1. Personal Statement

I am an academic interventional radiologist specializing in image-guided interventional treatments. I first became interested in managing patients with Hepatocellular carcinoma(HCC) when I was a fellow in interventional radiology at Rush University Medical Center, where a portion of my time was spent in presenting cases in a multi-disciplinary tumor board. This opened my eyes to the limitations of the available treatment options for these patients. After my fellowship I continued as a faculty at Rush University Medical center for the next 5 years. I was the lead interventional radiologist in my group for interventional oncology. Managing patient with hepatocellular carcinoma has been a humbling experience. The currently available treatments are limited and the chance of a cure for this cohort of patients is very small. Although many novel treatments have been introduced in the recent past including drug eluting beads and radioembolization, the outcomes have not changed significantly.

My experience has encouraged me to look for other options for the treatment of Hepatocellular cancer. I have worked with other PIs and submitted R21 and CPRIT grants for looking at liver directed treatments for HCC. I have also done retrospective studies looking at outcomes after treatment of HCC with drug eluting beads and Y 90. The gap in knowledge from my clinical and research experience is in identifying the tumor biology to directed treatment. With this goal in mind I have approached the problem from the angle of identifying tumor biomarkers which will predict the tumor response. I believe that this will give us the opportunity to choose the right treatment for the right patient.

The outcome of patients with Hepatocellular carcinoma is very poor and it is of critical importance to develop new techniques to improve quality of life, reduce morbidity of treatment and prolong survival. In this project I will be collaborating with Dr. Hongyu Wang one of my colleagues who has extensive experience with Aptomer design and tumor biomarker identification. Our combined clinical and lab experience, coupled with the expertize of the advanced imaging center at UT Houston Health Science center provides the ideal environment to develop novel tools to enhance the treatment of these patients.

2. Positions and Honors

Position and Employment

07/1998 – 06/2002             Staff Radiologist, Amrita Institute of Medical Sciences, Kochi, India

10/2002 – 07/2003             Consultant Radiologist, Al Ahalia Hospital, Abudhabi, United Arab Emirates

11/2003 – 06/2005             Consultant Radiologist, Burnley General Hospital, Lancashire, United Kingdom.

07/2005 – 06/2007             Fellow, Rush University Medical Center, Chicago, IL

07/2007 – 12/2012             Attending, Rush University Medical Center, Chicago, IL

07/2011 – 12/2012             Associate Director, Section of Interventional Radiology, Rush University Medical Center, Chicago, IL

01/2013 – 09/2016             Assistant Professor, UT Southwestern Medical Center, Dallas, TX                                                                                                                

04/2013 –03/2016              Medical Director, Interventional Radiology, Parkland Memorial Hospital, Dallas, TX

09/2016-  Present               Associate Professor, UT Houston Health Science Center, Houston TX

09/2016-  Present               Section Chief, UT Houston Health Science Center, Houston TX

Other Experience and Professional Memberships

2004 – Present            Radiological Society of North America (RSNA), Member

2006 – 2009                American Roentgen Ray Society (ARRS), Member

2005 – Present            Society of Interventional Radiology (SIR, formerly SCVIR)) Member

2005 –  Present           American College of Radiology, Member

2003 – Present            Fellow of Royal College of Radiologist UK

1998 – Present            Indian Radiological and Imaging Association

Honors

1998      Diplomate of National Board of Radiology                                   National Board of Examinations, New Delhi, India

2003      Fellow of Royal College of Radiology (FRCR)                             Royal College of Radiologist, London, UK

2011      Certificate of Added Qualification (CAQ)                                     American Board of Radiology

2014      Magna Cum Laude                                                                                    Radiological Society of North America

2014      Certificate of Merit                                                                                       Radiological Society of North America

2014      Best Educational Exhibit                                                              Society of Interventional Radiology

2014      Certificate of Merit                                                                                      Society of Interventional Radiology              

2014      Best Educational Exhibit                                                              Global Embolization Symposium &Technologies

2014      Physicians Vascular interpretation (RPVI)                                   American Registry for Diagnostic Medical Sonography (ARDMS)

2015      Harvey L Neiman Grant                                                                             Society of Interventional Radiology 

2015      Certificate of Merit                                                                                      Society of Interventional Radiology 

2015      Certificate of Merit                                                                                      Radiological Society of North America

2016      Certificate of Merit                                                                                      Society of Interventional Radiology              

2016      Certificate of Merit                                                                                      Society of Interventional Radiology 

2016      Mentor: Constantine Cope Research Award                               Society of Interventional Radiology    

2016      Mentor: Resident in training research Award                               Society of Interventional Radiology 

2017      Best Educational Exhibit                                                                            Society of Interventional Radiology

2017      Best Educational Exhibit                                                              Association of University Radiologist

2018      Runner up for the best Scientific Research Paper        Journal of Vascular and Interventional Radiology

3. Contribution to Science:

1. We compared overall survival and toxicities after yttrium-90 (90Y) radioembolization and chemoembolization with drug-eluting embolics (DEE) in patients with infiltrative hepatocellular carcinoma (HCC) in a retrospective study.We did find that DEE was associated with more grade 1&2 toxicities but the overall survival was not different in the 2 groups. This study proves that new technology has not impacted the overall survival of patients with infiltrative HCC. However, the toxicity profile has improved. The key is in patient selection based of tumor biology. Thus the search for identifying the patients who will benefit from different treatments based on tumor biology.

Selected Peer-reviewed Publications

1. Single-Center Comparison of Overall Survival and Toxicities in Patients with Infiltrative Hepatocellular Carcinoma Treated with Yttrium-90 Radioembolization or Drug-Eluting Embolic Transarterial Chemoembolization. Joseph L. McDevitt,Ali Alian, , Baljendra Kapoor, Stacy Bennett, Amanjit Gill, Abraham Levitin, Mark Sands, K.V. Narayanan Menon, Federico N. Aucejo, Bassam Estfan, Anil K. Pillai, Sanjeeva P. Kalva, Gordon McLennan JVIR 2017 July PMID 28689934
2. Yttrium-90 Radioembolization of Hepatic Metastases from colorectal cancer Raval M, Bande D, Pillai AK, Ganguli S, Blaszkowsky LS, Beg MS, Kalva SP Front Oncol.2014 25:4:120 PMID 25120951

2. I have contributed to several Quality Improvement initiatives in clinical practice to set benchmarks. Some of the efforts are in        the field of oncology to determine the ideal time for exchange of nephrostomy tubes. In our research we have shown a difference in outcomes in cancer and non-cancer patients. This research also showed that the optimal time to do a tube exchange in patients with cancer is between 40 and 60 days. Previously there has not been a data driven protocol for this process. This paper was awarded the runner up best research paper in the Journal of Vascular and Interventional Radiology in 2017.

Selected Peer-reviewed Publications

1. Long-Term Percutaneous Nephrostomy Management of Malignant Urinary Obstruction: Estimation of Optimal Exchange Frequency and Estimation of the Financial Impact of Patient Compliance. McDevitt JL, Acosta-Torres S, Zhang N, Hu T, Odu A, Wang J, Xi Y, Lamus D, Miller DS, Pillai AK. JVIR J Vasc Interv Radiol. 2017 Apr doi: 10.1016/j.jvir.2017.02.031. PMID: 28385361
2. Comparative evaluation of non-procedural nephrostomy -related complications in patients with         ureteric obstruction due to cancer versus other causes: Is the protocol of routine 3-month nephrostomy exchange optimal for both disease processes?   T Hu, N Zhang, J McDevitt,A Odu, Y Xi, D Lamus, AK Pillai JCIR 2017

3. I have contributed to the development of a six sigma tool to evaluate process in interventional radiology. For instance, my paper of utilizing DMAIC methodology to increase IVC filter retrieval has been in place for over 3 years. The national retrieval rates are very low. One of the reasons for the poor retrieval rates is poor patient follow up. We utilized a quality improvement tool namely Define, Measure, Analyze, Implement and Control to improve the filter retrieval rates for IVC filters in our institution.  The filter retrieval rates prior to implementing this program was 8% and this increased to 52% after an automated system of scheduling patients for a clinic follow up was implemented. This was also associated with increase revenue to the section. This project was presented at the 2014 SIR meeting and was awarded first prize. This article underscores the utilization of quality improvement tools to improve processes in interventional radiology. It describes by example how a Quality improvement project can be done utilizing the DMAIC methodology.

Selected Peer-reviewed Publications

1. 1. Improving inferior vena cava filter retrieval rates with the DMAIC methodology. P Sutphin, S Reis, A Mckune, M Ravanzo, SP Kalva, Pillai AK  JVIR 2015;26: 491-98 PMID25636673
   2. Approaching the Practice Quality Improvement Project in Interventional Radiology Reis SP, White B, Sutphin PD, Pillai AK, Kalva SP, Toomay SM. J Am Coll Radiol.2015,(PMID26337461)
   3. Safety and Effectiveness of Denali Inferior Venacaval Filter: Intermediate Follow up results Reis SP, Kovoor J, Sutphin PD,Toomay S, Trimmer C, Pillai AK, Reddick M, Kalva SP Vasc Endovascular Surg 2016,Aug 31 PMID 27581228

4. I have introduced innovative methods to do difficult procedures to reduce complications and improve outcomes. For instance, I have popularized the use of Intravascular ultrasound to gaining access to the portal vein. The research published in the Journal of Vascular and Interventional radiology in transforming the technique of performing the Transjugular intrahepatic portosystemic shunt creation. I have had several invited talks to demonstrate these new innovative techniques.

Selected Peer-reviewed Publications

1. 1. Utility of Intravascular US-Guided Portal vein access during transjugular intrahepatic portosystemic shunt creation: Retrospective Comparison with conventional technique in 109 patients. Pillai AK, Andring B, Faulconer N, Reis SP, Xi Y,Iyamu I, Sutphin PD, Kalva SP J Vasc Interv Radiol 2016, 27: 1154-9 PMID 27363298
   2. Portal Hypertension: A review of portosystemic collateral pathways and endovascular interventions: Pillai AK, B Andring, A Patel, C Trimmer, S Kalva Clin Radiol 2015 July (PMID 26188844)
   3. A retrospective analysis of technical factors influencing patency of Transjugular intrahepatic portosystemic shunts: Does the distance between the venous end of the stent and the hepatocaval junction matter in the era of Stent-grafts. World Journal of Gastroenterology 2015 Jul 14;21(26): 811—7 .B Andring, Kalva SP, Sutphin P, A Anene, R Sinivas, Burell M, Xi Y, Pillai AK(PMID 26185383)

5.  I have also introduced the technique of directly accessing the thoracic duct from the neck for lymphangiograms. The intranodal lymphangiograms are performed to take care of lymphatic leaks. This procedure is new and directly accessing the thoracic duct was not previously described.

Selected Peer-reviewed Publications

1. Interventional radiology in the management of thoracic duct injuries: Anatomy, techniques and results. Toliyat M, Singh K, Sibley RC, Chamarthy M, Kalva SP, Pillai AK Clin Imaging. 2017 Jan 3;42:183-192.PMID 28103513
2. Direct Percutaneous Access to the  Cervical Portion of the Thoracic Duct, an Alternate to Traditional Access through the Cisterna Chyli. Reis SP, Macfurlane J,Anene A,Pillai AK  J Vasc Interv Radiol 2015;12:1902-4 (PMID 26596185)

A complete list of my peer reviewed publication can be viewed at

https://www.ncbi.nlm.nih.gov/labs/bibliography/1doyk3zEFI9kf/bibliography/public/

D.           Research Support

Completed Research Support

Grantor:  Society of Interventional Radiology

Title of Project:  “Improving Quality of Care for Patients with Percutaneous Nephrostomy through a Dedicated Interventional Radiology Driven Follow-up Program”.

Role of the Nominee:  Principal Investigator

Annual amount and date (direct costs only):  $30,000

Total Award Amount:  $30,000; 6/1/2015-5/31/2016 I year

Grantor:  Nordian/BTG

Title of Project:  A Phase III Clinical Trial Evaluating TheraSphere® in Patients with Metastatic  Colorectal Carcinoma of the Liver Who Have Failed First Line Chemotherapy

Role of the Nominee:  Institutional Principal Investigator

Annual amount and date (direct costs only):  None, company sponsored Clinical trial;

Grantor: Gore Medical

Title of Project: Endoprosthesis versus Percutaneous Transluminal Angioplasty (PTA) to Revise Arteriovenous Grafts at the Venous Anastomosis in Hemodialysis Patients (Gore REVISE study).

Role of the Nominee:  Institutional Principal Investigator

Annual amount and date (direct costs only):  None, company sponsored Clinical trial; 2009-2012

Grantor:  Gore Medical

Title of Project:  The GORE VIATORR TIPS endoprosthesis versus Large-Volume Paracentesis for the treatment of ascites in patients with portal hypertension.

Role of the Nominee:  Institutional Principal Investigator

Annual amount and date (direct costs only):  None, company sponsored Clinical trial; 2011-2013

Ongoing Research Support:

Grantor:  Society of Interventional Oncology

Title of Project:  “Identify Proteomic Biomarkers for Outcome Prediction of Lipoidol TACE ”.

Role of the Nominee:  Principal Investigator

Annual amount and date (direct costs only):  $100,000

07/01/2018-06/31/2020 2 years