Book Review

Nuclear Medicine in Clinical Diagnosis and Treatment

N Engl J Med 1995; 333:1653-1654December 14, 1995

Article

Nuclear Medicine in Clinical Diagnosis and Treatment
Edited by I.P.C. Murray and P.J. Ell. 1388 pp. in two volumes, illustrated. New York, Churchill Livingstone, 1995. $249. ISBN: 0-443-04710-3

This encyclopedic overview of applications of nuclear medicine in a clinical setting is a substantial work containing 114 chapters by 149 authors from around the world. The book has eight major sections. The first seven describe the application of nuclear medicine to acute care, renal disorders, gastrointestinal function, neurologic and psychiatric diagnosis, tumor diagnosis and therapy, disorders of bones and joints, and cardiology. The final section deals with the basic sciences. Some sections are subdivided into parts dealing with methodology and patient-related topics. The book covers all major areas of nuclear medicine in detail. The section on nuclear medicine in acute care is of interest, since it provides information on the study of unstable patients. The nuclear-cardiology section is perhaps the most ambitious in that it contains a separate part on the latest developments. All nine chapters in the basic-sciences section are written in a question-and-answer style.

The editors state that the preparation of the book took several years. Given this time and the multitude of authors, it is remarkable that the book is so coherent and up to date. Most chapters are short and to the point. There is no doubt that this textbook gives a balanced view of nuclear medicine and should be useful both to students and workers in the field of nuclear medicine. In their preface the editors mention that, at the risk of repetition, an attempt has been made to ensure that the proportion of the book allocated to the various topics bears a relation to the relative contribution of each procedure to contemporary nuclear medicine. They certainly have succeeded in this attempt.

No book is perfect, at least not for all readers. For example, I did not find the question-and-answer style of the basic-sciences section very useful. What should the reader with a question that is not asked do? Personally, I believe that a technique should not be applied before it is understood. Therefore, putting the basic-sciences section before the clinical sections seems more appropriate than putting it at the end of the book. The early appearance of basic science would reduce some of the need for repetition, since in some of the clinical chapters the authors feel it necessary to explain briefly the methodology (e.g., a chapter explaining positron-emission tomography occurs in both the nuclear-cardiology and basic-sciences sections). Similarly, the section on acute care would be better placed at the end rather than at the beginning.

Somewhat disappointing is the treatment of the measurement of cerebral blood flow and oxygen metabolism with the use of oxygen-15–labeled water and molecular oxygen, respectively. Although these measurements are properly mentioned in the chapter on acute care of patients with neurologic diagnoses, the discussion of them in the methodology part of the section on neurologic and psychiatric diagnosis is incomplete and, at times, not entirely correct. Neuroactivation studies that use positron-emission tomography and oxygen-15–labeled water are also poorly represented. In the area of methodology, the main shortcoming is the lack of a chapter (or sufficient description in other appropriate chapters) on tracer kinetic modeling, the discipline that attempts to relate uptake of a tracer (radiopharmaceutical agent) in terms of physiologic or pharmacologic variables (i.e., the quantification of images). Other problems are that the index does not list all relevant occurrences of some key words in the text, and the grouping of all color images at the end of each volume rather than at the appropriate places in the text is somewhat inconvenient.

Despite these minor criticisms, this book is destined to become one of the leading textbooks of nuclear medicine in years to come. It should find its place in any medical library. It should be used as a reference not only by workers and students in the field of nuclear medicine but also by any physician who refers patients to a department of nuclear medicine for diagnostic tests or therapy.

Adriaan A. Lammertsma, Ph.D.
Hammersmith Hospital, London W12 0PB, United Kingdom