Faro SH, Mohamed FB, eds. Law M, assoc. ed. Functional Neuroradiology: Principles and Clinical Applications. Springer 2012, 1029 pages, 897 illustrations, $249.
To see how far neuroradiology has come in the past decade, one only has to look through this important and well crafted 1029-page hardcover book, edited by Scott Faro, Feroze Mohamed, Meng Law, and John Ulmer. The book has contributions from 96 authors, with a strong mixture of PhDs and MDs.
The book covers all the major areas of what one would consider functional imaging (that is, imaging related to or derived from data which is not strictly anatomic in nature). There are nine parts to this book: (1) Diffusion and Perfusion Imaging; (2) MR Spectroscopy (surprisingly short at 55 pages); (3) Multi-Modality Functional Neuroradiology (includes multiple approaches to brain trauma, epilepsy, brain training MS, psychiatric disease, pain); (4 and 5) BOLD functional MR (Physical Principles and Application—these 2 parts take up 313 pages, over 1/3 of the entire book; this undoubtedly reflects the academic interests of the academic interests of the two primary editors, Drs. Faro and Mohamed, rather than BOLD’s relative importance in functional neuroradiology); (6) DTI; (7) Beyond Proton Imaging (includes MEG, PET/CT, personalized medicine, metabolic MRI (predominately material on Sodium MR imaging); (8) Functional Spine and CSF imaging (surprisingly missing is material on CSF flow in the spine and at the cervical medullary/base of skull area); (9) Neuroanatomic Brain Atlas.
Actually, for those starting out in the discipline of functional neuroradiology, this last section might be the best place to begin, because one immediately can get oriented to the major areas of the brain which can be investigated with BOLD and become familiar with the major white matter tracts as seen on color DTI. One can then migrate to other parts of the book which may be of interest, such as tractography (fiber tracking). These and other highly technical areas are explained well while still keeping enough technical information to allow one to understand in reasonable depth (at least for a neuroradiologist) the science behind many of these derived images.
While one might insist that a clinical neuroradiologist could perform his/her duties adequately without the need to understand or even apply most of the imaging described in this book, it is fairly clear that the field of neuroradiology is shifting in incremental steps towards quantitative imaging and more objective measurements of CNS pathology.
This book should now be considered the standard reference in functional neuroradiology. This reviewer has no doubt that the next edition will be longer, larger, and more useful. What is needed is a deep analysis on how these imaging procedures (all of which add to the cost of medical care) actually alter patient outcomes, or at the least surgical and medical decisions. Many examples come to mind; for example, it is all well and good to show how spinal cord DTI varies between different tumor types, but the glaring question is what specific use is made of this information in patient care/surgery that would otherwise not have been part of the care? Attention in each chapter should be paid to this issue. In some instances, as in stroke, the usefulness of advanced techniques is fairly obvious. Also, we all can point to selected cases where tractography may have altered the surgical approach, but overall, many of these techniques are of unproven benefit. This needs a full analysis in the next edition, which will undoubtedly be in 2 volumes given current size and weight of this single book.
Functional Neuroradiology: Principles and Clinical Applications is strongly recommended to all neuroradiologists: it is where the field is headed.
