518 CLINICAL RADIOLOGY

Book Reviews

Handbook of Neurotological Diagnosis. Edited by J. W. House and A. Fitzgerald-O'Connor. Dekker, New York, 1987. 432 pp., 162 figs. $79.75 (USA & Can.), $95.50 (all other countries).

The stated aim of this co-operative endeavour between scientists from the United States and Europe is to provide the reader with a broad knowledge of the recent developments in the rapidly advancing field of neurotology and to provide instructional reference for specific areas of neurotological evaluation and diagnosis. The volume covers physical examination, neurological evaluation, audiology, radiology, metabolic aspects of neurotology, immune problems, electronystag- mography and facial nerve disorders.

It is intended primarily for the clinician, especially the otolaryngol- ogist and neuro-otologist but contains a large section (112 pages) devoted to radiology. This is presented in two chapters: one on general tomography in the neurotological patient and the other on CT of the petrous bone and posterior fossa. Both are excellent up-to-date accounts of their subject. The first of these by Dr Peter Phelps is especially recommended as a concise and authoritative account of the radiological investigation of the petrous bone in all its aspects.

The work is richly illustrated with fine line anatomical drawings, clear photographs and well reproduced CT scans and radiographs. It achieves its purpose and is recommended to those radiologists inter- ested in otoradiology. It should also be acquired for the hospital library so that the general radiologist may have access to it.

G. A. S. Lloyd

Practical CT. Technology and Techniques. By L. L. Berland. Raven, New York, 1986. 285 pp., 138 figs. $34.

This is an amazingly readable book about the physics, principles and techniques of CT. Amazing because the topic is not very close to the heart of most practising radiologists. Yet the facts contained within this book are presented in a pleasing form and can be easily assimil- ated. The author is obviously closely involved with day-to-day CT and he is clearly blessed by being well integrated with both clinicians and experts in physics. Certainly he covers most, if not all, of the problems encountered in a modern CT unit. There is even-handed discussion about the pros and cons of all the major manufacturers. In the section on selecting equipment discussion is general rather than specific to any particular machine. This sensibly prevents the information from get- ting out-of-date too quickly. The important features of machine specification which provide the best capability for rapid sequence studies with table incrementation are clearly described.

I imagine that the staff of any CT Unit would find a few points in this book which would improve their practice. I was particularly impressed by the discussion about selectable scan factors for routine studies - a whole chapter of 24 pages. I, for one, will pay more attention to possible out-of-field artefacts in the future. Indeed the whole subject of artefacts is well covered in Chapter 11 (26 pages).

I suspect that many workers in the UK will find the sections on specific examination techniques somewhat less useful than the other parts of the book. It would appear that most CT examinations in the author's department run along recognised protocols rather than being tailored to fit the clinical problem. Much larger quantities of contrast medium (e.g. 180 ml of 60%) are used than in most centres in the United Kingdom. He rightly stresses the proper administration of contrast medium, emphasising that poor enhancement techniques (e.g. drip infusion) can give less information than unenhanced studies (especially in the liver). Maybe this reviewer is a lone wolf in still advocating an initial unenhanced survey run for most general work, thereby concentrating the rapid-sequence post-contrast medium images in a selective fashion.

The only sad thing about this book is that it has come out in 1987. Many of us have had to learn these rudiments the hard way! But it will prove a lasting and useful text for those now acquiring or entering the field of CT. It is substantially more up-to-date than Seeram's 'Com- puted Tomography Technology' which was excellent in its day. The production by Raven Press is attractive and I am confident that this paperback will be much in demand. It may get dog-eared rather quickly in our busy unit!

Adrian Dixon

Paediatric Body CT By A. Daneman. Springer, London, 1987. 374 pp. 317 figs. £135.

There are 23 chapters divided into five sections. Section 1 as an introduction gives useful details specifically relevant to the paediatric patient. Section 2 covers the chest, mediastinum, lung parenchyme as well as the pleura and thoracic cage. Section 3 covers the abdomen. There are 11 chapters within this section covering not only technique and various specific organs but also the retroperitoneum, an approach to abdominal and pelvic masses and a chapter entitled 'Miscellaneous'. The fourth section is on the neck whilst the final section covers the muscular skeletal system, with a final chapter on special areas.

There are numerous illustrations all of a high quality and well reproduced. The author has illustrated the majority of clinical condi- tions described. The preface states that the head, face and spinal cord have not been included. There is no doubt that this book covers paediatric anatomy and the common pathologies to be encounted in a district general hospital or specialist unit fairly comprehensively.

The book clearly describes the practice at The Hospital for Sick Children, Toronto. There is only brief mention that there maybe other ways of doing CT and other indications for CT may exist. In Section 2 on the chest malignancy receives a disproportionately large coverage with other pathologies not fully explored. There is a chapter dedicated to the adrenal glands with a large part covering both neuroblastoma and pheochromocytoma. For a book published in 1987 it is surprising that there is no mention made of the role of metaiodobenzylguanadine isotope scans (MIBG). In the chapter on masses and inflammation in the abdomen and pelvis there is a slant towards malignancy and the inflammatory section is far too short. No mention is made of the use of radio-isotope labelled white blood cells in the investigation of occult infection. In the muscular skeletal system there is a single legend showing the use of CT for rotational injuries in the upper cervical spine with virtually no mention of this in the text. Since there are numerous CT machines in district general hospitals yet only few paediatric neuro- radiologists one feels that the importance of this technique for the adequate assessment of C1/C2 in children with torticollis should have been better covered.

Many chapters have too few references and the index is rather limited. The book lacks clear statements as to the indications for the use of CT compared with other imaging modalities. There is repetition in the text in virtually every chapter on technique, and frequently the text is duplicated in the legend of the illustrations.

This book is a clear statement of the practice at The Hospital for Sick Children, Toronto, over the past 11 years and is a valuable guide to the way one important leading paediatric institution uses a modern CT scanner.

I. Gordon

Clinics in Oncology, March 1986: Nuclear Medicine in Oncology. Edited by Duncan Ackery and Vincent Batty. Balli6re Tindall/W. B. Saunders, London/Philadelphia, 1986. 250 pp., 77 figs. £17.50.

It is well established that radioistotope imaging offers several tech- niques, such as bone scintigraphy, which are more sensitive than conventional radiological techniques. In this multi-author volume these basic nuclear medicine techniques are carefully re-evaluated. In addition, the development of newer radiopharmaceuticals for imaging and therapeutic use is well covered.

With approximately 50% of patients with breast and prostatic malig- nancies developing metastatic bone disease, the chapter reviewing the treatment of metastatic induced bone pain is particularly useful. The use of radiolabelled antibodies for the treatment of a variety of tumours in discussed. This is surely a field that will expand in the future. The book finishes with two chapters devoted to the newer imaging techniques of positron emission tomography and nuclear magnetic resonance, with reference to their role in oncology.

I believe this book to be a useful review of the current status of nuclear medicine in oncology. The text is well written, the illustrations are of good quality and all the chapters are well referenced. Anyone who is involved in oncology practice will find this interesting reading material.

A. T. Irvine