Neuroimaging

Preface
Neuroimaging

Laszlo L. Mechtler, MD, FAAN, FEAN, FASN

Editor

With its disciplined process of relating lesion visualization to symptoms, neuroimaging

is central to neurology and used by most of its subspecialties. Neurologists possess
unique insights into the appropriate use of imaging and are well positioned to
contribute important advances in neurodiagnostics. For these reasons, an understand-
ing of neuroimaging makes us better neurologists. Neurologists who make urgent
point-of-care decisions are particularly inclined to interpret directly from images; ex-
amples include neurohospitalists, stroke specialists, critical care neurologists, inter-
ventional neurologists, neurooncologists, and practitioners who use teleneurology.
Advances in the burgeoning field of functional neuroimaging require a greater depth
of neuroscience training and will certainly benefit from the active involvement of clinical
and research neurologists who are also trained in neuroimaging. I hope to see in the
future the establishment of efficient multidisciplinary “neuro” departments that merge
neurology, neurosurgery, clinical neurophysiology, neuroradiology, nuclear neurology,
and neurorehabilitation, according to which the equipment would be purchased and
run on a service basis. This arrangement would optimize patient care, improve training,
and expand opportunities for research. The evolution of anatomic and especially func-
tional neuroimaging will dictate the need for neurologists to be sitting at the same table
as our esteemed neuroradiology colleagues.
To achieve any success in neuroimaging training efforts, a healthy respect for the
complexity of imaging technology is needed that encompasses recognizing how arti-
facts can mimic pathology, understanding how certain techniques can mask or high-
light pathology, and learning the process for unbiased interpretation of images while
concisely addressing the clinical question. Experienced neuroimagers find the mix of
clinical neurology and imaging to be fulfilling and believe that such an integrated career
can be an incentive for medical students to choose neurology as a specialty. Given the
predictions of a dangerous shortfall in the US neurology workforce, this lure should not
be taken lightly.

Neurol Clin 38 (2020) xi–xii

https://doi.org/10.1016/j.ncl.2019.10.001 neurologic.theclinics.com
0733-8619/20/ª 2019 Published by Elsevier Inc.
xii Preface

As the editor of 2 previous issues on neuroimaging in Neurologic Clinics, I would like

to thank Dr Randolph Evans for bestowing and entrusting me with another.. Either Dr
Evans believes in me or he is hoping I’ll get it right the third time. I would like to thank
Donald Mumford, developmental editor of Neurologic Clinics at Elsevier, for his sup-
port of the field of neuroimaging. I am indebted to all the authors who contributed their
time and efforts to this issue. I would also like to thank my executive assistant,
Amanda McFayden, for her tireless help in organizing and coordinating this issue.
In my first issue, I thanked my family; in the second issue, I thanked my parents, and
now I would like to acknowledge the great neuroimaging minds that have taught and
guided me in my 35-year career as a neuroimaging neurologist. This includes Drs
William Kinkel, Jack Greenberg, Lawrence Jacobs, Joseph Masdeu, Vernice Bates,
and Joseph Fritz. I can only hope that I have shared that knowledge with the scores
of neurologists, fellows, residents, and students that have trained at the DENT
Neurologic Institute and at annual meetings of the American Academy of Neurology
and the American Society of Neuroimaging, the latter of which I am proud to have
served as President.
It is my hope that you enjoy reading the latest neuroimaging issue of Neurologic
Clinics as much as we enjoyed putting it together for you.

Laszlo L. Mechtler, MD, FAAN, FEAN, FASN

Dent Neurologic Institute
Roswell Park
Comprehensive Cancer Center
State University of
New York at Buffalo
3980 Sheridan Drive
Buffalo, NY 14226, USA
E-mail address:
lmechtler@dentinstitute.com