MR relaxometer for improving clinical outcomes in hemodialysis

Michael J. Cima
David H. Koch Professor of Engineering
MIT Koch Institute for Integrative Cancer Research

2020 SENSE.nano Symposium
Tuesday, September 22, 2020
Session 3: Body systems
2:30PM – 2:45PM EST

Tuesday, September 29, 2020
Panel discussion: Needs and innovation
1:10PM – 1:50PM EST

Abstract
We recently discovered in a human clinical trial that the MR signal originating from skeletal muscle is an absolute measure of excess volume in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). HD patients are prescribed a volume of fluid to be removed by ultrafiltration during their dialysis session based on an assumed “dry weight.” Current real-time assessment measures include hematocrit with the objective of keeping it constant. The vascular volume is maintained during dialysis using this technology. Hematocrit does not, however, provide a measure of how close the patient is to his/her dry weight.

Clinical signs and symptoms are used to identify hypovolemia due to excessive fluid withdrawal. These non-specific indicators often lag behind the onset of hypovolemia and their presentation is highly variable between patients. Excessive fluid removal during HD is associated with nausea, vomiting, cramping, and chest pain. We have constructed a sensor that will measure the tissue relaxivity of muscle without the need for an MRI. This bedside instrument is portable and compatible with the dialysis suite. Our goal is to improve management of ESRD patient during HD and ultimately improve outcomes.

A photo of Michael CimaBiography
Dr. Michael J. Cima is the David H. Koch Professor of Engineering and a Professor of Materials Science and Engineering at the Massachusetts Institute of Technology and has an appointment at the David H. Koch Institute for Integrative Cancer Research. He earned a B.S. in chemistry in 1982 (phi beta kappa) and a Ph.D. in chemical engineering in 1986, both from the University of California at Berkeley. Prof. Cima joined the MIT faculty in 1986 as an Assistant Professor. He was promoted to full Professor in 1995. He was elected a Fellow of the American Ceramics Society in 1997. Prof. Cima was elected to the National Academy of Engineering in 2011. He now holds the David H. Koch Chair of Engineering at MIT. He was appointed faculty director of the Lemelson-MIT Program in 2009, which is a program to inspire youth to be inventive and has a nationwide reach. In 2018, Cima was named a co-director of MIT's Innovation Initiative and the associate dean of innovation for the School of Engineering.

Prof. Cima is author or co-author of over two hundred peer reviewed scientific publications, thirty seven US patents, and is a recognized expert in the field of materials processing. Prof. Cima is actively involved in materials and engineered systems for improvement in human health such as treatments for cancer, metabolic diseases, trauma, and urological disorders. Prof. Cima's research concerns advanced forming technology such as for complex macro and micro devices, colloid science, MEMS and other micro components for medical devices that are used for drug delivery and diagnostics, high-throughput development methods for formulations of materials and pharmaceutical formulations. He is a coinventor of MIT’s three dimensional printing process. His research has led to the development of chemically derived epitaxial oxide films for HTSC coated conductors. He and collaborators are developing implantable MEMS devices for unprecedented control in the delivery of pharmaceuticals and implantable diagnostic systems. Finally, through his consulting work he has been a major contributor to the development of high throughput systems for discovery of novel crystal forms and formulations of pharmaceuticals.

Prof. Cima also has extensive entrepreneurial experience. He is co-founder of MicroChips Inc., a developer of microelectronic based drug delivery and diagnostic systems. Prof. Cima took two sabbaticals to act as senior consultant and management team member at Transform Pharmaceuticals Inc., a company that he helped start and that was ultimately acquired by Johnson and Johnson Corporation. He is a co-founder and director at T2 Biosystems, a medical diagnostics company. Most recently, Prof. Cima co-founded SpringLeaf Therapeutics, a specialty pharmaceutical company and Taris Biomedical, a urology products company.