This 122 page book authored by Drs Umanath Nayak, Ravikanti Satya Prasad, and Shobana Sekhar is a clinically oriented, image-rich introduction to computed tomography (CT) and magnetic resonance (MR) imaging of head and neck neoplasms. This book is a quick reference which helps clinicians choose appropriate radiologic tests to address specific clinical questions while offering extensive imaging examples of various head and neck tumors. It also highlights the ways in which radiology aids clinical decision-making in the treatment of head and neck neoplasms. The book is divided into 11 chapters, each of which is led by a short 1 to 5 page prose section in numbered outline form, followed by numerous annotated figures. This organizational method is somewhat abbreviated, but also direct and to the point. The first chapter is an introduction of radiologic modalities used in head and neck imaging and includes CT and MR images of normal head and neck anatomy. The information contained in these illustrations would be helpful to anyone interested in an introduction to or review of basic head and neck anatomy. However, some of the images appear too small for the number of highlighted structures in it. For example, an image that is approximately 1 square-inch in size contains 27 anatomic structures annotated by numbers. Due to the overall small size of the image, overlying annotation obscures many of the anatomic structures. This technical hindrance renders study of these images somewhat difficult. Chapters 2 through 10 are organized by anatomic location: oral cavity, oropharynx, larynx, hypopharynx, neck, thyroid and parathyroid, salivary gland, nasopharynx, paranasal sinus, and skull base. The 11th chapter addresses vascular tumors including paragangliomas and lymphovascular malformations. In each of these chapters, the outlined prose portion offers advice on what information different imaging modalities provide regarding tumors in that particular anatomic space, and what key anatomic regions may be assessed best by each imaging modality. In the chapters addressing anatomic areas affected by mucosal squamous cell carcinoma, the prose portion also comments on how imaging choices might change in the assessment of early vs advanced disease. As in the first chapter, the prose sections are followed by extensive CT and MR imaging examples of neoplastic disease View largeDownload slide View largeDownload slide processes that can be seen in each anatomic space. These images depict dramatic examples of head and neck neoplasms, some of which demonstrate extensive involvement of surrounding structures. The images here are on average larger than those presented in the first chapter, with considerably sparser, less crowded arrowed annotations. Therefore, these images overall offer excellent soft tissue contrast and anatomic detail. However, the figure legends, for the most part, are short and do not explicitly comment on the arrow annotations in the figure. This leaves it up to the reader to imply the anatomic importance of these annotations. While radiologists or clinicians experienced with head and neck imaging would not find this task daunting, someone new to the area may find the lack of guidance confusing or frustrating. There is a degree of selectivity to the images presented and the structures highlighted. Due to the abbreviated nature of the legends and preceding prose sections, it is sometimes unclear why the authors chose to present one disease entity or area of tumor invasion but omit another. This makes the imaging sections of each chapter seem somewhat haphazard. Although understandable that not everything can be covered in such a succinct, short volume, some commentary on the thought process behind figure selection and organization would have been valuable in clarifying the connections between the images and disease processes presented in each chapter. In both the prose section and the figure legends, the authors highlight key radiologic findings or areas of anatomic involvement that may change disease management of head and neck tumors. This commentary is especially valuable to the reader who needs guidance on how to order the appropriate study and effectively interpret the disease extent. On the other hand, there is relatively little information about what neoplastic entities may exist in each anatomic space and what characteristic imaging findings may be associated with each disease process. Some of the legends also do not clearly indicate the pathology of the mass pictured. Thus, the utility of this book in helping radiologists or clinicians arrive at a differential diagnosis for a head and neck mass is somewhat limited. Another potential drawback is that some of the commentary appears to reflect the authors’ institutional or regional practice patterns rather than highlighting universally accepted practice. For example, there is an assertion regarding contrast enhanced CT examinations that “a baseline noncontrast (Plain) study should necessarily precede the contrast study.” This is not standard practice in most imaging centers, and usually offers no additional diagnostic benefit in the evaluation of head and neck neoplasms. Overall, this book is a succinct volume with a wealth of imaging examples of head and neck neoplasms. It offers a handy supplementary reference for clinicians who may need an introduction or a refresher to basic head and neck anatomy, quick guidance on the selection of radiologic tests based on head and neck tumor location or extent of tumor invasion, or imaging examples of various head and neck tumors. However, readers completely novel to the field of head and neck imaging may benefit from a more comprehensive text to make sense of the complex regional anatomy and the variety of neoplasms that occur in it. Disclosure The author has no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. Copyright © 2018 by the Congress of Neurological Surgeons This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
Neurosurgery – Oxford University Press
Published: May 12, 2018
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