Light up your life

Although I am obviously biased, medical physics is, I believe, an exciting subject. This was illustrated by this year's Nobel prize award in physiology or medicine for the development of (nuclear) magnetic resonance imaging (MRI), deservedly given to Paul Lauterbur and Sir Peter Mansfield.

Unfortunately, this textbook fails to convey the cutting edge, the rapidity and the importance of developments in this field. It is aimed at "premedical students, allied health students... and students not majoring in natural science". It is intended to give a flavour of the subject to students who need to know something about it.

However, the book is not without mathematical equations (in fact, they are one of the better aspects of the book). In addition, it contains an extensive series of self-assessment questions, some quite testing, at the end of each chapter.

In a total of 319 pages, the author covers mostly imaging topics such as lasers, ultrasound imaging, conventional radiology and computerised tomography (CT), radioisotope imaging, radiotherapy (and radiation protection) and, finally, MRI. But, for obvious reasons, many topics have been omitted. They include electrocardiograms (ECG), imaging techniques such as magneto-encephalography (MEG); molecular imaging and small animal scanning, devices such as cochlear implants; and networking projects such as telemedicine.

When radiologists were questioned about the value of CT scanning in the early 1970s, they replied almost uniformly that it was of no interest, yet the technique is now considered basic and of fundamental importance - hence the 1979 Nobel prize for Allan Cormack and Godfrey Hounsfield. Then, as in this year, questions were raised about the appropriateness of the choice of Nobel laureates.

So what do I find disappointing? The clinical illustrations are out of date and are embarrassingly poor in terms of image quality. There are extensive references, but these are also badly out of date, with few up-to-date citations.

There are references to recent developments, such as 3D ultrasound, spiral (multi-slice) CT, conformal radiotherapy, computer-aided (robot) surgery, and so on, but these are brief. The text is illustrated with many diagrams, to attempt to explain some of the methodology but, in many cases, had I not been familiar with the method described, I would have found many of them unhelpful.

My main criticism is not the oversimplification of the matter presented, perhaps necessary in view of the intended audience, but its failure to convey the excitement of the rapid important progress in a subject that, in my view, is in the process of changing medical practice.

Andrew Todd-Pokropek is professor of medical physics and bioengineering, University College London.