This is a basic, concise textbook of thoracic imaging based on a 16-hour course presented through the University of Wisconsin Radiology residency, which follows a pattern approach to thoracic disease recognition. The intention is to stimulate interest in further in-depth reading on the covered topics in reference textbooks and journals. The authors also suggest it can be used as a review text prior to the American Board of Radiology oral examination. This is a self-described foundation text primarily aimed at first year radiology residents and pulmonary, internal medicine, and family practice physicians seeking basic knowledge and expertise in radiographic interpretation. It is unfortunate that there is no mention of radiographic technique and positioning. Overall, the images are of a reasonable quality; however, line diagrams may be more appropriate for representation of the variant accessories fissures, which are not well seen on the examples given, and which do not include an example of the azygous fissure. Perhaps the authors could make better use of available space to include more images and text. Specifically the section on normal anatomy would benefit from further expansion on mediastinal lines and stripes which are of greater importance than recognition of accessory fissures. While some chapters are organized by anatomy [9, 10, 13] and some by radiographic signs [2, 11, 14], some topics appear to be covered unevenly. There is relatively little explanation of the mechanisms of pulmonary arterial hypertension, and there is no definition of what constitutes enlarged central pulmonary arteries. There also seems to be confusion within the text between Eisen-Menger reaction andEisen-Menger syndrome. It is not clear why emphysema is not mentioned in the chapter on upper lobe disease, and why it is included in the section on airways disease with disproportionate emphasis and text on diffuse pan-bronchiolitis compared to the much more common Alpha- 1 antitrypsin deficiency. There is no mention of bronchiectasis occurring with Alpha-1 deficiency-related emphysema and the reader is not referred to the only CT example of early centrilobular emphysema seen in figure 15-4-D and the chapter on lung neoplasm. Widespread use is made of mnemonics, however, the lists on which these are based are limited. Authors do not seem to separate the radiographic findings of emphysema and hyperinflation, and although the observation of early calcification on CT is mentioned, no example is provided, nor is the significance of this observation documented. The example of the tree-in-bud pattern, figure 13-15 could be improved upon, and in the section on references in Chapter 2, references 6, 15, and 18 are listed as ""deleted in proofs."" Similarly, the section on centripulmonary nodule evaluation should, even in an introductory text, have been expanded somewhat in the role of contrast enhanced CT and PET scanning. An attraction of the book is the self-assessment chapter. The principal competing text would appear to be the text edited by McLoud, Thoracic Radiology: The Requisites (Mosby -Year Book, Inc., 1998) which, although slightly more expensive, would appear to represent a greater value even though it does not contain a self-assessment chapter.
Radiologists Collins (U. of Wisconsin-Madison) and Stern (U. of Washington-Seattle) offer a guide for physicians who want to learn to interpret radiographic images of the chest quickly and accurately, and an introduction that radiology residents can read easily during the first month of chest radiology rotation to get a grasp of the fundamentals. Their treatment can also be used to study for the American Board of Radiology oral examination. They seek to avoid being too dogmatic in prescribing protocols that are now in rapid evolution. Annotation c. Book News, Inc., Portland, OR (booknews.com)
Reviewer: Lisa Diethelm, MD (Ochsner Clinic Foundation)
Description: The focus of this book is on pattern recognition in chest radiology with an emphasis on underlying anatomy and physiology. Each chapter begins with a list of learning objectives and images and drawings emphasize the major points. This second edition replaces the original, published nine years ago. Illustrations have been updated for new technology and all have been maintained in electronic format from original to manuscript, preserving spatial and contrast resolution. The authors are recognized authorities in thoracic imaging with particular expertise in teaching.
Purpose: To quote the authors: "The objective of this book is to provide a practical tool for those wanting to quickly acquire a broad base of knowledge in thoracic imaging." It is an appropriate introduction to thoracic imaging for residents early in their careers, and also a useful review for senior residents prior to written and oral boards, meeting the authors' objective.
Audience: The most obvious audience is residents early in their careers, for whom this book provides a focused introduction. It is useful as well for residents preparing for written boards because it emphasizes principles that are fundamental to chest radiology which may appear in questions on that examination. It is useful to residents preparing for oral boards, because pattern recognition is fundamental for that exercise. The mnemonics are relevant and sufficiently quirky to be memorable without being obscure. Finally, the book is very useful for faculty members responsible for the residency curriculum in thoracic imaging, since all topics in the curriculum devised by the Society of Thoracic Radiology, of which both authors are members, are addressed. To put this in different terms: If a topic is in this book, readers can bet that it is considered important in chest radiology and should be addressed in lectures, case conferences, and reviews for residents at all stages of training.
Features: The design of the book emphasizes pattern recognition and underlying anatomy and physiology. It begins with a review of normal anatomy and then moves to categories of thoracic diseases sorted by the anatomic area affected. The use of learning objectives at the beginning of each chapter is helpful to focus both novice and experienced readers. The authors have laudably resisted expansion of the scope of the book. I predict the section on cardiac disease will grow as this becomes more significant in thoracic imaging.
Assessment: This is an extremely useful book. I have used the first edition both as a text for residents to read as well as a framework on which to structure the curriculum in thoracic imaging at our institution. The quality of writing and illustrations is excellent. The additions, updates, and improvements justify the second edition. The only quibble I have is the use of the term "alveolar lung disease" in place of "airspace disease," the latter term being preferred in the glossary agreed upon by the Fleischner Society and American Thoracic Society (which glossary can be accessed online through the Mallinckrodt website: www.mirchest.com/glossaryofterms.pdf).