Book Review

Imaging in Liver Disease: From diagnosis to treatment

N Engl J Med 1997; 337:1781-1782December 11, 1997

Article

Imaging in Liver Disease: From diagnosis to treatment
By Kenichi Takayasu and Kunio Okuda. 562 pp., illustrated. New York, Oxford University Press, 1997. $275. ISBN: 0-19-262634-5

Over the past 10 to 15 years, the role of imaging in the diagnosis and treatment of liver diseases has grown dramatically. The combination of new imaging techniques and diagnostic contrast agents has greatly improved our ability to examine the liver. In this regard, Japanese physicians have had a central role; indeed, many important imaging techniques, such as computed tomography (CT) during arterial portography and spiral CT, were initially described in Japan.

This book shows the features of common and uncommon focal tumors of the liver and biliary tract seen on imaging. The authors are recognized experts in this field, and the book is a testimonial to their experience. The emphasis on illustrating cases has kept the text to a minimum. For experienced readers, this will be an advantage. However, for those who are less familiar with liver disease, the details may be insufficient, although the text is well referenced. Hence, it may be appropriate to consider this book an atlas rather than a textbook.

The strengths of the book are its extensive case material with anatomical–radiologic correlations and the easily readable text. The book's limitation is that most of the images are from CT, ultrasonographic, and angiographic examinations. Very few magnetic resonance images have been included. However, the quality of the images is very high, and since CT and ultrasonography are the core noninvasive imaging techniques in clinical practice, this drawback is not that serious for use of the book as a teaching aid.

About two thirds of the book contains descriptions of normal anatomy and case studies of benign and malignant liver and biliary tract tumors. Also included is a short technical section on imaging studies of the liver, with an emphasis on CT, ultrasonographic, and angiographic techniques. This section also includes a chapter on how to perform percutaneous liver biopsies. The third section of the book, on the treatment of liver tumors, emphasizes image-guided therapy, such as transcatheter arterial embolization and percutaneous ethanol therapy.

The book will be most useful to hepatologists, radiologists, and liver surgeons, who will be able to use the illustrated cases as reference material for their own practices. Since experience with the use of Lipiodol in CT imaging is much greater in the Far East than here, cases involving this technique will be especially useful. In addition, subspecialty fellows will find the book to be an excellent learning guide.

Sanjay Saini, M.D.
Massachusetts General Hospital, Boston, MA 02114