The purpose and subject of this book is to provide a comprehensive overview of all types of phantoms used in medical imaging, therapy, nuclear medicine and health physics. For ionizing radiation, dosimetry with respect to issues of material composition, shape, and motion/position effects are all highlighted. For medical imaging, each type of technology will need specific materials and designs, and the physics and indications will be explored for each type. Health physics phantoms are concerned with some of the same issues such as material heterogeneity, but also unique issues such as organ-specific radiation dose from sources distributed in other organs. Readers will be able to use this book to select the appropriate phantom from a vendor at a clinic, to learn from as a student, to choose materials for custom phantom design, to design dynamic features, and as a reference for a variety of applications. Some of the information enclosed is found in other sources, divided especially along the three categories of imaging, therapy, and health physics. To our knowledge, even though professionally, many medical physicists need to bridge the three catagories described above.

This book offers a unique and focused study of the use of ultrasound during the first trimester, a critical time in a fetus' development. It includes basic examination guidelines as well as cutting-edge ultrasound modalities, including Doppler and three-dimensional ultrasound, for the period immediately preceding conception through early embryology. Beginning with a discussion of the safety and efficacy of diagnostic ultrasound and the use of this modality for the evaluation and treatment of infertility, recognized experts in the field explore conditions that may interfere with normal conception or development, including maternal diseases that would benefit from early scanning, elements of teratology, multiple gestations, ectopic pregnancy, gestational trophoblastic disease, fetal anomalies and invasive procedures in the first trimester. Numerous illustrations and figures are provided to serve as aids for understanding key concepts. First-Trimester Ultrasound is a valuable resource for many, in or after training, in obstetrics and gynecology, radiology, emergency medicine, family medicine and genetics.

Over the past twenty years, stress echocardiography has developed into a well-established technique that is versatile, patient friendly, and relatively inexpensive. This new, extensively revised and enlarged edition of Stress Echocardiography documents all of the very significant advances made since the fourth edition. The early chapters place the technique within a historical context and describe its pathophysiological basis. Thereafter, all aspects of stress echocardiography are discussed, clearly and in detail, by the distinguished pioneer, Eugenio Picano, and other contributors carefully selected for their expertise. Both mainstream and emerging applications are explained, and systematic comparisons with competing and complementary cardiac imaging techniques are provided. The text is supported by a large number of high-quality illustrations. This book is invaluable not only to cardiologists but also to non-experts, such as technicians and students.

Quantitative ultrasound (QUS) of bone is a relatively recent research field. The research community is steadily growing, with interdisciplinary branches in acoustics, medical imaging, biomechanics, biomedical engineering, applied mathematics, bone biology and clinical sciences, resulting in significant achievements in new ultrasound technologies to measure bone, as well as models to elucidate the interaction and the propagation of ultrasonic wave in complex bone structures. Hundreds of articles published in specialists journals are accessible from the Web and from electronic libraries. However, no compilation and synthesis of the most recent and significant research exist. The only book on QUS of bone has been published in 1999 at a time when the propagation mechanisms of ultrasound in bone were still largely unknown and the technology was immature. The research community has now reached a critical size, special sessions are organized in major international meetings (e.g., at the World Congress of Biomechanics, the annual meetings of the Acoustical Society of America, International Bone Densitometry Workshop, etc...). Consequently, the time has come for a completely up to date, comprehensive review of the topic. The book will offer the most recent experimental results and theoretical concepts developed so far and is intended for researchers, graduate or undergraduate students, engineers, and clinicians who are involved in the field. The central part of the book covers the physics of ultrasound propagation in bone. Our goal is to give the reader an extensive view of the mathematical and numerical models as an aid to understand the QUS potential and the types of variables that can be determined by QUS in order to characterize bone strength. The propagation of sound in bone is still subject of intensive research. Different models have been proposed (for example, the Biot theory of poroelasticity and the theory of scattering have been used to describe wave propagation in cancellous bone, whereas propagation in cortical bone falls in the scope of guided waves theories). An extensive review of the models has not been published so far. We intend in this book to present in details the models that are used to solve the direct problem and strategies that are currently developed to address the inverse problem. This will include analytical theories and numerical approaches that have grown exponentially in recent years. Most recent experimental findings and technological developments will also be comprehensively reviewed.

A concise introduction to the principles and practice of point-of-care echocardiography for neonatologists Practical Neonatal Echocardiography is based on an acclaimed course that the authors havetaught for the past 15 years at USC training neonatologists in cardiac ultrasound ofneonatal patients for on-the-spot examination and diagnosis. Drs. Siassiand Noori have trained hundreds of physicians to use ultrasound equipment toexamine neonatal cardiac function at the first sign of distress, leading to fasterdiagnosis and referral to pediatric cardiologists for treatment. This book is designed to helpreaders develop the skills necessary to perform a high quality neonatalechocardiographic examination, evaluate cardiac function, and recognizeabnormalities and defects. Practical Neonatal Echocardiography begins with an introduction to the basic principles of echocardiography and the ultrasound scanners commonly used at pediatric cardiac centers. Neonatal cardiac anatomy is clearly described through the use of 2-dimensional images andvideo clips. Subsequent chapters teach the assessment of cardiac function, bloodflow, shunts, physical defects, and abnormalities that may exist in the absence of adefect. Myocardial dysfunction, heart failure, shock, hypertension, cardiomyopathy,cyanosis, and more are discussed in detail with multiple illustrative cases. *Integrated throughout the chapters are 110 video clips, which when looped, will display a beating heart. These real-life cases will help readers hone their skills in recognizing defects in cardiac function and growth.*Covers essential principles of echocardiography with clear descriptions and illustrations*Describes common features of ultrasound scanners and how to use them

The 29th International Symposium on Acoustical Imaging was held in Shonan Village, Kanagawa, Japan, April 15-18, 2007. This interdisciplinary Symposium has been taking place every two years since 1968 and forms a unique forum for advanced research, covering new technologies, developments, methods and theories in all areas of acoustics. In the course of the years the volumes in the Acoustical Imaging Series have developed and become well-known and appreciated reference works. Offering both a broad perspective on the state-of-the-art in the field as well as an in-depth look at its leading edge research, this Volume 29 in the Series contains again an excellent collection of seventy papers presented in nine major categories: (1) Strain Imaging, (2) Biological and Medical Applications, (3) Acoustic Microscopy, (4) Non-Destructive Evaluation and Industrial Applications, (5) Components and Systems, (6) Geophysics and Underwater Imaging, (7) Physics and Mathematics, (8) Medical Image Analysis, (9) FDTD method and Other Numerical Simulations.

This study describes the physical foundations of biomedical engineering and bioinstrumentation in the context of their application to actual instruments. Extensive coverage of sound engineering derivations illustrates underlying principles of clinical instruments, while descriptions and classifications of clinical instruments serve to reduce confusion over the multitude of equipment currently in use. Detailed coverage of transducers and beam patterns is provided, which is essential for an understanding of instrument characteristics. Other topics discussed include the Doppler principle, examined in light of the increasing clinical importance of Doppler flowmeters and imagers, biological tissue types and ultrasonic tissue values based on actual experimental situations such as phased instruments, additional medical uses of ultrasound and safety.

This unique ultrasound atlas is dedicated entirely to pathology of the scrotal contents. The 357 illustrations constitute the major proportion of the book, each of them is accompanied by a labelled diagram and detailed description. The atlas covers the essential embryology and ultrasound anatomy, the principal clinical presentations encountered in practice by the clinician and radiologists, and the differential diagnosis of intrascrotal cysts and calcifications. For each chapter there is a short but precise text, supplemented by tables or decision-making algorithms followed by the relevant images.

Cardiovascular fluid mechanics is now used as a tool in determining diagnosis, treatment, and prognosis by physicians and surgeons working in the fields of cardiology and angiology. The text is based on a considerable amount of clinical and experimental data on blood flow in the heart and large vessels obtained using various methods such as ultrasound pulsed Doppler velocimetry (including Doppler color flow imaging), catheter-tip electromagnetic velocimetry, hot-film anemometry, and laser Doppler velocimetry. The book will introduce medical researchers and clinicians to this rapidly developing field and allow them to apply the knowledge and the methods of fluid mechanics to practical medicine.

Regional anaesthesia is used across specialties within anaesthesia, and is a rapidly growing sub-specialty. This new handbook covers both traditional and ultrasound guided techniques, concentrating on the differences between them. Offering readers a comprehensive overview for clinical practice, it includes paediatric and acute pain applications. Each topic covers anatomy, contraindications, landmark/US settings, technique, complications, and clinical notes. Discrete sections on pharmacology, principles, and training further the book's use for teaching purposes. It will appeal to both trainees and consultants in regional anaesthesia, as well as anaesthetic nurses and anaesthetic practitioners. Presented in the Oxford Specialist Handbook series, it offers practical advice as well as background information in a convenient pocket-sized title.

Echocardiography has now reached its maturity and plays a key role in the clinical assessment of cardiac function. However, its ability to assess myocardial perfusion remains a clinical challenge.

Myocardial contrast echocardiography is a technique that uses microbubbles. These microbubbles remain entirely within the intravascular space and their presence in any myocardial region denotes the status of microvascular perfusion within that region. During the last few years, a large number of research studies have been dedicated to this topic. The latest developments in echocardiographic techniques and second-generation contrast agents allow for the potential assessment of myocardial perfusion and provide an accurate endocardial border delineation.

In the present book, these new echocardiographic techniques dedicated to the assessment of myocardial perfusion are described in detail by experts from both sides of the Atlantic. Tips and tricks are included, explaining the basic concepts that are needed to understand and perform contrast echocardiography.

The opacification of the left ventricle by echo cardiographic contrast agents (echoventriculography) represents an alternative to cineventriculography, as determinations of left ventricular volume and ejection fraction are accurate and highly reproducible, when methods like color superposition and statist- ical imaging techniques are used in order to improve the outlining of the cavity and endocardial border. Detection of perfusion defects is possible [40]. The enhancement of myocardial contrast during the perfusion phase after injection into the left ventricle or the aorta further improves the endo- cardial border delineation. For practical purposes, the direct injection of echocardiographic contrast is inferior to the indirect opacification after per- ipheral venous injection which can be achieved with sonicated albumin, Albunex(R), SH U 508 A, HOE 155. These drugs are presently under clinical investigation. In up to 90% of the patients, left heart opacification is possible, yielding 30% intensity of the right ventricle. When these drugs are available, sophisticated computed methodologies have to be included in the echocardio- graphic machines in order to improve the determination of the left ventricular volume and ejection fraction [44]. In the future, cineventriculography will be rarely performed as echoventriculograms already show left ventricular contraction. This will possibly result in reduced side effects and costs. REFERENCES 1. Gramiak R, Shah PM, Kramer DH. Ultrasound cardiography: Contrast studies in anatomy and function. Radiology 1969; 939. 2. Kronik G, Hutterer B, Mosslacher H. Diagnose atrialer Links-rechts-Shunts mit Hilfe der zweidimensionalen Kontrastechokardiographie. Z Kardiol 1981;70:138-45.

The disorders induced by iodine deficiency affect at least one billion people. Because ofits effects on brain development, iodinedeficiency is the single most preventable cause of mental retardation in the world. Therefore, the United Nations and the Heads of State of almost all the world's countries represented at the Summit for Children in 1990 adopted resolutions to eradicate the disorders induced by iodine deficiency (IDD) by the year 2000. For geological and socio-economic reasons, most of the populations affected by iodine deficiency disorders live in isolated and usually mountainous areas, in pre industrialized parts ofthe world. The problem of iodine deficiency in Europe has been greatly underestimated in the last decades. After the remarkable studies on the effects of iodine deficiency and their prevention and correction in Switzerland, IDD was generally considered no longer a significant public health problem in Europe. However, surveys carried out in the early 1980's under the auspices of the European Thyroid Association, clearly demonstrated the persistence of moderately or even severely affected areas. These surveys also highlighted the lack ofinformation about large parts ofEurope, especially its eastern part. It is only quite recently, following major changes in international relations and thanks to the support of UNICEF, WHO, the International Council for the Control of Iodine Deficiency Disorders and the European Thyroid Association, that more extensive surveys have been conducted in several parts of Europe hitherto almost unexplored. These surveys showed that most European countries were iodine deficient."

The origin ofthe International Acoustical Imaging Symposium series can be traced to 1967, when a meeting on acoustical holography was held in C alifornia. In those days, acoustical holography was at the leading edge of research but, as the importance of this subject waned, so the title of the series was changed from Acoustical Holography to Acoustical Imaging in 1978. The early Symposia were held at various venues in the United States. In 1980. the series became international, with the Symposium that year taking place in Cannes in France. The pattern now is to try to met alternately in the USA and in another part of the world so that active researchers everywhere can conveniently attend at a reasonably high frequency. It was a great privilege for us in Bristol in the United Kingdom to be chosen to host the 25th Symposium, which convened on 19 March 2000 and spread over four days. We were blessed not only by good weather, but also by the attendance ofnearly 100 pa rticipants who came from 17 c ountries. A large number of papers were accepted for presentation, either orally or as posters. Whether an oral presentation or a poster, all were considered to have equal merit, and no distinction is made between them in the published proceedings. There were no parallel sessions, so every participant could attend every presentation. The re sultant disciplinary cross fertilisation maintained the t radition of past Symposia.

There are many human cancers which actively synthesize specific characteristic proteins such as melanomas, thyroid cancer and squamous cell carcinoma. Many cancer researchers have of course tried to utilize this specific activity as a key for the selective treatment of cancers. In the past for example, the molecular hybrid compound of DOPA, a substrate of melanin, and nitrogen mustard N-oxide hydrochloride, a ctyotoxic anti-tumor drug, was synthesized as Melphalan and used to treat malignant melanoma. A major problem arose though in that it was soon found to be highly suppressive toward bone marrow and quite toxic while not being remarkably effective. Thus, malignant melanoma could not be cured by it. Such failure led us to develop a novel bimodal therapeutic system which includes the use of non-toxic potentially cytocidal chemicals which selectively accumulate within the cancer cells and which are converted by a controllable modality into an actively cytocidal element in situ. We can now non-surgically cure malignant melanoma and glioblastoma with our selective cancer treatment, neutron capture therapy (NCT); as can be found in this volume. Included are 124 papers on the latest breaking developments discussed at the Sixth International Symposium on NCT for Cancer held in Kobe during the late autumn of 1994.

Marking the 200th National Meeting of the American Chemical Society, The Division of Nuclear Chemistry and Technology hosted a group of about 90 scientists from 15 different countries to discuss the new trends in radiopharmaceutical synthesis, quality assurance and regulatory control. This event took place in Washington, D.C. on August 27-30, 1990. When I first suggested the idea for this symposium, a group of scientists who pioneered the proposed topics offered their help to organize and run such a big task with me. Their names are listed here in appreciation. Thomas E. Boothe Cyclotron Facility, Mt. Sinai Medical Center, Miami Beach, Florida, USA Robert F. Dannals Division of Nuclear Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA Anthony L. Feliu Julich Nuclear Research Center, Julich, Germany Joanna S. Fowler Chemistry Department, Brookhaven National Laboratory, Upton, New York, USA George W. Kabalka Department of Chemistry, University of Tennessee, Knoxville, Tennessee, USA Hank F. Kung Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA James F. Lamb Imagents, Inc., Houston, Texas, USA Harold A. O'Brien, Jr. Los Alamos National Laboratory, Los Alamos, New Mexico, USA Joseph R. Peterson Dept. of Chemistry, University of Tennessee, Knoxville, Tennessee, USA Hernan Vera Ruiz International Atomic Energy Agency, Vienna, Austria Roy S. Tilbury University of Texas, M. D. Anderson Cancer Center, Houston, Texas, USA In addition, a number of distinguished colleagues have participated in the process of reviewing the manuscripts presented in this volume. Their effort is sincerely acknowledged.

Diagnostic and Therapeutic Ultrasound has recently taken an explosive growth for better safer, economic, mobile and high quality healthcare. This technology is very appealing for medical applications because it is non-ionizing, non-invasive and it is available in most of the medical and clinical facilities. Its low cost, when compared with other medical image modalities, makes it one of the preferred tools for medical monitoring, follow-up and diagnosis. Besides the traditional fields of Cardiology and Obstetrics, where it is extensively used for long time, it has became also very useful in the diagnosis of diseases of the prostate, liver and coronaries and carotids atherosclerosis. However, Ultrasound images present poor quality, very low signal to noise ratio and a lot of artifacts. The extraction of useful information from Ultrasound data for diagnosis is a challenge task that makes this medical image modality a very active field of research. The difficulties are being overcome and novel and advanced methods are being proposed for detection, characterization and segmentation of abnormalities in several organs. In fact, Ultrasound application range is vast, covering almost all organs of the human body, including the brain where Tran-cranial Doppler Ultrasound is very important to assess the brain vasculature. This book presents some of the recent advances in Ultrasound imaging technology covering several organs and techniques in a Biomedical Engineering (BME) perspective. The focus of the book is in the algorithms, methodologies and systems developed by multidisciplinary research teams of engineers and physicians for Computer-Aided Diagnosis (CAD) purposes. Cardiovascular and Cancer, the most common life-threatening diseases in western countries, are two of the most important topics focused in the book. However, other advanced issues are also presented such as Intravascular Ultrasound, 3D US and Ultrasound in Computer-Aided Surgery (CAS). Some chapters are direct contributions from medical research groups where Ultrasound has also received great attention in the last decade. By this, new techniques based on Ultrasound were introduced in the clinical practice for diagnosis and therapeutics, mainly in hospital facilities.

General Section. Progress in laparoscopy (new instruments, technical innovations, integration between laparoscopy and sonography). Special Section. Traditional and present indications for laparoscopy. Laparoscopy inliver diseases. Oncological lapaoscopy (diagnosis, staging and follow-up for malignant tumors). Emergency laparoscopy.

Renal sonography forms a basic part of routine diagnostic strategy. This textbook summarizes eighteen years of experience in diagnostic ultrasound. We want it to serve as a guide to both imagers and mere consumers of information. That is why we shall emphasize practical advice and diagnostic pitfalls; it is also why we shall often deal with the relations of sonography with other diagnostic procedures, which it may complement or replace, precede or follow, the purpose being to achieve efficiency at low cost. We shall limit our subject matter to the kidney itself and the neighboring retroperitoneal compartments, dealing only briefly with the lower urinary tract, which requires specialized procedures. We devoted considerable space to renal sonography in our book Clinical Atlas of Ultrasonic Radiography, published in 1973. Since then, nothing has changed and everything has changed. Nothing, because even then the differential diagnosis between a solid and a cystic mass, the etiologic diagnosis of a nonsecreting kidney, and the positive diagnosis of a traumatic juxtarenal hematoma were quite reliable, making possible drastic reductions in the indications for instrumental roentgenologic examinations. Everything, be cause improved resolution and grey scale imaging (already partially achieved in 1973, thanks to real time) have profoundly refined both anatomic and pathologic ultrasonic studies. And now high resolution real time imaging has revolutionized renal examination techniques, whereas Doppler is entering routine ultrasonic diagnosis."

There are two major reasons for having this symposium. First, Tohoku Univer sity is the place where ultrasound investigations in Japan originated. Starting from the research studies of Professors H. Nukiyama and Y. Kikuchi of To hoku University, Professor J. Saneyoshi of Tokyo Institute of Technology, and Dr. K. Kato of Osaka University - all graduates of Tohoku University - the results spread to all parts of Japan. More recently we have had acoustic macro scopic studies by researchers like Professor N. Chubachi. As regards tissue char acterization, which was the main theme of the symposium, the collaboration among research workers in Japan and the United States started 10 years ago between Professor F. Dunn of the University of Illinois and staff members of Tohoku University and the Tokyo Institute of Technology. So this conference commemorates the lOth anniversary of that joint research effort. The second reason for this conference is that the application of ultrasound has become wide spread and indispensable in the routine clinical activities of medicine. But there have not been many breakthroughs in terms of quantitative and qualitative measurement of the living body tissues. Also, there are many problems with regard to practical application. There are various points that have not been elucidated yet as to the physical and acoustical characteristics of ultrasound itself. The methodology has not in all cases been well established. Therefore, the scientific elucidation of these areas is essential.

Digital radiography is a general term describing any projection radiological system in which the image exists in digital form at some stage between acquisition and viewing. In an earlier form, radiographic films were dig itized in an attempt to enhance and redisplay information of interest. The field has evolved to its current state, in which X-ray signals are detected electronically, converted to digital form, and processed prior to being recorded and displayed. A primary goal of digital radiography is the re moval of interfering effects from secondary structures in an image, so that clinically significant details can be displayed with enhanced visibility. The achievement of this goal involves many parameters, including con trast agents, subtraction techniques, processing techniques, filtering tech niques, system noise, and quantitative aspects. It is the purpose of this book to present material by noted individuals in the field covering several of the above topics. The authors acknowledge the secretarial and editorial assistance of Mrs. Helen Taylor and the editorial assistance of Mrs. Ruth McDevitt. James G. Kereiakes Stephen R. Thomas Cincinnati, Ohio Colin G. Orton Detroit, Michigan ix Contents 1. DIGITAL RADIOGRAPHY: OVERVIEW B. A. Arnold, 1. G. Kereiakes, and S. R. Thomas 1. Introduction . . . . . . . . . 1 2. Point-Scanned Detector Systems 3 3. Line-Scanned Detector Systems 4 4. Area Detector Systems 5 4.1. Stimulable Phosphors 5 4.2. Selenium Detectors ."

Despite the many advances made in the diagnosis and therapy of cancer, the mortality rate is still about half that of the incidence rate. However, the odds are not evenly distributed. Prognosis for some cancers is good, but for others, few patients will survive 12 months. This latter group of cancers is characterised by a proclivity to disseminate malignant cells in the host organ. The degree of surgery possible may be limited by the critical nature of the organ, and chemotherapy and radiotherapy are of palliative value only. In some cases systemic metastases occur, but in other cases, failure to achieve local control results in death. First among these cancers are the high grade brain tumours, astrocytoma 3,4 and glioblastoma multiforme. Local control of these tumours should lead to cure. Other cancers melanoma metastatic to the brain, for which a useful palliative therapy is not yet available, and pancreatic cancer for which localised control at an early stage could bring about improved prognosis. Patients with these cancers have little grounds for hope. Our primary objective is to reverse this situation with Neutron Capture Therapy (NCT). The purpose of this fourth symposium is to hasten the day whereby patients with these cancers can reasonably hope for substantial remissions. The first symposium on NCT was held in Boston in 1983, followed by Tokyo in 1985 and Bremen, Germany in 1988.

An international meeting of experts on Cardiovascular Imaging by Ultrasound was held in Aachen from 26-27 April, 1991. It provided new and interesting insights into what has already been achieved in ultrasound-based cardiovascular diagnosis and therapy and what will be introduced in clinical practice in the near future. Since the introduction of ultrasound in clinical practice in 1984 there has been no other physical principle that has added and will continue to add so much to clinical diagnosis and therapy. Echocardiography, once established as a non-invasive diagnostic tool, is increasingly becoming an invasive technique for cardiovascular imaging. This book contains the edited contributions from 38 scientists and engineers from all over the world who presented the most up-to-date findings on 2-dimensional echocardiography, different Doppler modalities, contrast and stress echocardiography and the different modalities of transesophageal echocardiography, including mono-, bi- and multiplane TEE, as well as pulsed and CW-Doppler application via TEE. Exciting and promising developments are discussed in the field of intravascular ultrasound, tissue characterization, ultrasound ablation, ultrasound-based 3-dimensional reconstruction of the heart, and high frequency Doppler analysis.

It is now 150 years ago, on 25th May 1842, that the son of a Salzburg ston emason presented a scientific work "On the coloured light of the double stars and certain other heavenly bodies" at a meeting of the Royal Bo hemian Society of Sciences held in Prague. Christian Andreas Doppler, then professor at the Prague Technical Institute, set a milestone in scien tific history in the meeting room of the Royal Society in the Charles Uni versity, just a few meters from the National Theatre where another genius from Salzburg, Wolfgang Amadeus Mozart, had celebrated his musical triumph with the premiere of his opera Don Giovanni fifty-five years earlier. Doppler's lecture set out in brilliant simplicity what we now call the Doppler principle, which since has found numerous uses in astronomy, which was of primary interest to Christian Doppler. In addition, it has found countless practical applications in physics, navigation, aeronautics, geodesy, medicine, science and technology. In medicine alone, Doppler sonography is now an established diagnostic procedure in the fields of childbirth, cardiology and diseases of the blood vessels, neurology, neuro surgery and vascular surgery, and is continually finding new medical appli cations in today's world of high technology."