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Book Review |
Wake Forest University Health Sciences
Winston-Salem, NC
27157-1088
Edited by Steve Halligan and Helen M. Fenlon. New York, NY: Marcel Dekker,
Inc., 438 pp., 2004. $175.00
As is true of most multiauthored texts, the writing style and format of individual chapters are not uniform, although the editors, Drs. Halligan and Fenlon, both of the United Kingdom, have striven to ensure that the flow of the material is reasonably consonant. Each chapter includes an in-depth discussion of technique, individual imaging protocols, or underlying physical principles, when appropriate, and a discussion of normal and disease findings. In general, the text emphasizes clinically pertinent information rather than experimental data and reviews the common findings of less commonly used diagnostic studies and interventional techniques.
The book begins with short, but concise, chapters reviewing CT and MR colonography. Issues of polyp size detection, radiation exposure, and pitfalls of detection are discussed in relation to CT colonography, whereas the discussion of MR colonography emphasizes bright lumen and dark lumen colonography techniques. The diagnostic accuracies of both techniques are presented.
Next, the book continues with three chapters on the evaluation of the liver, one each devoted to MRI, microbubble contrast-enhanced sonography, and MDCT. All three chapters begin with pertinent technique recommendations. The discussions of disease are organized along the now familiar line separating diseases into focal and diffuse presentations. Although all three chapters are contemporary and well written, the chapter on MRI of the liver is particularly well organized and richly referenced. The discussion of MDCT of the liver nicely delineates issues of contrast enhancement physiology and slice thickness. The discussion of microbubble-enhanced sonography is excellent, although it emphasizes physical principles proportionately more than imaging findings compared with the other chapters, which probably relates to the relatively greater overall available general experience with CT and MRI of the liver.
Next, the book continues with four chapters that could be considered loosely as related to evaluation of the gastrointestinal tract, especially the small bowel. These chapters begin with a discussion of MDCT angiography of the hepatic and mesenteric vasculature, which begins with a simple review of technique and is well illustrated with ample reformatted and volume-rendered images. This chapter is followed by a well-referenced discussion of PET of the gastrointestinal tract, emphasizing esophageal cancer, and includes a limited discussion of PET of colorectal and pancreatic cancer as well as of hepatic tumors and inflammatory bowel disease. No PET/CT images are included in this chapter, which is unfortunate but is not an intrusive disadvantage.
After the chapters related to the gastrointestinal tract are two chapters addressing the evaluation of small-bowel disease using MRI and CT. The discussion of MRI enterography contains a succinct review of methodology and is nicely illustrated. Unfortunately, in the middle of this chapter are color plates of images from microbubble-enhanced sonography evaluation of the liver, which is confusing and seems out of place. The concluding chapter in this group discusses CT enterography and is, likewise, illustrated well. The figure caption for figure 1 in this chapter is erroneous, but this is a minor complaint. Both chapters emphasize the great potential contribution to the evaluation of small-bowel disorders using both CT and MRI through an analysis of extraenteric findings and evaluation of the bowel wall directly.
Finally, the book continues with six chapters exhibiting no particular overall relationship to one another and consisting of both diagnostic evaluation and interventional treatments. The initial chapter of this group discusses radiofrequency ablation of liver disease. It begins with a treatment of the three main devices currently available, continues with a short discussion of the utility of radiofrequency ablation in primary and secondary liver disease, and concludes with remarks about procedural considerations and complications. This chapter is followed by a discussion of endoscopic sonography, which is an interesting presentation of details of endoscopic sonography likely not familiar to most radiologists because this technique is most commonly performed in North America by gastroenterologists. The chapter is a well-referenced and well-illustrated presentation, although the author, a member of a radiology department, is a strong advocate of endoscopic sonography evaluation of the proximal gastrointestinal tract in comparison with CT and MRI.
The next chapter is a discussion of the imaging of rectal cancer, which nicely directs attention to the importance of sonography or MRI in localized evaluation of the rectum, especially the evaluation of the relationship of a tumor to the mesorectal fascia, and the utility of imaging in this assessment. Illustrations in this chapter are excellent. This chapter is followed by an interesting discussion of the placement of self-expanding metal colonic stents that, however, like endoscopic sonography, is probably a technique primarily used by nonradiologists in North America. The next chapter is a discussion of imaging of the anal canal, and, as with rectal cancer imaging, intracavitary sonography and MRI are properly emphasized. The illustrations, drawings, and discussion are excellent, although there are minor errors in the captions for figures 3 and 6.
Finally, a chapter on dynamic imaging of the pelvic floor concludes the text. Unfortunately, although the illustrations of cystoproctography are fine, the MRI illustrations in this chapter are probably older because they are suboptimal, although they do show the findings described. However, the discussion of pelvic floor abnormalities is excellent.
The salient feature of the design of this textbook is that it is a composite of loosely related chapters about topical subjects of new interest in radiology. Therefore, it is not an exhaustive treatise of one subject. To some readers, this might appear disjointed or incoherent, whereas to others it might appear selective and yet inclusive. This very design, however, means that there are few, if any, competing texts. Because it is a selected survey of a variety of subjects, this book probably would be most useful to radiologists in practice with body imaging responsibilities trying to ensure their understanding of these selected topics is up-to-date.
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