Professor Richard Underwood is a professor of cardiac imaging at Royal Brompton Hospital, where he treats private and NHS patients.

He studied chemistry at Merton College, University of Oxford, graduating with first class honours, then studied medicine and graduated in 1977. After his general medical training, he specialised in cardiac medicine and learned about invasive and non-invasive techniques. For the last 30 years he has practised non-invasive cardiac imaging, with major clinical and research interests in nuclear cardiology, magnetic resonance and in cardiovascular X-ray computed tomography.

Professor Underwood has worked at Royal Brompton Hospital since 1985, and been part of its academic wing, the National Heart and Lung Institute, Imperial College London. In 1993, he became an honorary consultant at the Royal Marsden Hospital. In 1995, he became an honorary professor at University College London.

At Royal Brompton Hospital, Professor Underwood is lead clinician for nuclear medicine, research, training and strategy. At Harefield Hospital, he is lead clinician for nuclear medicine.

Clinical expertise

Professor Richard Underwood's areas of expertise include:

He receives referrals and requests for second opinions from across the world.

He is an expert in a number of imaging techniques:

  • radionuclide imaging of the heart
  • myocardial perfusion imaging, to detect narrowing of the coronary arteries and assess the risk of future problems such as a heart attack
  • solid-state gamma cameras, to check the condition of patients with coronary disease and manage patients undergoing arrhythmia ablations
  • PET imaging, to see inflammation and infection in the heart.

Research interests

Professor Richard Underwood has been closely involved in developing magnetic resonance techniques to investigate the cardiovascular system. He has contributed substantially to its progression from a research technique to an everyday clinical tool.

His research interests include:

  • assessment of myocardial perfusion using pharmacological stress
  • characterisation of hibernating myocardium
  • use of cardiac imaging in heart failure and the assessment of myocardial viability and hiberation
  • cost-effectiveness of cardiac imaging techniques.


Professor Richard Underwood has published and lectured widely and he has written or contributed to some of the standard textbooks of cardiovascular medicine.


Professor Richard Underwood has led important training courses on nuclear cardiology at national and international level. He teaches undergraduate students at Imperial College London and has been the module lead for clinical sciences.

Professor Underwood has used his expertise to chair working groups, contribute to, or advise a number of organisations:

  • European Society of Cardiology’s working group on nuclear cardiology and magnetic resonance
  • British Nuclear Cardiology Society
  • International Congress of Nuclear Cardiology and Cardiac CT
  • Civil Aviation Authority
  • National Institute for Health and Care Excellence (NICE)
  • Department of Health and Social Care’s myocardial perfusion imaging group.