Combined Scintigraphic and Radiographic Diagnosis of Bone and Joint Diseases

E. Edmund Kim

doi:10.2967/jnumed.113.126557

Yong-Whee Bahk

New York, NY: Springer, 2013, 615 pages, $339

Bone is no longer considered a static structure. It alters as osteoblasts are mineralized and osteoclasts are resorbed. Combined structural, biochemical, and functional imaging of bone is now among the most widely used technologies in clinical practice and research. The advent of micrometric bone scanning of the trabeculae—with its ability to provide the best possible and most meticulous naked-eye grasp of minute anatomy and fine visible chemical changes—has clearly created a royal road to bona fide molecular imaging and accurate diagnosis.

The internationally well-known author of this book has purposely established a more precise, easily practical, and better system of scintigraphic diagnostics of bone diseases based on piecemeal analysis and interpretation of signs demonstrated by bone scanning using pinhole collimators, γ-correction (an image-processing algorithm that transforms image pixel values nonlinearly to code), and electronic magnification of γ-corrected pinhole scans.

This fourth edition was intended, first, to rewrite and expand most of the existing chapters and, second, to introduce the more recently developed γ-correction pinhole scan diagnosis of several bony disorders, including occult fracture, stress reaction, bone marrow edema, neck sprains, and whiplash injury. The main features of this revision are the new insights and excellent micrometric scan images made possible by the use of pinhole collimators with novel γ-correction and electronic magnification of the corrected scans, judicious integration of the refined structural and biochemical scan findings, and close correlative analysis of the data with those of other imaging modalities for a whole range of bone and joint diseases. The author was able to specifically and differentially demonstrate pinpoint, minute rodlike, tiny speckled, and grossly mottled and geographic uptake of ^99mTc-hydroxymethylene diphosphonate in various bone diseases. These micro- and macrometric scan findings permit accurate diagnoses and characterizations of bony disorders.

This revision is well written and clearly illustrated with superb images and a convenient index. I highly recommend this book to nuclear physicians, radiologists, pathologists, orthopedic specialties, and scientists, as well as to imaging technologists and medical students.