MTF is the magnitude of the Optical Transfer Function, which is the Fourier Transform of the Point Spread Function.
The PSF is itself the square magnitude of the Fourier Transform of the complex pupil function. With incoherent light, virtually always true in photography, we don't see phase in the PSF because the waves coming from the lens keep smashing into the sensing plane during exposure time and so their phase relationship is lost. Therefore the PSF is always made up of only real, as opposed to complex, intensity as we all know. (Incidentally, this implies Hermitian Symmetry: negative frequencies of MTFs are a mirror image of positive ones).
The FT of the PSF, however, is typically complex, giving rise to phase components in the Spectrum. In fact we can express the OTF in complex notation as a magnitude (MTF) multiplied by a phase component referred to as the Phase Transfer Function: OTF = MTF * PTF. We can estimate both quantities in the System OTF using the slanted edge method.
When the PTF is locally zero (e.g. unaberrated lens with circular aperture), clearly OTF = MTF.
When it is not it can be either linear or non-linear. A linear PTF simply moves the image around (e.g. Tilt, geometric distortion). Non-linear phase instead blurs the image (e.g. Spherical, Coma, Astigmatism, Field Curvature, etc.).
Using the Transfer Function framework, System OTF is the product of the OTF of the individual components of the system (e.g. Lens * Pixel aperture). The OTF will generally be real with no PTF if both components are real.
The OTF of a component of an imaging system is only real if the relative PSF is a centrally symmetric even function (i.e. PSF(x,y) = PSF(-x,-y). Examples of even functions are an Airy function and a square pixel aperture.
I hope this clarifies why comments about MTF are often qualified by the addition of 'ignoring phase'. Where sharpness is concerned it might as well be 'ignoring non-linear phase components'.
Thoughts, additions, deletions?