Foreword

As the wealth of laboratory and clinical research in cancer takes us beyond today's practice into the new paradigm for 21st century medicine in which malignant disease will be detected much earlier, where tumors will be genotypically profiled and factors influential in phenotype will become known, and where treatments will be targeted according to abnormalities in specific molecular pathways and directed to eradication of small volume disease using highly sophisticated surgical and radiotherapy techniques, so medical imaging will take center stage. Thus we are at the dawn of a new era in medicine and the vision of imaging in this new era has been captured by Drs. Padhani and Choyke in their book New Techniques in Oncologic Imaging.

The goal of cancer imaging is to provide a detailed portrait of a tumor by combining exquisite morphological information with pathophysiological and metabolic measurements. The elegant anatomical detail provided by three-dimensional, multi-slice computed tomography (CT) is likely to continue as the mainstay for providing morphological information on the presence and extent of tumor, tumor volume, and anatomic relationships. Morphological information provided by magnetic resonance imaging (MRI) surpasses CT in well-defined anatomical sites and in the evaluation of specific tumors, so the role of MRI in this context continues to evolve. However, the fundamental requirement remains—the need to provide detailed morphological information about relevant biological processes including angiogenesis, hypoxia, apoptosis, cellular membrane integrity, necrosis, and other malignancy specific processes. Based on these parameters, clinicians will be able to make more precise management decisions noninvasively, thereby fine-tuning cancer therapy whether it be with targeted drugs, surgery, or radiotherapy. Such developments in imaging will also allow new therapies to be developed such as robotic surgical procedures and focused physical therapies.

This text is aimed at those who are or wish to be engaged in advanced imaging including scientists, physicists, chemists, biologists; radiologists, and clinicians—all of whom have an increasing need for the latest information on advances in cancer imaging techniques that will underpin much of the future developments in clinical practice.

Drs. Padhani and Choyke have recognized and responded to this exciting challenge in New Techniques in Oncologic Imaging. A major advantage of this text is that the editors have brought together state-of-the-art evidence in all the different imaging modalities being applied to cancer research and, in so doing, have provided a comprehensive review of the whole field of morphological and functional measurement of tumors. This text will not only allow those focused on one aspect of research to acquaint themselves with progress in other modalities, but will set the scene for functional imaging to be viewed as a whole rather than as a topic of measurement confined to one modality. At this time of staggering advances in imaging, this approach provides an outstanding contribution to medical literature. Surely this will guide and inform future clinical practice, which will be based on integrated morphology, pathophysiological, and metabolic information rather than being confined to measurement provided by a single technique.

Drs. Padhani and Choyke are both outstanding experts in cancer imaging who have contributed individually to the growing body of literature in the field of functional imaging. They have brought their expertise and experience together in New Techniques in Oncologic Imaging, and have recruited a superb team of experts from many different fields of cancer imaging from the United States and Europe. The text covers ultrasound, CT, magnetic resonance, nuclear medicine, and positron emission tomography, and looks to the future with reviews on electron spin resonance, optical imaging, and bioluminescence.

The important issue of image processing, central to the development and effective use of modern imaging, is also appropriately considered. The editors are to be congratulated for their vision and commitment in bringing this exciting project to fruition.

Janet E. Husband, OBE. FMedSci, FRCP, FRCR

Professor of Diagnostic Radiology Royal Marsden NHS Foundation Trust President, Royal College of Radiologists

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