This literature review details how male circumcision has been a subject of debate for many years with different parties quoting different benefits and risks. The incidences of these risks are seldom quantified. This paper attempts to assess the rationale for circumcision on medical, religious and cultural grounds and examines the relative rate of complications. It also attempts to assess the proposed benefits, one of which relates to infection transmission but these are small on a population scale. The stated risks of surgical complications are small. No studies show impaired sexual functioning following circumcision. All complications are increased and of greater severity with untrained personnel performing circumcision. The available evidence does not justify routine circumcision.

Thyroid disease management has changed little over the last 60 years and recent work suggests that the older approach remains the most effective. Treatment of benign hyperthyroidism has shown that functional imaging is essentially linked to therapy and uptake of iodine-131 ((131)I) cannot be assumed but should be tested by pre-imaging with radio-isotopes as 10% of patients may not be suitable for (131)I therapy and 1% may have a co-existent cancer. Differentiated thyroid cancer remains unique in that it is almost alone among common solid tumors in that it is routinely cured even if cannot all be removed by surgery. This is achieved in the majority of patients by a treatment introduced in the 1940s and does not involve the use of chemotherapy drugs but a simple and cheap isotope preparation; (131)I. However, in some differentiated thyroid cancers there is no accumulation of (131)I and we know this is due to the loss, or downregulation of the sodium iodide symporter gene. This has led to the development of several strategies to overcome this loss/downregulation, for example with the use of lithium or retinoids or gene treatment. However, all these approaches have yet to be proved in a randomized controlled trial. Advances in imaging especially using (18)F-fluorodeoxy-glucose PET has enabled patients with thyroid cancer to be more accurately imaged, resulting in a greater chance of cure through surgery and external-beam radiotherapy, especially if uptake of (131)I is poor. Another approach has been the idea of using radiolabeled somatostatin analogs, which are able to demonstrate uptake in the tumor and, more recently, beta-emitting isotopes have been used for therapy when other options have failed. Therefore, whilst the treatment of differentiated thyroid cancer is, to some degree, 60 years old, new methods have been proposed and are now being tested in this disease.

Vertebral collapse is a significant event in the paediatric patient with a real potential for associated deformity and morbidity. While in adults the causes tend towards the malignant, particularly metastatic and metabolic disease, the paediatric population demonstrates a different range of diagnoses. This article reviews the typical imaging findings of the more common underlying acquired pathological causes of vertebral collapse in children, including Langerhans cell histiocytosis, chronic recurrent multifocal osteomyelitis, osteogenesis imperfecta. Other causes include pyogenic osteomyelitis and tuberculosis and neoplastic lesions, either primary, metastatic or of haematological origin.

Objectives: To determine if unexpected aorta uptake seen in some patients is influenced by popular modern reconstruction algorithms using semi-quantitative and qualitative analysis. Methods: Twenty-five consecutive patients without suspected vascular disease were selected for 18F-FDG positron emission tomography/ computed tomography (PET/CT) scanning and images of the aorta were created using iterative reconstruction (IT), IT + time of flight (TOF), IT + TOF + point spread function correction (referred collectively as UHD) with and without metal artefact reduction (MAR) algorithms. An experienced radiologist created aorta and blood pool (BP) regions of interests then copied these to all reconstructions for accurate positioning before recording target aorta standardized-uptake-values (SUV max ) and background BP SUV mean . Furthermore, target-to-background ratio (TBR max ) was defined by aorta SUV max -to-BP SUV mean ratio for more analysis. Results: For aorta SUV max with IT, IT + TOF, UHD, UHD + MAR reconstructions the mean ± standard deviation recorded were 2.15±0.43, 2.25±0.51, 2.25±0.45 and 2.09±0.4, respectively. Values for BP SUV mean were 1.61±0.31, 1.58±0.28, 1.58±0.28 and 1.47±0.25, respectively. Likewise, for TBR max these were 1.35±0.19, 1.43±0.21, 1.43±0.19, 1.43±0.18, respectively. ANOVA analysis revealed no significant differences for aorta SUV max (F(0.86) p=0.46), BP SUV mean (F(1.22) p=0.31) or TBR max (F(0.99) p=0.4). However, the qualitative visual analysis revealed significant differences between IT + TOF with UHD (p=0.02) or UHD + MAR (p=0.02). Conclusion: Reconstruction algorithm effect on aorta SUV max or BP SUV mean or TBR max was not statistically significant. However, qualitative visual analysis showed significant differences between IT + TOF as compared with UHD or UHD + MAR reconstructions. Harmonization of techniques with a larger patient cohort is recommended in future clinical trials.