Nimmi Ramanujam

Overview:

Dr. Ramanujam is the Robert W. Carr Professor of Engineering and Professor of Cancer Pharmacology and Global Health at Duke University. She founded the Center for Global Women’s Health Technologies (GWHT) in 2013 where she empowers trainees to create impactful solutions to improve the lives of women and girls globally. This center, since inception, has catalyzed new research activities and the development and commercialization of several technologies that advance prevention and treatment of cervical and breast cancer. The fundamental goal of her work is to create technologies that bring proven hospital-based solutions to point of care settings and, at the same time, pursue basic science research to understand and prevent cancer recurrence, specifically in breast cancer. 

Dr. Ramanujam’s work has led to low-cost community and home-based technology innovations that provide widespread cancer surveillance globally. To complement her translational efforts, Dr. Ramanujam’s post-doctoral fellowship with Prof. Britton Chance inspired her to exploit the dynamic changes in tumor metabolism that allow cancers to go under the radar and recur in a stealth mode when conditions are favorable. She is also creating a liquid-based ablative therapy with dual roles - (1) to address the pressing issue of cancer control in environments where access to surgery is scarce, and (2) enhance tumor kill through a combination of necrosis and T cell infiltration occurring as a result of tumor antigen presentation following ablation. She has created two companies Zenalux and Calla Health to commercialize her breast and cervical imaging products. 

Dr. Ramanujam has built several global initiatives. The most notable is a consortium to impact cervical cancer prevention in low resource settings. Her MacArthur Foundation 100&Change proposal, Women-Inspired Strategies for Health:  A Revolution against Cervical Cancer (WISH) has been recognized as one of the Top 100 of the 755 proposals submitted to this $100M grant competition and is now part of the Bold Solutions Network (Macarthur 100&Change). In addition to her cervical cancer prevention initiative, she has also created a global women’s education program that intersects design-thinking, STEM concepts, and the U.N. Sustainable Development Goals to promote social justice awareness (IGNITE). She has launched an arts and storytelling initiative to raise awareness of sexual and reproductive health inequities (https://theinvisibleorgan.com/). 

Dr. Ramanujam has more than 20 patents to-date and more than 150 publications for screening, diagnostic, and surgical applications. She has raised over $30M of funding to pursue these innovations through a variety of mechanisms including NIH R01s and R21s, NIH Bioengineering Partnerships, NCI Academic Industry Partnerships, NIH Small Business grants and USAID funding. As the director of the Center for Global Women’s Health Technologies, she has developed a network of 50+ partners including international academic institutions and hospitals, non-governmental organizations, ministries of health, and commercial partners; this consortium works to ensure the technologies developed at the center are adopted by cancer control programs in geographically and economically diverse healthcare settings.  

Dr. Ramanujam has received numerous awards including the MIT TR100 Young Innovator award (MIT), the Global Indus Technovator award (MIT), the Stansell Family award (Duke), multiple Era of Hope Scholar awards (DoD), the Emerging Leader in Global Health Award (CUGH), the Social Impact Abie Award (AnitaB.org), the Biophotonics Technology Innovator Award (SPIE), the Women in Molecular Imaging Leadership Award (WMIC), the Michael S. Feld Biophotonics Award (OSA) and the Wom C Global Impact Award (Duke). She is a fellow of several optical and biomedical engineering societies including OSA, SPIE, and AIMBE. She is a Fulbright scholar and the 2020 IEEE Distinguished Lecturer. She is an elected member of the National Academy of Inventors. She has demonstrated her work’s global impact through presentations at the United Nations and TEDx events, and a number of national and international plenary talks. Her work has been featured in a number of venues including ABC News, Wired Magazine and NPR. 

Positions:

Robert W. Carr, Jr., Distinguished Professor of Biomedical Engineering

Biomedical Engineering
Pratt School of Engineering

Professor of Biomedical Engineering

Biomedical Engineering
Pratt School of Engineering

Research Professor of Global Health

Duke Global Health Institute
Institutes and Provost's Academic Units

Professor of Pharmacology and Cancer Biology

Pharmacology & Cancer Biology
School of Medicine

Affiliate of the Duke Initiative for Science & Society

Duke Science & Society
Institutes and Provost's Academic Units

Core Faculty in Innovation & Entrepreneurship

Duke Innovation & Entrepreneurship
Institutes and Provost's Academic Units

Core Faculty Member, Duke-Margolis Center for Health Policy

Duke - Margolis Center For Health Policy
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1989

University of Texas, Austin

M.S. 1992

University of Texas, Austin

Ph.D. 1995

University of Texas, Austin

Grants:

A Portable low-cost, Point of Investigation CapCell Scope to Image and Quantify the Major Axes of Metabolism and the Associated Vasculature in In vitro and In vivo Biological Models

Administered By
Biomedical Engineering
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

A Novel Optical Spectral Imaging System for Rapid Imaging of Breast Tumor Margins

Administered By
Biomedical Engineering
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Novel see and treat strategies for cervical cancer prevention in low-resource settings

Administered By
Biomedical Engineering
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Culturally appropriate screening and diagnosis of cervical cancer in East Africa

Administered By
Biomedical Engineering
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Towards a viable solution for a see and treat paradigm for cervical pre-cancer in East Africa

Administered By
Biomedical Engineering
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

Physiologic, metabolic, and structural alterations in breast cancer: Assessment via optical technologies

Optical spectroscopy was used to assess structural and functional changes which occur in breast tissue for the optical diagnosis of cancer in humans in vivo, and characterization of mammary tumor biology in animal models. © 2006 Optical Society of America.
Authors
Ramanujam, N; Brown, JQ
MLA Citation
Ramanujam, N., and J. Q. Brown. “Physiologic, metabolic, and structural alterations in breast cancer: Assessment via optical technologies.” Optics Infobase Conference Papers, 2006. Scopus, doi:10.1364/fio.2006.jwc1.
URI
https://scholars.duke.edu/individual/pub1453761
Source
scopus
Published In
Optics Infobase Conference Papers
Published Date
DOI
10.1364/fio.2006.jwc1

Use of genetic algorithms to optimize fiber optic probe design for the extraction of tissue optical properties

An approach for optimizing the probe geometry for extracting optical properties is developed. It was found that optical properties could be extracted with accuracies of better than 0.5 cm-1, while requiring no a priori assumptions. © 2005 Optical Society of America.
MLA Citation
Palmer, G. M., and N. Ramanujam. “Use of genetic algorithms to optimize fiber optic probe design for the extraction of tissue optical properties.” Optics Infobase Conference Papers, 2006. Scopus, doi:10.1364/bio.2006.me45.
URI
https://scholars.duke.edu/individual/pub1454508
Source
scopus
Published In
Optics Infobase Conference Papers
Published Date
DOI
10.1364/bio.2006.me45

Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver.

OBJECTIVE:Ethanol ablation, the injection of ethanol to induce necrosis, was originally used to treat hepatocellular carcinoma, with survival rates comparable to surgery. However, efficacy is limited due to leakage into surrounding tissue. To reduce leakage, we previously reported incorporating ethyl cellulose (EC) with ethanol as this mixture forms a gel when injected into tissue. To further develop EC-ethanol injection as an ablative therapy, the present study evaluates the extent to which salient injection parameters govern the injected fluid distribution. METHODS:Utilizing ex vivo swine liver, injection parameters (infusion rate, EC%, infusion volume) were examined with fluorescein added to each solution. After injection, tissue samples were frozen, sectioned, and imaged. RESULTS:While leakage was higher for ethanol and 3%EC-ethanol at a rate of 10 mL/hr compared to 1 mL/hr, leakage remained low for 6%EC-ethanol regardless of infusion rate. The impact of infusion volume and pressure were also investigated first in tissue-mimicking surrogates and then in tissue. Results indicated that there is a critical infusion pressure beyond which crack formation occurs leading to fluid leakage. At a rate of 10 mL/hr, a volume of 50 μL remained below the critical pressure. CONCLUSIONS:Although increasing the infusion rate increases stress on the tissue and the risk of crack formation, injections of 6%EC-ethanol were localized regardless of infusion rate. To further limit leakage, multiple low-volume infusions may be employed. SIGNIFICANCE:These results, and the experimental framework developed to obtain them, can inform optimizing EC-ethanol to treat a range of medical conditions.
Authors
Morhard, R; Mueller, JL; Tang, Q; Nief, C; Chelales, E; Lam, CT; Alvarez, DA; Rubinstein, M; Katz, DF; Ramanujam, N
MLA Citation
Morhard, Robert, et al. “Understanding Factors Governing Distribution Volume of Ethyl Cellulose-Ethanol to Optimize Ablative Therapy in the Liver.Ieee Transactions on Bio Medical Engineering, vol. 67, no. 8, Aug. 2020, pp. 2337–48. Epmc, doi:10.1109/tbme.2019.2960049.
URI
https://scholars.duke.edu/individual/pub1453889
PMID
31841399
Source
epmc
Published In
Ieee Transactions on Bio Medical Engineering
Volume
67
Published Date
Start Page
2337
End Page
2348
DOI
10.1109/tbme.2019.2960049

Optical Technologies for Improving Healthcare in Low-Resource Settings: introduction to the feature issue.

This feature issue of Biomedical Optics Express presents a cross-section of interesting and emerging work of relevance to optical technologies in low-resource settings. In particular, the technologies described here aim to address challenges to meeting healthcare needs in resource-constrained environments, including in rural and underserved areas. This collection of 18 papers includes papers on both optical system design and image analysis, with applications demonstrated for ex vivo and in vivo use. All together, these works portray the importance of global health research to the scientific community and the role that optics can play in addressing some of the world's most pressing healthcare challenges.
Authors
Bowden, AK; Durr, NJ; Erickson, D; Ozcan, A; Ramanujam, N; Jacques, PV
MLA Citation
Bowden, Audrey K., et al. “Optical Technologies for Improving Healthcare in Low-Resource Settings: introduction to the feature issue.Biomedical Optics Express, vol. 11, no. 6, June 2020, pp. 3091–94. Epmc, doi:10.1364/boe.397698.
URI
https://scholars.duke.edu/individual/pub1448905
PMID
32637243
Source
epmc
Published In
Biomedical Optics Express
Volume
11
Published Date
Start Page
3091
End Page
3094
DOI
10.1364/boe.397698

In Vivo estimation of total hemoglobin concentration and hemoglobin saturation in the detection of cervical epithelial pre-cancers

Total hemoglobin concentration, hemoglobin saturation and scattering coefficient were extracted from cervical diffuse reflectance spectra (400-600 nm) using a Monte Carlo-based model. Total hemoglobin was shown to distinguish pre-cancerous from normal tissues (p < 0.05). © 2007 Optical Society of America.
Authors
Chang, VTC; Cartwright, P; Ramanujam, N
MLA Citation
Chang, V. T. C., et al. “In Vivo estimation of total hemoglobin concentration and hemoglobin saturation in the detection of cervical epithelial pre-cancers.” Optics Infobase Conference Papers, 2007. Scopus, doi:10.1364/fio.2007.fwe2.
URI
https://scholars.duke.edu/individual/pub1448587
Source
scopus
Published In
Optics Infobase Conference Papers
Published Date
DOI
10.1364/fio.2007.fwe2