This is an impressive textbook with highly eminent contributors providing a vast wealth of information. The text is enhanced with strong support from the evidence base throughout, and the range of issues and body sites covered is excellent. It is split conveniently into three sections. The first sets the technological background for the topic. This is followed by some valuable clinical examples from the full range of sites. The final section covers practical suggestions for the establishment of a successful image-guided radiation therapy (IGRT) program. Topics covered in all these sections are comprehensive and current with an outstanding level of detail. The book’s greatest strength is definitely the impressive array of contributing authors that the editors have selected. Even the best of ingredients, however, need combining and balancing with care in order to provide a perfect dish; in this case, slightly more vigorous editing is needed in order to achieve a Michelin star.

When reading the text, the overall impression is not of a coherently edited book but more of a journal of related articles. Thus each chapter, while generally excellent in itself, has not been fully integrated with the book as a whole. This leads to frequent repetition of information. For example, Chapter 3 has discussion on in-room imaging that overlaps considerably with the introduction. There are further examples of déjà vu between Chapters 11 and 5 and Chapters 6 and 19. Many chapters include their own definition and explanation of cone-beam CT (CBCT); if the reader reaches Chapter 13 still requiring an explanation, then they clearly should not be let loose in a department! The book is considerably heftier than it needs to be because of these overlaps.

In addition to the overlap, there are numerous inconsistencies between chapters. There is confusion between chapters’ use of acronyms with most authors studiously ignoring Chapter 1’s newly introduced “IGART” in favour of the more commonly accepted “IGRT” and “ART”. Dong’s impressive “Genitourinary” piece on errors not only repeats much of Van Herk’s Chapter 3 material but even cites Van Herk (2004) without mentioning the chapter he wrote in the same book! As a standalone piece, the chapter is excellent but really needed setting in the context of the book as a whole. The reader is left with the impression that the editors have not read the book in its entirety. Some cross-referencing would be of value here.

The chapters are individually very well written but again could do with the guiding hand of an editor to keep them focussed and consistently structured. Chapter 8 is interesting but discusses the use of intensity-modulated radiotherapy (IMRT) for head and neck management. It appears to belong to an IMRT book, and its only real contribution to the book is the introduction of another NWA (“never written again”) acronym: “IGIMRT”. Chapter 17 is ostensibly about CNS tumours but includes primary bone tumours. Some chapters, such as 16 and 18, are fascinating reading but do not actually add much about IGRT to the discussion. There is also some variation in format of the clinical chapters with some authors choosing to summarise and critique all the literature in the field while others provide a series of case studies of their personal experiences. There is a wide variety of chapter structures with some chapters having conclusion and some having summaries or “future research” sections.

Chapter 19 is clearly the commercial break with a word from the sponsors. In a similar vein, out of the 71 contributors to the book, 14 were manufacturers. It might have been more interesting to have some clinical perspective on the equipment.

Minimalist editing aside, if the reader is prepared to skip the overlaps, the random structure of the chapters and the commercial advertisements, there is a wealth of information crammed in between. The authors’ combined knowledge, expertise and experience is invaluable throughout. The evidence base supporting the chapters is wide and both summarised and critiqued to a high standard. The “clinical” chapters provide a valuable insight into the practical uses of IGRT, and the reader is able to benefit from an impressive range of highly experienced contributors. It is this range of expertise perhaps that also provides the book’s multidisciplinary appeal; radiation oncologists, therapy radiographers, medical physicists, dosimetrists and managers will all find something of interest. The book is destined to become a firm favourite with plenty of illustrations, clinical examples, a useful searchable online companion and enough detail on IG and ART to satisfy the keenest of enquirers. Overall, this is a comprehensive and valuable text that provides excellent value for money and will certainly not disappoint the hungriest of readers.