Clinical Brain Imaging: Principles and Applications

Clinical Brain Imaging: Principles and Applications

John C. Mazziotta, Ph.D., Sid Gilman

Philadelphia, PA: F.A. Davis Company, 480 pp, 1992

This is a book for the lean and mean 90s. Once mighty medicine must now genuflect before the mightier bean counter. Rationalization of medical resources is the buzz word. And so it goes with neuroimaging, whose expensive technology demands appropriate use.

This book correlates four methods of neuroimaging: x-ray computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT). Ultrasound is inexplicably excluded, even though it is computer-based and cross-sectional and well-established for neonatal neuroimaging.

The book is methodical and would serve well as a text for a graduate course in neuroscience. The first four chapters tackle the basic principles, i.e., physics, physiology and pharmacology of CT, MRI, PET and SPECT. Although these chapters are simplified from a physicist’s perspective, others will find them tough going. A resident in neurosurgery who is deprived of sleep is not likely to wade through them. This is a shame, since the chapters establish a firm foundation for the rest of the book.

The remaining chapters deal with the clinical aspects of neuroimaging, attempting to cover such broad subjects as neoplasms, cerebral vascular disease, movement disorders and dementia. Here the book excels, highlighting the indications and limitations of each method of imaging. Flow charts are often included, guiding the reader through the most appropriate use of each technique to arrive at a proper diagnosis.

All this technology is still evolving and is outpacing the typesetter. Despite the epilogue entitled “Future Visions,” the book is already becoming dated. The exciting MRI developments of magnetization transfer contrast and relative cerebral blood flow imaging are not mentioned at all.

In summary, this is a well conceived and executed book which I recommend to anyone involved in the neurosciences, particularly those on the clinical side who are trying to cope with the multitude of imaging techniques now available.