The book is divided into two parts: Part I deals with the relevant physics and planning algorithms of protons (H Breuer) and Part II with the radiobiology, radiopathology and clinical outcomes of proton therapy and a comparison of proton therapy versus photon therapy (BJ Smit). Protons can be used for radiosurgery and general radio therapy. Since proton therapy was first proposed in 1946 by Wilson, about sixteen facilities have been built globally. Only a very few of these have isocentric beam delivery systems so that proton therapy is really only now in a position to be compared directly by means of randomised clinical trials, with modern photon radiotherapy therapy sys tems, both for radiosurgery and for general fractionated radiotherapy. Three-dimensional proton planning computer systems with image fusion (image of computerised tomography (CT), magnetic resonance registration) capabilities imaging (MRI), stereotactic angiograms and perhaps positron emission tomography (PET) are essential for accurate proton therapy planning. New planning systems for spot scanning are under development. Many of the older comparisons of the advantageous dose distributions for protons were made with parallel opposing or multiple co-planar field arrangements, which are now largely obsolete. New comparative plans are necessary once more because of the very rapid progress in 3-D conformal planning with photons. New cost-benefit analy ses may be needed. Low energy (about 70 MeV) proton therapy is eminently suitable for the treatment of eye tumours and has firmly established itself as very useful in this regard."

This volume provides an overview of X-ray technology and the historical development of modern CT systems. The main focus of the book is a detailed derivation of reconstruction algorithms in 2D and modern 3D cone-beam systems. A thorough analysis of CT artifacts and a discussion of practical issues such as dose considerations give further insight into current CT systems. Although written mainly for graduate students of biomedical engineering, medical physics, medicine (radiology), mathematics, electrical engineering, and physics, practitioners in these fields will also benefit from this book.

Developments in teleradiology are progressing at great speed. As a consequence, there is a need for a broad overview of the field. This first-ever book on teleradiology is presented in such a way that it should make it accessible to anyone, independent of their knowledge of technology. The text is designed to be used by all professionals, including radiologists, surgeons, nurses and allied health professionals, and computer scientists. In a very short time, driven by technical developments, the field of teleradiology has become too extensive to be covered by only a small number of experts. Therefore, Teleradiology has been written with chapter contributions from a host of renowned international authorities in teleradiology (see the Contents and the Contributors). This ensures that the subject matter focusing on recent advances in teleradiology is truly up to date. Our guiding hope during this task was that as editors of multiple chapters we could still write with a single voice and keep the content coherent and simple. We hope that the clarity of this book makes up for any limitations in its comp- hensiveness.

For decades clinical electrophysiology has been considered a discipline for adepts, able to interpret not so obvious intracardiac signals. With the advent of new technologies, offering a three-dimensional reconstruction of cardiac anatomy and generating colour-coded maps, the approach to the complex world of electrophysiology is changing: A three-dimensional colour-coded electroanatomic map of a left atrium could be a precise and self-explanatory representation based on intracavitary signals, on which correct diagnosis is made and successful ablation is performed. As expected, this makes the difference especially in cases exhibiting complex arrhythmias (atypical atrial flutters, postsurgical arrhythmias), in which the task could be really tough.

The book is based on a multicentre experience and describes the most difficult cases of each centre, as far as arrhythmia is concerned. For each case, the crucial role of electroanatomic mapping in providing unique information and new insights in a field still in evolution is very evident. The book will prove to be very a useful tool for all the operators working in this field.

The International Diagnostic Course in Davos (IDKD) offers a unique learning experience for imaging specialists in training as well as for experienced radi- logists and clinicians wishing to be updated on the current state of the art and the latest developments in the fields of imaging and image-guided interventions. This annual course is focused on organ systems and diseases rather than on modalities. This year's program deals with diseases of the abdomen and pelvis. During the course, the topics are discussed in group workshops and in plenary sessions with lectures by world-renowned experts and teachers. While the wo- shops present state-of-the-art summaries, the lectures are oriented towards future developments. Accordingly, this Syllabus represents a condensed version of the contents presented under the 20 topics dealing with imaging and interventional therapies in abdominal and pelvic diseases. The topics encompass all the relevant imaging modalities including conventional X-rays, computed tomography, - clear medicine, ultrasound and magnetic resonance angiography, as well as image-guided interventional techniques. The Syllabus is designed to be an "aide-memoire" for the course participants so that they can fully concentrate on the lecture and participate in the discussions without the need of taking notes.

Sarcoidosis is a complex multisystem disease. Shortness of breath (dyspnea) and a cough that won't go away can be among the first symptoms of sarcoidosis, but sarcoidosis can also show up suddenly with the appearance of skin rashes and other dermatoses.

An Atlas of Sarcoidosis: Pathogenesis, Diagnosis and Clinical Features combines illustrations and clinical images of the authors' extensive practices, so that readers have unparalleled access to a comprehensive collection of sarcoidosis images. The atlas is designed to complement and provide a visual supplement to already existing texts on sarcoidosis. Each organ involvement is dealt in a brief and easy to comprehend manner. Various radiographic and laboratory abnormalities are then linked to the clinical features in order to encourage a smooth and easy practical integration at the bedside and to help practising pulmonologists, dermatologists and other clinicians who require a comprehensive visual encyclopedia of sarcoidosis images.

Providing a thorough overview of rapid developments in medical therapy, surgery, and angioplasty, this reference provides a complete review of carotid artery stenosis treatment, as well as a clear overview of carotid surgery and stenting. Offering chapters by seasoned authorities on epidemiology, imaging with ultrasound and angiography, cholesterol lowering, blood pressure management, homocysteine treatment, and diet modification, this guide is a stand-alone source for current information and understanding of this burgeoning science.

Paleoradiology is the use of X-rays and advanced medical imaging modalities in the evaluation of ancient human and animal skeletons as well as biological materials from archaeological sites. Paleoradiological studies have been performed on mummies, skeletal remains and fossils to determine their sex and age at death. Diagnostic paleoradiology is the use of X-ray studies to detect ancient diseases. The broad range of themes and imaging techniques in this volume reflects four decades of research undertaken by Don Brothwell in the fields of anthropology, human paleopathology, and zooarchaeology, combined with two decades of skeletal radiology experience during which Rethy Chhem read over 150,000 skeletal X-ray and CT studies."

Continuous technical developments of radiological imaging techniques have not only improved the potential of organ-based radiological diagnostics, but now also allow for dedicated whole-body exams which may be used in the field of screening and preventive diagnosis. The concept of this book is to provide clinicians with a broader understanding of screening and preventive diagnosis using radiological imaging. The first part of the book is dedicated to the fundamentals of screening and preventive diagnosis, and will comprise chapters on epidemiology and pathology, technical and organizational aspects of radiological screening, and chapters on legal issues and cost-risk analysis. The second part of the book will discuss the most important practical examples of radiological screening and surveillance, both for unselected populations, as well as for individual risk groups.

Pixel detectors are a particularly important class of particle and radiation detection devices. They have an extremely broad spectrum of applications, ranging from high-energy physics to the photo cameras of everyday life. This book is a general purpose introduction into the fundamental principles of pixel detector technology and semiconductor-based hybrid pixel devices. Although these devices were developed for high-energy ionizing particles and radiation beyond visible light, they are finding new applications in many other areas. This book will therefore benefit all scientists and engineers working in any laboratory involved in developing or using particle detection.

In general, image processing texts are intended for students of engineering and computer science, and there is little written at all on the specific requirements of medical image processing. Students of medical radiation science (Diagnostic radiography, Nuclear medicine, Radiation therapy) usually have minimal mathematical and computer science training and find the available texts incomprehensible. A text that explains the principles of image processing in minimally-mathematical language is needed for these students. Contrary to the claims of some textbook authors, the vast majority of technologists that process images do not need to understand the mathematics involved, but would nevertheless benefit from a thorough understanding of the general process.

To celebrate its 5th edition, the International Symposium on Biomedical S- ulation (ISBMS) was organized in conjunction with the International Meeting on Simulation in Healthcare (IMSH). IMSH is the premier simulation in heal- care meeting and largestsingle gathering of clinicians, educators, administrators and other simulation stakeholders. This unique link-up aimed at bringing - gether simulation users with those involved in its scienti?c and technological developments in order to foster closer interaction. The joint meeting was held in Phoenix, Arizona during January 23-24, 2010. Biomedical modeling and simulation are at the center stage of worldwide e?orts to understand and replicate the behavior and function of the human organism. The Physiome Project and Virtual Physiological Human (VPH) i- tiative aim to develop advanced computational models that will facilitate the understanding of the integrative function of cells, organs, and organisms, with the ultimate goal of delivering truly personalized medicine. At the same time, progressinreal-timebiomedicalmodeling andsimulationhasenabledmorec- plex, interactive simulations, o?ering the possibility of highly sophisticated task trainers, proceduralandpatientsimulatorsto supportmedicaltrainingandsafer clinical practice. It is in this contextthat ISBMS seeks to act as an international forum for researchers in this increasingly important area to share their latest work, discuss future trends and forge new collaboration

Despite the fact that Interventional Radiology is steadily moving toward a cli- cal specialty with the need for broad medical training, daily craftsmanship will always remain fundamental to what an interventional radiologist does. Without basic catheter and wire skills IR would not be what it is today. When I watch ex- rienced colleagues work I am always surprised to see that, concerning the technique and the materials, we all make the same choices. There is apparently a common IR skill, which is universal and can be learned with experience. I always see this with new IR fellows, that it takes time to step away from improvising and letting the p- cedure take the lead to logic and standardized control over a procedure. Choosing the right materials for the right job and building a level of con dence with these materials is a very important part of any IR fellowship. Why can a supervisor get a stable catheter position with a new wire in no time, whereas the fellow almost gives up? The difference is knowing your materials for this speci c indication and c- bining routine and standardized operational procedures. Hands-on workshops are always very popular at every IR meeting because one can really learn about basic skills. Lectures with the title "How I do it," can always count on a full audience.

Disease whether it is acute, chronic, or at end stage, is all too regularly accompanied by pain. Pain is often difficult to control, in malignant disease in particular, even by using appropriate medications. Anesthesiologists and pain therapists have developed new invasive therapies including nerve block, sympatholysis, and neurolysis useful for both diagnosis and pain management. To insure the efficiency and safety of these procedures, and furthermore for elaborate techniques such as vertebroplasty, cementoplasty, and radio frequency bone ablation, imaging guidance becomes mandatory. This state-of-the-art book describes the techniques elaborated by interventional radiologists in the treatment and palliation of a variety of benign and malignant painful conditions. Each chapter written by an expert in the field concentrates on a particular aspect of pain management, with emphasis on practical issues. This book will serve as an invaluable source of information for the radiologist willing to learn about new pain therapy techniques aimed at optimizing or replacing more invasive traditional methods.

Mathematical sciences are contributing more and more to advances in life science research, a trend that will grow in the future. Realizing that the mathematical sciences can be critical to many areas of biomedical imaging, we organized a three-day minicourse on mathema- cal modelling in biomedical imaging at the Institute Henri Poincar'einParis in March 2007. Prominent mathematicians and biomedical researchers were paired to review the state-of-the-art in the subject area and to share mat- maticalinsightsregardingfutureresearchdirectionsinthisgrowingdiscipline. The speakers gave presentations on hot topics including electromagnetic brain activity, time-reversal techniques, elasticity imaging, infrared thermal tomography,acoustic radiationforce imaging, electrical impedance and m- netic resonance electrical impedance tomographies. Indeed, they contributed to this volume with original chapters to give a wider audience the bene?t of their talks and their thoughts on the ?eld. This volume is devoted to providing an exposition of the promising - alytical and numerical techniques for solving important biomedical imaging problems and to piquing interest in some of the most challenging issues. We hope that it will stimulate much needed progress in the directions that were described during the course. The biomedical imaging problems addressed in this volume trigger the investigation of interesting and di?cult problems in various branches of mathematics including partialdi?erential equations, h- monic analysis, complex analysis, numerical analysis, optimization, image analysis, and signal theory. The partial support o?ered by the ANR project EchoScan (AN-06- Blan-0089) is acknowledged. We also thank the sta? at the Institute Henri Poincar' e.

The underlying physics of magnetic resonance imaging is a topic of considerable importance since a basic understanding is necessary to accurately interpret and generate high quality MR images. Yet it can be a challenging topic in spite of the best efforts of both teachers and students of the subject. Practical MR Physics reviews the basic principles of MR using familiar language and explains the causes of common imaging artifacts and pitfalls. The book will also be a helpful guide during review of clinical cases since the reader can look up specific imaging artifacts or pitfalls in the index. Featuring over 375 high quality images, numerous case examples, and concise, clinically oriented discussion of the physics behind the images, Practical MR Physics is an ideal resource for anyone who works in the field of MR imaging.

The second edition of this book has been significantly expanded to meet the demands of the increasing new trend of molecular imaging. A separate chapter on the basis of FDG uptake has been added. New to this edition are the more clinically oriented details on scintigraphic studies, their strengths and limitations in relation to other modalities. It further contains many new images, illustrations and tables.

Thechestradiograph(chestX-ray)isthemostcommonly- questedexamination,anditisprobablythehardestplain?lm tointerpretcorrectly. Accurateinterpretationcangreatly- ?uence patient management in the acute setting. It is, h- ever,oftenperformedoutofhoursandtheinterpretationis undertakenbyrelativelyjuniormembersofstaffwithno- mediateseniorsupportorradiologicalinput. Despitethe- creasingavailabilityofmorecomplexradiologicalinvesti- tions,thechestX-raycontinuestoberequestedasa?rst-line investigationandthisislikelytocontinue. The structure of this book derives from many teaching sessions that have been given to junior doctors and me- calstudents. Theauthorshavefoundthat,ingeneral,tea- ingregardingchestX-rayinterpretationhadlackedaformal structuredapproach,andjuniordoctorsandmedicalstudents foundinterpretingachestX-raydif?cult. Givingthemastr- turedapproachallowedthemtofeeltheycouldtackleint- pretationwithmorecon?dence. Weaimtoprovideaportablehandbookforjuniordoctors. The structure is based upon those lectures that the authors havegiven. Thebookitselfisintendedtobeeasilyaccessible andtohelpthiswehaveincludedtablescontainingthekey teachingpoints,toalloweasyreference. Wehaveincluded- tensiveexamplesofcommonpathologies. Thisbookis,h- ever,notanexhaustiveworkofreference. WehaveincludedbasicinformationonhowachestX-ray isperformedandhowsuchperformancefactorscanaffectthe qualityoftheimage. Weconsidertheimplicationsofrad- tiondoseandgivedetailsofbasicnormalanatomy. Wethen explainwhynormalstructuresappearastheydoonthechest vii viii Preface X-ray. Theabilitytointerpretthenormaliskeytointerpr- ingtheabnormalandweexplainwhyabnormalitiescreatethe imagingfeaturestheydo. Using a structured logical approach, we focus on both anatomical abnormality and more generalized patterns of lungdisease. Our ultimate aim is to equip the reader with a con?dent, simplebutlogicalapproachtochestX-rayinterpretation. R. Joarder N. Crundwell Acknowledgments We would like to acknowledge Christina Worley for all her hardworkinpreparingthemanuscript. We would also like to acknowledge the following for their valuable contribution to this book: Steve Page, DCR, MSc, Conquest Hospital, St Leonards-On-Sea, East Sussex, UK,andAndrewDeveling,DipMDI,ConquestHospital,St Leonards-On-Sea,EastSussex,UK ix Contents Preface...vii Acknowledgments ...ix PartI 1 ChestRadiography ...3 1. 1. RadiographicTechnique ...4 1. 1. 1. Postero-anterior(PA)...4 1. 1. 2. Antero-posterior...6 1. 1. 3. Lateral ...7 1. 1. 4. Obliques...9 1. 1. 5. PenetratedPostero-anterior ...12 1. 1. 6. Inspiration/ExpirationPostero-anterior 12 1. 1. 7. ApicalLordotic ...12 1. 2. KeyPoints...13 2 The Normal Chest X-ray: An Approach toInterpretation...15 2. 1. UnderstandingNormalAnatomy ...17 2. 2. ReviewAreas...22 2. 3. Pseudo-abnormalitiesonaNormalFilm...24 2. 4. KeyPoints...27 PartII 3 TheMediastinumandHilarRegions ...31 3. 1. MiddleMediastinumandHilarRegions...34 xi xii Contents 3. 1. 1. CardiacAbnormality...

This book, written by leading experts from many countries, provides a comprehensive and up-to-date description of how to use 2D and 3D processing tools in clinical radiology. The opening section covers a wide range of technical aspects. In the main section, the principal clinical applications are described and discussed in depth. A third section focuses on a variety of special topics. This book will be invaluable to radiologists of any subspecialty.

This book constitutes the refeered proceedings of the 21st International Conference on Information Processing in Medical Imaging, IPMI 2009, held in Williamsburg, VA, USA, in July 2009

The 26 revised full papers and 33 revised poster papers presented were carefully reviewed and selected from 150 submissions. The papers are organized in topical sections on diffusion imaging, PET imaging, image registration, functional networks, space curves, tractography, microscopy, exploratory analyses, features and detection, image guided surgery, shape analysis, motion, and segmentation and validation.

This edition of Neuroimaging Clinics focuses on these minimally invasive, image-guided therapies. It includes guidelines for patient assessment and selection, choices of pharmaceuticals and materials commonly used, as well as, advice from noted experts about complication avoidance. Common procedures such as biopsy, epidural steroid injection and vertebroplasty (or balloon assisted vertebroplasty) are discussed. Newer procedures, such as sacroplasty, synovial cyst rupture, spinal cord stimulators, neurolysis, percutaneous discectomy, and minimally invasive treatment of spinal stenosis, are introduced.

FIMH 2009 was the ?fth international conference on Functional Imaging and Modeling of the Heart. It was held in Nice, France, during 3-5 June 2009. This biennial scienti?c event presents research and development e?orts in the ?eld of cardiovascularmodeling and image analysis to better understand the physiology and pathologies of the human heart. The ?nal objective is to improve the di- nosis and therapy of cardiac diseases, which remain a major health issue in the western world and in Asia. This internationalconference is fostering the collaborationbetween scientists invarious?elds(signalandimageprocessing, biophysics, biomedicalengineering, robotics, computerscience, appliedmathematics, etc. )andexpertsincardiology, radiology, surgery, biology and physiology. Duringthepast8years, FIMHhasestablisheditselfasaleadinginternational conference on the methodological aspects of functional imaging and modeling of theheartwithastrongemphasisonclinicalapplicationsandvalidation. Thep- vious conferences were held in Helsinki (2001), Lyon (2003), Barcelona (2005) and Salt Lake City (2007) with an increasing number of peer-reviewed articles published in theLecture Notes in Computer Science proceedings availableatthe time of the event. Links to current and previous meetings and associated LNCS volumes are available at http: //www-sop. inria. fr/asclepios/events/FIMH09 The2009proceedingscontainoriginalarticlesselectedafteracompetitiveand rigorous peer-review process. The authors had to submit a full paper (8 pages in the proceedings format) to be reviewed in a double-blind process by 3 or 4 members of the international Program Committee composed of 55 prominent scientists in th

The International Diagnostic Course in Davos (IDKD) offers a unique learning experience for imaging specialists in training as well as for experienced radiolo gists and clinicians seeking state of the art knowledge and an update regarding the latest developments in the field of musculoskeletal imaging. This syllabus is designed to provide IDKD course participants with the neces sary background material so that they can fully concentrate on the workshops. However, this text is also a comprehensive overview of current musculoskeletal imaging. While it is aimed at general radiologists, radiology residents, rheuma tologists, and orthopedic surgeons, it is also ofrelevance to clinicians in other spe cialties who wish to update their knowledge in this discipline. The authors are internationally renowned experts in their fields. The chapters are disease-oriented and cover all the major imaging modalities, including mag netic resonance imaging, standard radiography, computed tomography, and ultra sound. Additional information can be found on the IDKD website: www. idkd. org 1. Hodler G. K. von Schulthess Ch. L. Zollikofer Table of Contents Workshops Imaging oftheShoulderI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 William E. Palmer Imaging oftheShoulderII 7 Klaus Woertler Elbow Imagingwithan Emphasis on MRI 14 Lynne S. Steinbach, MarcoZanetti Wrist and Hand 24 LouisA. Gilula Imaging oftheWrist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 ChristianW. A. Pfirrmann MR Imaging oftheHip (Part I): Normal Labrum, Labral Tears, and Femoroacetabular Impingement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Christine B. Chung The Hip, PartII: Soft-Tissue Abnormalities 38 Cheryl Petersilge Imaging oftheKnee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 David A. Rubin, Arthur A. DeSmet Ankle and Foot 49 GeorgeY. EI-Khoury, JeremyJ. Kaye Magnetic Resonance Imaging ofMuscle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."

* Provides both general and specific information about the performance of PET/CT * Experiences based on over 10,000 patient studies * Includes extensive references * Case studies with over 700 illustrations permit an almost complete diagnostics * Offers interdisciplinary coverage that meets the need of Radiologists and Nuclear Medicine Specialists Since 1999/2000 simultaneous imaging of anatomical features and metabolic activities using fused PET and CT images has complemented and in many cases even replaced what was originally done as separate analysis. - Is this a small revolution? - In fact, this new approach can be considered to be without a rival for imaging diagnosis. The complementary efforts of nuclear medicine physicians and radiologists have improved the diagnostic value of PET/CT scans. The successful use of PET/CT in the field of oncology has been documented world-wide, and in cardiology we can take advantage of the significant findings of PET diagnosis, particularly in the USA. New prospects are now available for paediatric oncology and molecular medicine. Based on the experience gained by PET/CT experts with more than 10,000 patients, this manual impressively demonstrates the advantages of combined PET/CT. It also refers to publications from Europe, the USA and Asia as well as numerous studies. The comprehensive literature lists at the end of each chapter is extended on the CD which accompanies the book. This list goes beyond the field of PET/CT and takes into account neighbouring disciplines.