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Dr. Edith H. Quimby: A pioneering medical physicist and educator with outstanding contributions in radiation dosimetry

      Highlights

      • Edith Hinkley Quimby was a pioneering female physicist with pivotal contributions in diagnostic radiology and radiotherapy.
      • In 1963, Dr. Quimby became the second female ever to be awarded the prestigious American College of Radiology Gold Medal.
      • Dr. Quimby earned the widespread admiration of her colleagues at a period with very low representation of women scientists.

      Keywords

      1. Introduction

      Edith Hinkley Quimby (1891–1982) was a distinguished medical physicist and a pioneer in the research and development of diagnostic and therapeutic applications of radiation in medicine.
      • Howes R.H.
      • Herzenberg C.L.
      7 Other women physicists.
      With her systematic and important research, Quimby was one of the few leading scientists at the first half of the 20th century that established the fields of diagnostic and interventional radiology as we know it today.
      • Oakes E.H.
      Encyclopedia of world scientists.
      (Photo credit: Center for the American History of Radiology, courtesy AIP Emilio Segrè Visual Archives)

      2. Early life and education

      Born on July 10, 1891 in Rockford, Illinois, USA, Edith H. Quimby grew up in a family of 3 children and moved to several different states during her childhood. After graduating from high school in Boise, Idaho, Quimby was awarded a full tuition scholarship to Whitman College in Walla Walla, Washington, where she earned a BS degree in Physics and Mathematics in 1912.
      • Oakes E.H.
      Encyclopedia of world scientists.
      It was during her college education that Quimby was first inspired by her teachers, B.H. Brown and W. Bratton, to pursue a career as a scientist. After a short period of teaching science at high school in Nyssa, Oregon, she received a physics fellowship at the University of California where she earned her master's degree in Physics in 1915.
      • Howe R.
      During the same period, she married Shirley Leon Quimby, a fellow physics student. Following an appointment as a high school science teacher in Antioch, California, Quimby moved to New York in 1919 together with her husband, who had accepted a Physics teaching position at Columbia University.
      • Quimby Edith Hinkley
      The same year, Quimby joined as assistant physicist the first research laboratory in the United States devoted to medical applications of radiation, which had been recently established by Dr. Gioacchino Failla, former student of Marie Curie and Chief Physicist at the newly founded New York City Memorial Hospital for Cancer and Allied Diseases.
      • Quimby E.H.
      Medical radiation physics in the United States.
      • Quimby E.H.
      Gioacchino Failla, Sc. D. 1891-1961.
      As Quimby recalled: “This job turned up. I took it”.
      • Quimby I.W.E.H.
      This was the beginning of an exciting scientific journey for Quimby that led to many important discoveries and paved the way for establishing the medical physics profession at a period when radiological sciences were still at their infancy. Quimby was later awarded the honorary degree of Doctor of Science (Sc.D.) from Rutgers University in 1956 as well.
      • Howes R.H.
      • Herzenberg C.L.
      7 Other women physicists.

      3. Early career: a pioneer in radiation dosimetry

      Between 1919 and 1940, Quimby conducted research to quantify many different aspects of the radio-biological effects of radium and X-rays. Many of her research findings and standards of measurements were published in the form of original research articles in internationally recognized scientific journals and were frequently quoted in the academic and professional literature for decades.
      • Howes R.H.
      • Herzenberg C.L.
      7 Other women physicists.
      As a result, she was among the few first women scientists that began to earn recognition for her substantial contributions to the field of radiological sciences. For example, in 1940 Quimby was the first woman to be awarded the Janeway Medal of the American Radium Society
      • Quimby E.H.
      The specification of dosage in radium therapy - janeway lecture, 1940.
      and the following year she was awarded the Gold Medal of the Radiological Society of North America for contributions “which placed every radiologist in her debt”.
      • Oakes E.H.
      Encyclopedia of world scientists.
      Quimby realized quickly in her career the need for simple computational models that can be easily employed in clinics to deliver safe and effective radiation treatment doses to patients.
      • Failla G.
      • Quimby E.H.
      The economics of dosimetry in radiotherapy.
      Until then, the dose had to be estimated with cumbersome algorithms for each individual patient due to lack of standards.
      • Quimby E.H.
      The history of dosimetry in roentgen therapy.
      Quimby began by investigating the properties of radium (226-Radium) and X-ray radiation when interacting with living tissue.
      • Quimby E.H.
      • Martin H.E.
      A basis for dosage determination in interstitial irradiation.
      • Martin H.E.
      • Quimby E.H.
      Calculations of tissue dosage in radiation therapy - a preliminary report.
      • Martin H.E.
      • Quimby E.H.
      • Pack G.T.
      Calculations of tissue dosage in radiation therapy - (a second report).
      • Quimby E.H.
      The skin erythema dose with a combination of two types of radiation.
      Moreover, she introduced a dose pre-planning system for brachytherapy, also known as the Memorial system, employing a spatially homogenous distribution of radioactive source strength (activity) over a plane or volume of targeted tissue to deliver non-uniform dose distributions with larger dose depositions at the center relative to the periphery of each targeted lesion.
      • Quimby E.H.
      The grouping of radium tubes in packs or plaques to produce the desired distribution of radiation.
      Nuclear physics in medicine.
      This was in contrast to the Paterson-Parker pre-planning system for brachytherapy, also known as the Manchester system developed in Manchester's Holt Radium Institute around the same time period, where a spatially heterogeneous radioactive source distribution was applied with higher strength or activity sources being concentrated at the lesions periphery to attain a relatively homogeneous (±10%) dose distribution across a plane or volume of each targeted lesion.
      • Paterson R.
      • Parker H.M.
      A dosage system for gamma ray therapy.
      Typically, the overall source strength or activity required delivering the same cumulative dose to similar size planar or volume lesion will be much higher when using the Quimby system.
      • Suntharalingam N.
      • Podgorsak E.B.
      • Tölli H.
      Brachytherapy: physical and clinical aspects.
      In an effort to facilitate the wide clinical adoption of brachytherapy planning, Quimby published streamlined dose charts to enable the straightforward calculation of the total milligram/hour of radium needed to attain a certain amount of absorbed dose.
      • Martin H.E.
      • Quimby E.H.
      • Pack G.T.
      Calculations of tissue dosage in radiation therapy - (a second report).
      • Quimby E.H.
      • Copeland M.M.
      • Woods R.C.
      The distribution of roentgen rays within the human body.
      During the same period, Quimby introduced experimental methods to determine the different beta and gamma radiation doses required to trigger a similar degree of specific biologic effects, such as human skin erythema (skin reddening), thus setting the foundations for the practical calculation in routine medical practice of radiation type-specific quality factors allowing the quick estimation of an equivalent dose (skin erythema dose) which is an amount of radiation dose reflecting not only the physical amount of radiation energy deposited to a certain plane or volume of living tissue (absorbed dose), but also the degree of specific stochastic biologic effects as a result of the applied ionizing radiation to that tissue.
      • Quimby E.H.
      The skin erythema dose with a combination of two types of radiation.
      • Quimby E.H.
      • Pack G.T.
      Further studies on the skin erythema with combinations of two types of radiation.
      • MacComb W.
      • Quimby E.H.
      The rate of recovery of human skin from the effects of hard or soft roentgen rays or gamma rays.
      These initial systematic studies were based on roentgen units and equivalent doses relevant to specific biologic effects (skin erythema dose) which is different to the System International (SI) units of equivalent dose employed nowadays.
      • Quimby E.H.
      • Pack G.T.
      The skin erythema for combinations of gamma and roentgen rays.
      • Belisario J.C.
      A discussion on the skin erythema dose with Röntgen rays: some biological implications.
      Nevertheless, they served as the basis for later establishing the fundamental concept of relative biological effectiveness (RBE) in the field of radiobiology and health physics, thereby allowing us today to apply the appropriate set of experimentally-defined radiation-specific weighting factors to calculate from a given amount of absorbed dose in a living tissue (in SI units of Grays) the respective amount of equivalent dose in the same tissue (in SI units of Sievert) taking into account the stochastic biologic effects of each radiation type applied to that tissue.
      • Goldsmith S.J.
      Improving insight into radiobiology and radionuclide therapy.
      Moreover, during her early years at Memorial Hospital, Drs. Quimby and Failla were among the first to demonstrate the direct relationship between the darkening of dental films and the degree of skin erythema in radiation workers and the importance for establishing full-scale wearable film badge programs in radiation treatment departments of hospitals to monitor occupational radiation exposure using dental X-ray films with filters distinguishing between gamma and beta radiation.
      • Howes R.H.
      • Herzenberg C.L.
      7 Other women physicists.
      • Quimby E.H.
      A method for the study of scattered and secondary radiation in x-ray and radium laboratories.
      • Failla G.
      Radium protection.
      • DeAmicis E.
      • Spalding C.K.
      • Cowing R.F.
      Survey of X-ray exposures in hospital personnel.
      • Trout D.
      • Kathren R.
      • Zeimer P.
      Health physics before there were health physicists.
      • Brodsky A.
      • Kathren R.L.
      • Willis C.A.
      History of the medical uses of radiation: regulatory and voluntary standards of protection.
      • Dauer L.T.
      • et al.
      Cohort profile–MSK radiation workers: a feasibility study to establish a deceased worker sub-cohort as part of a multicenter medical radiation worker component in the million person study of low-dose radiation health effects.
      • Boice Jr., J.
      • et al.
      Evolution of radiation protection for medical workers.

      4. Later career

      In 1941–42, Quimby was appointed Assistant Professor at Cornell University Medical College and began teaching radiology courses. The following year she followed her mentor Dr. Gioacchino Failla to Columbia University College of Physician and Surgeons, where she was appointed Associate Professor of Radiology and later full Professor (1954). At Columbia University, Quimby contributed to the growth of one of the first and most recognized education programs in Radiological Physics in the United States. During the same period, Quimby expanded her research to artificial radioactive isotopes produced by accelerators and reactors, such as the synthetically produced radioactive sodium
      • Quimby E.H.
      • Smith B.C.
      Tracer studies with radioactive sodium in patients with peripheral vascular disease.
      • Quimby E.H.
      Radioactive sodium as a tool in medical research.
      and iodine.
      • Frantz V.K.
      • Quimby E.H.
      • Evans T.C.
      Radioactive iodine studies of functional thyroid carcinoma.
      • Werner S.C.
      • Quimby E.H.
      • Schmidt C.
      The clinical use of radioactive iodine.
      In collaboration with other Columbia investigators, Quimby studied the use of these isotopes for the treatment of thyroid disease,
      • Quimby E.H.
      • Mccune D.J.
      Uptake of radioactive iodine by the normal and disordered thyroid gland in children: a preliminary report.
      • Werner S.C.
      • Quimby E.H.
      • Schmidt C.
      Radioactive iodine, I-131, in the treatment of hyperthyroidism.
      various circulation studies
      • Smith B.C.
      • Quimby E.H.
      The use of radioactive sodium in studies of circulation in the extremities.
      • Smith B.C.
      • Quimby E.H.
      The use of radioactive sodium as a tracer in the study of peripheral vascular disease.
      • Smith B.C.
      • Quimby E.H.
      The use of radioactive sodium in the study of peripheral vascular disease.
      and the diagnosis of brain tumors,
      • Quimby E.H.
      Radioactive isotopes as aids in medical diagnosis.
      thus setting the foundations for nuclear medicine. Moreover, Quimby and Dr. Leonidas D. Marinelli published a series of mathematical models allowing the estimation of radiation dose distributions and their biological effects in internal organs, which served as the theoretical basis for today's internal radiation dosimetry models.
      • Marinelli L.D.
      • Quimby E.H.
      • Hine G.J.
      Dosage determination with radioactive isotopes. 1. Fundamental dosage formulae.
      • Marinelli L.D.
      • Quimby E.H.
      • Hine G.J.
      Dosage determination with radioactive isotopes. 2. Practical considerations in therapy and protection.
      Furthermore, she co-authored with physicists Otto Glasser, Lauriston Taylor, and James Weatherwax, a reference book entitled “Physical Foundations of Radiology” that quickly became a classic textbook for radiation dosimetry at the time.
      • Glasser O.
      Physical foundations of radiology.
      In addition to her teaching and research activities, Quimby contributed to the Manhattan Project, participated in the Atomic Energy Commission, served as a consultant on radiation therapy to the United States Veterans Administration and chaired a scientific committee of the National Council on Radiation Protection and Measurements.
      • Quimby Edith Hinkley
      She was also a renowned oral examiner for the American Board of Radiology (ABR) for nearly half a century.
      • Linton O.
      • Edith H.
      Quimby.
      Of note, Quimby advocated for the need of clinical medical physics departments in large hospitals across the United States, the inclusion of a physics section in the ABR examination and for the professional rights of medical physicists.
      • Linton O.
      • Edith H.
      Quimby.
      • Quimby E.H.
      The teaching of radiological physics as a part of training in radiology.
      • Quimby E.H.
      The clinical radiation physicist - a specialist within the field of radiology.
      • Quimby E.H.
      Medical radiation physics in the United-States.
      • Martinez N.E.
      Contributions from women to the radiation sciences: a brief history.
      Quimby has also been credited for her pioneering research in the safe handling of radioactive materials and as being one of the first physicists raising awareness regarding the harmful biological effects of radiation.
      • Quimby E.H.
      Safety in the use of radioactive isotopes.
      • Quimby E.H.
      The evaluation of personal radiation exposure.
      • Quimby E.H.
      Radiation hazards and what is being done about them - a symposium - introduction and statement of problem.
      • Quimby E.H.
      What nurses should know about radiation hazards.
      In the 1950s, Quimby's work began to receive international recognition and resulted in numerous awards by several scientific societies. In 1954, she was elected as president of the American Radium Society of which she remained a devoted member for many more years.
      • Quimby Edith Hinkley
      • Quimby E.H.
      Some historical notes about American radium society.
      In 1963, the American College of Radiology (ACR) bestowed upon Quimby the ACR Gold Medal, making her only the second woman in the history of the organization at that time to win the college's highest award; the first woman was Marie Sklodowska Curie, 32 years earlier in 1931.
      • Koomson J.
      • Arleo E.K.
      Dr. Marilyn Goske: innovator in pediatric radiation safety and education: one in a series highlighting women recipients of the ACR gold medal.
      • Spalluto L.B.
      • et al.
      35 years of experience from the american Association for Women Radiologists: increasing the visibility of women in radiology.
      Quimby was also one of the founding members of the American Association of Physicists in Medicine (AAPM) from which she received in 1978 the William D. Coolidge Award for her pioneering work on nuclear medicine, radiation therapy, diagnostic radiology and radiation protection.
      AAPM coolidge award to Edith Quimby.
      The AAPM later established a lifetime achievement award in her honor.
      • Martinez N.E.
      Contributions from women to the radiation sciences: a brief history.

      5. Devoted educator and examiner

      Edith H. Quimby had also been co-organizing since 1954, together with Dr. Sergei Feitelberg and Dr. Solomon Silver, a highly renowned annual training course in the “Clinical Use of Radioactive Isotopes” taking place in various New York based institutions with a medical physics training program.
      • Quimby E.H.
      The teaching of radiological physics as a part of training in radiology.
      • Quimby E.H.
      Training programs in clinical use of radioactive isotopes.
      Course in clinical use of radioactive isotopes.
      The course aimed at teaching in theory and clinical practice the proper clinical use of radioactive isotopes and included primary and guest lectures, experimental lab exercises and clinical measurements on patients and specimens.
      Course in clinical use of radioactive isotopes.
      Originally conceived as an annual 4-week full-time comprehensive course to allow participation across the United States, the response was so enthusiastic that it became necessary to offer later an alternate 8-month course for interested physicians and physicists in the New York City metro area.
      • Linton O.
      • Edith H.
      Quimby.
      The course curriculum was also published as a textbook in 3 editions.
      • Quimby E.H.
      • Feitelberg S.
      • Silver S.
      Radioactive isotopes in clinical practice.
      • Quimby E.H.
      • Feitelberg S.
      • Silver S.
      Radioactive isotopes in medicine and biology.
      • Quimby E.H.
      • Feitelberg S.
      • Silver S.
      • Gross W.
      Radioactive nuclides in medicine and biology.
      In fact, Quimby had earned the reputation of a devoted educator and meticulous board examiner among radiology residents and medical physicists across the United States.
      • Linton O.
      • Edith H.
      Quimby.
      • Quimby E.H.
      The teaching of radiological physics as a part of training in radiology.
      Dr. Stanley J. Goldsmith, Professor Emeritus of Radiology at Weill Cornell Medical College, was a student in Quimby's 8-month course in June 1968 at Mount Sinai Hospital. When we interviewed him regarding his memories of Dr. Quimby during our literature research, Dr. Goldsmith had stated: “She [Quimby] was very serious and very strict, the class started at 4pm and at 4pm she would walk over and close the door and lock it... You knew you were in the presence of a force, someone with a major impact on dosimetry…when people would say ‘Edith Quimby’ [it was] with reverence.”
      After her retirement in 1960 as Professor Emeritus of Radiology at Columbia University, Quimby continued her research,
      • Focht E.F.
      • Quimby E.H.
      • Gershowitz M.
      Revised average geometric factors for cylinders in isotope dosage. I.
      • Focht E.F.
      • Quimby E.H.
      • Gershowi M.
      Geometric factors in isotope dosage and revision of average G for cylinders.
      education and professional activities at various scientific societies until 1978 when she left Columbia University. She lived with her husband in Greenwich Village in Manhattan, was a member of the League of Women Voters and enjoyed sports, bridge, theater and detective novels. She died in October 11, 1982 at the age of 91.
      • Howes R.H.
      • Herzenberg C.L.
      7 Other women physicists.
      • Rossi H.H.

      6. Legacy

      Quimby is considered as one of the 20th century's most prominent researchers in medical physics and nuclear medicine.
      • Howes R.H.
      • Herzenberg C.L.
      7 Other women physicists.
      Her pivotal research contributions exemplified the value of devoting one's life-long career to the fearless search of answers, which later shaped forever the field of radiation dosimetry. Her streamlined, yet effective, radiation dose calculation methodologies quickly set the standards for future generations of physician and physicists enabling so many breakthroughs in the diagnosis and treatment of a vast range of diseases. Quimby was also a true pioneer in being one of the few first female scientists whose work had such a profound impact in her discipline deservingly earning a wide recognition and the true admiration of her colleagues and students at a period with a very low representation of women scientists. As noted by Harold Rossi of Columbia University in Physics Today, Quimby will surely be remember in the history of science: “… all too often, the creative achievements of scientific pioneers are overshadowed by further developments made by others or simply become anonymous components of accepted practice. Fortunately, Quimby's exceptional service to radiological physics was widely recognized.
      • Rossi H.H.

      CRediT author statement

      Nicolas A Karakatsanis: Conceptualization, Investigation, Validation, Writing-Original draft preparation, Elizabeth K. Arleo: Conceptualization, Investigation, Supervision, Writing-Reviewing and Editing. All authors have seen and approved the final version of the manuscript being submitted and warrant that the article is the authors' original work, hasn't received prior publication and isn't under consideration for publication elsewhere.

      Declaration of competing interest

      None.

      Acknowledgements

      The authors wish to specially thank Dr. Goldsmith for granting us with a personal interview regarding his memories of Dr. Quimby and reviewing the article prior to double-blinded peer review.

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        Training programs in clinical use of radioactive isotopes.
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        Third ed. Lea & Febiger, Philadelphia1968
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        Revised average geometric factors for cylinders in isotope dosage. I.
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