ABSTRACT
OBJECTIVE AND AIMS: The primary aim of this study was to evaluate the correlation between incidental focal colorectal foci on fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) with colonoscopic and histopathological results. The secondary aim was to determine to what extent these findings led to a change in patient management. MATERIALS AND METHODS: A retrospective study was performed among 5850 patients who had an FDG-PT/CT scan from July 2015 to July 2018. Among these patients, we identified patients with a PET/CT description of incidental colorectal FDG uptake, and a colonoscopy within 90 days from the PET/CT scan. PET/CT findings were compared with colonoscopy-detected lesions and eventually histopathology on a per-lesion analysis and a per-person analysis. RESULTS: A total of 145 patients were included in the study. A total of 180 foci of colorectal FDG uptake were detected on FDG-PET/CT. Of these, 86 foci corresponded to advanced colorectal neoplasia (ACRN), positive predictive value (PPV) 47.8%; 95% CI: 40.5-55.1%). On a per-patient analysis 81 patients had a least one ACRN at colonoscopy (PPV 55.9%; 95% CI: 47.6-63.8), this group included 20 patients (13.8%) diagnosed with cancer. There was a small positive correlation between focal FDG-uptake and the finding of ACRN at the same colonic segment at colonoscopy, which was statistically significant, rho = 0.2565, p = .002. The findings changed patient management in 67 (46.2%) cases. CONCLUSIONS: Incidental focal colorectal FDG uptake on PET/CT is associated with a high risk of ACRN and is affecting subsequent patient management. Further evaluation with colonoscopy is recommended when the patient is considered suitable for further treatment.
Subject(s)
Colorectal Neoplasms , Fluorodeoxyglucose F18 , Colonoscopy/methods , Colorectal Neoplasms/diagnostic imaging , Colorectal Neoplasms/pathology , Humans , Incidental Findings , Positron Emission Tomography Computed Tomography/methods , Positron-Emission Tomography , Radiopharmaceuticals , Retrospective StudiesABSTRACT
ABSTRACT: The use of electroconvulsive therapy (ECT) in cochlear implant (CI) users is debatable. Currently, no consensus statement exists about the safety for the patients and the implants. Here, we present a summary of the existing literature on ECT in CI users, consisting of 4 case reports and a cadaveric study. No harm to the patients or the CIs was reported. Based on our review, we have found no evidence to indicate that ECT in CI users is contraindicated.
Subject(s)
Cochlear Implants , Electroconvulsive Therapy , Electroconvulsive Therapy/adverse effects , HumansABSTRACT
In this case report a 38-year-old woman was admitted to hospital with anal bleeding and perianal pain after a consensual vaginal intercourse followed by an anal intercourse during which she felt a sudden profound pain. Nine days later she was diagnosed with an anovaginal fistula. A diverting sigmoideostomy was performed, and spontaneous healing was awaited. Rectovaginal fistula without concomitant anal sphincter injury as a result of consensual penile anal intercourse is an extremely rare occurrence, described only once previously.
