Gustav von Schulthess relishes research freedom

July 14, 2003

Prof. Dr. Gustav Konrad von Schulthess set out to make a name for himself at an early age. A member of a prestigious Swiss family and son of a respected Zurich physician, he preferred to be recognized on the basis of his achievements rather than his

Prof. Dr. Gustav Konrad von Schulthess set out to make a name for himself at an early age. A member of a prestigious Swiss family and son of a respected Zurich physician, he preferred to be recognized on the basis of his achievements rather than his surname. With that in mind, he left Switzerland after completing his undergraduate education and headed across the Atlantic to Cambridge, MA.

"I felt it was better to go to a country where I would be evaluated more neutrally," von Schulthess said. "I knew that I had reached that goal about one and a half years into my education in the U.S. when at a party I was introduced as Gustav von Schulthess, and the person I was talking to asked whether 'von' was my middle name."

His reputation is such that today's party-goers are more likely to question von Schulthess about interpreting perfusion MRI data or the justification for purchasing a combined PET/CT scanner. The name von Schulthess now equates to excellence in functional imaging and multimodality scanning in the nuclear medicine and radiology communities.

Von Schulthess is a busy man who wears a number of different hats. He is director of nuclear medicine and codirector of MR at University Hospital Zurich, and visiting professor of radiology at Stanford University. Appointment to these high-ranking positions has assured his ultimate goal: freedom to pursue an innovative program of research.

"In my position I can be very creative in identifying the projects I want to do and then trying to find the money for them," he said. "I have a position that is academia at its best. I have a fairly secure job, I live in an interesting environment, and I can essentially do whatever I like as long as I work."

And work he has: To date, von Schulthess has authored or contributed to 175 papers in peer-reviewed journals, 43 invited publications, and 17 books or book chapters. He holds two patents and has put his name to 130 conference abstracts or letters since 1995. He also owns a Swiss medical consulting company, is actively involved in a new company focusing on image reading during trials, acts as advisor to Amersham Health and Mobile PET Inc., and has served (or continues to sit) on the editorial boards of Magnetic Resonance in Medicine, Journal of Magnetic Resonance Imaging, Radiology, and Magnetic Resonance Materials.

Von Schulthess spent a year in medical school at the University of Geneva before switching to physics at the Swiss Federal Institute of Technology (ETH) in Zurich. He spent the next six years at Massachusetts Institute of Technology, initially as a graduate research student in physics and later as a medical student in the joint Harvard-MIT health sciences and technology division. He was graduated in 1980 with a Ph.D. in physics from MIT and an M.D. from Harvard.

Because U.S. visa regulations required him to leave the country for at least two years, he returned to Switzerland to take up a residency in internal medicine at University Hospital Zurich. But the prospect of additional years of study in order to match his peers' proficiency in differential diagnosis had little appeal.

"I knew that I was not in the right place in internal medicine, but what appealed to me were the physiological and pathophysiological aspects of that field," von Schulthess said. "Nuclear medicine obviously catered much more to that aspect of medicine than radiology."

He rose quickly through the ranks, moving from a residency in nuclear medicine at University Hospital Zurich to directorship of the division in just 10 years. At 41, he was at the time the youngest full professor in charge of a clinical service in the Zurich medical faculty. In a side-step on the way up the ladder, a research fellowship in MRI at the University of California, San Francisco, led to a concurrent appointment in the university's MR Center.

"I have been an extremely lucky person. I'm not the sort of person who sits and waits until things fall into my lap. I am always looking around, and I was able to maximize my opportunities," he said.

Von Schulthess suggests that his ability to look at clinical images quantitatively set him apart as an independent researcher at an early stage of his career. He also prides himself on being able to weigh the pros and cons of advances in medical imaging technology with higher predictive accuracy than many of his peers.

He is adamant about the need for better relations between nuclear medicine and radiology, and would rather build bridges than fuel turf wars. Swiss doctors have the option of receiving board certification in nuclear medicine and radiology with two years of additional training.

"This bridge-building may become quite relevant with PET/CT, which combines a technique traditionally associated with nuclear medicine with one associated with diagnostic radiology. The concept of a nuclear physician reading the PET scan and the radiologist reading the CT scan, then the pair of them having a case conference is a poor idea," he said. "Have you ever heard of one radiologist reading the images from a T1-weighted MR sequence, another reading the images from a T2-weighted MR sequence, then the two of them discussing the results?"

Von Schulthess now splits his time three ways among clinical duties, research, and teaching at the University Hospital and on the worldwide lecture circuit. As codirector of the International Diagnostic Course at Davos, Switzerland, he regularly persuades renowned medical imaging experts from many countries to spend a week of their time teaching and inspiring the next generation of radiologists. This year's course attracted more than 1000 registrants, the highest number to date.

The advice he would give these young people at the start of their careers is the same counsel he offers his own three children, who are in their 20s and perhaps wondering how to make their own name as a von Schulthess.

"I tell them it's not so important what you are doing. It is more important that you are interested in what you are doing and do your best," he said.

Paula Gould is a contributing editor for Diagnostic Imaging Europe.