Cavedon C, Rudin S, eds. Cardiovascular and Neurovascular Imaging — Physics and Technology. CRC Press Taylor & Francis Group; 2015; 470 pp; 329 ill; $143.96
Cardiovascular and Neurovascular Imaging is a comprehensive review of the physics of all imaging modalities related to cardiovascular and neurovascular imaging best suited for medical physicists and engineers. In general, the authors explain the principles behind the various methods discussed throughout the work, while often highlighting the historical background of each technique and underscoring the importance of physics and technology in the advancement of cardiovascular and neurovascular imaging. The work is abundantly referenced, with scholarly references, guidelines, and consensus recommendations. The book is organized into 7 major sections containing a total of 27 chapters and 462 pages as follows.
Section 1, “Physics Basis and Clinical Introduction”, contains 3 chapters, including “Introduction to the Physics of Vascular Imaging”, “Neurovascular Imaging: State of the Art and Clinical Challenges”, and “Cardiovascular Imaging: State of the Art and Clinical Challenges”. The first chapter provides a reasonably brief overview of general concepts in vascular imaging physics, while the latter two chapters are seemingly aimed at the non-physician scientist providing insight regarding the most common challenges and questions encountered in radiology practice (for example, stroke imaging and coronary artery disease assessment).
Section 2, “Physics and Technology: Principle Applications”, contains 6 chapters, covering the physics of x-ray angiography, CT angiography, MR angiography, carotid ultrasound, nuclear medicine cardiovascular imaging, and morphologic imaging of the heart. The governing equations relevant to each modality and their corresponding image generation processes are included, with several helpful figures along the way. Clinically relevant information and equations are also provided.
Section 3, “Focused Applications and Dedicated Technology: Geometries, Sources, Detectors, Advanced Image Reconstruction, and Quantitative Analysis”, contains 6 chapters, covering cone-beam CT for vascular imaging, digital techniques with a nonstandard beam geometry, dual-energy and multienergy techniques in vascular imaging, special detectors for digital angiography, micro-angiography, and micro ROI cone beam computed tomography. Each chapter details the components of its respective modality supplemented by suitable figures. The algorithms and equations for image formation are provided. Image artifacts and correction techniques are also included for each modality. A discussion on clinical applications start with a brief summary of the history of the modality followed by a summary of how the technologies are most commonly used in clinical practice.
Section 4, “Time-Resolved Imaging”, contains 6 chapters, covering motion control in cardiovascular imaging, time-resolved neurovascular 2D x-ray imaging, 3D perfusion in cardiac and neurologic applications, flow imaging with MRI, physics and engineering principles of fluid dynamics, and computational fluid dynamics. The chapter on motion control includes discussion on measuring motion signal via ECG before offering summaries on gated CT, MR, nuclear imaging SPECT and PET, ultrasound, and fluoroscopy. The time-resolved 2-D x-ray imaging chapter includes fundamentals of blood flow measurements including a fairly detailed discussion on blood flow and contrast media transport. Several velocity determination techniques are also introduced the details of which are probably of most interest to physicists and engineers rather than physicians. The ensuing chapter on 3D perfusion in cardiac and neuroimaging describes common clinical applications of cerebral and perfusion imaging to the non-radiologist. Basic physics and physiology of blood flow are well-explained before discussing flow imaging with MRI. Velocity and flow-quantification techniques are also well-treated, including a section on the relative merits of Cartesian, radial, and spiral K-space filling, which are becoming increasingly pertinent in the field of cardiovascular imaging as the industry moves away from conventional K-space filling. Sources of error in phase contrast imaging are also discussion. Principles of fluid dynamics and computational fluid dynamics chapters are probably most relevant to those involved in device and systems designs, such as engineers or those involved in image-based physics research.
Section 5, “Image-Guided Therapeutic Procedures”, contains 2 chapters, covering vascular imaging for image-guided interventions and angiography for radiosurgery and radiation therapy. Both chapters provide a good review on the clinical aspects of these topics. For example, the former provides an introduction and summary of the treatment of stroke and coronary artery disease. The latter discusses frame-based and frameless angiographic localization. Both chapters in include sections on quality assurance, which is surely to be appreciated by medical physicists.
Section 6, “Dosimetry and Radiation Protection”, contains 3 chapters, covering dosimetric techniques, patient dose control in fluoroscopically guided interventions, and radiation protection of staff and patients. The section starts by defining the quantities and units of measure of radiation and the relation to biological effects and risk (eg, flux and fluence, exposure, kerma, absorbed dose, equivalent dose, organ dose, effective dose, etc). A paragraph on relevant software such as PCXMC, accompanied by figures on its setup pages, is provided with an example of how to use Monte Carlo results to simulate dose based on a given set of conditions. The principles of detectors and measurement devices such as ionization chambers, thermoluminescent dosimeters (TLDs), photostimulable phosphor (PSP) technology, metal-oxide semiconductor field-effect transistor (MOSFET) detectors, x-ray film, and radiochromic film are discussed in brief subsections. Skin dose mapping systems such as PEMNET, CareGraph®, DICOM-based mapping software, and real-time skin dose tracking sections will be most appreciated by those physicists involved with interventional radiology, cardiology, and neurosurgery. Targeted to the same audience, patient dose control in fluoroscopically guided techniques are discussed in a separate chapter with sections on collimating, beam spectrum and filters, compensation (wedge) filters, image processing, frame rate reduction, and exposure geometry. Finally, the section ends with a comprehensive chapter discussing all major facets of staff and patient radiation protection.
Section 7, “Current and Future Trends”, includes a discussion on current and future trends in the field. The authors include their opinions (based on current trends) regarding the advancement of high-spatial resolution imaging and the relative benefits of each imaging modality to vascular imaging. The possibility of commercializing new innovative designs allowing for the generation of x-rays without the Bremsstrahlung mechanism are discussed, while technologies that have been available but not popularized are mentioned. Sections on improved image processing and image-guided therapeutic treatments are also provided.
In summary, Cardiovascular and Neurovascular Imaging provides a comprehensive physics review for the learning medical physicist and biomedical engineer. This book is not intended for most radiologists, except perhaps for the most physics- and mathematically-inclined that may wish to obtain detailed knowledge regarding a specific modality or frequently encountered physics-related problem in their practice. This work appears unique in bringing detailed information regarding every modality relevant to cardiovascular and neurovascular imaging together into one combined resource. Whether one is a beginning physicist or simply would like to obtain more knowledge about an area outside of their own expertise, this work is likely to provide an ample amount of information, or at least to point the reader in the right direction by way of its well-referenced sections, and is thus recommended for this type of audience.
