Ultrasound for Cancer Investigation: An Anecdotal History

Cancer surgery had been largely a blind art until, in 1949, a British surgeon working in Minneapolis exploited the potential of a US naval radar training device, in which a 15-MHz ultrasonic beam substituted for the radar. Within the next 5 years John Wild had reported work on the basis of much of modern practice: grey-scale imaging of tumours, quantitative tissue characterization, echo-endoscopy and even the question of possible hazards. Wild's work was stopped dead in 1955 by bureaucratic politics and, in spite of spectacular and eventually successful litigation, never recovered. In the following years, fashion in scanner design was aimed at outlining organ boundaries, with use of bistable display devices, consequent loss of grey-scale information, and general failure to image tumours. An exception to this trend was the work of the Commonwealth Acoustic Laboratory, in Sydney, who developed obstetric scanners with very good grey-scale representation. Helped by this, the author's group, at the Institute of Cancer Research and Royal Marsden Hospital, developed a series of scanners that were intended for abdominal and breast work, and which enabled, for the first time, visualization of a range of soft tissue pathology. It was curiosity as to the acoustic scattering processes underlying this visualization technique that led our group and others to embark on substantial, and still ongoing, studies of the physics of the subject.