 3D Angiography
3D MR Angiogram and 3D CT Angiogram are techniques whereby intravenous contrast is administered rapidly to a patient and 3D imaging sets are obtained. 3D rendering depicts both the arterial and the venous systems.

IP Virtual Endoscopy
Virtual endoscopy provides simulated visualization of patient specific organs equivalent or similar to those produced by standard endoscopic procedures. This technique covers a wide range of potential clinical applications and enables physicians to reliably see an internal view of obstructed lesions and most stenoses.

IP 3D Reconstruction
3D reconstruction of medical images can improve visualization of complex anatomy in a more intuitive manner. 3D visualization includes volume rendering, surfacing and multi-planar image reformation, which optimizes the analysis of pathology in complex body parts.

IP Measurement
IP Measurement analyzes areas of medical interest using 3D image measurements based on size, position, brightness, shape and topology. The reported numerical values represent width, height and density of specific anatomical regions and can be used for treatment monitoring (i.e., drug therapy, etc.).

IP Limited
IP Limited provides image processing services for protocols that do not include a radiologist report. The results are used for research purposes only and can be found in PACS.

The CIPS lab also develops software research to extend the capabilities of the lab through creating new software tools and automated algorithms for measurement, detection, and diagnosis of clinical images. Current projects include pulmonary image analysis, breast image analysis, organ segmentation and modeling, fat measurement, dynamic contrast enhanced MRI, tumor segmentation and measurement, spine and vertebra labeling, molecular imaging and 3D visualization.

User Guidelines

To order a clinical service, access the Clinical Research Information System (CRIS) and select the appropriate IP exam.

Established Technologies

The production of cellular therapies is complex. Most clinical cell therapy products require cell mobilization, collection, subset isolation, in vitro or in vivo stimulation, and culture over a period of several days. The production of some cellular therapies involves serial isolation steps and multiple stimulation and/or culturing steps. Cellular therapy product manufacture is further complicated by donor or patient genetic and physiological heterogeneity. The final product is often markedly different from the starting material.

Despite these complexities cellular therapies must be of high quality. Cellular therapies must provide the desired clinical affect without resulting in adverse effects. An adequate dose of cells must be provided to each patient, each product must meet release specifications, and lot-to-lot variation should be minimized.

In order to produce consistently high quality products, quality assurance has become a critical part of cellular therapy laboratories. Cell therapies must be safe, pure, sterile, stable, and potent. To ensure that cell therapies have these properties, they are tested in many ways both during and at the end of their production. The analysis of cell therapies has become an important part of the delivery of effective clinical cellular therapies.

The goal of these studies is to develop novel methods to assess the quality of cellular therapies. Traditional analytic assays including ELISA, flow cytometry, and ELISPOT have many limitations. Better assays are needed to assess the complex and multiple functions of cellular therapy products, some of which are not well understood. Gene expression profiling using microarray technology has been widely and effectively used to assess changes of cells in response to stimuli and to classify cancers. Preliminary studies have shown that the expression of noncoding micro RNA which play an important role in cellular development, differentiation, metabolism and signal transduction can distinguish different types of stem cells and leukocytes. Both gene and micro RNA expression profiling have the potential to be important tools for assessing cellular therapies. In addition, these assays could be used to identify biomarkers that correlate with the safety, purity, and potency of cellular therapies; validate that therapies prepared using different methods are equivalent; and assess changes in the cellular therapy manufacturing process. The development of these assays will lead to safer and more effective therapies for all patients being treated with cellular therapies.

Objectives

• Develop novel molecular methods to access cellular therapies
• Identify and validate biomarkers for cell potency, purity, and viability
• Validate biomarker expression by the cellular therapies with their clinical effectiveness

Development of New Cellular Therapies

The cell therapy laboratory invests a considerable amount of resources in the development of new cellular therapies. While the development of most of these cellular therapies are initiated in the laboratory of clinical investigators, the Cell Processing Laboratory must scale up and validate these procedures. For many protocols this process involves considerable scientific, medical, regulatory and laboratory input from the Cell Processing Section.

Established Technologies

NMRF is responsible for the following activities:

• Provide intellectual, technical and material support for investigators using its imaging and computer resources.
• Manage the NMR Center wide computer network.
• Provide support for NMR Center Steering Committee activities

NMRF imaging resource includes a state-of-the-art 7.0 T human MRI system and other resources required for anatomical, functional and spectroscopy studies.

NMRF core personnel includes a Director (Dr. Alan Koretsky), a Technical Director, an MRI Physicist, an MRI Technologist, a Network/Systems Administrator and a program assistant.

Positron emission tomography (PET) is an imaging technique that uses radioactive substances injected into patients to provide images of the body using specialized scanners. These PET images provide information about the function and metabolism of the body’s organs, in contrast to computed tomography (CT) or magnetic resonance imaging (MRI), which show the body’s anatomy and structure. PET is used mainly to study patients with cancer, heart disease, and neuropsychiatric diseases.

PET at the National Institutes of Health (NIH) is a large, state-of-the-art facility. It has three medical cyclotrons and ten hot cells to produce positron-labeled radiopharmaceuticals as well as four PET scanners. There is a large dedicated team of physicians, scientists, cyclotron engineers, radiochemists, radiopharmacists, and nuclear medicine technologists staffing the Department. Patients from several NIH Institutes receive PET scans in the Department through a large number of clinical research protocols.

PET is a research facility for the NIH intramural research program. All PET activities and services support intramural research.

Our challenge is to utilize resources efficiently and to encourage maximum involvement and professional development while exceeding the expectations of our investigators and their patients; our staff; and the public.

Established Technologies

• Virtual Colonoscopy
• Confocal Volume Rendering/Virtual Bronchoscopy
• Radiofrequency Thermal Ablation as Tumor Therapy
• New Applications of Radiofrequency Thermal Ablation
• Radiofrequency Thermal Ablation for Liver Tumors; Kidney Tumors; and Painful Bone and Soft Tissue Masses
• T1 correction in gadolinium enhanced myocardium

Established Technologies

• Cell Irradiator Facility

Instrumentation

• Gammacell 1000 Elite Sealed Source Irradiator

User Guidelines

Contact the Division of Radiation Safety for information on required training and security clearance procedures. Note that new irradiator users MUST BE ESCORTED by an approved user until notified by Radiation Safety that he unescorted access process has been completed.