David King

Founding father of coronary calcium imaging, a technique for the early diagnosis of heart disease

David King was one of the foremost figures in the development of the medical imaging technique known as computed tomography (CT), and especially electron beam CT (EBCT). He was instrumental in its evolution from a specialised brain-scanning procedure in the early Seventies to its current position as a diagnostic clinical tool of astounding versatility and global significance. In particular, he was considered by cardiology and radiology colleagues as the "founding father of coronary calcium imaging", a non- invasive technique for the early diagnosis of heart disease.

David Geoffrey King, medical engineer: born Newcastle upon Tyne 9 September 1947; Development Engineer, EMI Research Labs, Hayes 1972-74; Technical Co-ordinator, EMI Medical, Northbrook, Illinois 1974-76, Engineering Manager 1976-77, Product Support Manager 1977-78, Director of Product Applications 1978-81; Product/Business Manager, Image Processing Division, Kontron Electronics 1981-83; Director, Clinical Sciences, (GE) Imatron 1983-2004; Director, Clinical Services (consultant), Mount Sinai Medical Center, Miami Beach, Florida 1999-2001; three times married (one son); died Miami, Florida 24 April 2004.

David King was one of the foremost figures in the development of the medical imaging technique known as computed tomography (CT), and especially electron beam CT (EBCT). He was instrumental in its evolution from a specialised brain-scanning procedure in the early Seventies to its current position as a diagnostic clinical tool of astounding versatility and global significance. In particular, he was considered by cardiology and radiology colleagues as the "founding father of coronary calcium imaging", a non- invasive technique for the early diagnosis of heart disease.

Born in Newcastle upon Tyne in 1947 into a naval family, King was educated at Plymouth College and All Hallows School in Lyme Regis, Dorset. Having abandoned early plans to train as a concert pianist, he originally studied electrical and electronic engineering at Nottingham University, graduating with honours in 1969. He increasingly found himself drawn to medical applications, and by 1972 had become the lead engineer at EMI behind the construction of the first CT scanner. This resulted in the Nobel Prize for Medicine for its inventor, Sir Godfrey Hounsfield, in 1979, and led King towards further clinical applications of the technique while ensuring its commercial future.

He was responsible for the installation of the first-ever hospital-based CT scanner in 1973 at the Mayo Clinic, and indeed for hundreds more all over the world over the following two decades. Back at the EMI laboratories in Middlesex, meanwhile, he produced the world's first abdominal CT images by modifying one of the original brain scanners, and was able to develop and patent an important brain imaging application of CT.

It was not until the 1980s, though, that King started work in the field with which he is now most associated: the use of "ultrafast" CT scanners to assess heart disease. Having joined the EMI Medical division in Northbrook, Illinois, in 1974, King was among the first to recognise that a direct marker of early heart disease, "coronary calcium", could be a far more important predictor of heart attacks than conventional risk factors like cholesterol levels.

Scanning was simple and non- invasive, and would show signs of disease years or decades before any other testing became abnormal. In order to prove the concept, he convinced sceptical and traditionally trained academic cardiologists and radiologists to study the hearts of thousands of patients by having them undergo EBCT imaging.

Through King's influence, the value of coronary calcification imaging eventually became obvious to university physicians in Europe, Asia and the United States, and the EBCT scanner became the technological centrepiece of coronary risk assessment centres worldwide - despite its considerable manufacturing cost. Along the way, his evangelical zeal and revolutionary ideas also persuaded numerous academic physicians to re-direct their careers to the study of plaque imaging.

In 1981 he moved from EMI, first to Kontron Electronics, then in 1983, as Director of Clinical Services, to the medical systems company Imatron (now part of GE) in San Francisco, where he remained until his death. By 1990, he had become the intellectual "brain trust" co-ordinating research activities and international conferences that led to hundreds of papers in the field. He began a tradition of holding "calcium club" meetings at annual US cardiology conferences, which despite the hour (they were generally held at 6am) succeeded in attracting top practitioners together.

Outside work, King maintained his interest in classical music, and at various times successfully pursued sailing, badminton (played at county standard in the 1960s) and golf. A modest man who maintained strong links with his family in the UK, he had a well-developed sense of humour which never deserted him. He was also immensely practical, with considerable DIY and repair skills and a determination not to be beaten by inanimate objects. But his distinguishing feature was his ability to relate to other people and to inspire so many of them to work with him towards his visions for the future of medical electronics.

King was diagnosed with colon cancer after trying to give blood in the aftermath of the terrorist attacks of 11 September 2001. Although an early colon resection appeared successful (leading him thereafter to sign his name with a final semi-colon), the cancer later reappeared in his liver and did not respond to chemotherapy. As with heart disease, the first obvious symptoms of the cancer itself appeared only just before he died. He devoted much time in his final months to convincing others to undergo colonoscopies, a painful and invasive process which, if conducted early enough, might have saved his life. Ironically, the use of CT to conduct "virtual" colonoscopies is just beginning to make widespread and regular testing a realistic prospect.

David King received a Lifetime Achievement Award from the Society of Atherosclerosis Imaging at the American Heart Association annual meeting last year, and in December was honoured with a Distinguished Alumnus award from the School of Electrical and Electronic Engineering at Nottingham University.

Matt King and James Ehrlich