This an important book because it attempts to answer the most perplexing questions which face any large spine service.

The book is edited by two orthopedic spine surgeons (Drs. Vaccaro and Eck) and contains contributions from a total of 61 authors, who are primarily orthopedic or neurological surgeons.  The first chapter appropriately describes the meaning of the measures for evidence based medicine (EBM).  The authors describe the 5 steps in EBM evaluation starting with what is the question to be answered or addressed.  The authors go on to define levels I-V evidence.  This scale allows investigators to communicate and discuss what and how rigorous are the studies which involve either therapeutic, prognostic (disease outcome), prognostic (diagnostic test efficacy), or economic/decision analysis.  Finally, we are shown the levels (1A-2C) of recommendation for any given study.

With that material behind us, the authors tackle 10 questions involving spinal trauma, 10 questions involving degenerative disease of the cervical and thorocolumbar spine, 6 questions involving the use of devices and new technology and 3 questions involving spine infections.  This reviewer is certain that most, if not all of these questions have been discussed in combined spine surgery and radiology conferences in virtually every academic medical center.

Each issue is posed, diagnostic criteria described, treatments discussed and then different Levels of Evidence data is presented.  Admixed in the chapters are Tables, images (CT/MR/radiographs), flow charts (algorithms), consensus statements, “pearls,” conclusions, and references.

Great discussions and evidence for various options abound.  Here are some examples:  For recurrent HNP what is best – repeat discectomy or fusion; for back pain – ALIF or PLIF or TLIF; for cervical myelopathy – anterior or posterior approach; for compression fractures – kyphoplasty or vertebroplasty.  These are just 4 of the 29 questions posed.

This is exactly the book one should have ready access to since decisions in the clinical area are most often made on the basis of “experience” or “war stories,” not on evidence.  Here is a way to work through many of these vexing problems.

This 416-page hardcover book is a compilation of case material, basically called “case vignette” and comes with the capability of searching the full text online. Each case serves as a backdrop for discussing the particular entity in question. It is supplemented by further illustrations of other case material. The categories (each a different chapter) are: Hypoxic-Ischemic Brain Damage; Clinical-Anatomical Syndrome of Ischemic Infarction, Acute Stroke Imaging, Cardiac Embolism, Extracranial Large Artery Atherothrombosis, Intracranial Atherosclerotic Disease, Small Vessel Disease, Uncommon Causes of Stroke, Spinal Cord Infarction, Spontaneous Intraparenchymal Hemorrhage, Secondary Intraparenchymal Hemorrhages, Subarchmoid Hemorrhage, Vascular Anomalies of the Brain, Cerebral Venous Thrombosis.

All of these chapters should be of interest to the neurologist and neuroradiologist particularly so related to the one on Acute Stroke Imaging. Here the radiologist would be most interested in the protocols used for CT perfusion and the imaging, whether it is CT and/or MR based. Further, in this chapter there are 3 basic subsections: Computed Tomography; Magnetic Resonance Imaging; Imaging in Stroke Emergencies. Each has a number of case history vignettes which bring to reality the imaging which follows. The material reviews concepts are well known to neuroradiologist (e.g. insular ribbon sign, dense MCA, sulcal effacement, contraindications for thrombolysis, Alberta Stroke Program early CT Scores vs. ELASS, evolution of stroke to subacute and chronic stages). The section on MR Angiography (½ page) is skimpy and gives few if any technical details, and many of the explanations could have been more detailed and forthcoming.

Built into a number of sections of this book are discussions of treatments — although not extensive, this adds value to this imaging text. One extra item that could have been added would have been a brief description of treatment in the legends for various cases shown.  No treatment for example was mentioned in the legend when there was a large penumbra in relation to virtually no alteration in the CBV on CT perfusion. Concerning MR little is said about the actual parameters used in DWI for example. Certainly a mention of various B values (and demonstration of such) in the setting of stroke would have been of value. All that said, this reviewer does recognize that the authors did not intend to write a text on stroke but rather primarily show case material. The chapter is on acute stroke accurate and valuable and to those with limited experience in stroke imaging.

The authors have chosen their images well, with most cases demonstrating high quality MRs and CTs. Additionally, solid explanations are offered for the findings seen on MR or CT such as the reason for the non-hemorrhagic hypertensities seen on T1WIs in cerebral hypoxia, timing of their appearance, the reason for areas of vulnerable cortex, the false subarachnoid hemorrhage sign, and the theorical reason for the delayed appearance of white matter abnormalities in anoxic/ hypoxia injuries.

The legends throughout are in the main complete, but one has to wonder, for example, why in a large MCA infarct where the authors show both the CT and MR, they fail to mention a hyper dense clot in the right MCA. It should be noted that throughout the text the authors deal with important issues and terminology in a straightforward and unambiguous manner such as when they are describing territorial infarcts and their vascular supplies. In the future, the authors should consider labeling arteries in the PA view of the MCA and ACA; they did include such labeling of the vertebral–basilar system but not of the MCA and ACA. Territorial involvement of infarcts involving various branches of the intracranial circulation are well and simply described, and much of this would have appeal to the neuroradiologist because of the identification of various symptoms and syndromes. Some but minimal editorial/publisher errors are noted, such as the vertical 180^º rotation of a vertebral angiogram and the corresponding CT, or poorly windowed CTs and MRs

A review of mechanisms involved in cardiac embolism (chapter 4) nicely puts together neuroimaging and cardiac pathology/physiology. This gives one the chance to briefly review issues with which we as radiologists seldom deal — like the EKG findings in atrial fibullation or the echocardiogram findings in ventricular thrombi. Again, the pleasant part of reading this is the combination of case vignettes and bullet learning points related to both the heart and brain.

Other chapters flow nicely and smoothly as one goes from extracranial vascular disease (nice combination of vascular US and extracranial vascular angiography — DSA/MRA) to intracranial vascular disease to small intracebral vessel disease. The rest of the material is mentioned in the first paragraph of this review.

This is a book well worth purchasing. It puts together in a readable and practical manner the issues faced in dealing with the imaging of stroke.

In a very topical and important new 720-page text Clinical Neurotoxicology: Syndromes, Substances, Environments Michael R. Dobbs, the editor, and 65 contributors have catalogued, described, illustrated, and discussed a wide variety of substances which are toxic to the nervous system. In addition the authors devote the first 248 pages to an overview of neurotoxins, syndromes associated with neurotoxins, and the testing for neurotoxins.

The first thing one sees when opening the text are 15 pages of color plates with 2 to 4 color photographs on each page. These are referenced in the individual chapters, and they run the gamut from pertinent pictures of flowers, snakes, inhabitants of the sea, histopathology, and MR images among others.

There are 6 sections of the book: (1) Neurotoxic Overview, (2) Neurotoxic Syndromes — Symptomatic, Systems-Oriented approach in Clinical Neurotoxicology, (3) Neurotoxic Testing, (4) Neurotoxic substances (metals, drugs, organic, bacterial, animal, pesticides, plants, radiation cyanide, (5) Neurotoxic Environments and Conditions, (6) Neurological Weapons and Warfare (scary stuff in this section). Conceptualizing this book, gathering all the material, getting contributions from experts in each area, and synthesizing this into one complete and eminently readable book was brilliant.

One might ask-what could be the value of this book to a neuroradiologist? From a purely imaging standpoint — a reasonable amount. For example, in the chapters on toxic encephalopathies one is on cortical and mixed encephalopathies (no MR), the other on leukoencephalopathies, with some correlative MR images. The chapter on neuroimaging in neurotoxicology is short (10 pages) but does discuses and demonstrate major imaging findings. Imaging is not however the reason to consider the purchase of this book; rather it is the wealth of associated information on these diseases. This information would be difficult to obtain easily from other sources; it simply is an important and well conceived book. The chapters are punctuated by boxes containing vignettes of interest, excellent tabular information, case studies figures showing the mechanisms of neural injury, patient photographs, pictures of insects and more. There are so many sections of interest that the material can not be easily or simply summarized. I cannot imagine an entity not covered in this text.

In summary, this is an outstanding book; a masterful job. It is one of those books which by its title alone one would think it would have limited appeal, but actually the converse is true. It cuts across subspecialty areas and should be a book available (preferably purchased for one’s own library) to all neurologists, internists, ER physicians, epidemiologists, and even neuroradiologists.

The remarkable success of The Requisites: Neuroradiology (1^st and 2^nd editions) is well justified. Each in its time was generally recognized as the best source for learning and refreshing one’s knowledge in Neuroradiology. Now we have a 3^rd edition, published this year (2010), with David Yousem switching places with Bob Grossman in their editorship roles.

When comparing this 3^rd edition to the 2^nd edition published 7 years ago, one is immediately struck by a number if things: the book is lighter, the font is smaller, the paper is of different stock. The number of pages is less (619 vs 908-only in part due to the smaller font size). As  I began to leaf through the book, one of my thoughts was that I hoped the humor was not extracted. The original idea to instill humor, witicisms, limericks, etc was a break from the traditional way of presenting material and it kept one’s interest high. Maybe everyone didn’t like it, but I did. More about that later in this review.

The chapters are titled the same as the prior edition — 18 chapters in all. Remarkably this text is written in nearly its totality by Drs. Yousem and Grossman — a wide departure from most Radiology texts where the number of contributing authors is often triple the number of chapters. The one departure from this sole authorship by Yousem and Grossman is that in this edition of The Requisites, Robert D. Zimmerman has authored the chapter on Vascular Diseases of the Brain. As one might expect this 66-page chapter varies significantly from the similarly titled chapter in the 2^nd edition, not only because of a change in authorship but because of the evolution in techniques, perfusion techniques in CT and MR  in particular, which have matured over the past 7 years. This material bears study no matter the stage of one’s education or experience.

The other chapters are as follows: “Techniques in Neuroradiology”, “Cranial Anatomy”, “Neoplasms of the Brain”, “Head Trauma”, “Infectious/Inflammatory Disease of the Brain”, “White Matter Diseases Neurodegenerative Disease and Hydrocephalus”, “Congenital Disorders of the Spine and Brain”, “Orbit, Sella and Central Skull Base”, “Temporal Bone”, “Senonasal Disease”, “Mucosal Disease of the Head and Neck”, “Extramucosal Disease of the Head and Neck Anatomy and Degenerative Disease of the Spine”, “Approaches and Pitfalls in Neuroradiology”. What is important to recognize is that all of diagnostic neuroradiology is covered here.  That makes the book ideal for all those doing or learning neuroradiology.

New images have been added, more discussion of evolving techniques are included but in many places there is a similar discussion of the diseases (which is natural since the diseases haven’t changed). Much of the book is written in a conversational manner which makes reading more engaging. This is a five-star recommended purchase, but I still miss the abundance of  humor.

This 432-page hard cover book, with activatable online search capability of the full text, is basically a collection of cases (predominately case reports) and short scientific reports. It is edited by Peter Dyck with 7 other co-editors and has 145 contributors, who have mainly co-authored case reports. Given that this is primarily a compendium of peripheral neuropathy, the value to the neuroradiologist will be relatively low, however there is material here which would appeal to those with a particularly interest in imaging the PNS. While the imaging per se is limited, one can imagine after reading through a number of the cases how high resolution 3T (or higher) MR could have added to the work up of the patients.

Basically there are approximately 70 cases in the 80 short chapters, and each of those cases teaches a lesson about the symptoms and the pathology (incidentally, the histopathology shown is excellent). The material runs from diseases (or disease manifestations) some of which this reviewer is totally unfamiliar to some of the more commonly expected diseases. For any future issue the authors should include in the chapter on MR technique, normal MR images of the brachial plexus, lumbosacral plexus and the major peripheral nerves accompanied by drawings of each of these areas. Emphasis on our varying techniques with and without contrast should be included.

A number of these short chapters have interest to the daily practice of neuroradiology such as neurolymphomatosis of the PNS, malignant nerve sheath tumors, chronic inflammatory demyelinating polyneuropathy, adrenonmyeloneuropathy, Fabry’s disease, a surprising number of cases which were secondary to amyloid deposits, hereditary motor sensory neuropathies copper deficiency masquerading (imaging wise) as a primary vitamin B₁₂ deficiency. Many of the clinical histories were sad, but the most distressing was a patient with an amyloid neuropathy resulting in a deteriorating golf handicap.

This book is worth viewing (borrow it from one of your neurology colleagues) or worth adding to a neuro section’s library.

Low back and neck pain are leading causes of doctor visits and loss of work in the USA. The cost of back pain exceeds a hundred billion dollars in the USA alone. Many of these patients often proceed to surgery. It is now believed that surgery may offer no long term advantage, compared to more conservative treatment options; this is for the vast majority of patients experiencing pain without motor symptoms or significant neurology. Minimally invasive image guided spine procedures have been around for decades but have evolved, and the range of procedures available have expanded. Treatment options other than surgery, with the associated anesthesia risks, are therefore now available ,and an attractive, effective option to treatment.

Image Guided Spine Interventions gives a comprehensive but condensed account of many of the minimally invasive image guided spine procedures currently in practice.

This text is divided into eleven sections:

Section 1: “Vertebral Body Reconstruction: Techniques and Tools”
Vertebroplasty and Kyphoplasty have become the standard of care procedures in the treatment of painful vertebral insufficiency fractures of the spinal axis. The procedures are briefly described and compared. Advances in vertebral body reconstruction techniques are elucidated and discussed under 6 major subheadings. Mention is made of the latest controversies in the literature regarding vertebroplasty. Many clear images and photographs are included.

Section 2: “Biomechanics of Vertebral Bone Augmentation”
Stabilizing osteoporotic fractures by vertebral augmentation has been shown to potentially adversely affect the levels above and below the stabilized vertebrae. The risk of adjacent fractures is discussed and multiple diagrams are used to illustrate the distribution of stress on the endplates after filling with PMMA (cement).

Section 3: “Vertebroplasty Technique in Metastatic Disease”
This section starts with the epidemiology and clinical presentations of spinal metastases. Treatment options and the technique of percutaneous image guided vertebral augmentation, with Radiofrequency Ablation and Vertebroplasty +/- tumor debulking is described. A useful treatment algorithm is suggested.

Section 4: “Sacral Fractures and Sacroplasty”
The incidence causes and clinical presentation, including diagnosis of this condition is outlined. Treatment options are usually medically orientated to reverse the underlying osteoporosis. However, with intractable pain and loss of function, percutaneous sacroplasty is advocated. The technique of sacroplasty and its intricacies is described.

Section 5: “Percutaneous Therapy for Symptomatic Synovial Cysts”
The causal mechanisms are detailed, and their clinical presentation and imaging appearances are presented. Multiple cross sectional images are provided to demonstrate the pathology. The percutaneous technique in treating these cysts is then detailed.

Section 6: “Epidural Steroid Injections”
The techniques detailed in this section are an important treatment modality in the management of back and neck pain syndromes. This detailed chapter deals with patient selection, contraindications, image guidance methods as well as the technical considerations related to each anatomical region. Pertinent use is made of tables detailing and comparing the various glucocorticoids in use for these procedures. There are plentiful images, and anatomical models detailing specific points in the text.

Section 7: “Radiofrequency Neurolysis”
Facet syndrome and lumbar facet joint pain is often a difficult diagnosis. This section deals with the presentation and pathophysiology of the mechanism of pain generation. Diagnostic facet joint blocks are detailed and are an important diagnostic and therapeutic tool in treating these syndromes. The anatomy of the medial branches of the dorsal ramus involved in the pain production is described in detail. Techniques for performing medial branch blocks are described and clear annotated images included. Lastly, radiofrequency neurotomy, which is the next step in the treatment of this condition is discussed.

Section 8: “Pharmaceuticals Used in Image Guided Spine Intervention”
Choosing the correct corticosteroid is an important aspect when doing spine injections to minimize complications and maximize the effect of the injectate. This section deals with the agents and their pharmacological properties commonly used in image guided procedures.

Section 9: “Percutaneous Lumbar Discectomy”
The cost to the healthcare system from discogenic leg pain is staggering. Taken together, back pain and discogenic leg pain, result in more days lost than any other combined illnesses and injuries. Anatomy of the basic functional spine unit and pathophysiology of pain production is detailed in this section. A description of percutaneous lumbar discectomy and the instruments required is discussed.

Section 10: “Minimally Invasive Stabilization of the Degenerated Lumbar Spine”
Is a detailed section on much of the theory relating to this topic. It is a technique that endeavors to maintain motion in the spine without fusion, while still markedly reducing the intradiscal pressure. There are multiple illustrations and images which aid in the understanding of this section.

Section 11: “Spinal Cord Stimulation: Uses and Applications”
Management of chronic pain and the use of spinal cord stimulators is discussed. Technical challenges and techniques of implantation of these devices are shown. As mentioned, the above sections are complemented with reference to multiple diagrams, illustrations and well annotated  images. This book would provide a concise and handy reference text to those either performing or interested in performing these type of procedures. Each section is well organized and clearly written. It is presented in a concise, easy to follow manner. Images detailing procedures and techniques have ample annotations and suitably descriptive legends.

Although this publication would be useful to the neuroradiology audience and those radiologists interested in the latest in image guided spine interventions, the detail and emphasis is more appropriate to those practitioners performing these procedures. This text would be especially valuable to any practitioner contemplating a career in image guided spine procedures. Subject matter is covered comprehensively without being too detailed. The “non –procedural” neuroradiology audience may find certain technical procedural aspects as well as for example the pharmacology, not that relevant to their scope of practice. There are many other texts on image guided spine procedures available. Many of these are books targeted to specific procedures and as such contain a lot more detail.

Having said that, this text offers a good compromise in covering each chosen topic comprehensively without going into too much detail or being too verbose. A comprehensive list of references from current publications and leading authors in this field are included at the end of each section. Where appropriate, mention and a brief discussion is made of the controversies arising from recent studies.

Overall, this is a well written and detailed but concise text on image guided spine interventions. This would be extremely useful and informative to those practitioners already doing or interested in doing image guided spine procedures.

As all those radiologists who work closely with spine surgeons (neurosurgeons and orthopedic surgeons) know full well, the surgical options for treating low back pain are numerous and the approaches/devices are seemingly growing at a bewildering rate. Everyday we see new cages, spacers, interpinous implants, sponge filled growth factors, plates, and screws to say nothing of the varying approaches to interbody fusions (anterior, lateral, posterior, transforamenal). The list of options is, in fact, so long that one wonders how one procedure is chosen over another. While this book does not attempt to analyze the outcomes inherent in all operative procedures or to show consequences and complications of all these procedures it does serve to inform as to the relatively current status of spine surgery for LBP.

Edited by five European surgeons with contributions from 61 authors, this 285-page, (37 chapters) hardcover book covers the basic concepts in LBP, diagnostic considerations, conservative treatment, surgical treatment both fusion and other emerging technologies, and outcomes (cost and medical evidence). Chapters which a neuroradiologist might find interesting are those which deal with the end plate changes and diffusion in degenerative disease, disease (evidence to show that end plate alterations precipitate DDD),  dynamic (or kinetic) MR of the spine (surprisingly, no images are shown and the technical factors are sparse; both are certainly a limitation of these chapters), indication for spinal fusion (some indications are clear like a posttraumatic  instability, but other indications are controversial), the 4 chapters on common fusion procedures, (such as disc arthrophasty, rigid/semi rigid/ non rigid stabilization of the spine), and interspinous process implants. While all these chapters are short and do not touch on all aspects of the procedure under consideration, the material allows one to gain on appreciation of where the field stands in mid 2010. One interesting chapter (non exhaustive and lacking images) is entitled “Adjacent Level Disease: Myth or Fact”; it sets forth the consideration that perhaps non fusion technology might alter present assumptions concerning adjacent level disease.

As a general overview of this field, this book might be worth a glance, but from an imaging point of view in terms of how exactly to analyze images arising from these procedures and what complications may be secondary to these operative interventions, the book is too superficial.

With the plethora of books available on various aspects of the physics of diagnostic imaging and the instrumentation involved in radiology, it is refreshing to have a book available that deals not only with the basic science of medical imaging but also with the cognition involved in visualizing images. This soft cover, 334-page book Introduction to the Science of Medical Imaging edited by R. Nick Bryan (with 23 contributors) brings to the fore all aspects of medical imaging and does so in a highly illustrated and well studied manner. It differs, therefore, from many other publications which deal with just one modality like MR or CT or nuclear medicine. A theme running through the book, no matter what medical image we are looking at, is that underlying all these images is quantitative data which is vastly underutilized in our interpretations. The inherent message is that we will, over the span of the next half decade, be less wedded to subjective (qualitative) analysis and more atuned objective (quantitative) analysis.

Four sections take the reader from “Image Essentials” (what exactly is an image, how do you make an image, how do you analyze an image) to “Biomedical Images: Signal to Pictures” (nuclear medicine, generation of x-rays to radiographs, ultrasound imaging, magnetic resonance imaging, optical imaging [a potential future] contrast material nuclear medicine labeling) to “Image Analysis” (human observers, digital processing, registration and atlas building, statistical atlases) to “Biomedical Applications” (morphological imaging, physiologing imaging, molecular imaging). In many respects, this book is a significant departure from the more commonplace texts in radiology physics, both in concept and execution.

What this reviewer particularly enjoyed about this book is the lack (that’s right, “lack”) of overwhelming detail, which can and often does cause the radiologist to put the book down. For example, a digestible explanation of molecular imaging is, in general, difficult to find, but here in this book, Glickson’s 12-page explanation gives the reader a sense of the field and where molecular imaging is headed. We learn among many things about theranostic agents (new term to this reviewer, but the meaning refers to taking individual diagnostics to individual therapy or, I presume, a fancy word for personalized medicine), how optical imaging can be employed, distinguishing intrinsic vs. extrinsic probes, molecular imaging targets, detection of marker genes, and fluorescence energy transfer (difficult concept to grasp), Granted, while not all of these are useful in the clinical arena now some eventually will be. Familiarization with concepts and terminology is facilitated by this chapter. Ranges of size sensitivity for various agents or modalities gives the idea of the ultra ultra small size we are talking about (down to femtomolar concentration — get out your P. Chem book!), and the limitations of MR in the realm of molecular imaging is revealing. A desired future of imaging is to define in as rapid a manner as possible the response of an abnormality (cancer in particular) to a therapeutic regimen, allowing either the treatment to proceed or be terminated. Molecular imaging holds a key to that and this is well described in this chapter.

The sense one also gets from reading this book is the interplay between metaphysics and physics, between sensory and illusionary, between concrete and abstract. (Don’t let that be a dissuader to obtaining this book; rather, let it be a persuader). This concept is apparent particularly in the first part of the book, but it is to be emphasized that contained in these pages are critical physics concepts which are well described and particularly well illustrated (superb graphics and legends accompany them). One comes away not only with a fundamental grasp of medical imaging but also with ideas and concepts not usually discussed. Another example of this includes the building of statistical atlases and what that actually means.

Only for the die-hard would the last 23 pages be of interest. Here, three appendices include Linear Systems, Fourier Transform and k-space, and Probability/Bayesion Statistics and Information Theory.

This reviewer knows of no other source in medical imaging science that lays out the whole field so interestingly and with new twists in conveying information. It is a highly recommended purchase either for an individual or a department.

Inherited metabolic diseases are generally viewed with anxiety by house staff and general pediatricians. Clinical cases are usually rare and the clinical presentation of cases can be both non specific and complex, which leads to further apprehension among clinicians. This text gives concise information on diagnosis and management of inherited metabolic diseases and provides for a clinically based approach to inherited metabolic diseases.

Inherited Metabolic Diseases: A Clinical Approach is written in a very reader friendly manner. It has been co-authored by more than 25 accomplished authors with expertise in the subject.

The book has been divided into 5 parts, beginning with an introduction part where the various types of inborn errors of metabolism are discussed. This leads to the next part, which discusses a systematic approach to these disorders. Included is an important short chapter on anesthesia and metabolic disease where certain important considerations/ interactions between certain anesthetic agents and specific metabolic disorders are discussed. The next part is divided into 12 sections and pertains to approaching a patient with suspected with metabolic disease based on the system involved with an emphasis on specific presenting signs, symptoms, and laboratory abnormalities. Following this is a comprehensive discussion on investigations for metabolic diseases which includes not only premortem but also post mortem tests. The book ends with an extensive list of differential diagnosis clinical and biochemical phenotypes of these disorders. An added feature of this book is the accompanying CD-ROM with the whole content of the book including interactive tables and links.

Each section makes use of tables, lists, and charts. The book is well illustrated. Plenty of accompanying tables are helpful summaries of complex information which aids in diagnostic and therapeutic decisions. The only caveat of the book is that treatment options are not as extensively elaborated upon as the diseases themselves, but as the authors point out; detailed coverage of diverse issues of the long term care and treatment of inherited metabolic diseases was not one of the objectives of this book. Treatment is discussed in detail in situations where it is practically relevant, particularly in the emergency situation during the acute presentation of a metabolic disease.

Overall, Inherited Metabolic Diseases is a concise textbook which can serve as a user-friendly guide to the diagnosis and initial management of patients with metabolic diseases. This valuable resource would be a useful tool for pediatricians, internists, neurologists, and clinical geneticists.

MRI Parameters and Positioning: Second Edition is a book that is set out to be a reference guide to all new physicians, clinicians or technologists in the MRI field.  It describes, in a basic manner, the principles needed to build protocols.  It has very detailed sequences and parameters which cover all body parts.  It is well organized, and provides all the basic information in a small and compact fashion.

The book covers all areas of MRI ranging from patient preparation and positioning to additional sequences based on diagnoses.  It includes the imaging parameters for each sequence, (TR, TE, FA, thickness, and gap), which are needed to build protocols.

The first chapter in the book is on Brain imaging. The book has excellent pictures showing the drawing of the anatomy area being imaged. The drawing includes the coverage area as well as saturation bands position. This section has information on new sequences such as high resolution 3D T1 with fat saturation, used for IAC imaging, and the IDEAL sequence for orbits. IDEAL is a new technique that provides homogenous fat saturation in the orbits. There is a protocol for CSF Flow imaging in the brain with velocity encoding for phase contrast sequences and positioning lines for areas of interest.

The book has a specific chapter for spine imaging. Once again, it contains protocol references and good parameters for each sequence. This chapter not only covers routine protocols but also gives suggestions for tumor and post operative protocols. It also has a section in which MR myelography is covered. This section provides protocols for 2D and 3D MR Myelography.  It includes positioning lines and saturation bands.

There are chapters for Cardiac and Vascular imaging, which are very detail oriented in the protocols and parameters, as well as in the sequences based on diagnoses. For vascular imaging, newer techniques like 4D CE-MRA are discussed, and parameters are included. Contrast injection is covered, with an explanation of bolus detection techniques to optimize arterial enhancements. In the Cardiac section, the book includes detailed pictures for positioning in addition to anatomical landmarks. This chapter covers all protocols and techniques needed for cardiac MRI; it even has a part for Cardiac MR stress imaging, and phase contrast sequences for flow analysis. All cardiac sequences are included; from dark blood, to bright blood, to delayed enhancement imaging.

The chapter for Body imaging covers everything from breast to prostate imaging. It has great references for new sequences like body diffusion, BLADE, as well as for the new contrast for liver imaging, Eovist.  It also has protocol and parameters for Bowel imaging, Urograms, and soft tissue pelvis.

The part of the book dedicated to Muscoskeletal makes recommendations for the types of coils used and positioning. It covers the most routine sequences and parameters used today in muscoskeletal imaging. There are some protocols that provide additional sequences based on diagnoses; for example, Gradient echo sequence for cartilage imaging in the ankle. There are specific protocols for tumor and joint imaging; which include sequences for indirect arthrography.

There are other books in the market like Handbook of MRI Technique, which provide MRI protocols, positioning, effects of signal to noise, and contrast to noise ratio;  however, they do not provide the reader with the detail of sequences and parameters like this book does.

For future editions, I would recommend including anatomical landmarks with actual pictures for positioning, as well as post processing protocols none of which are mentioned in this book. It would have been an added plus for this book to have included parameters for 3 Tesla scanners, specifically for spine imaging and body imaging, since there are some restrictions and sequence modifications that have to be made in order to compensate for a higher magnetic field strength relaxation time. Also, a small explanation of pros and cons on why one sequence could substitute the other would have been of great help.

Overall, the book accomplished its goal, to provide a very detailed yet compact protocol book that includes patient preparation, positioning lines, protocols, sequences, parameters, and tips on improving the overall quality of the exam. It includes a wide range of protocols as well as new sequences. It provides proper references and a list of acronyms from different vendors. This book is not intended for experienced Radiologists, Physicians or Technologists who have a strong MRI background; however, it would be an important addition for those who are looking to build protocols, improve existing protocols, or simply become more familiarized with sequences and parameters needed for MRI.