Following Medical School in Rotterdam, I went to the UK to work as a junior Surgical trainee for 2 years. Upon my return to Amsterdam, I went on to do a PhD in the field of Diagnostic Imaging and Thrombosis and Haemostasis (being responsible for a large clinical trial and helping develop the plasma D-dimer test for clinical use under the guidance of Prof Jan-Wouter ten Cate and Prof Harry Buller) and subsequently completed both my Clinical Epidemiology and Diagnostic Radiology training (Prof Johan Lameris).

In 1999, I took up my first academic position as Senior Clinical Lecturer at the Academic Unit of Radiology (Prof Paul Griffiths), University of Sheffield, where I developed a pulmonary MRI unit together with the Pulmonary Vascular Diseases Unit and also took the clinical lead role in setting up PET-CT imaging.

In 2004, I moved to the University of Iowa to take up work as full Professor in the Department of Physiologic Imaging (Prof Eric Hoffman) in the Department of Radiology (Prof Laurie Fajardo). I gained tenured full professor status in Radiology, with secondary appointments in Medicine and Biomedical Engineering. I set up a hyperpolarized MRI programme for research purposes, give clinical leadership to the pulmonary research programme and developed a clinical cardiac CT service in collaboration with the Department of Cardiology.

During the period in Iowa, I also started a company (Quantitative Imaging of Iowa, QI2), which was sold in part to VIDA Diagnostics. The remaining interests were subsequently transferred to the UK upon my move here: Quantitative Clinical Trials Imaging Services Ltd.

In 2009, I moved back to the UK to take up the Scottish Imaging Network - a Platform of Scientific Excellence (SINAPSE) Chair of Clinical Radiology, filling a 9 year vacancy. This role has the broad remit of research, teaching and also clinical input as an Honorary Consultant for NHS Lothian Health Board. In addition, I co-direct the Clinical Research Imaging Centre, a £25 million development and a joint venture between the University of Edinburgh and NHS Lothian. In 2015/2016, we upgraded this facility with a MR-PET system (Siemens mMR), a new PET-CT system for the NHS (GE) and a full upgrade to existing PET-CT (Siemens mCT) with new support facilities (total £10 million).

www.ed.ac.uk/edinburgh-imaging

www.cir.ed.ac.uk

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My research has four main areas of interest, which overlap to some extent. In particular, we apply 3T MRI, 128 mCT-PET and 3T MR-PET (mMR) to a range of diseases to correlate and cross validate them for non-invasive assessment of patients. CRIC also has integrated facilities for image analysis, retinal imaging and a full radiochemistry suite with cyclotron and GMP laboratory.

Clearly, from the above, it is clear that this is very much a multidisciplinary team effort. It includes radiochemists, physicists, image analysis specialists, radiographers, support staff and radiologists. This group closely links in with research groups that intend to use imaging within their research, and CRIC covers the broad scope of the College of Medicine, the wider University and most specialities and age groups.

1. Cardiovascular imaging

Under the leading role of Prof David Newby, Chair of Cardiology, we have developed a spectrum of imaging modalities and are testing their value in novel indications in large patient cohorts. Examples of this work include the SCOTHEART trial, a multicentre randomised study in 4000 patients, to evaluate the role of cardiac CT angiography in the management of patients presenting to a chest pain clinic. This has helped establish a cardiac CT programme in Edinburgh.

Another large area of research includes the use of radiochemical/PET imaging to study inflammation and atherosclerosis in aortic valvular disease, coronary artery disease and aortic aneurysm disease. These methods will hopefully develop into biomarkers for patients at increased risk of acute events, where prevention may be helpful, and also to study new treatments and their effectiveness.

2. Pulmonary imaging

This work is deloping with colleagues in Pulmonary Medicine (Prof William Macnee and Prof Nik Hirani) and Radiology (Prof John Murchison and spans a range of topics, including pulmonary thromboembolism, lung perfusion in vascular and lung parenchymal disease (using both MRI and CT), molecular imaging of inflammation (COPD) and novel agents to study fibrotic processes (IPF).

I have also continued with my input into the COPDGene study (and the recent continuation of the COPDGene 2 study) and the IPFNet Investigators, taking part in the discussions, analysis of imaging data and performing radiology reads/expertise throughout.

3. Molecular imaging/Oncology

These areas overlap from the clinically applied methods (mainly 18F FDG) to novel regions of interest. A consortium of Engineering, Radiation Oncology, Veterinary Imaging and Radiology are trying to develop novel methods to study hypoxaemia in vivo in tumours, to enable better targeting of treatment (IMPACT project).

Molecular imaging is also expanding in this domain, where more focused treatments are developed and the mechanistic actions can be tracked using PET imaging. This field is essentially being used in Cardiovascular, Pulmonary and Oncologic imaging, while novel areas of interest expand into Neuroimaging (particularly Dementia research and regenerative medicine/stemcell treatment).

4. Imaging-based Biomarkers

It is clear that softwares need to be developed to facilitate fast and accurate image analysis. This is the only way to generate information beyond the simple images, which will assist decision making for patients, risk assessment and evaluation of treatment response.

Another way of facilitating this is through application of existing technologies into new areas. Retinal imaging has been developed at CRIC towards this and combines advanced image analysis and application in cardiovascular and neurologic disorders.

I am an imaging scientist, with a main role in clinical developments of biomarkers and quantification of diseases. My particular focus is on novel imaging tools developments in cardiothoracic, oncologic and molecular imaging, but there is wider interest, including sports medicine and brain research due to molecular imaging overlap. Ultimately, I am a multi-organ, multi-modality researcher.

In addition to offering state-of-the-art facilities, I am involved in developing novel computational tools, which can move these developments into a clinical application.