RAD RAPHERS

Radiography (1998) 4,227-229

Book reviews Advances in MRI Edited by Matthijs Omdkerk, Blackwell Science. f49.50. ISBN o-632-041 77-3

The title of this book may suggest a general review of recent technical and clinical advances in MRI. However, this is not the case. This book is actually the proceedings of the first Magnatom Vision User’s conference held in June 1995 (2 years 9 months ago). At that time, major magnetic reson- ance manufacturers were introducing clinical scan- ners which could be specified with higher strength gradient coils. These machines allowed the clinical employment of faster imaging, including breath- hold techniques, and the introductions of sequences which were sensitive to new parameters, for example diffusion. The Siemens company named their high gradient capable platform the Vision and this book refers to work done exclusively on this machine. Siemen’s acronyms and pulse sequence terminology are used throughout the book. Users of other manufacturers’ technology may find this frustrating.

conventional system to a high gradient system. Although the picture quality is good throughout, this book is no longer an adequate representation of the use of a high gradient MRI scanner. The Vision MR scanner at our institution has allowed diffusion weighted imaging and perfusion imaging, in the brain, breath-hold gadolinium enhanced angiography of the aorta and renal arteries,‘as well as cardiac line studies, all of which have proven clinically very useful. However, these topics are not even alluded to in this text. This book may find its use as a bench book in an MR unit with experience of the Vision system. It could be used as an accessory to the Vision instruction manual and is considerably lighter. It will allow a quick reference to the more clinical components of selecting protocols. However, users should remain aware of its major flaws; it is far from comprehensive and over-optimistic in its clinical recommendations.

The book is divided into five chapters. The first deals with fast and ultra-fast MR imaging tech- niques, but the treatment is cursory and disjointed. The second chapter on functional MRI is now significantly behind the state of the art. Chapter 3 concerns itself with MR mammography and the sub-chapter on limited indications for this tech- nique is probably the most consideied article. Chapter 4 deals with the application of the new fast MR imaging techniques, including the detection of hirer metastases, diagnosis of pelvic inflammatory disease, MR myelography and vertebral meta- stases. It includes several small studies which are generally over-optimistic. Readers wishing to acquaint themselves with the present indications for these techniques should read the major recently published reviews. Chapter 5 concerns itself with body applications of MR angiography, venog- raphy and perfusion.

D. Wilcock Senior Lecturer in Radiology

Universify of Leicester Leicester Royal Injrmary

Leicester LET ZWW, U.K.

Introduction to Health Care Delivery and Radiol- ogy Administration S. S. Hiss, W. B. Saunders. 1997. f 17.95. ISBN O-721 6-5314-6

In the preface to this 269-page book the author suggests that it is his intention to offer the reader an insight into the historical development of, and current issues facing, radiology services operating in the U.S. health care system. By doing so the author suggests that the reader will have a clearer understanding of, and be better piepared for, a future role in what he describes as a health care system undergoing rapid and fundamental change.

I am not sure which group may benefib from this The content of this book is divided into ten book. It assumes a good working knowledge of chapters of small format text interspersed with both the physics and the present clinical use of black and white photographs. The author makes MRI in radiology. It is certainly not an introduction extensive use of tables, graphs and organisational to the subject, nor can it be recommended to charts to illustrate and support the text. Each radiographers and radiologists upgrading from a chapter opens with a list of ‘objectives for study’,

1078-8174/98/030227+03 $18.00 0 1998 The College of Radiographers

228 Book reviews

and closes with a number of ‘study questions’ which the author indicates are designed to test the reader’s knowledge and understanding of the content of each chapter.

The first six chapters of the book provide an overview of the U.S. health care system, touching on a broad range of issues including its historical origins, the emergence of hospitals as organisa- tions, financial management, health insurance sys- tems and quality of care. Each of these chapters provides the reader with an interesting insight into a system of healthcare, which although different in many ways from the NHS, like the NHS is having to deal with many, of the same issues, such as rapidly changing technology, growing demand and financial constraint. Of particular interest is chapter three, which looks at structural models of hospital management and administration, many of which bear a striking similarity to those of NHS hospital Trusts; Chapter six, which describes methodologies and programmes for measuring and quantifying quality’ of care, provides the reader with some interesting ideas in an area which is becoming increasingly important in the NHS today.

The final four chapters focus more closely on radiology department management, administration and operational arrangements, business planning, human resource management and finally a brief outline of management issues surrounding ‘free standing’ radiology facilities based in private and community based health clinics. Although these subjects are focused on radiology services in the U.S., and despite language and terminology differ- ences, many of the concepts and issues the author identifies have close parallels in the NHS. The reviewer found the content in places to be a little superficial at times, and although interesting, the author has unfortunately done little more than scratch the surface of many of the topics he discusses.

Finally, and what does strike the reader on finishing this book, is the author’s limited use of clearly referenced material. This style must limit the value of this book to the reader who wishes to undertake further research on topics that the author can only touch on, in what is a relatively short work covering the vast subject of the U.S. health care sys tern.

In conclusion, therefore, this book offers the U.K. reader an interesting and useful introduction to the U.S. health care system. However, for the author’s intended audience of health care workers and students, the lack of referenced material does limit

the value of what is on the whole a reasonably well written publication.

Nigel Marsh Business Manager

York Heal& Services Trust York, U.K.

Catalogue of Diagnostic X-ray Spectra and Other Data (IPEM Report 781, K. Cranley, 6. J. Gilmore, G. W. A. Fogarty and L. Desponds (Electronic version prepared by D. Sutton). The Institution of Physics and Engineering in Medi- cine and Biology. 1997. f20. ISBN 090418188X

Report 78 revisits and expands upon the material of the Hospital Physicists Association report SRS 30 ‘Catalogue of Spectral data for Diagnostic X-rays’ by Birth, Marshall and Ardran which was published in 1979. Until the publication of Report 78, SRS 30 was the standard reference for beam quality data. This latest report goes much further than SRS 30 by providing a greater’ range of target/filter combination, target angle, tube ripple and attenuation materials. Targets available are Tungsten (30-150 kV), Molybdenum (25-32 kV) and Rhodium (25-32 kV) in 1 kV intervals and constant potential. For pulsating potentials the range is reduced to 55-90 kV in 5 mV intervals for 5% to 30% ripple in 5% intervals for Tungsten only. This range covers that commonly encoun- tered in radiology and mammography. Target angles are 6-22” for Tungsten and 9-23” for Molybdenum and Rhodium, all in 1” intervals. The attenuation coefficients for thirty-two materials are provided, which includes a comprehensive selection of common filter and phantom materials and also rare earth filters and patient equivalent compounds.

The information is provided as data files calcu- lated by Monte Carlo analysis using the method of Birch and Marshall. The spectral and attenuation data files are intended for use with a personal computer, using either the supplied software or in the user’s own programs. The spectrum generator software allows the user to select the target, filter(s), filter thickness and exposure factors. The software then displays the spectrum graphically and provides a listing of photons/mAs/mm2 in half keV steps, the mean photon energy, the air kerma (uGy/mAs) and the 1st HVL. These can be saved for further use or printed as required.

The CDROM based format, which includes the report as an on-line Adobe Acrobat Reader file,