Fundamentals of Medical Imaging

Citation

Suetens, P. (2017). Fundamentals of Medical Imaging (3rd ed.). Cambridge University Press.

Chapter Summary

The book has eight chapters in about 250 pages, followed by a short "Further Reading" section and an index. The structure is stated in the publisher's description: an introductory chapter on digital image processing, then one chapter for each of five imaging modalities, then two chapters on image computing and visualization. Per the publisher, each modality chapter covers the basic physics and interaction with tissue, the image reconstruction process, image quality, modern equipment, clinical applications, and biological effects and safety.

Chapter 1: Introduction to Digital Image Processing

A short opening chapter (14 pages) on digital image processing, placed ahead of the modalities, as the publisher's description states.

Chapter 2: Radiography

An 18-page chapter on projection X-ray imaging, following the common modality pattern of physics, image formation, image quality, equipment, clinical use and safety.

Chapter 3: X-ray Computed Tomography

A 38-page chapter on computed tomography. Reconstruction of an image from projections, central to CT, reappears in the nuclear medicine chapter.

Chapter 4: Magnetic Resonance Imaging

The longest chapter (49 pages). It opens with a short history of NMR and MRI, then states that a complete account of nuclear magnetic resonance needs quantum electrodynamics, which is beyond the book's scope, and instead gives a simplified account based on classical and quantum mechanics. It starts from the behaviour of a single particle with angular momentum and a magnetic moment in an external field, then moves to bulk matter.

Chapter 5: Nuclear Medicine Imaging

Begins with the history of radionuclide imaging, from the rectilinear scanner to the Anger scintillation camera, and relates tomographic reconstruction here to X-ray CT. It introduces single photon emission computed tomography (SPECT) and positron emission tomography (PET), the latter detecting pairs of photons.

Chapter 6: Ultrasound Imaging

Explains the pulse-echo principle (partial reflection at tissue interfaces, timed to locate tissue) and the other phenomena of sound propagation: diffraction, refraction, attenuation, dispersion and scattering. It also covers Doppler imaging of blood and myocardial velocities, with a historical introduction.

Chapter 7: Medical Image Computing

Motivates computer assistance by the growing number of images per case and the demand for objective, quantitative information, with radiotherapy planning and neurological disease as examples. It points out that 3D visualization needs filtered and sparse data, which implies intelligent preprocessing of the images. The chapter opens with the radiotherapy example of delineating the irradiation volume and neighbouring organs at risk.

Chapter 8: Visualization for Diagnosis and Therapy

Presents clinically relevant visualization methods, from resliced and 3D displays to computer-assisted intervention, in which preoperative images are used for planning and registered to the patient in the operating room. Stereotactic brain surgery is described as the pioneering application.

Key Concepts

Chapters 1–3: Image processing and X-ray imaging

• Digital image processing: the common foundation for all modalities.
• Projection imaging and tomographic reconstruction: forming images from X-ray transmission data.

Chapters 4–6: Magnetic resonance, nuclear medicine and ultrasound

• Nuclear magnetic resonance: spin angular momentum and magnetic moment in an external magnetic field, treated with simplified classical and quantum arguments.
• SPECT and PET: tomography of radionuclide distributions, the latter using photon pairs.
• Pulse-echo and Doppler ultrasound: timing of echoes for position, frequency shift for velocity.
• Image quality and safety: discussed within each modality chapter.

Chapters 7–8: Image computing and visualization

• Quantitative image analysis: objective measurements from images to relieve and support the radiologist.
• 3D visualization: displaying volumes beyond slice-by-slice viewing.
• Computer-assisted intervention: planning and guiding surgery from preoperative images.

Critical Analysis

Strengths

• Stated audience and level. The preface says the book is a course text for graduate and final-year undergraduate students with a background in physics, mathematics or engineering, and that mathematical proofs and details sit in separate paragraphs that can be skipped without losing the thread. The author also states an effort to make the text readable for biomedical scientists and medical practitioners.
• Computing the image is the focus. According to the preface, the emphasis is always on how the image is computed, while equipment design, clinical considerations and diagnosis get less space. This makes the book a coherent introduction to image formation across modalities.
• Covers acquisition and image computing together. After the five modalities, two chapters treat image computing and visualization for diagnosis, therapy and surgery.
• Illustrations and media. The preface refers to about 400 colour illustrations and 80 video clips. A review of the second edition in the Journal of Nuclear Medicine (2010, Tinsu Pan) recommended the book highly for imaging scientists and noted the coherent presentation of each modality.

Limitations

• Concise by design. At about 250 pages for five modality chapters and three others, each modality gets a compact treatment (for example 18 pages for radiography). The preface says the text reflects a 30-hour module and contains more material than that.
• Not a certification text. The Journal of Nuclear Medicine review of the second edition said the book may not be ideal for readers seeking radiology or medical physics board certification, since it concentrates on developing imaging devices. The preface also says equipment design and clinical diagnosis are treated in less detail.
• No exercises or appendix in the contents list. The contents list for this edition shows eight chapters, Further Reading and an index. The second edition had appendices on linear system theory and exercises and a companion website, so check whether comparable material is available for the third edition before relying on it for problem practice.

Where It Fits in the Course

Suetens is the shorter, heavily illustrated survey of the five modalities, at about 250 pages against roughly 500 for Prince and Links. Prince and Links's Medical Imaging Signals and Systems gives the same five modalities a parallel signals-and-systems treatment with a long mathematical foundation in its first part, and suits students who have already had a signals and systems course. Suetens's preface sets mathematical proofs in separate paragraphs that can be skipped, whereas the Prince and Links preface expects prior signals and systems and elementary probability, so Suetens is the lighter route for a first pass.

Smith and Webb's Introduction to Medical Imaging is a more compact introduction to the main clinical modalities, and Wolbarst and colleagues' Medical Imaging: Essentials for Physicians explains the physics conceptually for users of images. At the other end, The Essential Physics of Medical Imaging is a comprehensive reference aimed at radiology residents and medical physicists, and Barrett and Myers's Foundations of Image Science is a graduate treatment of imaging mathematics and image-quality assessment. Suetens sits between the introductions and these references.

How to Use This Book

Start with the preface and Chapter 1, then read the modality chapters in order or by need. Radiography and CT (Chapters 2–3) introduce projection and reconstruction, which help in understanding nuclear medicine imaging (Chapter 5); MRI (Chapter 4) is the longest chapter and its physics draws on both classical and quantum arguments, so it can be read after the others. Chapters 7 and 8 suit students heading toward image analysis, computer-assisted surgery or radiotherapy planning, and can be read after any one modality chapter.

Treat the highlighted mathematical details as optional on a first pass and return to them when preparing for a course exam or a project. Because the contents list shows no exercises section, pair the text with problems from the instructor or from a signals-oriented text such as Prince and Links, and use the Further Reading section to go deeper into one modality.