Purpose: To assess the likelihood of late radiation damages after radiotherapy for cervical cancer patients using radiobiological models.
Material and methods: The treatment plans of 94 patients at the age from 30 to 39 years (30 %) and from 40 to 49 years (33 %) were analyzed. The patients were diagnosed with squamous cell carcinoma of the cervix of 88 people, adenocarcinoma of the cervix — 1 person, mixed types of cancer tissue — 5. The combined radiation therapy course consisted of remote and intracavitary stages. In accordance with the recommendations of the GEC-ESTRO working group on gynecology, the total values of dose loads on organs at risk were found, namely: the bladder, rectum, sigmoid colon in volumes of 0.1; 1; 2, 5 and 10 cm3.
Results: The dependences of the accumulated frequency of late radiation injuries, namely cystitis, rectitis and enterocolitis for two modes of irradiation Split and Fraction for the bladder, rectum and sigmoid colon, depending on the radiation dose and the volume of the corresponding organ, were obtained. The dose–effect relationships for the manifestation of cystitis, rectitis and enterocolitis were constructed for both regimes in volumes: 0.1; 1; 2; 5; 10 cm3. The threshold values for the occurrence of radiation damage were estimated for two modes of irradiation for the bladder, rectum and sigmoid colon.
Conclusion: There is a decrease in the threshold of complications with an increase in the analyzed volume of irradiation. The threshold values of the probability of radiation injury for the two irradiation modes for the bladder and rectum coincided within ± 5 Gy. In the case of split-split treatment, radiation damage occurs earlier within 5 Gy. No reduction in the likelihood of late radiation injury was found when using this mode. The applied methods of treatment for these two groups of patients are equivalent in terms of the likelihood of late radiation damage and have the right for clinical use.

Methodological foundations of nuclear medicine in pediatrics are analyzed on the basis of literature data and personal experience. The main directions of radionuclide diagnostics and radionuclide therapy in children are briefly considered. The importance of accurate determination of the optimal value of the activity of a specific radiopharmaceutical administered to a child, considering his body weight and the study protocol, was noted. A tendency to an increase in the radiation load on patients is shown due to the widespread introduction into clinical practice of hybrid installations for radionuclide studies, when using which the dose of internal radiation from radiopharmaceuticals is supplemented by the dose of external radiation from X-ray CT. The need to consider the risk of radiation-induced carcinogenesis during nuclear medical procedures, the likelihood of which in children is significantly higher than in adults, is emphasized. The technological and psychological features of these procedures in children are discussed. The necessity of revision of domestic normative documents regulating the use of means and methods of nuclear medicine in pediatrics has been substantiated. 

Introduction: Gastric extranodal diffuse large B-cell lymphoma (DLBCL) is one of the most common types of lymphoma. The management of patients with DLBCL of s tomach includes immunochemotherapy, radiotherapy and surgery, but there is no standard approach. Endoscopy as a part of diagnostic workup is obligatory, but using positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDG) is not obligatory at different stages of observation and treatment.
Purpose: To evaluate the diagnostic precision of PET/CT with 18F-FDG in both assesement and treatment stages for patients with extranodal DLBCL of stomach. Materials and methods. In this study we describe early and late therapeutic outcomes of 23 patients with primary extranodal DLBCL of stomach, treated in our center between 2010 and 2018, who received R-CHOP immunochemotherapy regimen. There were PET/CT and fibrogastroduodenoscopy (EGD) provided for all patients on every stage of assessment.
Results: The diagnostic accuracy of PET/CT before the treatment was 87 %, after immunochemotherapy — 91,3 %, after radiotherapy — 100 %.
Conclusions: This study shows up the role of including PET/CT scan as an observation method for patients with extranodal DLBCL of stomach on each stage of treatment and response assessment, especially for long-term prognosis evaluation.

Purpose: To show the additional clinical importance of SPECT/CT method in the complex diagnosis of skeletal system.
Material and methods: Patient: male, 75 years. Medical history: At the beginning of July 2021 the patient noticed the presence of blood in urine, and after that he seeked medical assistance from urologist. During medical check up — suspicion on prostate tumor. 09.07.21 PSA > 100 ng/ml. The patient was directed to N.N. Blokhin National Medical Research Center of Oncology for further examination and treatment. Whole body bone scan revealed multiple foci of increased activities of the radiopharmaceutical in the lumbar spine, sacral vertebrae and in the projection of groin and scrotum. After bone scan, SPECT/CT was performed. Metastatic lesions of bone tissue were not confirmed, however, an inguinal scrotal hernia and a nodus in the pelvic cavity (probably of a metastatic) were detected.
Conclusion: The use of SPECT/CT made it possible to detect additional changes in the study area. Information about the presence of an inguinal hernia will help prevent complications.

Purpose: To evaluate the possibility of multiparametric MRI in the differential diagnosis of benign adrenal adenomas and adrenal metastases.
Material and methods: In our study we evaluated 27 adenomas and 13 adrenal metastases using MRI in 35 patients who underwent examination and treatment at the basis of the N.N. Blokhin National Research Center of Oncology during the follow-up period from 2019 to 2021. The following parameters were evaluated: contours, homogeneity (homogeneous and heterogeneous), T2-weighted SI ratio (isointensive, moderately hyperintensive or sharply hyperintensive) relative to muscle and spleen, signal intensity (SI) decrease on chemical-shift MRI, measurement of the chemical-shift SI index, adrenal-to-spleen SI ratio, areas under the ROC curve (AUC) for contrast-enhanced MRI, absolute and relative percentage wash-out. Sensitivity, specificity, and positive and negative predictive values were calculated. DWI with b-values 400 and 800 s/mm2 and ADCs imaging were measured in adrenal lesions.
Results: Metastases were subjectively more heterogeneous than adenomas (76.9  % vs 63  % of cases, p = 0.0181). Adenomas had higher T2-weighted SI (average value = 228; range from 91 to 732) than metastases (average value  =  331; range from 114 to 581), both quantitatively (p  =  0.0326) and subjectively by visual assessment (p = 0.0171).
According to the T1-WI out-of-phase data, a more intense MR signal was observed in metastases (average value 162; range from 102 to 242) compared with adenomas (average value = 74; range from 17 to 183) (p < 0.0001), which was confirmed by normalization to muscle (p < 0.0001) and spleen (p = 0.0002). Adrenal metastases were characterized by a significantly lower chemical shift index (average value = 3.8; range from –16.4 to 47.8; p < 0.0001) compared with adenomas (average value 55.4; range from –4.2 to 85.5), and a higher chemical shift index in the ratio adrenal gland/spleen (p = 0.0079). There were no significant difference in the value of ADC-cards of adenomas and adrenal metastases. However, a higher level of SI on DWI at b = 800 s/ mm2 without normalization (p = 0.0262) and with normalization to muscle (p = 0.0064) and spleen (p = 0.0007) was evaluated in metastases, as well as on DWI at b = 400 s/mm2 with normalization for muscle (p = 0.0086) and spleen (p = 0.035). On native T1-WI FS, there was a lower level of SI revealed in adenomas compared to adrenal metastases (p  =  0.0025), which was confirmed by normalization to the muscle (p  =  0.0028) and spleen (p = 0.0035). In the venous and delayed phases of scanning the SI in adenomas was also lower than in metastases both without normalization (p = 0.0123 and p = 0.007, respectively), and with normalization to the muscle (p = 0.013 and p = 0.0011, respectively) and the spleen (p = 0.0084 and p = 0.0012, respectively). However, the SI in the arterial phase of scanning with and without normalization, the accumulation of MRCS in all phases of MRI scanning, the absolute and relative percentage wash-out of MRCS and the area under the MRCS accumulation curve in the groups had no statistically significant difference.

Percutaneous image-guided cryoablation (PICA) in relieve pain from metastatic bone disease was performed in 24 patients. The cryoprobes were navigated and the ice sphere was monitored using computed tomography. Each patient, depending on the volume of the lesion, underwent from one to four ablations. Pain assessment was performed using a numerical rank scale. A decrease in the pain index after PICA was from 4.1±0.8 points to 1.3±0.5 points. The duration of analgesic affect correlated with local control of the tumor. A later postoperative complication was noted in one case in the form of a bone fracture in the ablation zone. Further study of the effectiveness of this technology is necessary by analyzing larger samples and comparing them with the results of treatment with other methods of local exposure.

A review of the literature on the early diagnosis of lung cancer, prepared based on the results of the analysis of domestic and foreign literature, which are published in electronic media. The literature was searched in the Elibrary system, including publications describing the current capabilities of laboratory, instrumental, and molecular genetic methods for early diagnosis of lung cancer. The review highlights the results of an international randomized trials of screening for lung cancer.

We present two patients with advanced unresectable intrahepatic cholangiocarcinoma successfully treated with combined systemic-regional chemotherapy. Intra-arterial treatment included oily chemoembolization and chemoinfusion (GEMOX) with additional systemic chemotherapy (GEMCIS). Chemotherapy did not stop after extrahepatic progression: metastases to the lungs and bones. Continuous symptomatic nutritional support allowed to minimize chemotherapeutic toxicity and to maintain good quality of life. One patient is still alive for more than 4 years, the other died of tumor progression in three years ten months. The importance of factors contributing to the long-term survival of patients with advanced intrahepatic cholangiocarcinoma is considered.

Purpose: Analysis of a clinical case of detection of metastatic lesions of the mediastinal subcarinal lymph node in a patient with hepatocellular liver cancer using positron emission tomography combined with computed tomography (PET/CT).
Material and methods: A patient with moderately differentiated hepatocellular liver cancer after surgical treatment and targeted therapy revealed a biochemical relapse. Complex examination (computed tomography, magnetic resonance imaging) revealed no pathological changes. PET/CT revealed pathological accumulation of 18F-choline in the subcarinal lymph node. After performing transbronchial lymph node biopsy and histological examination metastatic lesion was confirmed.
Conclusion: Whole body PET/CT scan revealed rare metastases of hepatocellular cancer in biochemical recurrence — in the mediastinal subcarinal lymph node, in the absence of other manifestations of the disease. Whole body PET/CT is the method of choice for suspected extrahepatic localization of hepatocellular carcinoma progression.