Nimmi Ramanujam

Overview:

Dr. Ramanujam is the Robert W. Carr Professor of Biomedical Engineering, and also a faculty member in the Global Health Institute and Dept. Pharmacology and Cell Biology at Duke University. She is an innovator, educator and entrepreneur and her mission is to develop and leverage technology to have the most wide reaching impact in women’s health. She directs the center for Global Women’s Health Technologies (GWHT), a partnership between the Pratt School of Engineering and the Duke Global Health Institute. Through the GWHT, she is empowering her trainees at Duke and beyond to be agents of change - providing them with the knowledge, confidence and critical thinking skills to create impactful solutions to improve the lives of women and girls globally.

 

Dr. Ramanujam’s research focuses on women’s’ cancers and in particular breast and cervical cancer. Her goals are to design innovations that enable complex referral services often reserved for hospitals to be accessible at the community/primary care level for cancer prevention, and to develop tools that will make cancer treatment more effective and efficient. One example of a technology she and her team has developed to achieve health care impact is the Pocket Colposcope. The Pocket colposcope has the potential to revolutionize cervical cancer screening in low resource communities by enhancing the effectiveness and scalability of the screening process, reducing loss to follow up and guiding effective treatment decisions. The Pocket Colpsocope has been deployed in India, Kenya, Tanzania, Zambia, Peru, Honduras, Guatemala and the U.S.  Design is at the heart of the innovation that underlies the Pocket colposcope. Dr. Ramanujam and her team have created a unique model to make design thinking and execution pervasive and in the process have created teachers, innovators and entrepreneurs outside of Duke. The program known as Ignite, has trained more than 50 university students to teach design thinking to more than 1000 students in low resource communities in Kenya, India, Guatemala and the U.S. The students in those communities then perpetuate the knowledge by maintaining that virtuous cycle within their own communities. These interactions have resulted in a community that is growing exponentially and has an international reach across a number of different sectors including academia, industry, non-governmental organizations and the government. Prof. Ramanujam has received recognition for her work in women's health and empowerment. She received the TR100 Young Innovator Award from MIT, the Global Indus Technovator award from MIT, Era of Hope Scholar awards from the DOD, the Stasnell Family award from the Pratt School of Engineering at Duke and the Emerging Leader in Global Health Award from the Consortium of Universities in Global Health (CUGH). She is a fellow of several optical and biomedical engineering societies including OSA, SPIE AIMBE. She has also been elected to the National Academy of Inventors. She is co-editor of the Handbook of Biomedical Optics. She has presented the global impact of her work at the United Nations.

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

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1989

University of Texas at Austin

M.S. 1992

University of Texas at Austin

Ph.D. 1995

University of Texas at 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

A Viable Solution for a See and Treat Paradigm for Cervical Pre-cancer in Africa

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

Publications:

Distinct Angiogenic Changes during Carcinogenesis Defined by Novel Label-Free Dark-Field Imaging in a Hamster Cheek Pouch Model.

There remain gaps in knowledge concerning how vascular morphology evolves during carcinogenesis. In this study, we imaged neovascularization by label-free dark-field microscopy of a 7,12-Dimethylbenz[a]anthracene (DMBA)-induced hamster cheek pouch model of oral squamous cell carcinoma (SCC). Wavelength-dependent imaging revealed distinct vascular features at different imaging depths and vessel sizes. Vascular tortuosity increased significantly in high-risk lesions, whereas diameter decreased significantly in hyperplastic and SCC lesions. Large vessels preserved the same trends seen in the original images, whereas small vessels displayed different trends, with length and diameter increasing during carcinogenesis. On the basis of these data, we developed and validated a classification algorithm incorporating vascular features from different vessel masks. Receiver operator curves generated from the classification results demonstrated high accuracies in discriminating normal and hyperplasia from high-grade lesions (AUC > 0.94). Overall, these results provided automated imaging of vasculature in the earliest stages of carcinogenesis from which one can extract robust endpoints. The optical toolbox described here is simple, low-cost and portable, and can be used in a variety of health care and research settings for cancer prevention and pharmacology research. Cancer Res; 77(24); 7109-19. ©2017 AACR.
Authors
Hu, F; Martin, H; Martinez, A; Everitt, J; Erkanli, A; Lee, WT; Dewhirst, M; Ramanujam, N
MLA Citation
Hu, Fangyao, et al. “Distinct Angiogenic Changes during Carcinogenesis Defined by Novel Label-Free Dark-Field Imaging in a Hamster Cheek Pouch Model..” Cancer Res, vol. 77, no. 24, Dec. 2017, pp. 7109–19. Pubmed, doi:10.1158/0008-5472.CAN-17-1058.
URI
https://scholars.duke.edu/individual/pub1279483
PMID
29021136
Source
pubmed
Published In
Cancer Res
Volume
77
Published Date
Start Page
7109
End Page
7119
DOI
10.1158/0008-5472.CAN-17-1058

A Fluorescence-Guided Laser Ablation System for Removal of Residual Cancer in a Mouse Model of Soft Tissue Sarcoma.

The treatment of soft tissue sarcoma (STS) generally involves tumor excision with a wide margin. Although advances in fluorescence imaging make real-time detection of cancer possible, removal is limited by the precision of the human eye and hand. Here, we describe a novel pulsed Nd:YAG laser ablation system that, when used in conjunction with a previously described molecular imaging system, can identify and ablate cancer in vivo. Mice with primary STS were injected with the protease-activatable probe LUM015 to label tumors. Resected tissues from the mice were then imaged and treated with the laser using the paired fluorescence-imaging/ laser ablation device, generating ablation clefts with sub-millimeter precision and minimal underlying tissue damage. Laser ablation was guided by fluorescence to target tumor tissues, avoiding normal structures. The selective ablation of tumor implants in vivo improved recurrence-free survival after tumor resection in a cohort of 14 mice compared to 12 mice that received no ablative therapy. This prototype system has the potential to be modified so that it can be used during surgery to improve recurrence-free survival in patients with cancer.
Authors
Lazarides, AL; Whitley, MJ; Strasfeld, DB; Cardona, DM; Ferrer, JM; Mueller, JL; Fu, HL; Bartholf DeWitt, S; Brigman, BE; Ramanujam, N; Kirsch, DG; Eward, WC
MLA Citation
Lazarides, Alexander L., et al. “A Fluorescence-Guided Laser Ablation System for Removal of Residual Cancer in a Mouse Model of Soft Tissue Sarcoma..” Theranostics, vol. 6, no. 2, 2016, pp. 155–66. Pubmed, doi:10.7150/thno.13536.
URI
https://scholars.duke.edu/individual/pub1121256
PMID
26877775
Source
pubmed
Published In
Theranostics
Volume
6
Published Date
Start Page
155
End Page
166
DOI
10.7150/thno.13536

Optimization of illumination frequency and preclinical validation of a wide-field structured illumination microscope designed for imaging in situ tumor margins

We present a widefield structured illumination microscope for imaging surgical tumor margins in situ. The impact of frequency and turbidity on optical section thickness and SNR was characterized to determine the optimal imaging frequency. © OSA 2013.
Authors
Fu, HL; Mueller, JL; Javid, M; Kirsch, DG; Ramanujam, N; Brown, JQ
URI
https://scholars.duke.edu/individual/pub1002276
Source
scopus
Published In
Cleo: Applications and Technology, Cleo at 2013
Published Date

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, Jan. 2006.
URI
https://scholars.duke.edu/individual/pub1030535
Source
scopus
Published In
Optics Infobase Conference Papers
Published Date

Leveraging ectopic Hsp90 expression to assay the presence of tumor cells and aggressive tumor phenotypes in breast specimens.

Hsp90 has been studied extensively as a therapeutic target in breast cancer in pre-clinical and clinical trials, demonstrating a variety of roles in metastatic progression. The evidence to date suggests a compelling opportunity to leverage attributes of Hsp90 expression beyond therapeutics with potential applications in breast cancer diagnosis, prognosis, and recurrence risk assessment. In this study, we developed a completely non-destructive strategy using HS-27, a fluorescently-tethered Hsp90 inhibitor, to assay Hsp90 expression on intact tissue specimens with comparable contrast to in vivo administration routes, and demonstrate the feasibility of our approach in breast cancer patients. In addition to Hsp90 inhibition being most effective in glycolytic tumors, we found ectopic Hsp90 expression to be highest in glycolytic tumors reinforcing its role as an indicator of aggressive disease. This work sets the stage for immediately using Hsp90 to improve outcomes for breast cancer patients without affecting traditional care pathways.
Authors
Crouch, B; Murphy, H; Belonwu, S; Martinez, A; Gallagher, J; Hall, A; Soo, MS; Lee, M; Hughes, P; Haystead, T; Ramanujam, N
MLA Citation
Crouch, Brian, et al. “Leveraging ectopic Hsp90 expression to assay the presence of tumor cells and aggressive tumor phenotypes in breast specimens..” Sci Rep, vol. 7, no. 1, Dec. 2017. Pubmed, doi:10.1038/s41598-017-17832-x.
URI
https://scholars.duke.edu/individual/pub1292997
PMID
29235516
Source
pubmed
Published In
Scientific Reports
Volume
7
Published Date
Start Page
17487
DOI
10.1038/s41598-017-17832-x