Leonard M. Freeman Editor Baltimore, MD: Lippincott, Williams & Wilkins, 1999, 346 pages, $11.14
This book consists of 8 topics covering some of the fundamental procedures in nuclear medicine today. Skeletal scintigraphy, brain imaging, lymphoscintigraphy, current radiopharmaceuticals, cholecystokinin cholescintigraphy, and the treatment of thyroid carcinoma are discussed in great detail, with a significant bibliography included. Because nuclear cardiology represents 30% to 60% of procedures performed in some nuclear medicine laboratories, omission of this topic is noted.
One aspect of the book that is unique compared with other nuclear medicine texts is the emphasis on the economics of diagnostic nuclear medicine. In the first chapter, discussions on cost-minimization analysis, cost-utilization analysis, cost–benefit analysis, diagnostic strategy, and a run-down of some cost-effective studies in current literature bring home the reality that in the managed care environment, nuclear medicine physicians must prove that the procedures are efficient and cost effective. Several chapters compare the efficacy of nuclear medicine procedures with other diagnostic modalities. The chapter on imaging skeletal infections compares the sensitivity and specificity of bone scans to MRI, radiography, 67Ga, and white blood cell scans in patients with osteomyelitis of the foot and in complicated osteomyelitis. These discussions and cited literature provide cogent information for the nuclear medicine practitioner.
All of the chapters provide in-depth, historical development of the respective procedure, current methods of and indications for use, elements of controversy, and some pitfalls. The future impact of nuclear medicine in diagnosis and follow-up, particularly in cancer patients, is discussed in several of the chapters. Increased use of SPECT and, where available, PET will increase the specificity of interpretation and prove cost effective, according to several authors. Except for some redundancy, the chapters are well written with good graphic support of the text.
This book is a must-read for nuclear medicine fellows and those beginning the practice of nuclear medicine. The book offers a significant review with an extensive bibliography for those who have been in practice for a long time but are facing the changes in nuclear medicine forced by the economic changes in health care delivery.