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Up Close with the Father of Spiral CT

By Dr Evelyn Ho


Not many are privileged to meet the inventor of life changing radiological imaging tools, but Radiology Malaysia has managed to bring this exclusive interview with Prof Dr Willi Kalender to you. These are imaging equipment which have had and continues to be a basis for further development. The Computed Tomography (CT) scanner was rated as the top medical innovation in 2001, together with the Magnetic Resonance Imaging (MRI), by American physicians. The perceived value of the CT and MRI innovation ranked above that of drugs such as ACE inhibitors and cholesterol lowering drugs - the statins.

The CT scan was invented by the late Godfrey Hounsfield. In the 1980s, volumetric (spiral) CT scan was developed by Willi A. Kalender. Since then, volumetric CT scanning has rapidly developed further with the advent of multislice scanners. The first prototype 16 multislice scanner was introduced in 2001 and in 2004, 64 multislice scanners are now on the market. At such subsecond speed of scanning, the CT scanner can obtain images of the heart and its blood vessels (coronary vessels) – as if it was frozen in time.
 

In 1996, Spiral CT arrives in Hospital Kuala Lumpur, Malaysia. These are images from the spiral CT scan 3D reconstructions of a vertebral (spine) fracture and an abdominal aortic aneurysm; and a coronal reconstruction of an abdominal aortic aneurysm (abnormal dilatation of the large arterial trunk in the abdomen).
 

Brief Biodata 
Born in 1949, Willi stepped into the world of diagnostic imaging after obtaining his Masters Degree in Medical Physics in 1976 from the University of Wisconsin, Madison, Wisconsin, USA. In 1979, he obtained his doctorate in Medical Physics from the same University. In 1988, he completed the post doctoral lecturing qualifications (Habilitation) for Medical Physics at the University of Tübingen. The latter is a requirement before full professorship can be awarded in Germany.

Kalender’s main interest is in diagnostic imaging, focused on volumetric CT although the other areas of research include radiation protection and development of quantitative diagnostic procedures for eg the diagnosis of osteoporosis, lung and cardiac diseases.

In November 2002, he was voted by Diagnostic Imaging as one of the 20 most influential people in Radiology! He is currently Professor and Director of the Institute of Medical Physics at the Friedrich-Alexander-University Erlangen – Nürnberg, Germany. The Institute’s research projects include multi-row detectors for faster volume scanning, image reconstruction algorithms, procedures for dose reduction by tube current modulation, an automatic exposure control (AEC) for CT, and new clinical applications. Cardiac CT and PET/CT fusion imaging of the thorax are priority areas in research to date (2004).

Willi is also Distinguished Visiting Professor at the Stanford University, Department of Radiology and Visiting Professor at the University of Wisconsin, Madison, Department of Medical Physics. He is a member of the International Commission on Radiation Units and Measurement (ICRU).

Willi Kalender shared with us, on the morning of 27 September 2004, on the day of the inaugural SEACOMP John Cameron lecture at the 3rd South East Asian Congress of Medical Physics (SEACOMP) and 4th Asia-Oceania Congress of Medical Physics (AOCMP) in Kuala Lumpur, Malaysia.
 
Up close with Prof Dr Willi A. Kalender 
As a child, Willi first wanted to be a farmer and then, a building construction engineer. Other than his parents, Professor John Cameron as well as Charles A. Mistretta (inventor of 3D digital subtraction magnetic resonance angiography) were his role models and had played an influential role in his life and development. Willi describes both John and Charles as relaxed and very friendly. No wonder, Willi Kalender is also very approachable and down to earth!

He first got interested in medical physics when he was a physics exchange student in the USA in 1973. He now has about 20 patents to his name. Willi describes his greatest strengths as being energetic and goal oriented. He believes in the practical implementation of solutions to medical problems.

Willi gains professional satisfaction from seeing his ideas evolve into clinical applications. His top 3 achievements includes Spiral CT, Cardiac CT and a happy family with 3 children! He is now “father” of spiral (volumetric) CT and would list cardiac CT as his “baby” as well.

His primary place of practice is in Germany and his appointments as visiting professor to Stanford University and University of Wisconsin are more for exchange of ideas and discussions. He spends about 95% of his time in Germany.

In Germany, although medical physicists are viewed very favourably, they are often not in important positions – yet are important in their service functions. In other words, they are not in “big boss” positions. Willi considers himself one of the exceptions as he is Professor and also Director in the Institute of Medical Physics!
 
Still too young to think of retiring! 
Does Kalender ever see himself tiring? No, he has not even considered or thought about retiring at the moment. When asked if he had any pearls of wisdom to pass to the whole world (to date), he felt he was still “too young” to pass any words of wisdom. Later he agreed he shared John Cameron’s comments- that one needed luck and a lot of hard work!

He would like to see medical physics be given greater prominence and play a more important role but medical physicists must be ready to assume such roles and accept the challenge(s).
 

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Friday, 06 May 2005