BOOK REVIEWS 475

Multiple Choice Questions in Imaging Sciences. By D. Finlay, J. Berry and G. Bell. Bailliere Tindall, Eastbourne, 1983. 128 pp. £4.95.

This small paperback is a collection of multiple choice questions in the imaging sciences. It is designed for those training in radiology and for those preparing for higher examinations in radiography. It is particularly apt for those taking Part I of the Fellowship of the Royal College of Radiologists. The questions are of the type used in the Fellowship, in which each question is divided into five parts, each of which may be false or true and of which at least one is true and one is false. The sections covered by the authors are Physics - 97 questions, Anatomy 107 questions and Techniques - 67 questions. They provide excellent practice in answering this type of question. The questions vary con- siderably in difficulty, as one would find in a multiple choice examination. The answers are given on the opposite page to the questions and can easily be covered whilst the reader is considering them.

The authors have clearly encountered the problems which beset examiners when setting multiple choice questions. These include making the questions too simple, which the authors have avoided in all but a few instances. Also, making certain that the wording is clear to the candidate. An example of this lack of precision is in the question on macro- radiography, where the term 'stationary X-ray tube' is used when the authors intend to say an X-ray tube with a station- ary anode, making the answer totally different. One or two of the answers are clearly incorrect. For example, in a postero-anterior chest radiograph, rotation of the thorax makes the hemithorax closest to the cassette whiter and not blacker and, in the coronary circulation, the posterior descending artery in the posterior interventricular groove arises from the left circumflex artery in the 10% of the people, in whom the left coronary artery is dominant and the atrio-ventricular node may then also be supplied by the left coronary. In these circumstances the answer given would not be correct. In other instances the authors have recognised the difficulty of covering all eventualities by using a device not available to examiners and that is the qualified answer.

This is, nevertheless, a useful little book which will give students of radiology and radiography valuable pre-examina- tion practice in multiple choice questions in physics, anatomy and techniques, It is recommended to those about to sit their examinations.

Ian H. Kerr

Quality Assurance in Diagnostic Radiology. World Health Organisation, Switzerland, 1982.66 pp.

Quality Assurance in Nuclear Medicine. World ttealth Organisation, Switzerland, 1982.70 pp.

The World Health Organisation is concerned with inter- national health matters; through it, more than 155 countries exchange views with the aim that everyone will be able to lead a socially and economically productive life by the year 2000. In order to achieve these laudable aims, it is essential for the organisation to take an interest in a very wide variety of problems and there is very little that is beneath its interest. It is not surprising, therefore, that two symposia were held in 1980 to address the problems of quality assurance in both diagnostic radiology and nuclear medicine. These two little booklets naturally differ ha content but they have a unity of theme. It is best regarded as an extension of the 'risk versus benefit' theme that characterises the recommendations of ICRP 26, for it is vital to conduct high-quality investigations in order to provide maximum benefit and minimal risk.

These booklets make it clear that the quality of an investigation is influenced by everyone who is involved, and this includes people making administrative arrangements, storing and providing previous patients' data, checking the equipment, the quality of the images and, inevitably, the contribution of the investigation to the general diagnostic strategies of the department. However, the books are not concerned only with high ideals but give a great deal of space to lengthy protocols, particularly for checking equipment. They make the point that the doctors in radiology and nuclear medicine are included in their general programmes and will require some special training to make them aware of the problems and techniques of quality control testing, even though they themselves will be involved in the clinical rather than technical aspects.

At a time when there seems to be a welter of restrictive documents relating to the uses of radiation in medicine, it is refreshing to find two simple booklets with such a positive approach. Other organisations should follow the example of W.H.O., who are concerned not only to promote a minimally acceptable standard throughout the world, but who aim to achieve a uniformly high international standard with inter- national comparisons of quality assurance programmes.

E. Rhys Davies