Textbook of Diagnostic Imaging

Textbook of Diagnostic Imaging

Book Review Textbook of Diagnostic Imaging. 2nd ed. Charles E. Putnam, MD, and Carl E. Ravin, MD Orlando, Fla: Saunders, 1994. Cloth, $295.00; pp 2,1...

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Book Review

Textbook of Diagnostic Imaging. 2nd ed. Charles E. Putnam, MD, and Carl E. Ravin, MD Orlando, Fla: Saunders, 1994. Cloth, $295.00; pp 2,117. Textbook of Diagnostic Imaging is a two-volume, clothbound, 2,117-page, organ-systems approach to radiology. The editors indicate this second edition has been revised to provide a "comprehensive, state-of-the-art text emphasizing the role of imaging in the diagnostic and therapeutic management of patients." The authors responded to constructive criticisms of the first edition and improved the sections on the central nervous system and the female patient. The quality of the reproductions is better, and numerous tables, algorithms, and diagrams have been added. The initial section is entitled "Fundamentals of Diagnostic Imaging." Considering the monumental task of explaining everything from production of x rays to the physics of magnetic resonance (MR) imaging, William Hendee and others did a commendablejob covering this ever-expanding topic in less than 100 pages. In the next section, "Central Nervous System", Charles Strother provided a continuous stream of thought to this better illustrated and vital section. The final central nervous system subdivision on sinus disease omits important data pertaining to the coronal anatomy of the sinuses, which is becoming of great importance with reference to the developing fiberoptic endoscopic techniques for sinus disease. Another oversight was omission of a subsection on intracranial occlusive vascular disease. Also, the section on extracranial vascular disease might have included a table correlating noninvasive duplex values with corresponding percentage stenoses. The subsequent sections (in order) on the pulmonary, gastrointestinal, genitourinary, musculoskeletal, and cardiovascular systems maintain the high standards set in the first edition. The fmal section, "Imaging the Female Patient" has been markedly improved. This is a key and timely accomplishment considering the trend in medicine to elevate female imaging to the status of a subspecialty. On the strength of contributions from Rudy Sabbagha, Arthur Fleischer, Faye Laing, Frank Hadlock, David Nyberg, and others, this section is one of the

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best. Considering the cutting edge presentation of modalities, such as color flow duplex and MR imaging of the pelvis, the absence of innovative technology from the breast imaging subsection was surprising. Almost the entire discussion was centered on mammography. Although still considered the gold standard, mammography is our most technically demanding radiographic study, which even when performed perfectly has a false-positive rate greater than 85%. Stereotactic biopsy, digital mammography, breast MR, and ultrasound are beginning to favorably impact the considerable false-positive rate of mammography. There are 107 mammographic images, no images on breast MR, and three images on breast ultrasonography. In some of the case presentations in which bilateral mammograms were displayed, the current convention of right breast on the left was violated. This text originates from Duke University; therefore, most of the teaching is understandably based on standards of practice in the United States, where advanced technology is readily available. Many of the suggested algorithms assume the readership to have access to this new technology, but there is ample discussion of most standard, even slightly dated, techniques for readers in parts of the world with limited technology. For example the importance of skull radiography is minimized but not unduly slighted in favor of the more "romantic" cross-sectional modalities of CT and MR imaging. The reason being, in the modern diagnostic algorithms based on technology available in the United States, skull films no longer play as significant a role in clinical practice. With a few exceptions, most sections were presented with review of standard techniques coupled with presentation of the most recent developments. This edition contains contributions from an all-star list of almost 200 investigative radiologists, making this one of the most comprehensive, concise, well-referenced texts of diagnostic imaging currently available. -Reviewed

Journal of Vascular and Interventional Radiology

by David L. Harshfield, MD

September-October 1995