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"An excellent primer on medical imaging for all members of the medical profession . . . including non-radiological specialists. It is technically solid and filled with diagrams and clinical images illustrating important points, but it is also easily readable . . . So many outstanding chapters . . . The book uses little mathematics beyond simple algebra [and] presents complex ideas in very understandable terms."
--Melvin E. Clouse, MD, Vice Chairman Emeritus, Department of Radiology, Beth Israel Deaconess Medical Center and Deaconess Professor of Radiology, Harvard Medical School
A well-known medical physicist and author, an interventional radiologist, and an emergency room physician with no special training in radiology have collaborated to write, in the language familiar to physicians, an introduction to the technology and clinical applications of medical imaging. It is intentionally brief and not overly detailed, intended to help clinicians with very little free time rapidly gain enough command of the critically important imaging tools of their trade to be able to discuss them confidently with medical and technical colleagues; to explain the general ideas accurately to students, nurses, and technologists; and to describe them effectively to concerned patients and loved ones. Chapter coverage includes:
Introduction: Dr. Doe's Headaches
Sketches of the Standard Imaging Modalities
Image Quality and Dose
Creating Subject Contrast in the Primary X-Ray Image
Twentieth-Century (Analog) Radiography and Fluoroscopy
Radiation Dose and Radiogenic Cancer Risk
Twenty-First-Century (Digital) Imaging
Digital Planar Imaging
Computed Tomography
Nuclear Medicine (Including SPECT and PET)
Diagnostic Ultrasound (Including Doppler)
MRI in One Dimension and with No Relaxation
Mapping T1 and T2 Proton Spin Relaxation in 3D
Evolving and Experimental Modalities
Auteur
Anthony Brinton Wolbarst, PhD, a physicist formerly at Harvard Medical School, the National Cancer Institute, and the U.S. Environmental Protection Agency, is currently an Associate Professor at the University of Kentucky College of Health Sciences, Division of Radiation Sciences and College of Medicine, Department of Diagnostic Radiology in Lexington, Kentucky, USA.
Patrizio Capasso, MD, is Professor and Division Chief of Vascular & Interventional Radiology in the Departments of Diagnostic Radiology and Surgery at the University of Kentucky Chandler Medical Center Lexington, Kentucky, USA.
Andrew R. Wyant, MD, is Assistant Professor for Physician Assistant Studies at the University of Kentucky Chandler Medical Center Lexington, Kentucky, USA. Among many other courses that he teaches is a popular clinical skills seminar in in Radiographic Interpretation.
Contenu
Preface x
Acknowledgments xiii
Introduction: Dr. Doe's Headaches: An Imaging Case Study xiv
Computed tomography xiv
Picture archiving and communication system xv
T1, T2, and FLAIR MRI xvi
MR spectroscopy and a virtual biopsy xvii
Functional MRI xviii
Diffusion tensor MR imaging xviii
MR guided biopsy xx
Pathology xxi
Positron emission tomography? xxi
Treatment and follow-up xxii
1 Sketches of the Standard Imaging Modalities: Different Ways of Creating Visible Contrast Among Tissues 1
Roentgen has surely gone crazy! 2
Different imaging probes interact with different tissues in different ways and yield different kinds of medical information 4
Twentieth-century (analog) radiography and fluoroscopy: contrast from differential attenuation of X-rays by tissues 7
Twenty-first century (digital) images and digital planar imaging: computer-based images and solid-state image receptors 16
Computed tomography: three-dimensional mapping of X-ray attenuation by tissues 17
Nuclear medicine, including SPECT and PET: contrast from the differential uptake of a radiopharmaceutical by tissues 20
Diagnostic ultrasound: contrast from differences in tissue elasticity or density 26
Magnetic resonance imaging: mapping the spatial distribution of spin-relaxation times of hydrogen nuclei in tissue water and lipids 28
Appendix: selection of imaging modalities to assist in medical diagnosis 30
References 36
2 Image Quality and Dose: What Constitutes a Good Medical Image? 37
A brief history of magnetism 37
About those probes and their interactions with matter . . . 39
The image quality quartet: contrast, resolution, stochastic (random) noise, artifacts and always dose 47
Quality assurance 57
Known medical benefits versus potential radiation risks 61
3 Creating Subject Contrast in the Primary X-ray Image: Projection Maps of the Body from Differential Attenuation of X-rays by Tissues 67
Creating a (nearly) uniform beam of penetrating X-rays 69
Interaction of X-ray and gamma-ray photons with tissues or an image receptor 75
What a body does to the beam: subject contrast in the pattern of X-rays emerging from the patient 83
What the beam does to a body: dose and risk 87
4 Twentieth-century (Analog) Radiography and Fluoroscopy: Capturing the X-ray Shadow with a Film Cassette or an Image Intensifier Tube plus Electronic Optical Camera Combination 91
Recording the X-ray pattern emerging from the patient with a screen-film image receptor 92
Prime determinants/measures of image quality: contrast, resolution, random noise, artifacts, . . . and, always, patient dose 98
Special requirements for mammography 114
Image intensifier-tube fluoroscopy: viewing in real time 122
Conclusion: bringing radiography and fluoroscopy into the twenty-first century with solid-state digital X-ray image receptors 125
Reference 126
5 Radiation Dose and Radiogenic Risk: Ionization-Induced Damage to DNA can cause Stochastic, Deterministic, and Teratogenic Health Effects And How To Protect Against Them 127
Our exposure to ionizing radiation has doubled over the past few decades 127
Radiation health effects are caused by damage to DNA 129
Stochastic health effects: cancer may arise from mutations in a single cell 132
Deterministic health effects at high doses: radiation killing of a large number of tissue cells 139
The Four Quartets of radiation safety 146
References 151
6 Twenty-first Century (Digital) Imaging: Computer-Based Representation, Acquisition, Processing, Storage, Transmission, and Analysis of Images 152
Digital computers 153
Digital acquisition and representation of an image 157
Digital image processing: enhancing tissue contrast, SNR, edge sharpness, etc. 166
Computer networks: PACS, RIS, and the Internet 168
Image analysis and interpretation: computer-assisted detection 170 Computer an...