Professor Torsten Almén, MD, Ph.D., born 1 September 1931—died 8 January 2016

Radiology Professor Torsten Almén, the father of non-ionic contrast media, was a unique and outstanding Swedish radiologist. Born in Ystad, southern Sweden, he started his radiological career in 1959 at the department of Radiology in Malmö and remained there his whole career. Professor Almén´s research began with angiography. In his thesis (1966) he described a new steering instrument for selective angiography and simultaneously investigated the effect of iodine contrast media on patients. In his clinical work, his empathy for the patients led him to ask: “why do patients experience pain during angiography?” This question started a unique career as scientist, inventor and entrepreneur.

When performing a very painful lingual arteriography one day, he realised that every time he injected physiological saline, the patient experienced no pain. He remembered that when he was swimming in the salty water of the west coast of Sweden as a child his eyes burned, but did not in the brackish water of the Baltic Sea outside his home town Ystad. He concluded that it was the hypertonicity of the contrast media salt solutions that caused pain. Moreover, Prof. Almén assumed that the high osmolality of the iodine contrast media was responsible not only for pain, but also for several other side effects of contrast media. After reading some chemistry books, he designed chemical formulas of low- and iso-osmolar contrast media (1968); thus an ingenious idea was born.

Torsten Almén was appointed professor of diagnostic radiology at Lund University in 1986. Millions of patients are obliged to him for painless angiographies and other contrast media examinations with far less side effects than previously. Almén made an everyday clinical observation (pain), took the problem to the research laboratory, and solved it by studying chemistry. He then postulated, in opposition to most contrast media researchers and accepted concepts in chemistry at that time, a new formulation that he took out a patent for.

He unsuccessfully approached several national and international pharmaceutical companies asking if they were interested in trying to develop the new type of contrast media. One small company in Norway, Nyegaard & Co., took the chance and succeeded in creating a paradigm shift of chemical concepts for contrast media. That company later grew into Norway’s second largest company, Nycomed AG.

Almén was a translational researcher long before the ‘hyped’ term became popular. Instead of trying to solve a problem with old solutions his geniality lead him into a totally new era with non-ionic mono- and dimeric contrast agents. He was a tireless teacher and excelled in explaining the complicated matters of contrast media chemistry. The quality and honesty of his research was outstanding and set an example for many young radiologists.

Almén became ‘the icon of contrast media’ worldwide. This earned him many honorary memberships in international societies. He was rewarded the prestigious Nordic research prize ‘The Fernström Reward’ (1987). In 1989 he was elected a member of the Royal Swedish Academy of Science (that presents the Nobel Prize in Chemistry and Physics) and in 1995 he had a research centre in Pennsylvania, USA, named after him, the ‘Torsten Almén Research Center’ (TARC). In 1989 he received the ‘Antoine Beclere’ award from the French president.

Almén developed many other inventions and patents, amongst others, on bone cement, batteries and nebulizers. His acumen led him to introduce calculation of glomerular filtration rate by measurement of plasma clearance of iohexol. This has now become a standard method in many countries. He was also involved in the development of magnetic resonance imaging contrast media, especially based on the ‘Oberhausen effect’. Prof. Almén also suggested that some gadolinium molecules had antioxidant properties, an observation that has great potential for therapeutic use.

Radiology has lost a great man in Torsten Almén, but the results of his achievements will enrich the field for years to come. We all miss a unique personality, an outstanding researcher and a close friend. His loss is deeply felt by his wife Karin and his two sons from a previous marriage, Per and Pål.