Q&A Color Review of Neuroimaging

M.H. Lev, K. Forbes, S. Shetty, and J. Heisserman, eds. New York: Thieme; 2008, 224 pages, 113 illustrations (approximately), $39.95.

The newest entry into the arena of “show and tell” neuroradiology texts is Q&A Color Review of Neuroimaging by Drs Lev, Forbes, Shetty, and Heisserman. There are 113 questions (actually multiple questions under each) with corresponding images and what are termed “companion cases.” The format is to show images and ask questions; and then, turning the pages, the reader sees the diagnosis, a description of the imaging findings, a few words on the pathology and clinical situation, teaching pearls, and a couple of references.

A few things strike this reviewer. The first is the title “Color Review.” Although it is true that a color perfusion map appears on the cover (and it appears again in the text) and a color diffusion tensor image (DTI) is shown in a patient with a low-grade tumor, these are the only color images in the entire text. How the word “color” is justified being in the title is a mystery. Furthermore, if one picks up this paperback book and looks at the cover, one sees 2 images side by side. One is a postcontrast sagittal image and the other, a CT perfusion map. A reasonable assumption would be that these are from the same patient, but they are not. Why the publisher decided to show a color map of mean transit time in a stroke next to a pleomorphic xanthoastrocytoma is another mystery. Then we come to the one other color image, which is a DTI. However, strangely, it is not shown in concert with the routine imaging, so one never has the opportunity of seeing the benefit of having that DTI.

Then to add to a reader's discomfort is the decision of the publisher to list a few questions under each case but not to give the specific answers to the questions in the same location. Although it is true that one can read through the text and dig out the answers, the design of this is faulty. The material presented is partially representative of what one would expect to see in a quiz format of neuroimaging; however, given that head and neck imaging is considered part of neuroimaging, it is surprising that no such material is included. If, in fact, it was the author's intent, as they say, to offer practical real-life day-to-day neuroimaging studies, where, one wonders, is, for example, a temporal bone study or images for a neck mass or lymph node evaluation? Which entity is one more likely to run into—a Hallervorden Spatz (page 201) or a CT of a neck mass (not illustrated)? This book is, in this respect, unbalanced.

Nonetheless the brain and spine cases are well illustrated and do cover important aspects of neuroradiology in the major categories of diseases. To this reviewer, there are far better case review books, such as the “Case Review” series: “Brain Imaging” by L.A. Loevner (Elsevier Health Sciences, 1999); “Spine Imaging” by B.C. Bowen, A. Rivera, and E. Saraf-Lavi (Mosby, 2007); and “Head and Neck Imaging” by D.M. Yousem (Elsevier Health Sciences, 2005); or Neuroradiology Companion: Methods, Guidelines, and Imaging Fundamentals by M. Castillo (Lippincott Williams & Wilkins, 2005).

In summary, although the authors have compiled some interesting cases, in a future edition they need to consider a more balanced neuroradiology text and their publisher needs to give greater thought to its design.

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