John Mallard’s passing last week has special significance to those of us pushing boundaries in imaging-led healthcare, and prostate cancer in particular. He pioneered the development of MRI for cancer detection, something that has literally revolutionised the diagnosis and treatment of prostate cancer.
John Mallard was the first professor of medical physics at Aberdeen University, appointed in 1965, where he led a team that developed the first whole-body Magnetic Resonance Imaging (MRI) scanner. A year earlier, Prof Mallard had published work in the journal Nature on his research which indicated that magnetic resonance imaging, which uses strong magnetic fields and radio waves to produce detailed images of the inside of the body, might be able to diagnose cancer. Colleagues said this went largely unnoticed, according to the Times. He told the BBC in 2018 "The driving force for us was the fact that we had X-rays that were telling us everything about bones, but we had absolutely nothing that was telling us about the soft wet tissues within the body. And that's what MRI did.
"While the technology behind MRI was developed in the 1970s by the late Sir Peter Mansfield and his team at the University of Nottingham (who later shared the Nobel Prize in Physiology or Medicine in 2003 with the inventor of the technique, US chemist Prof Paul Lauterbur), it was John Mallard's team in Aberdeen that was responsible for developing the world's first full-body MRI scanner, “cobbled together with copper pipe from a local plumber and a tube from a children's play park”, according to Prof Tom Redpath, who was a young PhD student at Aberdeen studying under John Mallard. He says no one had any idea how successful and important the MRI scanner would become.
Their prototype, the world’s first whole-body MRI scanner, resides at the Aberdeen Royal Infirmary, and is pictured below. It was first used on 28 August 1980 on a local man who was battling terminal cancer, and went on to scan more than 1,000 patients before it was replaced by an updated model three years later. Prof Redpath retired nine years ago and told the BBC: "It's completely unlike a modern MRI scanner - there is no plastic facing to it, so you can actually see the guts of the thing and recognise the pieces of coils and copper and magnet that would actually make up a modern scanner."
Mallard's team at Aberdeen went on to develop Positron Emission Tomography (PET) which can produce detailed three-dimensional images of the inside of the body. Revisiting John Mallard’s transformative contributions to medicine through the development of MRI reminds us of the challenges and opportunities that define the process of innovation. In Mallard’s case, it took over 15 years to bring his ideas to working prototype. Once demonstrated, however, further development and application surged ahead, transforming radiology and diagnostics in multiple areas of healthcare. It also underscores how long new innovations can take to demonstrate benefit, and the need for determined people – scientists, technologists, clinicians, healthcare professionals and industry leaders to drive them through, sometimes at the risk of their jobs and reputations.
This has certainly been the case in the application of MRI to prostate cancer diagnostics, first identified in the early 2000s and approved by NICE as a standard of care in 2019. Finally, John Mallard personified the significance of the UK as a centre of innovation in science and technology, and MRI in particular. His genius, creativity and dedication has led so much of the innovation driving our advancements in prostate cancer diagnostics and treatment that have since taken place here in the UK.
What has been your experience with MRI? We’d love to hear from you.
