The Pathfinder

Brian Lundstrom, M.D., Ph.D., associate professor of neurology, brings a distinctive and, in many ways, quietly radical perspective to BIONIC. His vision centers on noninvasive neuromodulation as a path toward durable disease modification and, in some cases, cure, rather than lifelong symptom management.

With a background in biophysics, Dr. Lundstrom found his scientific calling in neurophysiology and studying the neural code — how neurons compute and encode signals. He became interested in working with patients with epilepsy, who routinely have their neural activity recorded to better understand the underlying disease. Because of this, epilepsy provides a unique opportunity to understand and improve neurological function for many disorders.

Ultimately, Dr. Lundstrom had a deep scientific goal: developing objective ways to measure brain excitability and function. With that foundation, clinicians could personalize brain stimulation, predict how patients will respond and intentionally drive long-term care.

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This led him to his clinical focus on the use of neural stimulation to treat epilepsy — both invasive (using implanted electrodes) and noninvasive (through external or wearable devices). And it’s through noninvasive therapies, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), that he sees opportunities to change the field.

“I’ve treated patients with epilepsy who undergo repeated stimulation, both invasive and noninvasive, and see a lasting reduction in their seizures, even after treatment has stopped,” says Dr. Lundstrom. “This is likely because our brains are highly plastic and can relearn healthier patterns of activity over time given optimal stimulation.”

What makes a noninvasive approach so compelling is its lower risk, with a lower barrier to access. “Patients must undergo surgery for an implanted device, and these are typically offered as a ‘last resort,’ when other treatment options have failed,” says Dr. Lundstrom. “But external stimulation is much lower risk and provides an opportunity to intervene much earlier in the disease course.”

[BIONIC supports a future] where we’re not only building more sophisticated devices, but these devices are more accessible, reaching more people and redefining how we think about neurological care.

— Brian Lundstrom, M.D., Ph.D.

These devices can be used outside of a hospital setting. Already some patients receive home-based stimulation for 20-30 minutes a day, several days a week, guided by their clinicians. In addition to epilepsy, these approaches can help with mood disorders, pain, tinnitus and even mild cognitive impairment, improving access to therapy across geographical barriers.

And Mayo Clinic is uniquely positioned to lead in this new arena because of its primary value: The needs of the patient come first.

“These noninvasive technologies attract less attention from commercial investment because they can be harder to monetize,” says Dr. Lundstrom. "But at Mayo Clinic, we are focused on what benefits our patients the most. And BIONIC exemplifies that, by supporting a future where we’re not only building more sophisticated devices, but these devices are more accessible, reaching more people and redefining how we think about neurological care.”

The post The Pathfinder appeared first on Mayo Clinic Magazine.

The Pioneer

To Gregory Worrell, M.D., Ph.D., William L. McKnight-3M Professor of Neuroscience, BIONIC doesn’t feel futuristic, but rather like the next logical innovation in neurological care — work Mayo Clinic has pioneered for years.

“We’ve already invested over a decade into building the scientific, technical, clinical and ethical foundation of this program,” he says. “BIONIC is our opportunity to harness emerging device and digital technologies to scale this work globally and make major advancements rather than incremental progress.”

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Dr. Worrell — who is also a recipient of the Tianqiao and Chrissy Chen Established-Investigator Career Development Award in Translation Research — is a pioneer in neurostimulation. His research focuses on understanding how seizures develop and how epilepsy affects memory, mood and sleep.

Through his work, Dr. Worrell and his team have created a “next-generation” implantable brain-sensing and stimulation system. This technology leverages artificial intelligence to learn from ongoing brain activity and personalize a patient’s therapy over time, advancing toward truly autonomous adaptive neuromodulation. Currently, he is leading clinical trials to evaluate this technology in patients with medically intractable focal and generalized epilepsy.

“Every person’s epilepsy is different,” says Dr. Worrell. “Patients need personalized, precision treatment because seizures and epilepsy-related symptoms aren’t generated by the same circuit in every person. Importantly, brain activity changes with brain state — whether a person is awake, sleeping, dreaming or experiencing a seizure. Yet clinicians have traditionally stimulated the brain the same way regardless of brain state. There’s no adaptation.”

This is the real chance to personalize treatment — when we’re already there, already recording, already learning from that patient’s brain.

— Gregory Worrell, M.D., Ph.D.

Because patients already undergo extensive monitoring during invasive epilepsy evaluations, the care team can test multiple stimulation targets and parameters at the bedside. This allows clinicians to optimize therapy for each patient before they permanently implant the device.

Dr. Worrell sees this approach as a bridge, enabling learning and personalization at the bedside today, while advancing toward a future in which implanted device systems continuously learn from brain activity and adapt therapy in real time. 

“We can now quantify the brain’s state in real time and test adaptive therapy in the moment,” he says. “This is the real chance to personalize treatment — when we’re already there, already recording, already learning from that patient’s brain.”

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The Architect

For Sean Pittock, M.D., Glenn W. and Katherine K. Hasse Chair of Neurology and Applebaum Family Professor of Neurosciences, BIONIC represents the natural evolution of work he's championed for nearly two decades.

In 2006, Dr. Pittock established the first dedicated Autoimmune Neurology Clinic in the United States — a multidisciplinary practice built on a transformative insight: that many conditions dismissed as untreatable neurodegenerative diseases were actually reversible autoimmune disorders responsive to immunotherapy. His approach has always been translational, extending laboratory discoveries directly to patient care.

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As a director of Mayo Clinic's Neuroimmunology Laboratory, he has spent the last decade building multidisciplinary teams focused on Mayo Clinic’s Connect to Cure initiative. He has built his career on finding biomarkers that allow clinicians to intervene before irreversible damage occurs.

Now, with BIONIC, Dr. Pittock sees an opportunity to apply that same philosophy to the brain's electrical signals.

[Electrical signaling data] is an underused biological resource, and one of our major goals is to harmonize all of that data in a new sort of biobank.

— Sean Pittock, M.D.

"A lot of electrical signaling data is already collected as a routine part of neurological diagnostics and surgical care," he says. "Really, it's an underused biological resource, and one of our major goals is to harmonize all of that data in a new sort of biobank."

For Dr. Pittock, collecting and interpreting this electrical data, particularly how signals change with aging or disease, is crucial for detecting conditions early enough to make a difference.

The post The Architect appeared first on Mayo Clinic Magazine.

The Navigator

Before Kai J. Miller, Ph.D., M.D., Ph.D., Professor of Neurosurgery, was a clinician, he was a physicist, and a neuroscientist. Because of this, Dr. Miller — who is also a recipient of the Tianqiao and Chrissy Chen Established-Investigator Development Award in Translational Research — embodies the core promise of BIONIC: translating deep scientific understanding directly into patient impact.

“A physicist is somebody who makes observations of the world and then tries to derive simple mathematical descriptions from that,” he says. “Then you learn rules based on those descriptions about how the world works. And our brains are part of the world.”

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Thanks to this multidisciplinary training, he approaches the brain as a physical system whose signals can be measured, modeled and translated into care. His research is focused on understanding brain circuit dynamics by measuring electrical activity via implanted electrodes. In essence, he says, “I develop tools to understand brain signals, and use this to directly help my patients.”

During procedures for epilepsy and other neurological conditions, Dr. Miller and his team record electrical activity directly from the brain. These signals reveal functional boundaries that traditional imaging cannot find — borders between regions that control movement, language, sensation or cognition.

Using advanced algorithms and AI-assisted analysis, the researchers interpret those signals as the surgery happens, generating individualized maps that reflect how that specific person’s brain is organized. These maps can then guide decisions on the patient’s care in the moment, leading to precise, personalized care, and new therapies for brain stimulation.

A physicist is somebody who makes observations of the world and then tries to derive simple mathematical descriptions from that. Then you learn rules based on those descriptions about how the world works. And our brains are part of the world.

— Kai J. Miller, Ph.D., M.D., Ph.D.

In the future, Dr. Miller sees a future where neurosurgery increasingly relies on adaptive models that predict outcomes before interventions occur. Digital representations of a person’s brain, built from real data, can help clinicians choose the safest and most effective path forward.

This work reflects a fundamental shift in how Mayo Clinic approaches brain care. By listening to the brain’s own signals and using them to guide action, Dr. Miller is helping move neurosurgery from approximation toward precision. This approach, grounded in science, sharpened by technology and guided by clinical judgment, illustrates how BIONIC turns deep understanding into safer, more personalized care for people facing serious or complex neurological diseases.

The post The Navigator appeared first on Mayo Clinic Magazine.

The Orchestrator

Gelareh Zadeh, M.D., Ph.D., arrived at Mayo Clinic in January 2025 with a clear mandate: to transform how the institution approaches neurological disease.

As chair of Neurosurgery, David C. and Flora C. Pratt Distinguished Chief Medical Officer for Mayo Clinic Platform, and a William J. and Charles H. Mayo Professor, Dr. Zadeh brings both the scientific credentials and the leadership vision to drive that change.

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Before joining Mayo Clinic, Dr. Zadeh spent nearly two decades building one of North America's premier brain tumor programs at the University of Toronto and Princess Margaret Cancer Centre, where she became the first woman elected as chair of the Division of Neurosurgery and earned recognition with the Canada Gairdner Momentum Award.

Dr. Zadeh brings her expertise in cancer genomics and disease prediction modeling to a transformative vision for BIONIC, and she cautions that the path to transformation won't be easy.

There is a lot for us to learn at a physiological, cellular and genomic level. And that, really, is the inspiration for BIONIC.

— Gelareh Zadeh, M.D., Ph.D.

"We don't understand neurological circuitry as well as we need to," she explains. "There is a lot for us to learn at a physiological, cellular and genomic level. And that, really, is the inspiration for BIONIC."

She sees the field of neuroscience as still in its infancy — and that gap between what we know and what we need to know has become her rallying cry for building BIONIC as an institution-wide effort. By bringing together neurologists, neurosurgeons, bioengineers and neurophysiologists, she's orchestrating a fundamental shift: moving from treating symptoms to understanding and speaking the brain's own language.

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Rewiring the Future

Every thought, memory and movement generates an electrical signal in the brain. For decades, clinicians have recorded these signals during routine diagnostics and surgical care without fully understanding their meaning. But these thousands upon thousands of datapoints could reveal how the brain works, how it changes with age and how it breaks down in disease. Mayo Clinic's BIONIC initiative aims to crack the code.

Despite the wealth of recording data, the field of neuroscience remains in its infancy. The brain's circuitry is far more complex than many realize, and the gap between what we know and what we need to understand has created an urgent challenge: How do we translate the brain's own language into treatments that can halt or reverse neurological disease?

Mayo Clinic's institution-wide initiative brings together neurologists, neurosurgeons, bioengineers, data scientists and neurophysiologists in a rich ecosystem that aims to answer that question through three interconnected approaches.

The program plans to do this first by collecting and harmonizing electrical signaling data into a comprehensive biobank called NeuroElectromics. This will create the next frontier in neuroscientific discovery and provide an unparalleled resource for the greater neuroscience community.

THE BRAINS BEHIND BIONIC

Mayo Clinic's BIONIC initiative brings together neurologists, neurosurgeons, computational scientists, biotechnologists and bioengineers to harness the brain's electrical language.

THE ORCHESTRATOR

Gelareh Zadeh, M.D., Ph.D., arrived at Mayo Clinic with a clear mandate: to transform its approach to neurological disease.

Read More

THE ARCHITECT

For Sean Pittock, M.D., BIONIC represents the natural evolution of work he's championed for nearly two decades.

Read More

THE PIONEER

To Gregory Worrell, M.D., Ph.D., BIONIC doesn’t feel futuristic, but rather like the next logical innovation in neurological care.

Read More

THE NAVIGATOR

Kai J. Miller, Ph.D., M.D., Ph.D., embodies BIONIC's core promise: translating scientific understanding into patient impact.

Read More

THE PATHFINDER

Brian Lundstrom, M.D., Ph.D., brings a distinctive and, in many ways, quietly radical perspective to BIONIC.

Read More

Secondly, researchers will apply advanced artificial intelligence (AI) and machine learning modeling to identify early biomarkers for neurological disease — patterns in electrical signals that could predict a person's risk for dementia, epilepsy, mood disorders and degenerative conditions long before symptoms are visible.

Finally, Mayo Clinic experts will close the loop, by turning those insights into precision neuromodulation therapies that speak back to the brain, allowing it to heal itself.

The vision is ambitious, moving from reactive symptom management to proactive, personalized care guided by the brain's own signals. Instead of waiting for decline or relying solely on surgical intervention, these tools would monitor activity and respond in real time, creating a therapeutic conversation between the brain and the device. Implantable devices could sense abnormal activity and deliver electrical stimulation to stop a seizure before it starts. Wearable devices could rewire abnormal neural circuits through noninvasive stimulation. Cell-enhanced implants could release neurotransmitters or critical proteins precisely where needed. Simple recordings of voice, eye movement and gait can serve as early biomarkers of deterioration.

Turning this vision into reality requires more than technology alone. It demands leaders who move seamlessly between clinic and lab — clinicians who can listen closely to the brain's activity and translate it into care for people living with serious or complex diseases.

At Mayo Clinic, that work comes to life through several of the physicians driving BIONIC forward, each bringing a distinctive perspective and expertise to this transformative effort.

The post Rewiring the Future appeared first on Mayo Clinic Magazine.

Precision Without Compromise

In the mid-2000s, Nadia Laack, M.D., a pediatric radiation oncologist at Mayo Clinic, saw an opportunity for patients. Mayo Clinic in Rochester was in the midst of designing a new facility for proton beam therapy — a powerful form of radiation that uses streams of protons to destroy tumor cells.

Dr. Laack knew that many patients would benefit the most from pencil beam scanning, the newest form of proton beam therapy. With this precise tool, she could direct protons at the exact contours of a tumor without injuring nearby organs.

But there was a catch. With pencil beam scanning, patients must remain perfectly still. For cancers in the lungs or abdomen, even the subtle movement of breathing could throw the beam off target.

And to prevent young children from wiggling, any form of proton therapy requires anesthesia, which greatly lengthens time in the treatment room.

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As a result, existing proton beam facilities only offered pencil beam scanning for cases where movement could be more controlled. These facilities also strictly limited the number of children they would treat each day so that, from a financial perspective, they could reserve more space for adults who could be moved in and out quickly.

Dr. Laack found these compromises unacceptable. Her colleagues agreed. Mayo Clinic would build the first proton beam facility in the United States that would exclusively offer the more advanced pencil beam scanning approach without limiting access for children.

To do so would come with significantly more work for Dr. Laack and her team, who partnered with engineers and physicists to design new tools to adapt to patients’ movements. And she brought on anesthesiologists to help engineer new ways to move kids in and out of treatment more quickly.

The Mayo Clinic Richard O. Jacobson Building housing the state-of-the-art proton beam facility opened in 2015. And Dr. Laack’s team has never had to turn away a child.

“We didn’t want anything to stand in the way of our ability to treat kids who needed our care,” she says.

Promise in Pencil Beam

Dr. Laack was committed to building a pencil beam scanning facility because she saw how much potential the treatment had to reduce the long-term side effects of radiation for many patients.

Traditionally, patients received radiation with photons, X-rays that pass into the body, through the tumor and out the other side of the body.

Photon radiation is an effective treatment for many cancers and is still commonly used today. But its path through the body requires radiation oncologists to limit the dose or risk damaging healthy tissue.

Proton beam therapy works by using a particle accelerator to whip protons up to a super high velocity — nearly the speed of light. A technician then directs these highly energized protons at a tumor. As protons pass into the body, they release most of their energy within the tumor, minimizing the radiation hitting healthy tissue around the cancer.

Pencil beam scanning is an even more targeted form that delivers protons packed into balls the size of pencil erasers, rather than a scattering of protons covering a wider area.

That precision is critical for children who could develop long-term side effects — such as growth, fertility or vision issues — if healthy tissue is damaged along with the tumor. Adults too can benefit from pencil beam scanning when tumors are situated in sensitive areas such as the brain, spinal cord, heart, lungs, liver and other abdominal organs.

Making Pencil Beam Possible

Dr. Laack and her team from the Division of Medical Physics collaborated with colleagues in the Department of Engineering to design tools to follow tumors in real time and only deliver protons when the tumors are on target. The team developed a respiration tracking tool, for example, that they place on a patient’s abdomen to capture the movement of breathing. They can then automatically trigger the proton beam to pause each time a tumor moves above or below the beam’s reach with each breath in and out.

To open access for more children, the team worked with Mayo Clinic anesthesiologists to figure out how to shorten treatment time. Their solution: prepare children for treatment outside of the pencil beam scanning room.

In the pretreatment area, a young patient lies on a specialized mobile table and begins receiving anesthesia from a compact delivery system. Once asleep, the child is then wheeled on the table into the pencil beam treatment room without interruption to anesthesia. Then a robotic arm docks onto the treatment table and moves it into the beam position. The robotic arm also has a compact anesthesia system built into the base, so the transfer of anesthesia tubes and lines is quick and seamless.

When designing this solution, the team was inspired by how anesthesia is delivered on the Mayo Clinic’s medical helicopters, says Dr. Laack. “You have a tight space in a helicopter too, and you don't want anesthesia lines in the way.”

In the proton beam treatment rooms, technicians use advanced imaging techniques to quickly pinpoint the precise location of the tumor. The robotic table adjusts and aligns the child perfectly so that the pencil beam directly hits the tumor.  

Commitment to Research and Care

Dr. Laack’s passion for designing the best possible cancer care began when her grandfather was diagnosed with leukemia. At the time, she was a college student at Colorado State University. She knew she couldn’t learn enough fast enough to help him. But she committed then to studying cancer so that she could help others.

As a medical student at Loma Linda University in California, Dr. Laack conducted research alongside her coursework, earning a master’s in physiology with a focus on breast cancer research.

She envisioned herself as a full-time cancer researcher. But then she began clinical rotations and discovered how much she values working with patients. “I was still passionate about studying cancer biology,” she says, “But the patient interaction was what brought me the most meaning and joy.”

It is so important to have all the tools in our toolbox so we can continue offering these patients the very best care.

— Nadia Laack, M.D.

As a radiation oncology resident at Mayo Clinic, she discovered that she was especially drawn to helping one patient group in particular: children. Working with kids facing difficult diagnoses was emotionally challenging, she says. “But I felt this was where I was needed the most.”

Today, Dr. Laack cares for patients of all ages, with a special focus on children. She also continues her research.

Before launching the proton beam facility, for example, Dr. Laack and her team spent a decade studying proton therapy and developing computer models that could project how effective and safe their new pencil beam facility would be for treating a wide range of cancers, including brain, breast, prostate and lung. After opening, they led more than 70 clinical trials to confirm that their proton therapy treatment resulted in the best outcomes. 

“The safety of our patients is the highest priority,” she says.

Accelerating Radiation Therapy Innovation for Patients

Today, Mayo Clinic’s proton beam therapy program has treated more than 10,000 patients, and soon, Mayo Clinic and Dr. Laack will have yet another radiation tool available for patients.

Within a few years, the recently constructed Duan Family Building at Mayo Clinic in Florida will be the first clinic in North America to offer a new technology: carbon ion therapy.

Carbon ion therapy is precise, much like proton therapy. But because carbon ions are more massive than protons, their impact is even more damaging to a tumor — making this form of radiation especially effective for patients with large or resistant tumors.

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Dr. Laack was an early proponent of bringing carbon ion therapy to Mayo Clinic. She recognized that Mayo Clinic staff were uniquely positioned to develop the new technology because of the knowledge they had already gained in proton therapy.

“We believed strongly that if anybody in North America was going to offer carbon ion therapy to patients, it needed to be Mayo Clinic,” she says. “We have the physics, the engineering and the physician expertise to be able to do it well and safely.”

Few of Dr. Laack’s pediatric patients require carbon ion therapy because pediatric tumors typically respond well to photon or proton therapy. But for some adult patients, and for children with treatment-resistant tumors, the technology could fight off cancer better and faster than existing therapies. Dr. Laack wanted to ensure that carbon ion therapy would be available for these patients.  

“Patients with some of the most difficult cancers — the hardest of the hard — come to us for hope and healing,” Dr. Laack says. “It is so important to have all the tools in our toolbox so we can continue offering these patients the very best care.”

The post Precision Without Compromise appeared first on Mayo Clinic Magazine.

Leading the Charge in Carbon Ion Therapy

Laura Vallow, M.D., stands at the forefront of a medical milestone: bringing carbon ion therapy to the United States.

As chair of the Department of Radiation Oncology at Mayo Clinic in Florida, Dr. Vallow leads a team of physicians, scientists and international collaborators who are advancing research in carbon ion therapy, an advanced cancer treatment that uses high-energy carbon particle beams to precisely target tumors.

“It’s not just another form of radiation,” says Dr. Vallow. “Carbon ions have unique biological properties. Our goal is to unlock that full potential.”

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Small-Town Roots, Big Ambitions

Raised in a small town 35 miles south of Chicago, Dr. Vallow grew up surrounded by family — including 28 cousins, a mom who served as a nurse, an uncle who was the fire chief, and another uncle who was the police chief. Hard work, helping others and service to the community were constant themes.

“There was always this closeness in my family,” she says. “Work and family were intertwined, and they had fun doing it. No one pushed me toward a specific career. Instead, they taught me to find my passion and work hard at it.”

For Dr. Vallow, that passion was science. She attended the University of Illinois where she earned a degree in biochemistry. During her years as an undergraduate student, she joined Argonne National Laboratory, where she worked alongside Ph.D. scientists and presented at national conferences, building the confidence to envision a future in science.

“I realized I could do this — and succeed,” she says. “I was excited for a life of helping and impacting others through science.”

Finding Medicine

Eager to continue her scientific career, Dr. Vallow entered Stritch School of Medicine, Loyola University Chicago where radiation oncology quickly captured her interest.

“Radiation oncology has this fascinating technology you get to explore,” she says. “It’s the perfect blend of science, technology and patient care.”

These are diagnoses that too often are a death sentence. Despite decades of work, progress has been limited. Carbon ion therapy gives us a real chance to change that.

— Laura Vallow, M.D.

After completing her residency at Rush Presbyterian St. Luke’s University, she joined Mayo Clinic in 2001. Specializing in breast radiation oncology, Dr. Vallow became a leader in clinical trials and advancing innovations to improve outcomes for patients with breast cancer, such as shorter treatment courses and effective positioning for minimal impact on heart and lungs during treatments. In 2021, she became chair of the Department of Radiation Oncology.

“Once I started at Mayo Clinic, I knew that I never wanted to go anywhere else,” she says. “I love the integration of science and patient care. It’s a wonderful thing to take care of patients in this environment where everyone pushes you to be your best.”

Shattering Limitations

Today, Dr. Vallow no longer runs a single lab. Instead, she oversees multiple research efforts, including collaborations with carbon ion centers in Asia and Europe. At the center of her work is Mayo Clinic’s new integrated oncology building — the Duan Family Building — which will house the nation’s first carbon ion treatment facility.

Current radiation therapy applies a one-size-fits-all approach, using general parameters that don’t account for biological differences between tumors and normal cells. Dr. Vallow wants to change that.

“We envision profiling tumors to understand which patients will benefit most, and at which dose,” she says. “That’s how we’ll shatter current limitations to make treatments more personalized — and more powerful.”

Her department is already advancing this vision. One prospective study, led by colleague Bradford Hoppe, M.D., compares outcomes and quality of life for patients with bone sarcoma receiving traditional care at Mayo Clinic versus those treated at international carbon ion centers.

Through studies like this, the team will extend carbon ion benefits to more people with more types of cancer.

Shaping the Future

Dr. Vallow credits Mayo Clinic’s leadership with taking bold steps to bring carbon ion therapy to the U.S.

“Many institutions have talked about it, but no one has done it,” she says. “Our responsibility is to do this so well and lay out the research so impeccably that others can follow, and together we’ll expand access to carbon ion nationwide.”

Under her leadership, the department is poised to continue to grow as Mayo Clinic opens its doors to patients in need of carbon ion therapy. Dr. Vallow’s vision includes tackling some of the most intractable cancers, such as glioblastoma and pancreatic cancer.

“These are diagnoses that too often are a death sentence,” she says. “Despite decades of work, progress has been limited. Carbon ion therapy gives us a real chance to change that.”

And now, with carbon ion therapy on the horizon, Dr. Vallow’s passion continues to drive her to reshape the future of cancer care.

“I didn’t always know I would end up as a physician researcher, but now, I couldn’t imagine doing anything else.”

The post Leading the Charge in Carbon Ion Therapy appeared first on Mayo Clinic Magazine.

Information overload continues to vex clinicians. The sheer quantity of data available in a patient’s electronic health record (EHR) alone makes it almost impossible to obtain a comprehensive picture of their condition. And while artificial intelligence-enabled algorithms are helping to summarize these reports, it’s not enough.

One solution is to develop a visualization system that quickly puts all the patient’s most important information at a clinician’s fingertips. That information needs to include not just content from the EHR but details on their genetic makeup and environmental exposure to toxins, input from wearables, published systematic reviews and meta-analysis, and so much more. That’s exactly what knowledge graphs (KGs) are designed to do. The latest research demonstrates that these tools are accomplishing that feat. 

What Is a Knowledge Graph? 

A KG is “a network of real-world entities — i.e., objects, events, situations or concepts — and illustrates the relationship between them. This information is usually stored in a graph database and visualized as a graph structure, prompting the term knowledge graph.”   

These visualization tools have a long history in healthcare, dating back to the famous graphic created by the English physician John Snow in the 1800s. As Figure 1 illustrates, he was able to link cholera outbreaks to water pumping stations in London. That connection became crystal clear when one looked at his map. The areas in the city circled in red represented the greatest number of cholera cases, most of which clustered around the Broad Street pump, circled in green.  

The cause-effect relationship between microbe-saturated water and cholera may be obvious to 21st century clinicians, but to Dr. Snow’s colleagues, it was a revelation. Similarly, clinicians and researchers who are deploying knowledge graphs are seeing hidden insights that are having an impact on patient care. 

Why Knowledge Graphs Are Important 

To date, there’s evidence to show that KGs are playing an important role in repurposing drugs so that they can be used to treat conditions they were not originally approved for. They can also improve clinical decision support when linked to EHR data, enabling them to detect hidden patterns, which in turn improve diagnostic predictions and treatment options. There’s also reason to believe KGs can support precision medicine and contribute to clinical research by generating better hypotheses and improving the reasoning process. 

These impressive accomplishments take advantage of a KG’s basic structure, which includes nodes, edges and labels — the so-called triple. As Figure 2 illustrates, nodes can include various types of data, including disease phenotypes, exposure to specific environmental factors, drugs and diet. Edges represent the relationships between these nodes, and labels can be the text used to explain the relationships. They can be as simple as a caption for a table or be more complex, referring to variables plotted on an X and Y axis. 

Figure 2 comes from a group of investigators who created a KG called SPOKE, an acronym for scalable precision medicine open knowledge engine. Their system took advantage of 41 specialized databases, 21 types of nodes and 55 types of edges. These data sources included content from molecular and cell biology, pharmacology, and clinical practice. Morris et al explain: “SPOKE has been used for a variety of biomedical applications including drug repurposing … disease prediction and interpretation of transcriptomic data … among others. More recently, we developed an algorithm to embed electronic health records onto SPOKE, which, when combined with machine learning techniques, enables a wide range of applications relevant to precision medicine.” 

Ziad Obermeyer, M.D., a professor at the University of California, Berkeley, once said: “The complexity of medicine now exceeds the capacity of the human mind.” With the flood of new data resources now available, that complexity has grown exponentially. Well-constructed KGs are “connecting the dots,” helping clinicians manage this information overload. As they find their way into routine medical practice, there’s reason to believe they will improve patient outcomes. 

This article was originally published on Mayo Clinic Platform.

The post A Deeper Dive Into Knowledge Graphs appeared first on Mayo Clinic Magazine.

A Childhood Dream, A Lifelong Mission

When Bradford Hoppe, M.D., was in middle school, he was told to make a collage using magazine cutouts to visualize his future goals. He created an image of a doctor living near the beach.

Today, his artwork has become a reality. Dr. Hoppe serves as a consultant in the Department of Radiation Oncology at Mayo Clinic and lives with his family in Atlantic Beach, Florida. But it’s not just a childhood dream that drives him. After nearly losing both his wife and his father to cancer, he is more determined than ever to transform the future of cancer care.

Following in His Father’s Footsteps

Raised in Los Altos, California, Dr. Hoppe grew up admiring his father’s lifelong career as a radiation oncologist at Stanford Medicine.

Dr. Hoppe says his dad’s work in Hodgkin lymphoma left a lasting impression that made him eager to follow in his footsteps. While traditional radiation could cure the condition, it could also lead to serious long-term side effects such as second cancers or heart complications decades later.

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“I became interested in this idea of optimizing clinical outcomes while minimizing risk of side effects. I knew I wanted to be part of the next generation of radiation therapy,” says Dr. Hoppe.

After earning a B.S. in biology at Stanford University and an M.D. at Cornell University Medical Center, Dr. Hoppe spent a year in Brazil conducting infectious disease and immunology research. He studied the impact of schistosomiasis, a parasitic disease, on the immune system and volunteered at a leprosy clinic.

“The work in infectious disease was really engaging in Brazil. But when I returned home, I knew I wanted to get back to my first passion: radiation oncology. I wanted to continue to advance the field just like my father had done.”

Shifting Coasts, Deepening Focus

After spending most of his life on the West Coast, Dr. Hoppe moved to the East Coast to pursue a radiation oncology residency at Memorial Sloan Kettering Cancer Center in New York, where he met his future wife, Sonia.

After completing an M.P.H. at Harvard School of Public Health, the couple then moved to Florida where Sonia began working in radiation oncology at Mayo Clinic and Dr. Hoppe became a faculty member at the University of Florida Health Proton Therapy Institute. There, he held the James E. Lockwood Endowed Chair in Proton Therapy and pioneered the development of proton therapy in the management of lymphoma, thymoma and lung cancer before joining Mayo Clinic in 2019.

“My wife had been working at Mayo Clinic as a radiation therapist for about 10 years before I joined,” says Dr. Hoppe. “When Mayo Clinic announced its plans for particle therapy, I knew it was the right move.”

Reimagining Carbon Ion Therapy

Dr. Hoppe is part of a team at Mayo Clinic that is bringing carbon ion radiation therapy to the United States. Similar to proton therapy, carbon ion can be delivered to a specific depth in the body, reducing damage to critical organs. However, unlike proton therapy, carbon ion causes clustered DNA damage, which is more effective in killing cancer cells, particularly with radiation-resistant cancers, and can be completed in less time than a traditional radiation therapy course. 

Mayo Clinic’s Duan Family Building in Florida will provide advanced cancer treatment options that are currently only available in Asia and Europe. The building opened to patients in July 2025, with the first carbon ion treatment expected to be available by 2028.

We are building upon existing strategies and making them better to shape a new future. And we’re getting closer every day.

— Bradford Hoppe, M.D.

Dr. Hoppe and his colleagues have toured and learned from existing carbon ion centers in Japan, Germany, Taiwan, Korea, Italy and Austria. But it’s not a simple copy-and-paste process.

“Mayo Clinic is approaching carbon ion therapy differently than other institutions,” explains Dr. Hoppe. “Traditionally, carbon ion therapy has been limited to rare, hard-to-treat tumors that don’t respond well to other treatments. But with the advances in precision medicine, we are working to identify patients with radioresistant forms of more common cancers who could benefit.”

Leading an International Collaboration

Dr. Hoppe is leading a collaborative clinical trial with centers in Europe and Asia to compare surgical treatment, proton radiation and carbon ion approaches for patients with pelvic bone sarcomas. The team is studying whether patients being treated with carbon ion therapy have higher cure rates compared with proton therapy and better functional quality of life compared with surgery.

Studies like this one will help experts better understand which cancers would benefit from carbon ion therapy.

“The key is knowing which patients will benefit from which treatments,” explains Dr. Hoppe. “It’s difficult for patients who have already undergone radiation unsuccessfully to jump into carbon ion because we don’t want to exceed radiation dose levels to critical structures and cause more problems for the patient. Our goal is to be able to identify the patients who would do better with carbon ion therapy at the time of diagnosis to improve outcomes and spare them from unnecessary side effects.”

A Mission Fueled by Experience

While Dr. Hoppe has realized his childhood dream, his mission has grown even more meaningful.

“My wife and my father both were diagnosed with metastatic cancers more than five years ago that were expected to be terminal,” says Dr. Hoppe. “Both have undergone cutting-edge, personalized treatments and are in remission.”

Dr. Hoppe is building on his father’s legacy — but also creating his own. His research in bone sarcomas is just the beginning.

“I imagine a future where Mayo Clinic will be able to identify patients most suitable for proton therapy and carbon ion radiation therapy through radiomic and genomic signatures. That means better outcomes, fewer side effects and more lives saved. We are building upon existing strategies and making them better to shape a new future. And we’re getting closer every day.”

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