Pleural mesothelioma (MP) remains an aggressive disease with a poor prognosis and a median survival of no more than 18–20 months, despite the use of all current treatment approaches. Radiation therapy for MP is traditionally used as а part of a three-modal approach in radical treatment. The lack of reliable randomized trials has led to an absence of consensus of the optimal radical treatment strategy and current guidelinesтfor the MP treatment are quite contradictory regarding the use of radiotherapy. A literature based on theтMedLine database (Web of Science) was analyzed.

Our own experience in multimodal treatment of 8 patients with MP based on retrospective data demonstrates low local control in the irradiated area: 4 patients had isolated local relapse during 1 year; 4 patients had local relapse in combination with distant progression. Univariate analysis had not revealed predictors of isolated local progression after adjuvant radiation therapy in multimodal treatment.

Although the role of radiotherapy in the treatment of MP remains unclear, significant successes in planning and conducting of radiation therapy show, that long-term survival now can be achieved for these patients, for whom, until recently, only palliative treatment had been considered appropriate.

High-grade gliomas are characterized by rapid growth, poor prognosis and frequent unsatisfactory treatment results. Radiation therapy remains one of the main methods of treatment of this disease. However, the question of choosing the optimal macroscopic (Gross Tumor Volume — GTV) and clinical (Clinical Target Volume — CTV) volumes in the planning of radiation treatment remains controversial. There are several approaches to the target volume delineation for radiotherapy of high-grade gliomas, depending on the peritumoral edema. There is no correlation between the frequency of recurrences and methods of delineation of gliomas. GTV should be defined as the area of enhancement on the post-contrast T1-weighted MRI, i.e. postoperative cavity and residual tumor. Peritumoral edema is an unreliable orienting point when contouring target volumes.

The presented material summarizes the experience of Cancer Research Institute and Tomsk Polytechnical University team in the development of original radiopharmaceuticals (RP) for nuclear medicine. The first such unique for world nuclear medicine RP was a Thallium­199. The Thallium­199 is successfully used for breast cancer diagnosis and its lymphogenous metastasis, as well as to visualize cancer of the larynx and laryngopharynx, their relapses and for differential diagnosis of inflammatory and tumor processes of the musculoskeletal system. The great practical importance for nuclear medicine has the organization of a waste­free production of sorption and extraction generators of Technetium­-99m at the IRT­T TPU nuclear research reactor, as well as the creation of a fully automated ⁹⁹mTc module operating on a waste­ free technology. The development of the ^99mTc­Alotech for targeting imaging of sentinel lymph nodes (SLN) has also great importance for clinical oncology. The main advantage of ^99mTc­Glucoscin is that metabolic tumor imaging with the innovative RP use can be performed using a conventional gamma camera, which significantly reduces the cost of the diagnostic procedure. The present and promising developments of the research teams of the Tomsk Scientific Research Center and the Tomsk Polytechnic University are closely related to theranostics — the use of RPs obtained on the basis of same target compound labeled with different isotopes intended for the diagnosis or therapy of oncological diseases.

Purpose: To identify the MRI-hallmarks of liver metastatic neuroendocrine tumors (mNETs) with different localization of primary tumor.

Material and methods: 75 liver mNET patients were enrolled in the study. The hepatic metastasis patients were divided into two groups: with pancreatic mNETs (n = 37) and with gastrointestinal tract (gut) mNETs (n = 38), including those of a stomach, small and large bowel, and appendicular primary. All patients underwent abdominal contrast-enhanced MRI with the measurement: the number and the maximum size of the lesions, the presence and size of avascular zones in the lesions, the presence of MRI signs of hemoglobin deg-radation products. In the region of interest, which corresponded to a rounded section in the solid portions of metastases, were measured quantitative indicators of signal intensity on T₂-weighted images (WI), native and post-contrast T₁-WI, the degree of accumulation of MR contrast agent (MRCA) and its washout, the value of apparent diffusion coefficient (ADC). A total of 171 lesions were assessed. The data were compared in the varying localization of the primary NET groups of patients.

Results: The study demonstrated that the solid portion of the gut mNETs compared with that of the pancreatic mNETs are characterized by lower ADC-value (p = 0.0102, medians: pancreatic mNETs — 1036 × 10^–3 mm²/s, gut mNETs — 846 × 10^–3 mm²/s), less active accumulation of MRCA on the arterial (p = 0.0002, medians: pan-creatic mNETs — 1.48, gut mNETs — 1.24) and venous (p = 0.0026, median: pancreatic mNETs — 2.22, gut mNETs — 1.9) phases of contrast enhancement, longer washout of MRCA (p = 0.0057, median: pan-creas mNETs — 0.92, gut mNETs — 0.98). Based on regression-factor analysis, a model for determining the localization of primary tumors based on MRI signs of liver mNETs was created with an accuracy of 93.8 %.

Conclusion: Gut mNETs compared with that of the pancreatic mNETs are characterized by lower ADC-value, less active accumulation and longer washout of MRCA. The data can be used to draw up a personalized examination plan of patient with liver mNETs from the unknown primary.

Purpose: To evaluate the capabilities of ultrasound elastography in assessing the effectiveness of treatment of patients with special lesions of peripheral lymph nodes in lymphoproliferative lesions.

Material and methods: To evaluate the capabilities of ultrasound elastography in assessing the effectiveness of treatment, an ultrasound study was carried out for 93 patients with lesions of peripheral lymph nodes with lymphoma in dynamics before treatment and after 2/3 courses of chemotherapy using Acoustic Force Radiation Impulse (ARFI — shear wave elastography) and eSie Touch (compression elastography).

Results: Assessment of the dynamics of the average, minimum and maximum values of the shear wave velocity showed statistically significant differences. The most reliable changes were recorded when assessing the average and maximum indicators of the shear wave velocity (p = 0.0000001). Also, after two / three cycles of chemotherapy, the indicator X, XX m/s (p = 0.00001) was significantly less frequent, which was previously detected in the LN with the most rigid structure. Compression ultrasound elastography revealed softening of the LN structure in the form of an increase in the frequency of occurrence of I and II elastotypes.

Conclusions: Our study confirms that ultrasound elastography allows, in a short time and without negative ionizing effects on the patient, to assess the effectiveness of the selected chemotherapy routes.

The lecture materials are based on 40 years of experience of the A.M. Granov Russian Research Center of Radiology and Surgical Technologies and the International Lymphoma Radiotherapy Group (ILROG). The rationale and clinical scenarios for the use of radiation therapy for the unfavorable course of Hodgkin’s lymphoma and diffuse large B-cell lymphoma are presented.

Purpose: Demonstrate a clinical case of poorly differentiated chordoma, confirmed using a wide range of research methods.

Material and methods: A 63-year-old female patient with poorly differentiated chordoma who underwent immunohistochemical examination, MRI, CT and scintigraphy.

Results: An immunohistochemical study confirmed the morphological affiliation of the tumor, supplemented by the data of imaging methods.

Conclusion: The poorly differentiated type of chordoma has a specific immunohistochemical picture, however, differential diagnosis based on imaging methods is currently a difficult task.

Primary lymphomas of the central nervous system (PCLCS) are relatively rare tumors, usually having a multifocal manifestation in the brain and rapid progression. It is not always possible to make a correct diagnosis for MRI, since similar radiological manifestations (markers) of this disease, when using routine protocols, MRI can occur, for example, in malignant gliomas. This article presents a clinical case of a refinement diagnosis — PLCNS when using MRI in sequence (SWI), which was confirmed by the data of histological examination of surgical material.