Spiral and Multislice Computed Tomography of the Body

Spiral and Multislice Computed Tomography of the Body by Mathias Prokop, Michael Galanski, Aart J. van der Molen, Cornelia Schaefer-Prokop
Thieme, New York, 2003, $189.

Applications of CT, considered a "mature" technology in the late 1980s, have exploded in the past decade. Spiral scanners reinvigorated the field, and led to the introduction of multislice technology, which radically altered the diagnostic imaging landscape.

While multislice CT has created tremendous opportunities for radiologists, it also introduced new complexities in image acquisition that, unless mastered, can be limiting. So radiologists should cheer the publication of Spiral and Multislice Computed Tomography of the Body, a new book written by recognized European experts in the field.

The first five chapters of this handsomely illustrated text address technical aspects of single and multislice CT scanning through the newest generation 16-slice scanners.

The first chapter beautifully explains single-slice scanning and reconstruction principles, transitioning painlessly to multislice techniques. While some of the technical materials in may not interest the casual reader, the practicing radiologist trying to compare the various CT vendors will be grateful for a reference that discusses the nitty-gritty of how each manufacturer does it.

The second chapter, on image processing and display techniques, gets right to the heart of what makes multislice CT images so compelling: the postprocessing that creates images in new planes or with a simulated 3-D or endoscopic appearance. Contrast media administration, which often gets short shrift in other texts, is thoroughly discussed in Chapter 3, laying the foundation for CT angiography and visceral imaging protocols.

In Chapter 4, the myriad acquisition and reconstruction parameters are explained, with excellent tables describing the tradeoffs inherent in different settings. Radiation dose and image quality is well described in Chapter 5. Overall, these superb technical chapters are like doing a hands-on fellowship in a cutting-edge department.

The clinical chapters of the book are also outstanding. Newcomers to CT may want to start reading at Chapter 7, "Image analysis." Dr. Prokop addresses the basic issues of CT lesion characterization, for example, what blood, gas, and calcification look like and what they might mean in various contexts. From there, subsequent chapters are organized by organ system. Individual pathologic entities are discussed in subsections within each chapter.

Almost every entity is illustrated, and numerous tables assist the reader in finding concise lists of differential diagnoses and lesion features. Image quality is uniformly outstanding and state-or-the art. Beginning with a review of contrast administration principles and scan techniques, the chapter on the liver is especially good. The authors address the latest CT applications including cardiac and coronary artery scanning, although PET-CT is not discussed. They have also chosen not to discuss body CT screening at the present time, preferring to wait until its utility can be proved.

The book's design makes it easy to find information. Tables have a blue background, and chapters are indicated with shaded blocks on the page edges. For improved readability, references are compiled at the end of the book and organized by theme, with an updated list available at the publisher's Web site.

Prokop's book will thoroughly familiarize the reader with the many parameters to be chosen with multislice scanners, and offers practical suggestions and protocols for image acquisition. In short, this single volume is an outstanding reference and may be unique in combining a state-of-the art technical reference with an encyclopedic overview of clinical CT.

By Dr. Terry S. Desser
AuntMinnie.com contributing writer
March 10, 2003

Dr. Terry Desser is an assistant professor of radiology at Stanford University School of Medicine in Stanford, CA.

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The opinions expressed in this review are those of the author, and do not necessarily reflect the views of AuntMinnie.com.

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