After 20 years of study, Dr Stuart Grieve has a comprehensive knowledge of what radiology can reveal about the human body. His current work at the Charles Perkins Centre involves trialling a dramatic new advance imaging technology.
Professor Stuart Grieve (BSc ’96 MBBS ’06) is travelling from Sydney to Grafton when he talks to SAM Heritage. He is about to compete in the Grafton to Inverell Cycle Classic, known as Australia’s toughest one-day cycling race. It is clearly not for the faint hearted: you could call it a 228-kilometre stress test for the heart.
Dr Grieve knows a lot about the heart and what causes it stress. He is a highly skilled clinician and a scientist with a focus on non-invasive imaging in healthcare, including the recent technological advance of 4D Flow Magnetic Resonance Imaging (MRI).
His interest in MRI, which uses strong magnetic fields rather than x-rays to generate images of body organs, started when he was an undergraduate studying science and biochemistry at the University of Sydney. “The light-bulb moment was when I first saw an MRI image as part of that biochemistry course,” Dr Grieve says.
This was the start of a 20-year training program that saw him complete a PhD in MRI at Oxford University in the UK, then postdoctoral studies on brains and hearts and 12 years of clinical training in medicine and radiology. The result is comprehensive technical and clinical knowledge.
On returning to the University of Sydney, Dr Grieve set up the lab at the Charles Perkins Centre where he now works. His team is researching 4D Flow MRI, which takes 3D MRI into the 4th dimension, time, by showing how the blood travels through the heart – it’s like an MRI scan in motion. This means that even before an aortic valve replacement is carried out, doctors can see how the implant will interact with the heart after surgery. It improves outcomes substantially.
To support this work, Dr Grieve is running the biggest ever trial of 4D MRI, called 4DCARE, for which he has recruited 600 people across four sites in Sydney and Melbourne. The aim is to prove that 4D diagnostics are cheaper and three times faster than conventional MRI.
The team has scanned 15 former rugby players – ex-Wallabies – and is scanning a further 30. Associate Professor Sharon Kay, a colleague of Dr Grieve, noticed many elite rugby players had an unusual pattern of significant aorta enlargement, possibly due to the type of training they undertake and the impact of their sport.
“There is overwhelming recognition that high-level sportsmen experience problems from multiple concussions and they have relatively high rates of depression and suicide,” Dr Grieve says. “We are looking for changes in the wiring of the brain and whether these relate to measurements that can make someone vulnerable to depression.”
Dr Grieve splits his time between clinical work and research. “We are pushing the envelope in terms of maximising the potential of MRI, but we don’t want to be only a technical lab,” he says.
“The mandate for any work we do is that it must relate to clinical care. For this reason, we are aiming to roll out the technologies we have developed to be tested in large-scale trials as this level of evidence is the only meaningful pathway to clinical change.”
To talk about how you can support Professor Grieve’s work, please contact Lachlan Cahill: ph (02) 8627 8818
Written by Dr Kerry Little
Photography by Sarah Rhodes (BA ’96, M.Pub. ’09)