Radiology Flashback - 2.2
Published by Vijay April 1st, 2007 in CT, History, Medical Research, Medicine, Radiology, Science
William Henry Oldendorf, MD., 1925 - 1992
In a foot note in an earlier post, I had written:
Many feel that William Oldendorf, an American Neurologist, should also have been offered the award for a device he built from junk box parts in 1960.
That was a direct quote from a Historical Perspective article1 written by Samuel M. Wolpert in the March 2000 issue of the American Journal of Neuroradiology.
Oldendorf had trained with A.B. Baker in the early 1950’s in one of the few programs requiring neurology residents to perform arteriograms and pneumoencephalograms on their own patients. From 1953 to 1955 Oldendorf did all these invasive studies on his patients at the University of Minnesota Hospital. He disliked these invasive, traumatic, tedious tests, which provided only limited and indirect information about the brain. He knew there had to be something better and he strove to find it.
When several structures overlap each other in x-ray pictures, important underlying structures may be obscured by those less important. This is particularly true of the cranial cavity.
The idea that formed the basis for his original work on the CT scan came from an engineer who was working on a project to develop an automated apparatus for rejecting frost-bitten oranges using shadow radiography to reveal dehydrated segments. Projecting from this scan and rejection technique, Dr. Oldendorf proposed scanning the head by a transmitted beam of X-rays, thereby being able to reconstruct the radiodensity pattern of a plane through the head.
In 1961, he published a seminal article2 describing the results of experiments in scanning an object from many angles along its perimeter. These experiments showed that cross-sectional images might be obtained from the detection and recording of slight density variations in the composition of structures within the head.
His experimental model was deceptively simple but incorporated the fundamental concepts and hardware implementation that are present in modern computed tomographic scanners. The apparatus was crude and largely constructed from junk box parts, among which was a train flat car and track confiscated from his son’s collection. At the cost of $1,700, he applied for a patent thinking that this would generate industrial interest in implementing his concept. This patent was awarded in 1963. A letter from one of the world’s major X-ray manufacturers ended: “Even if it could be made to work as you suggest, we cannot imagine a significant market for such an expensive apparatus which would do nothing but make a radiographic cross-section of a head”! Faced with this reaction he turned his attention to other scientific work and heard nothing further about the concept until 1972.
Oldendorfs work was invaluable to researchers in the field of neuroimaging, despite his inability to interest X-ray equipment manufacturers in his invention.
Oldendorfs studies in the late 1950s and early 1960s were acknowledged by Sir Godfrey Hounsfield in his own work that led to the invention of the X-ray CT scanner and the Nobel Prize for Medicine in 1979.
In recounting a history of his life in neuroimaging to the American Society of Neuroimaging (ASN) in 1992, Oldendorf discussed Godfrey Hounsfield and his successful introduction of the CT scanner. He was kind enough to mention my 1961 paper as the only preexisting attempt to do the same thing that he did. Although the original CT picture was crude, it was obvious that it was a revolution.
In 1974, he was awarded the first Ziedses des Plantes Medal by the German Society of Neuroradiology and the Medical Physics Society of Wurzburg in recognition of his pioneering study.
In 1975, Oldendorf and Hounsfield were awarded the Albert Lasker Award for Clinical Research for the conception of the principles that led to the development of computed tomography.
Rosalyn Yalow, a Nobel laureate in physiology and medicine in 1977, nominated Oldendorf for the prize and was upset that he did not get it.
William J. Broad wrote in an article3 in 1980 that “Politics in Stockholm may have forced a would-be laureate off the CAT scanner ticket.”
Each Nobel Prize has its winners and losers, and this year’s award in physiology or medicine is no exception. Several would-be laureates who worked on the early development of computerized axial tomography (or CAT scanning) are quietly wondering just what went wrong.
One such person with an unusually bad case of after-the-fact blues is William H. Oldendorf, a neurologist at the University of California School of Medicine, Los Angeles, and the Brentwood Veterans Administration Hospital. Oldendorf wrote the first paper on the subject of radiographic tomography (1961), received the earliest patent (1963), and shared the 1975 Lasker Award for his “original conception of a scanning system” with Godfrey N. Hounsfield, who along with Allan M. Cormack won the Nobel this year.
“Anybody who goes into science expecting to win the Nobel Prize is about as realistic as a person going to Las Vegas to get rich,” Oldendorf says. “But my feeling is that I should be preparing to go to Stockholm.”
What makes this feeling especially hard to live with is the fact that many Stockholm watchers, including a previous laureate, say Oldendorf was actually slated to go to the ceremony this year. (Laureates are among the select few who can make nominations for the prize.) One knowledgeable observer says Oldendorf got bumped on the day the prize was announced during a heated debate in the Nobel Assembly.
Reasons given for the omission of Oldendorf include consideration by the Nobel Assembly of the effect that awarding the prize to two Americans and one Englishman would have on the multimillion dollar litigation over patent rights now under way between U.S. and British manufacturers of CAT scanners. Another is discrimination against a physician-clinician by the basic science faction of the Nobel Assembly.
(Download the free pdf file of the article here).
References:
1. Wolpert SM. Neuroradiology Classics. Am J Neuroradiol. 2000 Mar;21(3):605-6. Read the Full Text online article here.
2. Oldendorf WH. Isolated flying spot detection of radiodensity discontinuities—displaying the internal structural patterns of a complex object. IRE Trans Biomed Electronics BME 1961;8:68-72.
3. Broad WJ. Riddle of the Nobel Debate. Science 207, 37 (1980). Free pdf.
Other Sources:
Lasker Foundation.
American Society of Neuroimaging.
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