Riccabone M. Pediatric Imaging Essentials. Radiography, Ultrasound, CT, and MRI in Neonates and Children. Thieme; 2013; 364 pgs.; 633 illustrations, $119.99.
Pediatric Imaging Essentials is a 9-chapter, 364-page book with 633 illustrations covering key topics in pediatric radiology. The stated mission of the author, as written in the preface, is to summarize essential knowledge in pediatric radiology and its subspecialties “as clearly and concisely as possible” while helping students prepare for certification examinations. This book also addresses the unique challenges encountered in pediatric imaging while offering brief guidance on the management of likely real-life scenarios (ie, optimizing patient cooperation, radiation dose issues, appropriate study selection, etc). The ardent tone taken by the author in the preface translates to an overall high-quality, accurate, pertinent, and well-organized work that achieves and surpasses the author’s stated goal. For the purpose of this review, which is likely to be read by the neuroradiology audience, special attention will be paid to 2 of the 9 chapters, as they are likely the most relevant to those reading pediatric cases in a neuroradiology department.
In 36 pages—including text, diagrams and images—chapter 1, “Special Imaging Issues in Children,” manages to cover key points in radiology physics, radiation protection, and modality-specific issues encountered in pediatric imaging. The author continually emphasizes the ideal stance of a pediatric imaging specialist, which is to conduct imaging studies only with a valid indication and rationale while avoiding tests that produce ionizing radiation, in keeping with the ALARA principle (“As Low As Reasonably Achievable“). Moreover, the chapter is surprisingly abundant in content and clarity, given that it is a summary. Its content includes radiation physics topics such as the definition of “physical” and “radiation risk” quantities (ie, absorbed dose, effective dose, weighting factors, etc), deterministic and stochastic radiation effects, estimation of radiation risk, risks of prenatal radiation exposure, and accidental radiation exposure. The chapter also compartmentalizes the major modalities (radiography, fluoroscopy, ultrasound, computed tomography, and magnetic resonance imaging) encountered in pediatric radiology, outlining the specific strengths, limitations, and particular areas of usefulness of each in the pediatric setting. Areas where differences exist between children and adults are stressed. Also of note, the text offers protocoling advice for CT, largely based on numbers from the Society of Pediatric Radiology (SPR). Out of all of the chapters in this book, this one is perhaps the most universally applicable to both general and specialized neuroradiologists. In addition, this chapter could probably be recommended for radiology residents as preparation for their pediatric rotation, real-life practice, and their board examinations.
Chapter 4, “Imaging of the Pediatric Central Nervous System and Spine,” includes 41 pages of text, images and tables. This includes a dedicated 19 page section titled “Neurosonography in Newborns and Children.” The chapter begins with general considerations and technique recommendations regarding CT, MR, and radiography, after which the development of the central nervous system and pneumatization of the paranasal sinuses are summarized. This is followed by the bulk of the text, which outlines the classic congenital brain malformations, phacomatoses, encephaloceles, spinal cord abnormalities (dysraphism, diastematomyelia, and tethered cord), metabolic diseases, craniofacial anomalies, cerebral conditions in the newborn, and infections. The neurosonography section follows, which includes a brief discussion of advantages and limitations of the modality. Technique details are summarized. A summary of normal findings is provided, followed by summaries of key pathologies encountered during neurosonographic examinations, including but not limited to periventricular leukomalacia (PVL), hemorrhage, hydrocephalus, malformations, and masses. Ultrasound of the spine, orbit, and eye are also included. Overall, the content in this chapter is of sufficient depth to serve as a “high-yield” information source for radiology residents or to reacquaint the practicing radiologist with the diverse array of pediatric neurologic pathologies. However, due to brevity, the neuroradiologist will probably be left wanting to refer to a more detailed text, which is not surprising when one considers the stated goal of the book.
The remaining chapters include “Imaging of the Pediatric Chest,” “Imaging of the Pediatric Gastrointestinal Tract,” “Pediatric Uroradiology, Imaging of Pediatric Trauma,” “The Pediatric Musculoskeletal System,” “Pediatric Oncoradiology, Syndromes, Metabolic Disorders, and Other Characteristic Features in Children.” The overall organization and level of depth of these additional chapters is similar to the neuroradiology chapter described above. Specifically, the radiology resident or general radiologist will enjoy a well-organized outline of key topics in the pediatric radiology subspecialties that includes all of the “high-yield” pertinent facts one should expect from a book that strives to summarize essential knowledge. All of the included images are of excellent quality and accompanied by readily-understood captions. In general, the references are from current scholarly publications or refer to older landmark articles, or “classics,” (for example, Felson’s Chest Roentgenology). Also regarding the references, the author at times cites European-based recommendations without mentioning the American counterpart, probably in the interest of conciseness. Thus, the American reader may at times feel compelled to cross-check the presented guidelines with US guidelines not included in the text.
In summary, while the text is of exemplary quality and organization, and while it imparts a considerable amount of information, considering its small size, dedicated pediatric radiologists or neuroradiologists will almost certainly desire specialized references. Indeed, in several areas throughout the text, the author asks the reader to refer to additional resources for more detail. However, this impression should serve only as an honest footnote to the more subspecialized of us readers, as the work is, overall, of the highest standards and easily succeeds in meeting the author’s stated goal of offering a clear and concise summary of the pediatric imaging specialty. There is probably room for this book in the shelves of radiology residents of any year (especially those preparing for the new Core examination) as well as general radiologists who would like a concise resource to reacquaint themselves with pediatric radiology.
