Extract from: Memoirs of Lyn Oliver AM PhD,
Physics in Medicine, Making a Better Healthcare
A Change in Research and Terminology
By the 1970s, research workers were becoming much more innovative and aiming for bigger things. Samples for the experiments were becoming more about creating an image from the NMR signals. Researchers were imaging the inside of fruit (Andrew and Mansfield) and mice (Mallard) by detecting the resonant signal of hydrogen (water) content whilst scanning over the subject.
The prime effort in progressing their research was becoming more a problem of how to improve the magnetic field strength of the electromagnetic system, improve mathematical calculation methods for signal data handling and designing a practical means of scanning the whole of a human body.
With the ‘cold war’ between USA and Russia and the increased threat of nuclear warfare, the word ‘nuclear’ was not viewed favourably. So, it was generally agreed for commercial reasons that the term ‘nuclear magnetic resonance’ should be replaced by a more publicly acceptable term of ‘Magnetic Resonance Imaging’ (MRI).
Seeking MRI Glory
Consequently, by 1970, the race to design, build and commission a clinical MRI whole-body scanner intensified. Mansfield at Nottingham University and Mallard at Aberdeen University in the UK were progressing at about the same level. Damadian in New York, USA, aimed to produce a similar MRI machine and applied for patents in 1972 – 4 and built a device for human measurements by 1978.
Each research centre sought to win the prize of being the first to develop an MRI machine that could scan a whole length of a human. Apart from the honour and becoming a world leader in medical MRI scanning, a first would be rewarded financially from patented royalties and much more from commercial enterprise agreements.
Damadian was the founder of FONAR in 1978. But progress was proving difficult.
Technical limitations were beginning to hinder scientific progress by researchers everywhere. Problems to overcome were the need for:
- a large enough tunnel to fit a reasonable size patient who could pass through the whole patient length on a couch, but with a sufficient magnetic field of view recorded;
- a strong enough magnetic field of sufficient strength for the patient with sufficient bore size; and
- an adequate signal to noise ratio to obtain statistical accuracy for a satisfactory image;
Mallard’s group managed to do this and their first patient was scanned in 1980. The radiologist, Dr Francis Smith, diagnosed from the MRI images that the patient had cancer in the chest, liver and in multiple sites in the bone structures. The same MRI machine continued to be fully booked for regular clinical work for over 10 years. A Mark 2 version replaced it in 1993.
John Mallard received due recognition for his research team’s achievements in having developed in such a short time these technological advances leading to widespread use of MRI.
MRI Nobel Prize 2003 – The Sting in the Tail
The race to be the first routine clinical patient care service, was achieved in 1980. But world recognition for MRI, applied to clinical medicine, was not recognised in any way until the Nobel Prize was announced in 2003.
The 2003 Nobel prize was awarded to:
Paul Lauterbur and Peter Mansfield for “their outstanding contribution to medicine or physiology”.
In particular, the prize stated it was:
“for their discoveries concerning magnetic resonance imaging”
The 2003 Nobel Prize for MRI was 30 years since Lauterbur and Mansfield’s NMR work was published and 23 years since Mallard successfully commissioned an MRI scanner for regular clinical use.
That was an extraordinarily long time later compared with other NMR Prize winners. The approximate number of years previous NMR winners received their Nobel Awards were:
Rabi (1930s) 14 years;
Bloch and Purcell 6 years;
Kurt Wuthrich 22 years;
Richard Ernst 11 years;
Lauterbur and Mansfield 30 years
Not having been named as the Nobel Prize winner for MRI was a bitter blow to Damadian since he had previously publically claimed in 1977 that he was the inventor of MRI for patient purposes.
Damadium demanded that the Nobel Prize committee review its decision. “They had clearly made a mistake and had not taken sufficient note of his MRI patent and research work”, he said.
He made full-page advertisements in the New York newspapers to claim this. Many Americans expressed their support and shock that Damadian was not included in the Nobel Prize winners.
He later moderated his demands and suggested sharing with Lauterbur and Mansfield for the prize as being a reasonable solution. But the Nobel committee did not change their decision.
Damadian had invested heavily in his FONAR company. As well as satisfying his MRI claim to have been first, winning the Nobel prize would have provided significant rewards for his commercial business.
NMR differences for normal living tissue were previously reported by researchers prior to 1971 (see, for example, Odelbad). But, as far as can be established, Damadian was the first to report that the NMR relaxation times of tumour samples, were different. Damadian’s 1971 paper was referenced in many other research papers. Regardless of the Nobel prize issue, his NMR studies of tumour samples should be recognised as a first.
Lauterbur should also have referred to Damadian’s 1971 work in his 1973 Nobel prize winning paper.
However, supporters claimed that the 2003 Nobel Prize was awarded for the original work of Lauterbur and for Mansfield’s contribution to NMR studies producing an image. This later led to the ability to provide clinical whole-body MRI by other researchers, such as Mallard.
And, as shown in the literature, Damadian’s original Indomitable design could only provide a point dose map of NMR measurements and not a true discernible image of the internal structures of a whole body scanned human.
However, there were some justified rewards to Damadian later for his significant effort to produce a whole of body MRI diagnostic tool for cancer.
The company was initially struggling financially to compete against other MRI scanner competitions. Ironically, FONAR has since adopted the Mansfield computational techniques and has claimed a number of significant medical breakthroughs using their more modern equipment designs.
FONAR had earlier taken GE to court for infringement of Damadian’s patents. It was a long hard battle. But eventually, FONAR won and GE had to pay in 1997 approximately $130M. FONAR continues to exist as a viable company supplying NMR/MRI diagnostic equipment.
Mallard made comment in his invited paper in Physics in Medicine and Biology, 2006 entitled Magnetic resonance imaging—the Aberdeen perspective on developments in the early years,
where he said:
“The limitation to three persons for such an award, which is perhaps an outdated one, and which was not in Nobel’s original Will, has frequently led to the omission of worthy names in the past. It is relevant to remember that the Royal Society awarded its Wellcome Prize and Gold Medal for MRI in 1984 to four UK physicists. If in imagination, the Nobel limitation was removed, then the author would name seven people for the creation of clinical MRI.”
It is not clear who the seven Mallard people he would have selected if there had been no limitation on the number of nominees for the Nobel Prize. Regardless of what Mallard thought, it remained limited to two winners of the 2003 Nobel Prize.
Lyn Oliver AM PhD July 2021
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- Making the human body transparent
- The pathway to clinical imaging
- Creating an NMR image from biological samples
- My brush with fame
- 2003 Nobel Prize
- The first clinical whole-body MRI scanner
- Rekindling my ‘brush with fame’
- IOMP Medal (2016) awarded to John Mallard for his MRI work
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