Manoel de Abreu
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Manoel de Abreu was the son of Julio Antunes de Abreu and Mercedes da Rocha Dias. He was born in São Paulo, Brazil, on 4 January 1892 1. He graduated in 1913 from the Faculty of Medicine of Rio de Janeiro and defended his doctoral dissertation in 1914 1.
In 1915, he moved to Paris, where he attended the Nouvel Hôpital de la Pitié, the Hôtel-Dieu Central Radiology Laboratory, and the Hospital Laennec 1,3.
Development of chest fluorography
At Laennec Hospital in Paris, Manoel de Abreu had, for the first time, the idea of creating a low-cost diagnostic method based on fluorescent screen photography, that would allow for the mass population screening of tuberculosis. Technical problems prevented him from developing his idea in 1919 1.
In 1922, when he returned to Rio de Janeiro, there was a tuberculosis epidemic in the city that had a marked personal impact 1. In 1924, Manoel de Abreu again tried to develop screen photography, but to no avail.
He married Dulce Evans de Abreu in São Paulo on 7 September 1929 1.
In Rio de Janeiro, he was the head of the radiology service of Hospital Jesus, and due to the large burden of pulmonary tuberculosis seen in children 1. In July 1936, de Abreu presented to the Brazilian Society of Tuberculosis a novel technique of photographing a fluoroscopic image and producing small images of the thorax quickly and in large volumes, which he called roentgenphotography. He was the first to establish this new method of investigation for mass radiography of the chest in the fight against tuberculosis.
The high mortality rate of tuberculosis in the 1930s and 1940s and failure to combat the disease effectively led to the widespread rapid adoption of this new technique.
The exam consists of photography on a fluorescent screen, and the documentation is with standard 35 mm or 70 mm film. Its creator always recommended 35 mm film, which, although less expensive, required the use of special magnifying glasses for the interpretation of the exam.
In 1937, a Health Center in Rio de Janeiro received the first device designed to perform serial examinations of the population. During 1938, many countries incorporated chest fluorography as an essential instrument in the fight against the tuberculosis epidemic 1.
Dr Ary Miranda, president of the First Brazilian Tuberculosis Congress, held on May 1939, proposed that the name abreugraphy be used to designate the method devised by Manoel de Abreu 1,3. In other countries, the new diagnostic method received various names, such as roentgenfluorography (Germany), radiophotography (France), photoradioscopy (Spain), photofluorography (Sweden), schermography (Italy), mass radiography, mass miniature radiography, and miniature chest radiography (England and the United States) 1,3,4.
Eventually the World Health Organization ruled against using abreugraphy 2 for mass screenings as better understanding of the risks of radiation became apparent and population prevalence and potential benefits changed.
Manoel de Abreu developed lung cancer, dying on 30 April 1962, at the age of 70 1.
He was awarded numerous honors, both in Brazil and abroad.
- honorary member of the German Society of Radiology (1940)
- honorary member of the American College of Radiology (1945)
- medical medal of the year from the American College of Chest Physicians (1950)
- diploma of honor from the Academy of Tuberculosis Physicians (1950)
- gold medal of the Colegio Interamericano de Radiologia (CIR) (1958)
- discovery of chest photofluorography
- 1. Bedrikow, R. (2001). Manoel de Abreu. Jornal de Pneumologia, 27(1),56-58. https://dx.doi.org/10.1590/S0102-35862001000100010
- 2. Gikovate F, Nogueira DP. [Sistematical mass roentgenphotography: economical unviability and eventual danger regarding exposure to radiations. 1976]. (2006) Revista de saude publica. 40 (3): 389-96. doi:10.1590/s0034-89102006000300004 - Pubmed
- 3. Andrew L. Banyai , M.D, ABREUGRAPHY: A MERITORIOUS EPONYM .doi:10.1378/chest.55.4.273
- 4. Ongre A. [Abreugraphy and the introduction of mass X-ray screening to Norway]. (2008) Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke. 128 (24): 2872-4. Pubmed