Barker PB, Golay X, Zaharchuk G, eds. Clinical Perfusion MRI: Techniques and Applications. Cambridge University Press; 2013; 356 pgs; $125

This textbook is divided into two sections. The first section covers the basic principles and technical aspects of various methods that are used to measure perfusion with MRI, which would be very valuable to basic scientists working in this field. The second section covers various clinical application of the methods described in section one, which would be of great importance to radiologists.

Section 1

The first chapter describes fundamental aspects of various methods that are used for measuring blood flow with their mathematical expressions, as it applies to Fick’s principle, central volume principle, and the Kety-Schmidt method. Chapter 2 gives detailed descriptions of dynamic susceptibility contrast (DSC) imaging using the gradient-echo imaging method and detecting changes on T2*-weighted images. The tracer kinetic model is described, as is the use of arterial input function to measure cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). Chapter 3 discusses arterial spin labeling (ASL), which does not require the use of exogenous contrast agent. Two different experimental methods are described for labeling the spins: pulsed-continuous ASL (pCASL) and pulsed ASL (PASL). Chapter 4 discusses dynamic contrast-enhanced (DCE) T1-weighted imaging to measure tissue permeability (K^trans), extravascular extracellular (v_e), and rate constant (k_ep). Chapter 5 evaluates methods for imaging brain oxygenation using the quantitative blood oxygenation level-dependent (qBOLD) technique, quantitative susceptibility mapping (QSM), and T2 relaxation under spin tagging (TRUST). Chapter 6 describes yet another method that uses preparation pulse pre- and postcontrast to detect changes in signal in a given voxel, to calculate absolute cerebral blood volume. Chapter 7 discusses the use of functional BOLD imaging and BOLD-ASL.

Section 2

Chapter 8 evaluates the clinical application of DSC, ASL, and structural imaging techniques, including MRA and DWI for evaluation of acute ischemic stroke, transient ischemic attack, chronic hypoperfusion, arterial venous malformation, and aneurysms and vasospasm. Chapter 9 discusses the use of ASL to investigate relative changes in regional blood flow between Alzheimer disease and normal aging, mild cognitive impairment, and various other neurodegenerative diseases. Chapter 10 describes the use of perfusion methods in evaluating global and focal hypoperfusion/hyperperfusion, and demyelinating inflammatory disorders of CNS. Chapter 11 discussed the use of DSC, DCE, and ASL to evaluate different types of tumors, predict tumor grade, and monitor efficacy of therapy.

The remaining chapters discuss the use of methods described in section 1 in various other organ systems, such as in the evaluation of breast cancer, liver metastases, prostate cancer, kidney diseases, and cardiac diseases.

This book provides a useful resource to basic scientists who are interested in studying CNS hemodynamics; all the concepts and their theoretical models are described in detail in section 1 of this book. All the chapters are well organized, and figures/illustrations help to get the point across to the reader. The second section of the book, chapters 8–11, would be of great benefit for neuroradiologists, as all aspects of perfusion imaging are discussed in the contexts of various diseases, along with the methods’ strengths and pitfalls.

Overall, the book is comprehensive:  I believe it should be used as a reference in every radiology department.