When I learned that Alexander Gottschalk, MD, FACR, FCCP, would be receiving the Benedict Cassen Prize at the 53rd Annual Meeting of the Society of Nuclear Medicine (SNM of Reston, Va), held June 3?7 in San Diego, I made it a point to attend. I first “met” Gottschalk when writing the cover story of our January 2006 issue—The Best of the Best, which recognized Gottschalk in the category of “Nuclear Medicine Specialist”—and I interviewed him for the article.

The Cassen Prize is presented each year at SNM to honor a physician or scientist who has made a significant contribution to the field of nuclear medicine. During the award presentation, Frederick J. Bonte, MD, gave a thoughtful and touching introduction of Gottschalk, who was born in Chicago, graduated from Harvard College (Boston) and then Washington University Medical School (St Louis), and took a radiology residency in Chicago. “At the end of his residency,” Bonte said, “Alex made one of those life-changing decisions.” He accepted a fellowship with John Lawrence, MD, in the cyclotron unit at the University of California, Berkeley, and was assigned to work with Hal Anger, developer of the gamma camera.

Gottschalk’s story is filled with one accomplishment and accolade after another, including chairing the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II study group, serving as president of both the SNM and the Fleischner Society, authoring 300-plus papers, acting as editor of the Yearbook of Nuclear Medicine for 9 years, and much more. “Alex has had a remarkable career that qualifies him in every respect for the receipt of the Cassen Prize,” Bonte said. “He is a scientist, investigator, and leader of his chosen specialty, and in every way is worthy of its highest honor.”

Currently a professor of radiology in the Department of Radiology at Michigan State University (East Lansing), Gottschalk accepted his award and went on to fully engage the full house with a dynamic lecture on how to interpret and report the ventilation/perfusion lung (V/Q) scan in the post-PIOPED II era. Gottschalk summarized the latest results, which were published in the June 1, 2006, edition of the New England Journal of Medicine.

In this day when many studies are finding their way to the multislice CT suite, Gottschalk offered a word of caution to those who believe CT angiography (CTA) should replace the V/Q scan wholesale. It depends on the patient and situation, he advised. Gottschalk highlighted the advantages of CTA: It’s fast, a CT technologist is available 24/7, the suite is near the emergency department, the diagnosis is not exclusive, and a CT venography (CTV) for thromboembolic disease can be performed at the same time. However, he also noted the disadvantages of CTA. First, the studies might not always be read by an experienced individual. Next, many patients—those with allergies, pregnant women, and those with decreased renal function and elevated creatinine—cannot have a CTA; in fact, in the PIOPED II study, 25% of patients were ineligible. Also, Gottschalk addressed the radiation dose issue with CTA. One CTA exam is the equivalent of 6.6 mammograms, he noted, and added, “Dose to the breast from CTA is not a trivial problem, and the V/Q scan reduces that dose significantly.” Clearly, he said, V/Q should be the first test for young females presenting with chest pain.

But it was Gottschalk’s closing remarks that moved me. He announced that he is battling a serious illness and that the 2006 SNM meeting could be his last. “I will miss my colleagues and the terrific science at this meeting,” he said. “If this is the end of my 43-year run, it’s hard to suggest a better way to go out than this.” He received a standing ovation.

Gottschalk is a true inspiration, a dedicated physician who has made many contributions to the medical-imaging field. In fact, one of his former residents referred to him as the “midwife of modern nuclear medicine.” I couldn’t agree more and wish him a speedy recovery.

Andi Lucas, editor