Runge VM. Imaging of Cerebrovascular Disease: A Practical Guide. Thieme; 2016; 160 pp; 711 ill; $79.99
In a short, easy-to-read, soft-covered book, “Imaging of Cerebrovascular Disease: A Practical Guide,” Dr. Runge has compiled all the key points in CVD imaging without going into elaborate and unnecessary details. The reader will come away understanding how to acquire and interpret vascular disease imaging, including stroke, vascular malformations, and aneurysms. By providing an initial chapter on MR and CT techniques, Dr. Runge lays a foundation for the 5 chapters that follow. Nice comparisons both technique-wise and with images at 1.5 T and 3.0T scanners are described and illustrated.
Dr. Runge has previously published material on MR physics and on contrast material in MR imaging, so the first chapter is a summary of his experience as it relates to CVD. It is important to start with the reading of this chapter, but one must have a basic knowledge of MR to fully appreciate this material. The material is not intended for someone trying to understand the fundamentals of MR imaging. There is less time spent on CT, in part due to the fact that there are fewer variables to manipulate or consider; nonetheless, the underpinning of CT in CVD is explained.
The chapters on normal anatomy and hemorrhage are short and adequately illustrated.
The chapter on ischemia is one that should be made available to new residents rotating through neuroradiology and all neuroradiology fellows. It will serve to emphasize the appearance and evolution of strokes, using different MR parameters and different strength MR systems. It is noteworthy that when describing and illustrating infarcts, there is a mention of the particular part of the brain involved. Such inclusion in any radiology report makes it more meaningful and helps with the anatomic/clinical correlations. Parameter maps …
Dornhoffer JL, Gluth MB, eds. The Chronic Ear. Thieme; 2016; 368 pp; 472 ill; $179.99
If you ever thought that imaging of ear diseases (middle ear in particular) is challenging, then wait until you read this book. The Chronic Ear details the breadth of pathophysiology, clinical approach, and surgical management of chronic ear pathology.
The book is divided into eight sections. Section 1, “The Fundamentals of Chronic Ear Disease,” is dedicated to the fundamental principles of anatomy and physiology of ear disease. Section 2 details the clinical evaluation and office management of chronic ear disease, while Section 3 is dedicated to the various surgical techniques. In all these 3 sections, the chapters are didactic, detailed, and easy to follow. The anatomy, histology, and pathophysiology is exhaustive yet written in simple language. The pictures are very illustrative and descriptive, and the image quality is excellent. The radiographic evaluation is included in Section 2. The chapter is only a few pages but covers the most important aspects of radiologic anatomy, preoperative diagnosis, post-operative evaluation/complications, and surveillance. The figures are representative and clearly labeled, and the captions are comprehensive.
Sections 3 through 7 are dedicated to various treatment/surgical options and are presented in a round-table approach. In contradistinction to the first 3 sections, the chapters in these sections are shorter and more practical. Each section starts with a one-paragraph overview/introduction describing the issue at hand. This is followed by small subsections and short chapter discussions of the issue that include real-life cases, technique descriptions, and standardized approaches to patient selection/management. It is obvious that the editors chose a broad-minded approach in presenting the diverse literature.
Section 8 describes “Special Topics and New Horizons in Surgery for Chronic Ear Disease”. This is a very interesting part of this book. It describes new techniques …
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Gondi V, Yock TI, Mehta MP. Proton therapy for paediatric CNS tumours — improving treatment-related outcomes. Nat Rev Neurol. 2016;12(6):334–345. doi:10.1038/nrneurol.2016.70.
In this review, the authors provide an introduction to the types of pediatric CNS tumors for which proton therapy can be considered, and discuss the evidence that proton therapy limits toxicities and improves quality of life for patients. As you no doubt remember from your residency, a proton has a defined maximum penetration depth, called the Bragg peak, at which the majority of its energy is released over a few millimeters. The Bragg peak is determined by the energy of a proton, and can be shortened to match the distal edge of the target by placement of customized tissue-equivalent material in the beam path. Before reaching the Bragg peak, a proton loses only a small amount of its energy, so delivers a lower ‘entrance’ dose than does conventional X‑ray therapy. Beyond the Bragg peak, a proton has no energy, so delivers no ‘exit’ dose. The improvement in dose distribution achieved with proton therapy can meaningfully affect the risk of long-term radiotherapy effects, such as secondary malignancy, cognitive toxicity, endocrinopathy, hearing loss and vasculopathic effects. Despite its higher up front costs, proton therapy has been shown to be more cost effective than X ray therapy owing to the dramatic reduction in the excess costs of managing long-term toxicities. Keep in mind that randomized trials of proton ther¬apy versus X ray therapy are unlikely due to the rarity of the diseases involved and the ethical issues surrounding the enrollment of children into trials in which one arm is asso¬ciated with a greater likelihood of toxicity. Uncertainty about the biological effects of proton therapy on certain healthy tissue and the relative inaccessibility of proton therapy, especially in developing nations, pose …