Nick Bryan R, ed. Introduction to the Science of Medical Imaging. Cambridge Medicine 2009, 334 pages, 159 illustrations, $125.00.
With the plethora of books available on various aspects of the physics of diagnostic imaging and the instrumentation involved in radiology, it is refreshing to have a book available that deals not only with the basic science of medical imaging but also with the cognition involved in visualizing images. This soft cover, 334-page book Introduction to the Science of Medical Imaging edited by R. Nick Bryan (with 23 contributors) brings to the fore all aspects of medical imaging and does so in a highly illustrated and well studied manner. It differs, therefore, from many other publications which deal with just one modality like MR or CT or nuclear medicine. A theme running through the book, no matter what medical image we are looking at, is that underlying all these images is quantitative data which is vastly underutilized in our interpretations. The inherent message is that we will, over the span of the next half decade, be less wedded to subjective (qualitative) analysis and more atuned objective (quantitative) analysis.
Four sections take the reader from “Image Essentials” (what exactly is an image, how do you make an image, how do you analyze an image) to “Biomedical Images: Signal to Pictures” (nuclear medicine, generation of x-rays to radiographs, ultrasound imaging, magnetic resonance imaging, optical imaging [a potential future] contrast material nuclear medicine labeling) to “Image Analysis” (human observers, digital processing, registration and atlas building, statistical atlases) to “Biomedical Applications” (morphological imaging, physiologing imaging, molecular imaging). In many respects, this book is a significant departure from the more commonplace texts in radiology physics, both in concept and execution.
What this reviewer particularly enjoyed about this book is the lack (that’s right, “lack”) of overwhelming detail, which can and often does cause the radiologist to put the book down. For example, a digestible explanation of molecular imaging is, in general, difficult to find, but here in this book, Glickson’s 12-page explanation gives the reader a sense of the field and where molecular imaging is headed. We learn among many things about theranostic agents (new term to this reviewer, but the meaning refers to taking individual diagnostics to individual therapy or, I presume, a fancy word for personalized medicine), how optical imaging can be employed, distinguishing intrinsic vs. extrinsic probes, molecular imaging targets, detection of marker genes, and fluorescence energy transfer (difficult concept to grasp), Granted, while not all of these are useful in the clinical arena now some eventually will be. Familiarization with concepts and terminology is facilitated by this chapter. Ranges of size sensitivity for various agents or modalities gives the idea of the ultra ultra small size we are talking about (down to femtomolar concentration — get out your P. Chem book!), and the limitations of MR in the realm of molecular imaging is revealing. A desired future of imaging is to define in as rapid a manner as possible the response of an abnormality (cancer in particular) to a therapeutic regimen, allowing either the treatment to proceed or be terminated. Molecular imaging holds a key to that and this is well described in this chapter.
The sense one also gets from reading this book is the interplay between metaphysics and physics, between sensory and illusionary, between concrete and abstract. (Don’t let that be a dissuader to obtaining this book; rather, let it be a persuader). This concept is apparent particularly in the first part of the book, but it is to be emphasized that contained in these pages are critical physics concepts which are well described and particularly well illustrated (superb graphics and legends accompany them). One comes away not only with a fundamental grasp of medical imaging but also with ideas and concepts not usually discussed. Another example of this includes the building of statistical atlases and what that actually means.
Only for the die-hard would the last 23 pages be of interest. Here, three appendices include Linear Systems, Fourier Transform and k-space, and Probability/Bayesion Statistics and Information Theory.
This reviewer knows of no other source in medical imaging science that lays out the whole field so interestingly and with new twists in conveying information. It is a highly recommended purchase either for an individual or a department.
