British Journal of Radiology 75 (2002),396 © 2002 The British Institute of Radiology
Bone Densitometry for Technologists. By S L Bonnick and L A Lewis, pp. xviii+311, 2001 (Humana Press Inc., Totowa, NJ), $74.50 ISBN 1-58829-020-4
R J Pettit
This book has been jointly written by a medic in the field of women's health and a radiology technologist, both practicing in the USA. The first few chapters deal with some of the conventions used in densitometry that will help anybody who is new to the subject to understand some of the specific terms used. The concept of bone mineral density is introduced, as well as a discussion of accuracy and precision (also covered separately later in the book), measurement sites, and Z and T scores. The various techniques that can be used to determine bone density are described (e.g. radiographic photodensitometry, SPA, DPA, DXA, QCT, etc.) and a useful overview of these methods is given. Normal appearances of skeletal anatomy are also demonstrated, with many useful photographs contained within the text. Some examples of common artefacts are highlighted and shown in picture format. These are helpful for those technologists starting work in bone densitometry who are not familiar with X-ray images. The anatomy of the lumbar spine, proximal femur and forearm are shown in detail; some mention is given to metacarpals, phalanges and the calcaneus.
One chapter is a 45 page listing of all the devices available for measuring bone density in the USA that have been approved by the Food and Drug Administration. It names each device and details its operating characteristics (e.g. scan time, skeletal site, precision, radiation exposure, etc.). It is useful as a reference but is of limited use. Another chapter is entitled "Computer basics" and that is exactly what it describes. It explains what a mouse, trackerball and printer are (amongst other things) and is probably not necessary in a book like this.
Radiation safety is discussed, with doses given in rems; in most cases the Sievert value is given in brackets. If this book was written by British authors, some discussion of IR(ME)R and its implications would be expected. In addition, some of the radiation protection measures mentioned are not ones that are routinely used in this country. Therefore, care must be taken when utilizing the information given, and a British text covering radiation issues would be more useful for those starting out in densitometry.
Quality control is discussed, followed by a chapter on osteoporosis, which gives a helpful overview of the disease for those new to the subject, although some of the references are not relevant to the UK. Some practical issues are covered in the final chapter relating to the interpretation of bone densitometry data (e.g. the importance of the technologist including correct vertebrae).
This book is well written, with good diagrams and photographs throughout the text. It concentrates mainly on bone densitometry using DXA, although other techniques are discussed. It would be a useful book for a technologist starting out in the field of bone densitometry.
