Peter Kerley

Biography

• Born on October 27, 1900 in Dundalk, Eire
• 1923 – MB BCh University College Dublin
• 1925 – Diploma in Medical Radiology and Electrology, Cambridge
• 1930 – Radiologist, Westminster and Royal Chest hospitals. Later department director
• 1932 – MD, University of Ireland
• 1939 – Foundation fellow, Faculty (later Royal College) of Radiology
• 1944 – Director of the UK mass radiology TB screening programme, detecting over 10,000 cases; Röntgen award of the Toronto Radiological Society; 1946 – FRCP
• 1949-1952 First editor of Journal of Faculty of Radiologists (now Clinical radiology)
• 1951 – CBE (Commander of the Most Excellent Order of the British Empire) for endeavours in mass radiological screening for tuberculosis
• 1952 – CVO (Commander of the Royal Victorian Order) for services to King George VI (diagnosis of his lung Cancer)
• 1952-1955 President of the Faculty of Radiology
• 1962 – Fellow of Honour of the Faculty of Radiologists, Royal College of Surgeons in Ireland, Dublin
• 1972 – KCVO (Knight Commander of the Royal Victorian Order) for services to the Royal family and prime-ministers
• 1972 – Gold medal, Royal College of Radiologists
• Honorary Fellowships of Australasian College, American College and Eire faculty of Radiologists
• Died on May 14, 1979

Medical Eponyms

Kerley lines – Types A, B and C (1933 and 1951)

1933 – Kerley first described horizontal lines that he postulated to be perivascular lymphatics in patients with mitral stenosis and left ventricular failure

Passive hyperaemia of the of the lungs caused by mitral stenosis or heart failure gives remarkable and very varied x-ray appearances. A severe attack of hyperaemia always leaves permanent radiologic evidence behind it…the shadows of perivascular lymphatics persist as fine, sharp lines, most marked at the bases and near the hila.

BMJ 1933;2:594–597

1951 – Kerley differentiated these horizontal lines as ‘lines A, B, and C‘

These abnormal lines … are about .5–1 [millimeters] wide. They are of three types. (A) Lines several inches long, rather ragged and radiating from the hilum. They do not bifurcate and they do not follow the normal branching pattern of bronchi and vessels. (B) Short, sharp lines seen only at the bases, usually less than an inch long and running transversely out to touch the pleural margin. (C) Fine interlacing lines giving the network appearance. It is the fine interlacing lines which have given rise to the term reticulation.

Other Eponymous terms

The Kerley special – A keen sportsman, particularly shooting, fishing and golf, Kerley designed his eponymous fly ‘the Kerley special’, useful for salmon, trout and sea-trout. After Kerley’s passing, a colleague remarked:

Kerley’s great invention in fishing was the ‘Kerley special,’ a dry fly which could catch sea trout, grilse, even salmon. Though it is not in the same class as his ‘Kerley B lines’ in mitral disease, it perhaps deserves a place – if a lowly one-on his honours list.

BMJ 1979;1:1095

Couch Kerley Travelling Professorship (1972 onwards)

Sir Peter Kerley lectures. (1977-1998)

Controversies

An esteemed colleague, James F. Brailsford (1888 – 1961), criticized the TB screening programme for ruining doctors clinical skills by diagnosis of early tumours and TB. Kerley acerbically responded:

It is not misinterpreting Dr. James F. Brailsford to summarize his views on the diagnosis of tuberculosis and carcinoma as follows – wait until the patient has a big hemoptysis or a palpable tumor.

Kerley P. Modern trends in radiology. BMJ 1949; 2: 870

Major Publications

• Kerley P. Pathology of early pulmonary tuberculosis as revealed by x-rays. Br J Radiol 1930;3:404–416
• Kerley P. Radiology in heart disease. BMJ 1933;2:594–597 [Kerley Lines]
• Kerley P. Technique in mass miniature radiography. Br J Radiol 1942;15:346–347
• Hart P, Kerley P, Thompson B. Correspondence: civilian mass radiography. BMJ 1945;1:885
• Kerley P. Correspondence: Modern trends in radiology. BMJ 1949;2:870
• Kerley P. Recent advances in radiology. Blakiston 1931
• Shanks SC, Kerley P. Twining EW. A Text-Book of X-Ray Diagnosis By British Authors. Volume I-IV. 1938-1969 (original three volumes Vol I, Vol II, Vol III)
• Shanks SC, Kerley P. A Text-Book Of X-Ray Diagnosis: Vol II. Saunders. 1951: 403–415 [Kerley Lines]

References

Biography

• Obituary: Sir Peter Kerley. BMJ 1979;1:959
• Obituary: Sir Peter Kerley. BMJ 1979;1:1095
• Starer F. Obituaries: Sir Peter Kerley. Br J Radiol 1979;52:604
• Biography: Peter James (Sir) Kerley. Munk’s Roll : Volume VII.

Eponymous terms

• Fleischner FG, Reiner L. Linear x-ray shadows in acquired pulmonary hemosiderosis and congestion. N Engl J Med. 1954; 250(21): 900-905.
• Carmichael JH, Julian D, Jones G. Radiological signs in pulmonary hypertension; the significance of lines B of Kerley. Br J Radiol. 1954; 27(319): 393-397.
• Trapnell DH. The peripheral lymphatics of the lung. Br J Radiol. 1963; 36: 660-672.
• Heitzman ER, Ziter FM Jr, Markarian B, McClennan BL, Sherry HT. Kerley’s interlobular septal lines: roentgen pathologic correlation. Am J Roentgenol Radium Ther Nucl Med. 1967; 100(3): 578-582
• Simpson L. Irish contributions to our understanding of heart disease. Heart Lung Circ. 2003;12 Suppl 2:S73-7.
• Sekar T, Swan KG, Vietrogoski RA. A beeline through Sir Peter James Kerley’s life. AJR Am J Roentgenol. 2011 Apr;196(4):W375-9.