Abstract
25 May 1943–28 November 2021
Dr Hylton Meire was a pioneer in the adoption of clinical ultrasound within radiology in the early days of this, now widely utilised, imaging modality, and it is with great sadness that we report his death on 28 November 2021. Dr Meire qualified as a doctor in 1967 and completed his FRCR in 1973 having been a radiology registrar at King’s College Hospital, London from 1970 to 1975. During this time, he had the responsibility for Diagnostic Ultrasound within the department.
From 1975, he worked as Consultant in Ultrasound, at the Clinical Research Centre, Harrow, before returning to King’s College in 1982 as Consultant Radiologist in charge of Ultrasound; a post he held for 18 years. Around the same time, Hylton was also the Director for Ultrasound at the Portland Hospital for Women and Children in London.
Dr Meire had a deep enthusiasm and passion for medical ultrasound, which he converted into an impressive and invaluable portfolio of publications throughout his career. His first paper in 1973 was entitled Ultrasound ‘A’ and ‘B’ Scanning in the Diagnosis and Follow-up of Popliteal and Calf Swellings and was followed by a further 102 peer-reviewed papers, 19 invited leading articles, 62 book chapters and 12 ultrasound text books. As such, Dr Hylton Meire was a name found commonly in ultrasound departments as a key author of several gold standard textbooks.
In one early publication from 1979, Hylton extolled the virtue of medical ultrasound. This particular publication was a review of recent literature in which Hylton identified the important, relevant or promising aspects of medical ultrasound for the average radiology reader to help his radiologist colleagues appreciate the scope of this new modality. However, even at this early stage, he identified that obstetrics was the greatest consumer of ultrasound services.
It is impossible to do justice to all of Hylton’s prolific and influential writing and research, but perhaps one of his most valuable and essential works was the book from 1993 ‘Clinical Ultrasound: A Comprehensive Text’ which he co-edited with David Cosgrove and Keith Dewbury. The review in the BMJ stated that, while the title was a brave statement, the contents provided a comprehensive coverage of the subject and confidently achieved the aim. A second edition by the, now famous, trio was published with the addition of Pat Farrant as co-editor. This second edition received yet another glowing review: The text is clear and helpful. The consistency in terminology between sections written by multiple authors is very helpful. One extremely helpful aid the authors have placed on many of the images is an indicator of where the scanner was placed to acquire the image. This makes images much easier to understand and is something that all textbooks should have.
Dr Meire held many editorial, honorary and professional posts throughout his rich career and was also an examiner for the original Diploma in Medical Ultrasound, awarded by the College of Radiographers. He was a very active member, supporter and director of BMUS and held the presidency between 1990 and 1992. Following this, Hylton went on to become, among other posts, the Honorary Secretary of EFSUMB between 1993 and 1999 and an active protagonist of clinical ultrasound both throughout his career and long after his retirement. Indeed, Hylton was invited to present the eponymous keynote Donald, MacVicar and Brown (DMB) lecture at the 2006 BMUS annual scientific meeting. During this DMB lecture, Hylton discussed the 20-week anomaly scan and nuchal translucency test, which were now common practice within the United Kingdom. To give you a sense of his feelings, Hylton believed that the term ‘translucency’ was nonsensical and preferred the term ‘nuchal thickness’ and, thinking about it, it is hard to disagree. His DMB lecture was a scientific critique and personal analysis of these two common examinations. He concluded that the rapid progressive improvements in the quality of ultrasound had led to widespread claims about the utility of the technique as a routine screening procedure for all obstetric patients. He noted, however, that large scientific studies that might prove these claims had not been performed and generally have failed to support the value and notion of population screening. As is noted from the topic of the debate at the 2021 BMUS ASM, held on line, this thorny issue raised by Hylton all those years ago remains largely unanswered.
Hylton was a somewhat of a maverick within clinical ultrasound and had a formidable intellect. He loved to see things from ‘outside the box’ and welcomed contributions from anyone who was willing to challenge the norm and explore new ideas. He respected all practitioners, regardless of professional background. If one was confident enough to present a proffered paper then he felt it appropriate for that author to be questioned, regardless of whether one was a medic, sonographer or physicist. His critique strengthened the quality of the presentation or publication and often left the author with a sense of achievement and pride that someone like him – had taken time to listen, understand and support. An enduring memory that many of his colleagues and friends within the ultrasound world have is one of Hylton’s quick wit, ready smile and words of support.
Surprisingly, Hylton found time for hobbies and family life. He particularly enjoyed, gardening, woodturning and DIY. He is survived by his widow, Gillian, three children – Richard, Louise and Charlotte, and two grandchildren. As a radiologist with such a significant impact on clinical ultrasound and loyal supporter of BMUS, Dr Hylton Meire will be sadly missed.
Sincere and grateful thanks to many of Hylton’s colleagues and friends for their helpful contributions.