8
Received July 5, 1994; accepted after revision September 16, 1994. 1A11 authors: Department of Radiology, Stanford University Medical denter, Stanford, dA 94305-5105. Address correspondence to H. Jones. AJR 1995;164:753-760 0361-803X/95/1643-753 © American Roentgen Ray Society 753 ;i : #{149} :‘ ‘#{149}‘ :i. Perspective Ii A History of the Department of Radiology at Stanford University Henry Jones1, Judy Illes, William Northway Radiology at Stanford University has enjoyed 89 years of accomplishments in clinical and academic medicine. Estab- lished 9 years after Wilhelm Roentgen’s discovery of X-rays, the department has been a center for the development and application of many new approaches to diagnostic imaging, cancer therapy, and nuclear medicine, and for rigorous train- ing in the scientific approach to radiologic research. Did Stanford Physics Professor Discover X-rays Before Roentgen? Many individuals had the opportunity to precede Roent- gen. Sir William Crookes, for example, had been experiment- ing with electrical discharges in evacuated tubes (Crookes’ tubes) since the early 1880s and had documented that pho- tographic plates stored near these tubes became fogged. At one time, he returned some plates to the manufacturer as unsatisfactory. A. W. Goodspeed, professor of physics at the University of Pennsylvania, inadvertently made a roentgeno- gram in 1890 but did not follow up on the “accident.” In 1893 and 1 894, Stanford’s Fernando Sanford, professor of physics, produced images on photographic plates shielded from light. He experimented extensively and submit- ted a paper to a journal that turned it down, remarking that they did not publish fairy tales. Sanford put the paper away and did not submit the work to another journal despite the urging of his friends. Apparently he, like the others, failed to recognize the true source of the images he produced. Formative Years: 1 904-i 948 Cooper Medical College Hospital (subsequently Stanford- Lane) in San Francisco recruited its first roentgenologist, G. M. Lehman, in 1904. Lehman took charge of roentgenogra- phy, X-ray, and quartz lamp therapy. (In the early 1890s, ultraviolet radiation was used both systemically and locally to treat a broad spectrum of diseases. The rays were generated by carbon or mercury arcs. Since ultraviolet radiation is absorbed by glass, the treatments were carried out through quartz portals; hence the term “quartz lamp” therapy. Enthu- siasm for this therapeutic technique subsided, but it remains an important treatment for some skin diseases and other conditions.) Lehman’s stay was short-lived, however; he retreated to his German homeland after the great earth- quake of 1 906. Charles Cooper took over supervision of X- ray activities at that time; he was succeeded by Walter Boardman in 1911 and by W. E. Chamberlain in 1920. Chamberlain, who had trained as an internist, acquired an X- ray diagnostic unit in 1 919. Fascinated by its potential, he began applying it to clinical problems. In 1 920, he agreed to head radiology at Stanford-Lane Hospital on the condition that the school appoint to the faculty his close friend and classmate, Robert Reid Newell (“the smartest one in our class,” said Chamberlain) (Fig. 1). In 1930, Chamberlain left for Temple University in Philadel- phia, and Newell became head of the radiology division at Stan- ford, a position he held until 1947, when he returned to an appointment as professor of biophysics in the department of Downloaded from www.ajronline.org by Gordon & Leslie Diamond HCC on 06/27/16 from IP address 142.103.107.123. Copyright ARRS. For personal use only; all rights reserved

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Page 1: A history of the Department of Radiology at Stanford ...med-fom-neuroethics.sites.olt.ubc.ca/files/2016/06/A-history-of-the... · approach togastrointestinal radiology. Hepresided

Received July 5, 1994; accepted after revision September 16, 1994.

1A11 authors: Department of Radiology, Stanford University Medical denter, Stanford, dA 94305-5105. Address correspondence to H. Jones.

AJR 1995;164:753-760 0361-803X/95/1643-753 © American Roentgen Ray Society

753

;i� � �: #{149}� :�‘� �‘#{149}‘ :i.

� �

Perspective

Ii

A History of the Department of Radiologyat Stanford University

Henry Jones1, Judy Illes, William Northway

Radiology at Stanford University has enjoyed 89 years of

accomplishments in clinical and academic medicine. Estab-lished 9 years after Wilhelm Roentgen’s discovery of X-rays,

the department has been a center for the development andapplication of many new approaches to diagnostic imaging,cancer therapy, and nuclear medicine, and for rigorous train-ing in the scientific approach to radiologic research.

Did Stanford Physics Professor Discover X-rays Before

Roentgen?

Many individuals had the opportunity to precede Roent-

gen. Sir William Crookes, for example, had been experiment-ing with electrical discharges in evacuated tubes (Crookes’tubes) since the early 1880s and had documented that pho-tographic plates stored near these tubes became fogged. Atone time, he returned some plates to the manufacturer as

unsatisfactory. A. W. Goodspeed, professor of physics at theUniversity of Pennsylvania, inadvertently made a roentgeno-gram in 1890 but did not follow up on the “accident.”

In 1893 and 1 894, Stanford’s Fernando Sanford, professorof physics, produced images on photographic platesshielded from light. He experimented extensively and submit-ted a paper to a journal that turned it down, remarking thatthey did not publish fairy tales. Sanford put the paper awayand did not submit the work to another journal despite theurging of his friends. Apparently he, like the others, failed torecognize the true source of the images he produced.

Formative Years: 1 904-i 948

Cooper Medical College Hospital (subsequently Stanford-Lane) in San Francisco recruited its first roentgenologist, G.M. Lehman, in 1904. Lehman took charge of roentgenogra-phy, X-ray, and quartz lamp therapy. (In the early 1890s,ultraviolet radiation was used both systemically and locally totreat a broad spectrum of diseases. The rays were generatedby carbon or mercury arcs. Since ultraviolet radiation isabsorbed by glass, the treatments were carried out through

quartz portals; hence the term “quartz lamp” therapy. Enthu-siasm for this therapeutic technique subsided, but it remains

an important treatment for some skin diseases and otherconditions.) Lehman’s stay was short-lived, however; heretreated to his German homeland after the great earth-quake of 1 906. Charles Cooper took over supervision of X-ray activities at that time; he was succeeded by WalterBoardman in 1911 and by W. E. Chamberlain in 1920.Chamberlain, who had trained as an internist, acquired an X-ray diagnostic unit in 1 919. Fascinated by its potential, he

began applying it to clinical problems. In 1 920, he agreed tohead radiology at Stanford-Lane Hospital on the condition

that the school appoint to the faculty his close friend andclassmate, Robert Reid Newell (“the smartest one in ourclass,” said Chamberlain) (Fig. 1).

In 1930, Chamberlain left for Temple University in Philadel-

phia, and Newell became head of the radiology division at Stan-ford, a position he held until 1947, when he returned to an

appointment as professor of biophysics in the department of

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Fig. 1.-Robert Reid NewelI(left), head of radi- FIg. 2.-Henry S. Kaplan, chairman (1948- Fig. 3.-Robert Kaliman, first head of radio-ology (1932-1947) and head of nuclear medicine 1972) and director (1975-1984) of Louis B. Mayer biology (1956-1983).(1948-1957), and W. Edward Chamberlain (right), Cancer Biology Research Laboratory, circa 1981.head of radiology (1920-1930), circa 1927.

754 JONES ET AL. AJR:164, March 1995

medicine, which ultimately became the division of nuclear med-

icine in the department of radiology. From 1947 to 1948, FranzWindholz was acting radiology head while Newell was on leave.

During this formative period, significant contributions weremade in spectroscopy, stereoscopy, statistics of cardiac mea-

surement, and cardiac motion. In 1925, Chamberlain and W.Dock made the first motion picture studies of the heart in the

United States. Chamberlain and Newell were key to bringingout the maximum potential of the department in its earlyyears and to preparing it for the explosion of scientific

endeavors associated with the end of World War II.

Growth and Development: 1948-1972

In 1 948, Henry S. Kaplan (Fig. 2) became chairman of thedepartment of radiology at the age of 29. Kaplan was anexceptionally able scientist, leader, and administrator. He

had a strong commitment to clinical care and service andpromoted excellence in teaching at all levels. He believed

that an academic department must have creative programsin both clinical and basic scientific research and that such a

department should expose trainees to and involve them inresearch. He established a laboratory devoted to basicresearch; instigated clinical research projects involving resi-dents, medical students, and other members of the depart-ment; successfully applied for externally funded research

and training fellowships; augmented the already strongteaching curriculum; and promoted joint ventures with otherdepartments and divisions of the medical school.

In 1948, it was apparentthat post-World War II changes in

basic science research would necessitate expansion andinteraction of basic sciences with preclinical and clinical

medical disciplines. To meet this need, in 1 953, the Board ofTrustees of the University made the controversial decision to

move the clinical programs of the medical school from San

Francisco to a new facility to be constructed 30 miles south

on the 81 00-acre Stanford campus near Palo Alto, CA, closeto existing structures housing preclinical departments. Themove was accomplished in 1 959. At this time, the new Veter-ans Administration Medical Center (PAVAMC) nearby wasalso established as a teaching hospital for Stanford.

The subsequent history of radiology at Stanford Universityis probably best considered in the context of the several divi-sions that evolved since 1948.

Radiation Biology

Kaplan was well under way with his research on lympho-magenesis when he came to Stanford and brought with him

the unique strain of laboratory mice that, as he showed, wassusceptible to radiation-induced lymphoma. He obtained aresearch grant and recruited a full-time laboratory staff. In

1 956, he enlisted Robert Kallman (Fig. 3) to serve as head of

a new division of radiobiological research; with the move ofthe medical school to the campus, the radiobiological labora-tories and the experimental mouse colony were greatlyexpanded. Ultimately the division had sufficient resources tosupport a full-time Ph.D. faculty, a wide-ranging researchprogram in tumor cell radiobiology, radiation biochemistryand photobiology, and cellular physiology; and the divisionwas fully integrated with the clinical training of young radia-tion oncologists at Stanford.

Radiation Therapy

Believing that availability of a high-energy radiation sourcecould improve the effectiveness of radiation in treating deep-

seated malignant neoplasms, in 1 950 Kaplan undertook acollaborative research effort with Edward Ginzton of the Stan-ford physics department. By 1952, they had secured research

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Fig. 4.-Malcolm A. Bagshaw, director of radiation therapy (1960-1 972), chairman of radiology (1 972-1 986), and chairman of radiation on-cology (1986-1992), circa 1972.

AJR:164, March 1995 DEPARTMENT OF RADIOLOGY AT STANFORD UNIVERSITY 755

funding from the National Cancer Institute, the Office of NavalResearch, and the American Cancer Society to construct a 4-MeV linear accelerator suitable for radiation therapy [1]. The

Stanford medical linear accelerator was completed in 1956,the first instrument with this energy range in the westernhemisphere. Its first use was in the successful treatment of a

7-month-old boy suffering from retinoblastoma [2]. (Theheavy lead collimator was positioned using a hydraulic jackborrowed from a local auto repair shop.) That accelerator wasretired after 14 years of intensive service and is now dis-played at the Smithsonian Institution in Washington, DC.

Development of the linear accelerator [3] and realization ofits capabilities required continuing interaction with the physi-

cists at Stanford. As an extension of these collaborations, asection of radiologic physics evolved, with Mitchell Weiss-bluth appointed head in 1 958. With the move to the campus,Weissbluth transferred his activities to the department ofapplied physics, and C. J. Karzmark became head of theradiologic physics section. During the next 30 years until hisretirement in 1 988, Karzmark and his physics group devel-

oped treatment techniques basic to the evolution of modernradiotherapy using linear accelerators and pioneered rele-vant quality assurance concepts.

Malcolm A. Bagshaw (Fig. 4)joined the department in 1956

and in 1960 was appointed head of the radiation therapy divi-sion. He collaborated with Kaplan for 30 years in applying thelinear accelerator to cancer treatment. With the physicists,they developed the mantle and inverted-Y techniques for the

treatment of Hodgkin’s disease and non-Hodgkin’s lymphoma,the first comprehensive external radiation treatment of pros-tate cancer, and innovative techniques for the management ofhead and neck and gynecologic malignancies; and they

refined total skin electron-beam irradiation for mycosis fun-goides and related skin malignancies [4, 5]. With support fromindustry, they saw the emergence of the first commercial med-

ical linear accelerator in the United States in 1961 ; it was aflexible, isocentrically mounted, reliable 6-MeV linear acceler-

ator suited for installation in a single-story shielded room. One

of the first models was installed at Stanford in 1 961 and was in

service for more than 20 years.Bagshaw had interesting pastimes. He played classical gui-

tar and competed in national soanng contests. He was the firstperson to pilot a glider over the Sierra Nevada Mountains inCalifornia and Nevada. He even began building his own glider

but abandoned the project when the prototype glider, afterwhich he was modeling his own, fell apart in midair.

During the 1950s, Kaplan served on the National CancerAdvisory Council and, with his colleagues, crafted and suc-

cessfully implemented two programs that were to have far-reaching impact on the development of radiation therapy

during the next two decades. The first program providedfunding for a series of clinical research centers for oncol-ogy throughout the United States. One center was estab-lished at Stanford for the development of protocols for

comprehensive, prospective randomized clinical trials. Theother program supported the establishment of 25 NationalInstitutes of Health (NIH)-sponsored training grants in radi-ation therapy technology and physics, and subsequentlygrew to include many more. In 1960, there were only 120full-time radiation therapists in the United States; when theprogram was phased out in 1976, the number of radiation

therapists, now called radiation oncologists, had grown to

nearly 2000 [6].Early in the 1960s, after Kaplan had demonstrated the

lymphomagenic effect of whole-body irradiation in mice, he

and his coworkers began to amass evidence that thesetumors are ultimately caused by a unique family of viruses[7]. During the 1950s and 1960s, the division continued todevelop protocols designed to improve the survival ofpatients with cancer. In 1961 , Kaplan recruited Saul A.Rosenberg, a medical oncologist, to join the department.Rosenberg’s appointment in radiology and medicine resultedin a successful multidisciplinary approach to the study andtreatment of cancer. He and Bagshaw initiated the first ran-

domized, prospective studies of the treatment of Hodgkin’sdisease and other lymphomas, using high-energy radiationand statistical analysis to establish the validity of an aggres-sive approach to treating these diseases. Clinical trials topromote the understanding and management of Hodgkin’sdisease and non-Hodgkin’s lymphomas were highly produc-tive and resulted in dramatic improvement in the cure rate ofthese diseases [8]. Later studies evaluated the effects ofradiation sensitizers, heavy charged particles, and hyper-thermia in treating malignant tumors [9].

Nuclear Medicine

The field of nuclear medicine developed rapidly after WorldWar II, and under Newell’s leadership, Stanford was home tomany technologic advances, including his invention of the

focused collimator [10]. Newell was known for his lively intel-lect and sense of humor; the sign-Curioscopy-on the door

of the radiology unit bore testimony to this.In 1956, Joseph Kriss (Fig. 5), an internist with an interest

in thyroid disease, came to work with Newell. Newell retiredin 1957, and in 1958 the division of nuclear medicine wasestablished with Kriss as head. Using the computers thatwere becoming available in the Stanford area in the late

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Fig. 5.-Joseph Krlss (left), head of nuclear medicine (1958-1988); Ri-chard Evans (center), current chairman of radiation oncology, Universityof Kansas; and I. Ross McDougall (right), acting head of nuclear medicine(1988-1993); circa 1978.

Fig. 6.-Henry H. Jones, Mitchell Weissbluth, Henry 5. Kaplan (left toright). in California the rigors of academic life are mitigated by sea, sun,and occasional champagne; circa 1958.

756 JONES ET AL. AJR:164, March 1995

Fig. 7.-Herbert L Abrams, first director of diagnostic division (1960-1967), circa 1985.

1 950s, Kriss and his colleagues carried out dynamic studies

of organs such as the heart and kidneys.In addition to his talent as a physician, Kriss was a fine art-

ist. One of his more whimsical efforts involved creation of a

series of kachina dolls which he named “Warriors of the HighTech.” These were constructed using children’s blocks, cloth,

and feathers and were accoutered with both ancient and

modern weapons, button hooks acquired from antiqueshops, and resisters and condensers from electronics shops.Later he depicted these dolls via computer, and this series of

subtly colored pictures graces the walls of the nuclear medi-cine division today.

in skeletal radiology; during the 1950s he was involved in eval-

uating stabilized barium sulphate suspensions (work that hadbeen brought to the level of clinical trial by Windholz). Joneswas responsible for much of the resident training in diagnosis

and for medical student teaching. During this period, HerbertL. Abrams (Fig. 7), one ofthe first residents trained by Kaplan,joined the Stanford faculty; in 1951 he took over the full-timeresponsibility for radiology at the San Francisco General Hos-pital. Abrams returned to Stanford-Lane in 1 953, focusing on

congenital heart disease and angiocardiography, an interestthat he shared with Kaplan. Their 1956 book, Angiocardio-graphic Interpretation in Congenital Heart Disease, was one ofthe earliest works on this subject [11]. In 1956, Abrams

secured an NIH grant for the application of biplane-image-amplified cineangiocardiography both to experimental studiesin animals and to clinical problems, resulting in the first such

unit in the world [12]. That imaging approach remains the mostwidely used in the investigation of congenital heart diseasetoday. Not long afterward, Abrams initiated the first NIH-sup-ported research training program in cardiovascular radiology.

In 1960, Abrams became director of diagnostic radiologyat Stanford, while Jones became head of radiology at thePAVAMC. In 1972, Jones returned to the Stanford campus,and Leslie Zatz became head of radiology at the PAVAMCuntil 1985, when he was succeeded by Gerald Friedland.Matilde Nino-Murcia served as acting chief at the PAVAMCfrom 1 992 to 1994. Paul Stark is now head of the division.

In 1 961 , the first percutaneous transfemoral catheteriza-

tion technique using preformed catheters for coronary arteri-

ography was introduced at Stanford [13]. Modernpharmacoangiography also had its beginnings at Stanfordduring this period. In the experimental laboratory, the

changes in renal circulation as a response to the administra-

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Fig. 9.-William Northway, acting director of diagnostic radiology (1973-1974), associate chairman of department of radiology, and director of diag-nostlc division (1976-1981). Northway is working wIth an isolation chamberused for exposing newly born guinea pigs to high-oxygen atmospheres.

AJR:164, March 1995 DEPARTMENT OF RADIOLOGY AT STANFORD UNIVERSITY 757

Fig. 8.-Frank Zboraiske, director of diagnostic division (1967-1976).

tion of norepinephrine were demonstrated. In 1 962, Abrams

showed for the first time that neoplastic vessels in renal can-cer respond differently from normal vessels to injected nore-

pinephrine, enabling the pharmacologic distinction of normalfrom tumor vessels in the kidney [14]. In 1961 , Abrams’ mul-

tivolume Angiography [1 5] became the first major referencework in the field and stimulated development of this subspe-cialty. In 1967, Abrams became chairman of radiology atHarvard and director of radiology at the Peter Bent BrighamHospital and at the Dana Farber Cancer Center.

F. Frank Zboralske (Fig. 8) succeeded Abrams at Stan-

ford. Zboralske had an infectious enthusiasm for his work

and once was aptly referred to by Wylie Dodds as “the greatcheerleader.” Zboralske was known for his physiologicapproach to gastrointestinal radiology. He presided over amajor expansion of division space and the doubling of divi-sion faculty, resident, and fellow positions. He established

sections in genitourinary radiology, gastrointestinal radiol-ogy, neuroradiology, chest radiology, and ultrasound to join

the previously established cardiovascular section. In hisclinical gastrointestinal radiology unit and gastrointestinalradiology laboratory, fundamental studies were conductedon esophageal motility [16], physiology and cell biology,and esophageal disorders. One of the first NIH-supportedacademic training grants in diagnostic radiology was

awarded to the department in 1968. In 1970, a diagnosticoncology section was established to provide a focus for res-

idents in an area that was becoming ever more importantand complex [17].

During these years, William Northway (Fig. 9) defined thedisease known as bronchopulmonary dysplasia [18], and his

meticulous studies of pulmonary oxygen toxicity opened aye-nues to prevention and therapy of that disease [19].

The division of diagnostic radiology was one of the few inthe country to develop strong NIH research and training sup-port, including an oncodiagnostic fellowship training program.During the years 1948-1972, the department of diagnosticradiology at Stanford became identified with the application offundamental physiologic techniques, both in the animal labo-ratory and in the clinical arena, to the solution of importantproblems relevant to disease in humans.

Progress in Diagnostic and Therapeutic Radiology:

1 972-Present

After 24 years, Kaplan resigned his department chairmanshipto devote his time to research and follow-up of his Hodgkin’s dis-

ease patients. He died in 1984 after an exceptional career inradiology. Bagshaw became department chairman in 1972 andheld this position until 1986, when he continued as chairman ofthe new department of radiation oncology.

Radiobiology

In the 1970s, work continued on tumor cell radiobiology, radi-ation biochemistry and photobiology, cellular radiobiology,hyperthermia, and development of radiation sensitizers. In1975, the Louis B. Mayer Cancer Biology Research Laboratorywas dedicated with Kaplan as its head. This separate buildingwas designed for the safe handling of viruses being studied fortheir relationship to human cancers. In 1983, Kallman relin-quished his directorship of the radiobiological research divi-sion, and his position was taken by J. Martin Brown. Brown’sinterests in tumor hypoxia and the development of hypoxic cell

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I

.\\Fig. 10.-Richard Hoppe, chairman of radiation oncology (1992-present),

circa 1985.

758 JONES ET AL. AJR:164, March 1995

radiosensitizers and cytotoxics have made them major featuresof the programs in that division [20].

Radiation Therapy

As experience with the linear accelerator grew, protocolsfor treatment became more sophisticated, and additionalneoplasms and sites of involvement were included. Subspe-cialization developed and conjoint clinics were establishedwith other clinical services for optimum patient management.

Peter Fessenden, head of the physics section since 1982,

joined clinical colleagues and members of the Stanford high-

energy physics department to commission the Stanford med-ical pion generator. This superconducting, cryogenic, multi-channeled pion generator functioned for several years untilfunding was exhausted. It yielded pioneering physics, dosi-metric, and biological data [21].

Technologic achievements included advanced hyperther-mia equipment [22] and, in cooperation with members of theneurosurgery division, the development of a linear acceleratormounted on a robotic arm suitable for frameless stereotaxic

radiotherapy. In the clinic, new programs evaluated the use ofmonoclonal antibodies for the management of lymphomas

and metastatic breast and prostate cancer [23], and the use ofirradiation as an immunosuppressive therapy for patients whohave undergone organ transplantation.

In 1 986, the therapy and radiobiology divisions becamethe department of radiation oncology, with Bagshaw as chair-man. Bagshaw retired in 1992; Richard Hoppe (Fig. 1 0) isnow chairman.

Nuclear Medicine

During this period, Kriss demonstrated that the abnormal

stimulator in Graves’ hyperthyroidism was an antibody; withcolleagues in the radiotherapy division, he developed suc-cessful radiation therapy for Graves’ ophthalmopathy [24]. Thenuclear medicine program at the VA hospital was headed by

David Goodwin. Working with C. F. Meares ofthe University ofCalifornia at Davis, Goodwin became a leader in developingmethods for radioactive labeling of proteins and antibodies,

thus enabling their use as tracers [25]. Kriss retired in 1989and was succeeded by Ross McDougall (Fig. 5); WilliamStrauss is now the division director.

Diagnostic Radiology

In 1972, Albert Macovski joined the radiology departmentwith a joint appointment in electrical engineering. He estab-lished the medical imaging laboratory, one of the first such

academic laboratories in the world. His group implemented aresearch program in sonography, CT, energy-selective radi-ography, and nuclear medicine; the group was the first to rec-ognize the problem of beam-hardening artifacts in CT. Usinga dual-energy acquisition [26], they developed an image freeof beam-hardening artifacts and studied a variety of energy-selective imaging procedures, new applications includingbone densitometry, and a vessel imaging system known as

hybrid subtraction. The sonographic imaging program

yielded a dynamic focusing system with two cascaded delaysystems that are still widely used [27].

Also at this time, a meticulous review of the accurately

staged human embryos of the Carnegie collection led to arevision of the accepted view of development of the renal

system and the anorectal system [28]. Detailed anatomic-radiologic studies of the mediastinum led to improved under-

standing of normal anatomy and the distortions associatedwith adenopathy [29]. Extensive basic and clinical researchon imaging of brain abscesses was conducted [30]. Workcontinued on the development of contrast media for enhanc-ing imaging [31] and on extending and refining visualization

of the cardiovascular system [32].Zboralske was succeeded as head of diagnostic radiology

by Northway, who served in this capacity from 1 976 to 1981.Northway oversaw the development of the first advancedimaging laboratory in radiology at Stanford. This laboratorymaintained a close relationship with Macovski and under thedirection of William Brody exploited the capabilities of digitalsubtraction for angiography.

In 1981 , Ronald Castellino (Fig. 1 1 ) became head of diag-nostic radiology. Castellino’s work had established the role oflymphangiography and other imaging techniques in evaluat-ing lymphomas based on some of the earliest large prospec-

tive trials evaluating sensitivity and specificity of imagingtests with pathology as the gold standard [33]. Castellinodeveloped a long-range program for the emerging technol-ogy of MR imaging that included installation of both clinicaland research units. The research unit was a new type ofelectromagnet-based system that was installed in a labora-

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Fig. 1 1 .-Ronald Castellino, associate chairman of radiology and di-rector of diagnostic radiology (1981-1986) and acting chairman of diag-nostic radiology and nuclear medicine (1 986-1 989).

Fig. 12.-Gary M. Glazer, chairman of radiology (1989-present).

AJR:164, March 1995 DEPARTMENT OF RADIOLOGY AT STANFORD UNIVERSITY 759

tory dedicated to the memory of Felix Bloch of Stanford, whoshared a Nobel prize for his pioneering work on nuclear mag-netic resonance. The MR program culminated ultimately in

the opening of the Richard M. Lucas Center for Magnetic

Resonance Spectroscopy and Imaging (Lucas Center).Castellino pursued reorganizing the department into two

distinct entities: a department of radiology (diagnostic radiol-ogy and nuclear medicine) and a department of radiation

oncology (radiation therapy and radiobiology). With the sup-port of Bagshaw and Kaplan, he achieved this goal in 1986.At that time James Silverman became head of the diagnostic

division. As acting chairman, Castellino provided leadershipand continued growth for the new department of diagnostic

radiology and nuclear medicine until Gary M. Glazer (Fig. 12)from the University of Michigan arrived as chairman in thespring of 1989.

In 1 969 a children’s hospital opened. Three years later, itwas designated the Children’s Hospital at Stanford, andBruce Parker was appointed to head the radiology servicethere. He served as chief of the pediatric radiology section atStanford and as radiologist-in-chief at the new Lucile SalterPackard Children’s Hospital at Stanford until 1994, when he

became chief of radiology at the Texas Children’s Hospital in

Houston. Northway then assumed his responsibilities.

Expansion and Transformation: 1989-Present

With the appointment of Glazer as chairman of diagnosticradiology and nuclear medicine (renamed the department ofradiology in 1 991), the department entered a new era

marked by expansion and growth of faculty, programs, and

facilities. Dedicated recruitment has drawn nationally recog-

nized individuals in clinical and academic radiology. Strongclinical leadership is provided by Gabrielle Bergman (muscu-

loskeletal), Michael Dake (cardiovascular and interventional),Robert Herfkens (body MR), Debra Ikeda (mammography),Brooke Jeffrey (abdominal), Barton Lane (neuroradiology),and Ann Leung (thoracic). In 1990, a positron emissiontomography center was opened at the PAVAMC under thedirection of Goodwin and George Segall. Reconfiguring thedepartment also led to the creation of a basic science unit,the Radiological Science Laboratory, under the direction ofGary Glover. The Radiological Science Laboratory is housedin the Lucas Center, which, after detailed planning by thenew chairman, opened in May 1992 to become one of thefew facilities in the world with centralized resources dedi-cated to MR imaging and spectroscopy research. Important

contributions have already been made by Glover, NorbertPeIc, and others to MR imaging, CT, sonography, and inter-

ventional imaging, including the development of MR phase-contrast motion tracking methods for assessment of myocar-dial functional and musculoskeletal joint and muscle dynam-ics [34]; the extension of diffusion-weighted neuroimaging

methods to human studies for the detection of stroke [35];the development of helical CT angiography methods thatallow computer editing and three-dimensional presentationof vessel structures [36]; and the development of stent-grafts

for vascular disease [37].

The Lucas Center is host to a new National Cancer Institutetraining program in advanced techniques in cancer imaging

and was established in January 1995 as an NIH-fundednational research resource in advanced MR technology. Col-

laborations with Stanford faculty in radiology and electrical

engineering and with industrial leaders in medical imagingyield a team of individuals with synergistic talents in clinical

and basic imaging. New faculty resources, strong institutionalbacking, and expansion of the departmental infrastructurehave significantly increased the clinical, research, training,and educational programs in radiology at Stanford.

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760 JONES ET AL. AJR:164, March 1995

Recapitulation

Over its 89 years, the department has grown from a rudi-mentary facility with one staff person and no trainees to twodepartments with more than 50 full-time faculty membersand a large complement of fellows and residents. The radiol-ogy department at Stanford is well positioned in today’s envi-ronment to deliver high quality, compassionate patient care;

to develop new imaging and treatment technologies; and to

serve as a center for radiologic education and research.

ACKNOWLEDGMENTS

We acknowledge the contributions of Drs. Abrams, Bagshaw,Brown, Castellino, Fessenden, Friedland, Glazer, Goodwin, Hoppe,Kallman, Macovski, Marshall, McDougall, Rosenberg, Smith, Zatz,and Zboralske. We also thank Matthew Joyce for assistance in pre-paring the manuscript.

For their cooperation and assistance, we thank Dr. John Wilson

and Geof Pawlicki of Lane Medical Archives, Yaeko Shinomiya of the

Stanford News Service, Jacqueline Brown of the Office of MedicalDevelopment, Joyce Thomas of the Medical Center News Bureau,

personnel at the Visual Arts Services of the Medical School, andLinda Long and coworkers at the University Archives.

Due to length limitations, we have not been able to individuallycredit the many people without whose hard work and devotion thedepartment could not have functioned. We thank in particular long-term ancillary personnel and voluntary clinical faculty whose educa-tional and service contributions over the years have been invaluable.

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