The Journal of Thoracic Imaging

“To use roentgen rays successfully in practice, the physician must become familiar with appearances which present themselves in health: this statement applies particularly to the thorax and the pictures of this part of the body when seen on a large fluorescent screen presents so much that it should be studied systematically.”1 That assertion came in 1901, 6 years after the discovery of x-rays, in Francis H. Williams' classic tome, The Roentgen Rays in Medicine and Surgery.1 Dr Williams, an internist at the Boston City Hospital, was credited as being America's first radiologist because of his perception of diseases on x-ray films and fluoroscopic imaging. The first of 3 editions contained 635 pages with hundreds of illustrations and 6 chapters about the thorax occupying 146 pages. Those chapters discussed the anatomy and function of the chest, diseases in the thorax, pulmonary tuberculosis, pneumonia, emphysema, bronchitis, pleurisy with effusion, empyema, hydrothorax, and pneumothorax. Other chapters discussed techniques for producing effective images and shielding physicians from scattered radiation. His book, which gained worldwide acclaim, contained all there was to know about thoracic radiology at the time. That was only a start. Every radiology publication, and others in medicine, contained articles about chest x-ray technique and clinical uses. The first x-ray examinations as screening procedures were for the early detection of pulmonary tuberculosis. Although Dr Williams preferred fluoroscopy, most other pioneers chose x-ray films. The development of William Coolidge's hot cathode x-ray tube in 1913 and the introduction of cellulose acetate films made chest imaging more reliable and safer. In the United States, Henry Pancoast and Eugene Pendergrass at the University of Pennsylvania used thoracic x-ray screening programs to study respiratory diseases in coal miners, foundrymen, and workers with asbestos and other mineral dusts. Felix Fleischner (first of Vienna, Austria, and later of Boston), George Holmes (also of Boston), and many others wrote about x-ray findings of other lung diseases. In 1937, George Robb and Israel Steinberg of New York University described the first visualization of the heart and great vessels. Russell H. Morgan's invention of photo timers in 1942 and his development of image intensifiers in the 1950s at Johns Hopkins University, along with John Coltman of Westinghouse, represented tremendous strides in imaging all parts of the thorax.2 Books about chest radiology, particularly those by Ben Felson3 from Cincinnati and Robert Fraser and Peter Paré4 of Montreal topped the bestseller list for radiology texts for several decades. Besides x-ray films, other reports described the use of radionuclides, ultrasound, and computed tomography in chest examinations. Even though chest images were an estimated 40% of all x-ray studies, there were no journals devoted entirely to thoracic imaging and no subspecialty society fixed on the same topic. This was true until 1969, when the Fleischner Society attracted a small, select group of radiologists, pulmonologists, and thoracic surgeons. Then, in 1982, in the United States, the Society of Thoracic Radiology (STR) was organized. Still, there was no subspecialty journal devoted exclusively to the thorax. THE JOURNAL OF THORACIC IMAGING In December 1985, the first issue of the quarterly Journal of Thoracic Imaging (JTI) was published. It contained 10 articles, 7 from America and 3 from Britain. The topics included a review of basic chest film technique and digital imaging, digital subtraction, plain film tomography, computed tomography, magnetic resonance imaging, positron emission tomography, and ultrasound. The founder and editor was Eric N.C. Milne (Fig. 1), a native Scot then on the radiology faculty at the University of California, Irvine. The publisher was Aspen Systems Corporation. At the beginning, there was no societal affiliation.FIGURE 1.: Dr Eric N.C. Milne, founding editor of the Journal.Some time before the first edition, recalled Dr Milne, “Anne Paterson, then of Aspen Systems, contacted me about writing a book. She included a small questionnaire asking if there were any other books I would like to see published. I replied ‘Book NO. Journal YES!’ She liked the ideas I had laid out for her and asked me to provide titles of possible articles and possible authors, enough for six issues. That's when the hard work began! “Luckily I was deeply involved in giving papers and attending many meetings. I knew very well who was ‘hot’ in most topics and I was therefore able to come up with interesting forefront material—provided I could (a) get the authors to agree to supply a manuscript and (b) twist their arms to get the manuscript in on time. I had to go out and mine the material myself. “One of the fundamental problems at the beginning was ‘what does an editor of a new journal do exactly?’ Is it up to him to go out and find papers, or to sit back and wait for them? Until he has selected and received acceptance from a group of reviewers, is he supposed to do the reviewing? Is he supposed to actually edit the manuscripts for logic, clarity, brevity and grammar? Answer—all of the above, and more when starting a journal.” To compete with established journals (Radiology and the American Journal of Roentgenology) Eric Milne established the symposium concept. The symposium format allowed him to ask radiologists for papers in each one's area of expertise and to combine these papers to create a very full and expert coverage of the chosen topic. The concept was successful and remained the distinctive part of most all JTI issues, usually with guest editors. Each edition also contained original non-solicited articles on different topics. Once the Journal was established, he sought a suitable chest radiology society to become the Journal's sponsor. The publisher, Aspen Systems, was agreeable. As a founding member himself of the STR, he suggested to the executive committee that it would be very appropriate for the STR to sponsor the new chest radiology journal and got an affirmative answer in April 1987, effective with the second issue of JTI, volume 2. In 1988, the editor recruited Sandy Rubin of the University of Texas at Galveston and Philip Goodman of Duke at Durham, North Carolina, as associate editors. Shortly before he ended his term as editor, Eric Milne solved a crisis. “I sought papers from all the experts I knew for an issue on intensive care unit radiology. With a sinking heart I saw the deadline approaching and I was still 30 pages short, a week before the due date. However, I myself was a very busy and reasonably erudite critical care radiologist, so, one warm and sunny afternoon I sat outside in the California sunshine, on my patio, and began to write. By 3 o'clock the next morning I had finished a 30 page manuscript, including references. Within 24 hours, I had all of the figures and captions completed—and met the deadline. The paper turned out very successfully and has been one of my most quoted ones. Perhaps the pressure made me less verbose and more to the point, Who knows?” Five years after the first edition of the JTI, Dr Milne resigned as editor.5 The reason, he wrote in his final editorial, was that, although the editorial position gives a uniquely valuable and enjoyable opportunity to stay at the cutting edge of chest radiology, editing is very nearly a full-time business, and he had a long list of other things he wanted to do, including writing a major book on the physiological approach to reading chest films.5 EDITORIAL CHANGE—SANFORD RUBIN Sandy Rubin (Fig. 2) was chosen by Dr Milne as his successor. The editorial office moved to University of Texas Medical Branch, where he was the chest radiologist. Dr Rubin asked Phil Goodman to continue as associate editor and added Warren Gefter of the University of Pennsylvania and James Reed of the University of Kentucky in Lexington as new associate editors. Besides his knowledge of chest radiology, Sandy Rubin said he was well qualified to become editor because his wife gave him a dictionary and a thesaurus.FIGURE 2.: Dr Sanford (“Sandy”) Rubin, the second editor of the Journal.The new editor inherited enough accepted manuscripts to fill his first 2 issues. He continued the policy of organizing symposia. However, he skipped symposia in several issues to allow early publication of some of the articles on hand. His first issue in 1991 contained 15 articles and no symposium. Several of the articles still addressed the use of plain chest films. A growing number of unsolicited articles were being submitted by radiologists from other countries, particularly from Japan, where a Japanese Society of Thoracic Radiology had been established. By the summer of 1993, the JTI had added the formal sponsorship of the Japanese Society of Thoracic Radiology. The JTI editorial board now contained 22 members including 1 from Japan, Michio Kono of Kobe, and 2 others from different countries, Massimo L. Pistolesi of Pisa, Italy, and Carl J. Zylak of Hamilton, Ontario, Canada. Eric Milne was a member. The other American members were Lawrence M. Boxt of New York City; David S. Feigin of LaJolla, California; Ernest J. Ferris of Little Rock, Arkansas; Lawrence R. Goodman of Milwaukee, Wisconsin; Stuart A. Groskin and Zachary D. Grossman, both of Syracuse, New York; Richard A. Matthay and Jack L. Westcott of New Haven, Connecticut; Theresa C. McLoud of Boston; John D. Newell, Jr., of Denver; Kook Sang Oh of Pittsburgh; Anthony V. Proto of Richmond, Virginia; Carl E. Ravin and H. Dirk Sostman of Duke University; S. David Rockoff of Washington, DC; Ina Lyn Tonkin of Memphis, Tennessee; W. Richard Webb of San Francisco; and Elias A. Zerhouni of Baltimore. EDITOR NUMBER THREE—W. RICHARD WEBB By 1994, when Rick Webb (Fig. 3) became the editor, the JTI had grown in circulation to where the publisher was comfortable about continuing it. The personal subscription rates for four 1996 issues were $150 and for institutions, $185. The publication was listed in Index Medicus, MEDLINE, and Excerpta Medica. Aspen Systems became part of Raven Press. Raven was acquired by Lippincott, which also purchased Williams and Wilkins. The title on the masthead changed to reflect the expansion of ownership.FIGURE 3.: Dr W. Richard (“Rick”) Webb, the third editor of the Journal.Dr Webb, a professor of chest radiology at the University of California, San Francisco, had been a member of the JTI editorial board. He was a prolific writer, with 125 scientific articles, 5 books, 53 chapters, and hundreds of lectures in his curriculum vitae by the time he became JTI editor. He was a member of the Fleischner Society and was the 1992 president of the STR. “My first and last days as editor were the happiest ones of my 5-year term,” he said. He coopted the dining room table in his home and soon it was stacked with manuscripts and other editorial materials. A few authors submitted electronic drafts. Most of them still sent typescripts and glossy prints of illustrations. Indeed, he accepted only hard copies of illustrations. In his opening editorial, he stated his intentions. “The symposia have proven highly popular with the readership and serve as an important resource, at least on my bookshelf; I intend to continue with them in future issues. It is also critically important for the Journal to serve as a vehicle for publication of good original research on chest imaging, and to provide for the exchange of new ideas. For particularly timely papers, I would like to see the Journal offer publication within a few months of the paper's acceptance. I also hope to publish ‘state-of-the-art’ reviews, pictorial essays, ‘new horizon’ topics and other types of papers with significant educational value or that are likely to stimulate discussion.”6 He reappointed Warren Gefter, Philip Goodman, and James C. Reed as associate editors and retained Michio Kono of Kobe University in Japan. Several other Japanese radiologists were added to the editorial board. As editor, he did most of the reviewing of submitted articles and then copy edited those he chose to accept. For special topic issues and symposia, he called on his associate editors and members of the JTI editorial board. With the Japanese Society of Thoracic Radiology as a cosponsor, the volume of papers from its members increased. Besides the Japanese contributions, a flow of papers from Korea led to the Korean Society of Thoracic Radiology also becoming a JTI sponsor in 1998. He had a steady flow of manuscripts from England, France, Italy, and other European countries. In his final editorial in 1999, Rick Webb thanked the associate editors, editorial board members, guest editors, and foreign contributors. He also thanked his wife for the use of the dining room table and promised to clean it off. JEFFREY S. KLEIN—FOURTH EDITOR Jeff Klein (Fig. 4) was chosen as the fourth editor at the end of 1999. In his opening issue editorial, he wrote, “I walk in the very large footsteps of my predecessors… Although I do not intend on straying too far from the course charted by previous editors, there will be some changes made in the structure of the Journal. The mixture of articles will be expanded. Some of the highlights of the annual postgraduate course of the Society of Thoracic Radiology will be featured. I have asked Jud Gurney (of the University of Nebraska) to edit a regular column devoted to internet-related resources for radiologists interested in thoracic imaging. I would like to have an electronic version of the Journal available to subscribers via the internet. This, it is hoped, will result in a more expeditious publication of time-sensitive material, thereby circumventing some of the limitations inherent in a journal published quarterly. I have no doubt that this experience as editor will be somewhat analogous to the raising of my 6-month old son; a lot of hard work, very challenging and intimidating, but ultimately fruitful and rewarding.”7FIGURE 4.: Dr Jeffrey (“Jeff”) S. Klein, the fourth editor of the Journal.He changed 3 associate editors, appointing Ann Leung from Stanford University in Palo Alto, California, David Lynch of the University of Colorado in Denver and Charles White of the University of Maryland in Baltimore. Michio Kono from Japan was asked to continue, as was Jung-Gi Im of Seoul, Korea. He named 30 members of the JTI editorial board, including 11 radiologists from other countries. Besides the series on computers in thoracic imaging, edited by Jud Gurney, a series, “Classic Concepts in Thoracic Radiology,” was begun in 2001 by Barbara McComb of the Mayo Clinic in Jacksonville. He continued symposia, including a 2-issue feature on cardiac imaging, guest edited by William Stanford of the University of Iowa in Iowa City. Other symposia topics included lung cancer, thoracic trauma, pediatric chest problems, and imaging of transplantation patients. In several issues, color illustrations depicted pathology sections and anatomic sketches. Authors with color images were charged for the cost of color printing. Through its years, the JTI had devoted its to clinical and had to the of chest examinations in workers to mineral dusts. In the first issue in the editor published a by A. Henry of the Medical of on the of the the and the American of Radiology in a and screening programs for coal and asbestos The subscription had to for and for in the United A special of was to In of a new with the STR, to the JTI were included as part of the society for all in the Journal began from annual postgraduate by the STR. Jeff Klein his 5-year term as editor in S. In his opening editorial, White (Fig. his editors as a Journal with an the of Dr Charles S. the editor of the I to on the by Dr The Journal will continue to feature the symposia that have it its in the for the are symposia on pulmonary and articles will also be published with topics of “The of thoracic radiology is by the of the first of Thoracic Radiology. The Journal will on the of that and publish as well as and after appropriate It is my that the the Journal and thoracic worldwide will continue and He that the editorial would continue for a or so and then be by a to electronic That would be an he As his associate editors, he Ann David Jung-Gi and Michio His editorial board of 10 came from other countries. By he had Leung and Lynch and Phil of Israel Medical in Boston and of the University of Im and 10 radiologists had been added to the editorial board. The issue contained 5 were original scientific were pictorial and 6 were of the articles with the of pulmonary with computed tomography of for lung Five of the authors were from outside the United number of in most issues were who The use of color in and other illustrations was now with the editor or not to the authors for color In his final editorial in the White up his “The has been a time of tremendous in for submitted articles in the number of has nearly and is on a to more papers in of this be to the review in which now the to and timely of their the and of those who their work, the Journal could not its position as the subspecialty publication in to volume the Journal has seen in as by but as the Other changes the of the and editorial board expansion of the annual editorial board and of the and of the of the before and after the are in and of the Journal from and M. At the beginning of the of JTI publication, (Fig. of the Israel Medical in Boston became the editor. new editor, I to the by of the Journal and changes that will the Journal in that will the growing of and 2 major the electronic of the Journal and in the he wrote in the Dr M. the and present editor of the Journal.He the of the first editor, of the University of in and 2 new associate editors, of New York University, and of the Medical University of in Michio the Japanese associate editor 1994, and Jung-Gi of the Korean Society of Thoracic to continue as He the editorial board to including radiologists from France, Austria, Japan, the and The number of also increased. He in his editorial of that the publisher, Williams had to the electronic version of JTI beginning in the growing volume of would be only The use of color illustrations In its subscription the JTI was up with In the was The was and the for was In the of the and the same The for a copy was The and rates included both and electronic were at an The issues for were at pages for each That to pages issue in with the pages published only To the of new for the Dr and the publisher successfully a readership in early The on symposia would continue with authors selected by guest editors. The also would in have made great in the of the electronic of JTI and Phil wrote in his approach the of the Journal in the JTI will be both back to its and with new and electronic In the next 3 after his book publication, Francis Williams submitted of articles about chest imaging to of those journals in thoracic imaging. there been a Journal of Thoracic Francis Williams would have been to be published in it.

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