Samantha Holdsworth: science serving communities

At the heart of the Mātai Medical Research Institute sits a state-of-the-art MRI scanner – its powerful magnet allowing researchers to investigate everything from concussion and the impacts of meth use on the brain to cutting-edge MRI technologies.

But the machine is also a figurative magnet, says Associate Professor Samantha (Sam) Holdsworth, drawing together local, national and international researchers and members of the Tairāwhiti community.
“The scanner is only part of it,” says Sam, who is the director of the Gisborne-based institute, and a member of the Faculty of Medical and Health Sciences (FMHS) at the University of Auckland.

“A machine like this is a bit like a jumbo jet: you need the pilots, engineers, crew and ground support to make it fly. Operating it is one thing; using it to its full potential as a research platform takes a whole ecosystem of people and expertise.”

Sam has worked in many contexts, and says working with the community in a regional area, as with Mātai, is unusual.

“It feels more rewarding than anything else I’ve done professionally. You’re constantly hearing from and feeding back to the community, as well as helping to provide a platform for talented people in the region.”

Mātai was established in 2019 as a hub for medical imaging research and innovation, with a focus on clinical research that could be translated into benefit for its Tairāwhiti community.

In May, for example, researchers from Mātai, Tūranga Health and the University published findings showing notable differences in the brains of people recovering from long-term methamphetamine use, compared with a group of non-users. The work was backed from its earliest stages by the Fred Lewis Enterprise Foundation, which recognised the urgency of the issue for Tairāwhiti and New Zealand more broadly.

The research programme is investigating how the brain recovers through abstinence, while evaluating a culturally responsive model combining neuropsychiatric care, clinical science and broader support for its participants.

“It’s a good example of local philanthropy, researchers, community health leaders and university expertise coming together around an issue that really matters,” says Sam.  

Return to Tairāwhiti

Taking on the role at Mātai was a homecoming for Sam, who was raised in Te Karaka, a small town about half an hour north of Gisborne. She went to the town’s primary school, before heading off to boarding school, then on to the University of Canterbury to follow her passion for physics.

While she focused on astrophysics as an undergraduate, she’d always been interested in becoming a medical doctor. A simple internet search of ‘medicine and physics’ revealed a whole field she’d never heard of – medical physics – and its different imaging technologies immediately piqued her interest.

She undertook her masters in medical physics at QUT in Australia, before focusing specifically on MRI as a modality during her PhD at the University of Queensland.

“With MRI, there are so many different ways of seeing inside the body,” she says. “There’s so much room to push the field and reveal aspects of the body that we haven’t previously been able to see.”

Postdoctoral research followed at the Lucas Center for Imaging in the radiology department of Stanford University’s School of Medicine, where she ultimately spent 11 years, becoming a senior researcher.

Where Mātai has one powerful, high-end MRI scanner, Stanford has more than ten, says Sam. But when she returned to New Zealand in 2018 to take up her FMHS role, she was struck by how working in a more closely connected research environment could support collaboration and innovation.

“There were dozens of researchers across radiology and engineering working across different areas of MRI at Stanford, supported by an extraordinary depth of expertise and resources.

“New Zealand operates at a much smaller scale, but one of the strengths of that is that people end up working across disciplines and make the most of what they have.

“At the Grafton Campus, each floor brings together experts from very different fields, and that proximity – combined with a very Kiwi willingness to collaborate and find creative solutions – can be a powerful driver of innovation.” 

New MRI techniques and applications

As well as being a director at Mātai and a University faculty member, Sam is part of the new Medical Imaging Research Centre and is a principal investigator at the Centre for Brain Research (CBR).

She oversees several research programmes whose teams also include researchers from other New Zealand and offshore universities, including Stanford University and the University of Washington. Several Mātai projects also involve close collaboration with the University’s Centre for Advanced MRI.

Broadly, the work at Mātai spans the discovery and development of new imaging techniques, their application to better understand health and disease, and their translation into clinical and community benefit.

Alongside its research, Mātai also provides advanced clinical MRI services, helping bring specialist imaging closer to people in Tairāwhiti and creating a pathway for promising new methods to move into clinical practice.

Within the imaging-methods strand, two techniques being advanced are amplified MRI and ultra-high contrast MRI.

Amplified MRI, pioneered by Sam and colleagues during her time at Stanford, involves amplifying the motion of the brain by around 25 times so its movement, not usually visible, can be seen.

“It gives you a completely different way of looking at brain health, opening up all sorts of potential applications,” says Sam.

Early research led by Itamar Terem, one of Sam’s former research assistants at Stanford, together with colleagues, suggests amplified MRI may reveal altered patterns of brain motion in people with neurological conditions, including dementia.

Early data from another project – a collaboration between Mātai, Eye Institute Auckland, Gisborne Hospital, the University of Auckland and others – shows promise for a quick and non-invasive way to estimate brain pressure. This could potentially reduce the need for invasive procedures such as intracranial monitoring or lumbar puncture.

Work on the other technique, called ultra high contrast MRI, is being advanced by US-based Kiwi Professor Graeme Bydder, a globally recognised pioneer of new MRI methods, alongside his son, MRI physicist Dr Mark Bydder, as well as radiologist Dr Daniel Cornfeld and their team.

“Graeme and Mark discovered a new mathematical framework for explaining MRI image contrast in a way that is easier to understand,” explains Sam, “and applying this knowledge can produce images that reveal subtle abnormalities in the brain’s white and grey matter with more clarity.”

Early work suggests the method can reveal multiple sclerosis lesions and other white-matter changes that are faint or not apparent on conventional MRI images.  

Participation and place

Among the many projects looking at new applications for imaging technologies is one focused on concussion, and involving researchers across Mātai, Auckland Bioengineering Institute (ABI), FMHS, CBR, the Universities of Canterbury, Otago and Oxford, AUT, GE HealthCare and others.

With the participation of Gisborne Boys’ High School students, the study combines brain imaging with data from instrumented mouthguards to better understand head impacts over a rugby season and explore potential objective markers of concussion.

Another project is the Tairāwhiti Child Wellbeing Study, which is working with local children and whānau to build a reference dataset that better reflects the Tairāwhiti population. Working with ABI, the imaging data is helping researchers build computational models of the structure and function of children’s brains, hearts, lungs and musculoskeletal systems.

“What I love about being in Gisborne is that people can take part in studies they might otherwise never have had the opportunity to participate in because of where they live,” says Sam.

Mātai also supports undergraduate students through scholarships and research internships.

“These young people are seeing science in action. We’ve got a number who now want to study medical imaging at the University of Auckland, or do engineering, neuroscience or medicine.

“Seeing that kind of tangible impact among young people is just as exciting for us as the research findings themselves.”

Sam, who returned to New Zealand with her American husband and three boys, is enjoying living close to her family again after being overseas for so many years.

“Having our boys go to local schools and have a free-range type of upbringing, and being close to grandparents, has been really good from a family point of view.”

Such human connections are also at the heart of Mātai, says Sam, who credits many for backing the institute’s vision and progress so far. These include Mātai kaiwhakahaere Leigh Potter, Tūranga Health CEO Reweti Ropiha, MNZM and the wider Mātai and University teams.

She also credits mentors, including CBR founding director now Mātai patron Sir Richard Faull; ophthalmologist Professor Dame Helen Danesh-Meyer; and FMHS head of anatomy and medical imaging Associate Professor Miriam Scadeng.

Iwi, health, industry, academic, community and philanthropic partners have also been crucial, including cornerstone funder Kānoa, the government’s regional economic development and investment unit.

“It’s been a real honour to return to New Zealand, be part of a cutting-edge university, and work alongside the Mātai and uni teams, and our community, research and industry partners, to build something together.

“Being able to do this alongside such a great group of people is probably the part I value most.”

– Caitlin Sykes