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Book review |
It seemed helpful to have two (registrar and consultant) review this book – given its title. This 180 page book is set out in a random question and answer format of 80 cases as one might expect to face in the FRCR or MRCP examinations. Each case is introduced with an image followed by short questions sometimes with clinical information. The questions often start with radiographs or non-radionuclide scans allowing the candidate to suggest appropriate isotope imaging. The answers and teaching points are found on the following pages. A wide range of nuclear medicine techniques are discussed covering all parts of the body. Emphasis is given to more commonly encountered investigations such as bone scans, V/Q scans and renograms. Less frequent techniques are also covered including cardiac, neurological, biliary, GI and imaging techniques for infection. The use of PET for oncological imaging is also included with CT-PET having a brief mention. References for further reading and an index of the cases are given at the end for easy reference.
Knowledge required for the FRCR 2A exam is covered with discussion of agents and techniques used for various investigations. Illustrations of normal appearances and uptake for specific agents are given. Helpful tips on potential pitfalls in image interpretation are given such as artefacts mimicking pathology. Less commonly encountered techniques such as HMPOA brain scanning and imaging of neuroendocrine studies are also briefly covered. Cases also introduce newer applications such as PET scanning in lung cancer staging and follow-up.
There is discussion of the role nuclear medicine plays in the management of a variety of conditions. A major plus point for the radiologist is the integration of nuclear medicine with radiology with discussion of the relative advantages of each, a feature often missing from dedicated nuclear medicine texts. Understanding is aided by cases that reflect real-life clinical situations, making the reading much less dry than trawling through a textbook. As always there are some minor points of contention, e.g. recommending spiral CT following high probability V/Q scan and suggesting a post treatment baseline scan – a counsel of perfection rarely practiced and contentious in view of the additional radiation exposure.
One criticism of the book is that some of the images are very small and the quality of the images (particularly radiographs) does not always allow the abnormality to be spotted which can be frustrating. This is partly a consequence of a laudable attempt to keep the cost of the book low. However, the majority of images are of high quality and illustrate the teaching points being made adequately. The teaching points provided are very practical and one can imagine having to trawl through many pages of deeper textbook to find such information.
Overall, this is an enjoyable book suitable for candidates about to sit their FRCR or MRCP exams. Though short and concise, it covers a wide range of nuclear medicine techniques and clinical scenarios. It can be used as a starting point to stimulate further reading of investigations not frequently seen on a daily basis.
Though not an essential read, it is a good starting point for radiology candidates who feel a bit rusty with their nuclear medicine interpretation prior to the exam. With the emphasis on plain films and cross sectional imaging, and the modular training nuclear medicine is one of the subjects that (sometimes) falls to the wayside during exam preparation and registrars may not have had much exposure to nuclear medicine except during film viewing tutorials. It did help this registrar prepare for the exam, having not encountered many inexpensive and concise books that cover nuclear medicine in an exam type format. One would be unlucky to meet a nuclear medicine technique in the long case section of the FRCR 2B exam not covered by this book.
For those who do pass the exam (with or without the help of this book) there are two short, clear and helpful sections at the end describing the role of ARSAC, the IRMER regulations and the current routes by which training in nuclear medicine/radionuclide radiology can be achieved.
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