C. H. Joseph Chang

C. H. Joseph Chang (1929 - 2017)

C. H. Joseph Chang (장재현; Chang Chae-hyŏn) (1929–2017) was a Korean-American radiologist

After graduating from Severance Medical College in Seoul, Chang undertook postgraduate medical and radiological training in the United States. He joined the radiology faculty at West Virginia University before moving to the University of Kansas Medical Center in 1971, where he spent 36 years as Professor of Radiology and later headed the Division of Diagnostic Radiology.

Chang made important contributions to pulmonary vascular radiology and breast imaging. His early studies established normal and abnormal dimensions of the descending pulmonary arteries and led to the radiographic finding later known as the Chang sign. From the late 1960s onward he also investigated mammography and, at Kansas during the 1970s and early 1980s, became one of the early clinical investigators of computed tomographic mammography and dedicated breast CT.

He was active in organised radiology as a Fellow of the American College of Radiology, president of its Kansas chapter, and an early president of the Korean Radiological Society of North America.

Biographical timeline
  • Born on July 7, 1929 in Seoul, Korea
  • Medical education – Graduated MD from Severance Medical College and Hospital, Seoul.
  • 1955 – Immigrated to United States. Interned at St Joseph’s Hospital, Phoenix, Arizona, before undertaking radiology residency training at Emory University Hospital, Atlanta.
  • 1956 – Married fellow Korean physician Chung Sook “Sue” Chun (1930–2019) in Atlanta while both were undertaking residency training at Emory. Sue Chang later became a board-certified paediatrician and practised in Kansas City.
  • 1960 – Acting Chief of Radiology, Man Memorial Hospital, West Virginia
  • 1962 – Published normal radiographic measurements of the right descending pulmonary artery in 1,085 subjects, establishing the measurement framework for his later pulmonary vascular studies.
  • 1964–1970 – Associate professor of radiology at West Virginia University School of Medicine, Morgantown.
  • 1965 – With W. Clayton Davis, published A Roentgen Sign of Pulmonary Infarction, describing transient enlargement of a previously normal descending pulmonary artery during pulmonary infarction.
  • 1968 – Published Mammography: Evaluation of First 100 Cases at West Virginia University Medical Center, with breast imaging an established research interest.
  • 1969 – Elected Fellow of the American College of Radiology.
  • 1962–1967 – Published the sequence of work on descending pulmonary arterial measurements, pulmonary hypertension, pulmonary infarction and PE that produced the later Chang sign.
  • 1969 – While Associate Professor of Radiology at the West Virginia Medical Center, Morgantown, Chang was elected a Fellow of the American College of Radiology.
  • 1971 – Joined the Department of Radiology at the University of Kansas Medical School, Kansas City, Kansas.
  • 1976 – Second president of the Korean Radiological Society of North America (KRSNA).
  • 1977 – Published the first of a sequence of Kansas studies investigating computed tomography of the breast.
  • 1979 – President, Kansas Chapter, American College of Radiology.
  • Died November 15, 2017 in Mission Hills, Kansas, aged 88
Medical Eponyms
Chang sign (1965)

Chang established normal radiographic measurements of the descending pulmonary arteries and subsequently applied serial measurement to pulmonary hypertension, pulmonary infarction and embolic disease.

In 1965, Chang and W. Clayton Davis described transient enlargement of a previously normal right or left descending pulmonary artery during pulmonary infarction. The enlargement appeared early after embolisation and could regress as the episode resolved; this radiographic finding subsequently became known as the Chang sign.

His subsequent work extended beyond embolic disease to the radiographic assessment of pulmonary venous hypertension, including the diagnostic value of the lateral chest radiograph.

Key medical contributions
Breast imaging and computed tomographic mammography

Chang’s interest in breast imaging predated the CT era and whilst at West Virginia University, he reported his first 100 mammographic examinations.

At the University of Kansas during the 1970s, Chang and colleagues became early clinical investigators of computed tomographic breast imaging. Their work explored whether cross-sectional imaging and contrast enhancement could improve detection and characterisation of breast lesions, particularly in dense breasts or when conventional mammography was equivocal.

1977 – Computed tomography of the breast: a preliminary report investigated CT appearances of benign and malignant breast disease.

1978 – Subsequent studies examined CT evaluation of the breast and the preoperative identification of potentially precancerous lesions using a dedicated CT breast scanner.

1979–1980 – The Kansas programme expanded into larger clinical studies of dedicated CT mammography. In the largest reported series, 1,625 CT/M examinations were performed between October 1976 and July 1979, including 78 histologically confirmed cancers.

1981 – The group subsequently reported very small, clinically and mammographically occult breast cancers detected using CT mammography.

These studies did not establish CT as a replacement for conventional mammography, but they form part of the early clinical development of the concept now recognised as dedicated breast CT.

Major Publications
References

Biography

Eponym

the person behind the name

more eponyms…

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby, medical history, medical education, and asynchronous learning #FOAMed evangelist. Editor-in-Chief and Webmaster of Life in the Fast lane, LITFL | On Call 4e| Eponyms | Books | Horology |

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