Oliver Schnell, from Germany, winner of the EANS Aesculap Prize 2009 for the Best Clinical Entry spoke to Petra Ernestova on 24th August 2011. PE: Could you please introduce yourself shortly, just in one or two sentences. OS: My name is Oliver Schnell and I am a neurosurgeon at the Department of Neurosurgery, Klinikum Grosshadern, Ludwig-Maximilians-Universität München/Germany. PE: Do you have a medical family background? OS: No, but both my grandfathers were doing fine mechanical work, one being a watchmaker and the other being an electrician. Maybe that is the genetic background for my interest in microsurgical procedures. PE: What made you decide to go into medicine? OS: Beside other interests, I think I was most curious about the basic and clinical science of the human body. PE: And into neurosurgery? Had you also considered any other specialties? OS: I was fascinated by neuroscience and the combination of the necessity to have excellent anatomical and neurophysiological knowledge and the opportunity to use the most modern equipments in order to get the best operative results possible. Only for a few seconds I had thought about neurology (con: too few operations) or general surgery (con: is not neurosurgery). PE: Which area of neurosurgery did you specialise in, and why? OS: I was interested in neuro-oncology ever since I had spent an elective period in neurology/neurosurgery at the Memorial Sloan-Kettering Cancer Center in New York. After a few years of neurosurgical training I developed a special interest in glioma surgery. The main experimental basic and clinical research topic I am focusing on are integrins and their impact on glioblastoma invasion. PE: What qualities do you feel that a good neurosurgeon should have? OS: He should be a good observer and fast analyticist. He should be able to work in a concentrated and calm manner always focusing on the next steps ahead. He should have respect but no fear of what he is doing and always be aware of his skills and also his limits and never be to shy to ask someone more experienced for help in order to get the best results for the patients. PE: Do you have any neurosurgical "heroes"? OS: I recall a personal meeting with Professor Wolfgang Seeger at the time when he was in his last year as Head of the Department of Neurosurgery in Freiburg. He was the first neurosurgeon I ever met and also held clinical and neuroanatomical lectures at that time which amplified my interest in this field. PE: You won the EANS Aesculap Prize last year. Could you introduce your research project shortly? OS: Inhibitors targeting the integrin αvβ3 are promising new agents currently tested in clinical trials for supplemental therapy of glioblastoma multiforme (GBM). Aim of our study was to evaluate [18F]Galacto-RGD positron emission tomography (PET) for non-invasive imaging of αvβ3 expression in patients with GBM suggesting eligibility for this kind of additional treatment.

Potential applications of [18F]Galacto-RGD PET might be the selection and monitoring of patients before and during αvβ3 targeted therapies. A further potential application might be demonstrating receptor occupancy of αvβ3 antagonists by [18F]Galacto-RGD PET in order to evaluate the most efficient dose in each individual patient. This might be one step to implement the concept of a "personalized cancer therapy" in clinical routine. PE: Is there any new research you are involved with or some project you would like to start in future? OS: We moved forward in the field of integrin research and looked for a possible signalling molecule, which might play an important role in the proliferation of glial tumor cells. PE: How do you think neurosurgery will develop over the next ten or twenty years? OS: I think our growing knowledge about molecular genetics will have great impact on decision making and treatment planning for patients with neuro-oncological diseases. New technical developments and improved imaging procedures will help to optimize surgical as well as conservative treatment planning. Intraoperative imaging methods combined with neurophysiological monitoring methods will improve the neurosurgical results. PE: What do you believe to be the role of the EANS? And what do you feel should be its objectives over the next few years? OS: The EANS unifies neurosurgical societies with different training systems, social backgrounds as well as financial resources. This comprises an invaluable opportunity to learn from each other how to deal with (neurosurgical) questions differently. Since every system has its benefits and drawbacks, one objective of the EANS should be to further encourage the exchange of neurosurgeons from all over Europe in order to permanently improve our skills and deliver the best possible care to our patients. PE: How do you choose to spend your spare time? OS: I like doing sports, especially alpine skiing in the winter and biking in the summer. PE: Is there anything you can tell us that might surprise people reading the article? OS: It is well known that Roald Amundsen was the first to reach the South Pole in 1911 but only few people may know that the North Pole has not been reached by foot until 1969 by Sir Walter William "Wally" Herbert.