Journal Reviews

Type of book This book is offered as a multimodality approach textbook providing a concise overview of both basic and complex topics encountered by pediatric radiologists in their daily practice. The intention of the authors is to provide readers with core material in their subspecialty. The book focuses particularly on multi- modality imaging, attempting to cover the full gamut of radiological diagnostic techniques, including convention- al radiography, US, Doppler US, up-to-date CT and MRI techniques, as well as positron emission tomography (PET)-CT.

Contents The book is divided into 13 chapters. Chapters are arranged according to pathologies rather than the more typical, and easier to deal with, organ systems. Each chapter ends with a list, of variable length, of appropriate “further reading”, in which the articles recommended are sorted according to each specific topic.

Chapter 1 takes up the challenge of summarising, in 16 pages, the normal growth and development of the infant and child, and some of the imaging techniques used to document this process, including plain films, contrast studies, US, CT and MRI. Chapter 2 (20 pages) deals with neonatal imaging and is further subdivided into two parts covering the main differential diagnoses to be considered in emergency neonatal care issues: the spectrum of newborn respiratory distress and the neonatal abdomen. Chapter 3—relatively long at 34 pages—is devoted to congenital cardiac malformations and is superbly illustrated with state-of-the-art modalities and nice full-color diagrams.

The 19 pages (+ 2 pages for “further reading”) of Chap. 4 deal with accidental and non-accidental pediatric trauma involving any part of the child’s body, with illustrations composing an extensive part of the chapter. Chapter 5 (37 pages) discusses the issues of non-traumatic pediatric emergencies in remarkable detail. The causes of symptoms and/or the key imaging findings are summarized clearly in 12 well- constructed tables. The images are judiciously selected and of outstanding quality. Chapter 6 consists of a systematic and extensive review of various infections involving the different organs of a child’s body. Emphasis is placed on the poor specificity of most of the imaging findings. The manifes- tations of AIDS are discussed separately. In Chap. 7, the authors show how diagnostic imaging plays a critical role in differentiating benign from malignant lesions as well as staging and re-staging tumor extent in order to plan and monitor the most appropriate stage-adapted therapy. The study includes pediatric brain tumors and solid tumors outside of the central nervous system (CNS). Sixteen tables allow the authors to define the scope of this important topic in remarkable detail. Under the heading “ischemia”, several entities are, perhaps surprisingly, gathered together in Chap. 8. Sickle cell disease, with its various targeted-organ manifestations, serves as a prototype to illustrate the principles of ischemia, which obviously can also occur as a consequence of such entities as torsion, volvulus or herniation of an organ suspended from a vascular pedicle. Acute and sub acute cerebrovascular disease in the neonate and in the older child are also discussed and extensively illustrated. Chapter 9 deals with metabolic bone disorders. The different forms of rickets are nicely described, as are a huge variety of miscellaneous diseases in which the pathological findings are thought to be related to one or several biochemical defects. Chapter 10 on skeletal dysplasias and syndromes follows the usual scheme of presentation. The syndromes are discussed in alphabetical order. The approach is based primarily on radiographic findings with the addition of pertinent clinical data, including inheritance patterns. Chapter 11 outlines principles of pre- and post-transplant imaging of organs such as liver, kidney, lung, heart, small bowel and bone marrow, with illustrative examples. Post transplant lymphoproliferative disorders (PTLD) are also discussed, as well as the non-specific radiological features of transplant rejection. A special chapter (Chap. 11) is devoted to the imaging approach of “iatrogenic devices”, namely CSF shunts, endotracheal tubes, feeding tubes, intravascular catheters, cardiac devices and orthopedic devices. This chapter is extensively and superbly illustrated with pictures of some of the devices as well as imaging of pathological cases. Finally, Chap. 13 deals with radiation protection. A brief summary of the biological effects of radiation is presented, followed by the issues of radiation protection in radiography, fluoroscopy and angiography, and CT.

Strengths The editors must be praised for producing this up-to-date “Essentials” in a growing field where imaging has become increasingly complex. Essentials of Pediatric Radiology has indeed its well-known predecessors, nick- named “Requisite” (Blickman JG [1994] Pediatric Radiology: The Requisites. Mosby, London) or even yet “Essentials” (Burton EM, Brody AS [1999] Essentials of Pediatric Radiology. Thieme, New York) in the field. However, pediatric radiology has evolved considerably since these standard texts and this new book will provide excellent guidance, not only to practitioners in pediatric radiology, but also to pediatric medical residents whose rotations include pediatric services and care of children with enigmatic and complex problems. Most contributors to this book have captured the philosophy of “the essentials” in their text perfectly. The text is most often written concisely and the images have been selected judiciously. Production is excellent, with high-quality typography and image reproduction.

Weaknesses Inevitably, given the tremendous work of synthesis achieved to write this book, there are minor weaknesses. These seem related mostly to the deliberate editorial choice of arranging the chapters according to pathologies rather than to organs. As a result, some imbalance as well as some repetitions (epiglottitis, croup, epidermolysis bullosa, Torch infection, CNS vascular diseases, among others) may be noted between the chapters. Hirschprung disease is referred to only in the chapter on neonatal imaging (with a figure taken in a 9-year-old patient). Chapter 3, albeit of outstanding quality, probably takes up too much space compared to topics like pediatric trauma. In Chap. 8, one feels the intellectual acrobatics undertaken by the authors in order to fit the material within the proposed frame of “ischemia”. Finally, it is surprising not to find the reference book by Taybi-Lachman (Lachman RS [1996] Taybi and Lachman’s Radiology of Syndromes, Metabolic Disorders and Skeletal Dysplasias, 5th edn. Mosby, London) in the “further reading” at the end of Chap. 10.

Recommendation This book will be a key text for radiology fellows, radiology residents, and general radiologists, as well as for all pediatricians. It will find a comfortable spot on the library shelves of all radiology reading suites. It will help teaching colleagues in selecting material when preparing lessons for medical students and/or trainee radiologists.

Overall grade Excellent