Nuclear Medicine Imaging: A Teaching File

M. Reza Habibian, Dominique Delbeke, William H. Martin, Martin P. Sandler, eds.

Philadelphia, PA: Lippincott Williams & Wilkins, 1999, 912 pages, $179.00

Ten physicians and a physicist authored this encyclopedic book that uses the case presentation (teaching file) format to provide an excellent review of contemporary nuclear medicine imaging. The volume succeeds in highlighting recent clinical and technical developments. Nuclear Medicine Imaging: A Teaching File is a comprehensive compilation of more than 500 cases, arranged by organ systems and/or disease-specific chapters, and cross-referenced to other cases with similar diagnoses. It is targeted at nuclear medicine physicians, radiologists, trainees, and others with an interest in nuclear imaging, for daily clinical practice and/or board examination review.

This lavishly illustrated work is divided into 11 chapters. The first 10 chapters discuss clinical cases, and the eleventh provides case reviews of imaging artifacts. The clinical chapters include endocrine imaging (19 cases), pulmonary scintigraphy (40 cases), cardiovascular imaging (35 cases), neurologic imaging (28 cases), gastrointestinal scintigraphy (41 cases), renal imaging (30 cases), skeletal scintigraphy (75 cases), oncologic imaging (37 cases), infectious process (27 cases), and pediatric nuclear imaging (30 cases). Twenty-five case discussions of imaging artifacts are included as well.

Each chapter begins with a succinct introduction covering the indications, methodology, interpretation, and limitations of the relevant technique(s) or procedure(s). This is followed by case presentations, ranging from simple to more complex, and organized without any order of priority. Each case features the pertinent history, images relevant to the disease process, a short but informative discussion, differential diagnosis, and final diagnosis. Every chapter closes with a list of references and/or suggested readings that are usually an excellent sampling of the relevant primary or secondary literature.

The presentation of the images with a brief history permits the reader to render an interpretation and formulate a (differential) diagnosis before the findings and diagnosis are described in the text. This allows readers to test themselves by comparing their interpretations with those of the authors. The book also can be read cover to cover as a textbook or used as a reference source for nuclear medicine imaging solutions to specific clinical problems.

The highlights of Nuclear Medicine Imaging: A Teaching File include presentation of both “bread-and-butter” cases (e.g., bone scans to evaluate metastatic disease) and increasingly rare clinical cases (e.g., Lemierre’s syndrome diagnoses with ⁶⁷Ga whole-body scintigraphy); the redundancy of case discussions on specific disease processes, which serves to consolidate the teaching material; extensive correlation of scintigraphic imaging with cross-sectional anatomic imaging; and inclusion of a separate section on imaging artifacts.

The images are of extremely high quality, with even subtle abnormalities well visualized. However, the gray and white reproductions of what apparently were originally color myocardial perfusion images have a smeared appearance, which may make “reading” difficult, especially for the uninitiated.

In spite of the $179 price, which may be prohibitive for some pocketbooks, residents and fellows can benefit from the wealth of information and the intellectual approach demonstrated throughout the book. It should find a place in the library of any busy imaging center or hospital as an excellent reference textbook. A CD-ROM format will be very useful.

I would recommend this book to radiologists and nuclear medicine physicians. Physicians who primarily direct and interpret nuclear medicine studies will appreciate the practical suggestions. Radiologists more peripherally involved in nuclear medicine have an opportunity to survey recent developments and gain insight into how and when to include scintigraphy in the imaging workup. Congratulations to the authors for this fine work.