Purpose: Boron neutron capture therapy is a promising and prospective treatment method, including patients with high-grade glial brain tumors. Taking into account the planned bringing into service of a neutron source accelerator at the N.N. Blokhin National Medical Research Center of Oncology, the objective of the review was to update the current status of the effectiveness of a prospective treatment method.
Material and methods: A literature search was conducted to identify results of retrospective (with at least 30 patients analyzed) and phase I and II studies in the Pubmed database.
Results: Of the 58 publications found, 8 papers met the search criteria: a retrospective study, 5 phase I studies, and 2 articles with the results of phase II studies. An analysis of these works indicates a low level of methodology for conducting clinical studies of the BNCT effectiveness thus impossibility to recommend the method for routine practice.
Conclusion: Clinical trials with an appropriate level of methodology are required to recommend BNCT for patients with high-grade glial brain tumors as a standard treatment.

The basics of Boron Neutron Capture Therapy (BNCT) of malignant tumors and requirements for a therapeutic neutron beam are presented, neutron sources used or being developed for BNCT are listed, and features of dosimetry and  treatment planning system are indicated. 

Neutron Capture Therapy (NCT) — highly selective method of binary radiotherapy of malignancies, which is based on physical phenomenon of thermal neutron radiation capture by atoms’ nuclei. Currently only 10B mediated NCT, known as boron neutron capture therapy (BNCT), is used in clinical practice. Boronophenylalanine — a modified amino acid is most widely used as 10B carrier. Despite of more than 70-years history of BCNT clinical application and promising results of curing patients with different tumors, this method of treatment is still under research and development. The most urgent issue is studying and prediction of radiation effects of healthy and tumor tissues after BNCT application. This task can be solved in experiments involving animals. The review contains results of BNCT studies both in laboratory animals with different tumor models and veterinary practice. Induced and transplanted models of central nervous system, oral cavity as well as subcutaneous and metastatic models are considered in the review. Obtained results of the studies show possible high antitumor efficacy of BPA mediated BNCT and fundamentally different mechanisms of BNCT effect on tumor and healthy tissues comparing to other known types of radiotherapy. Many issues still require addition research with modern methods of studies, such as in vivo preclinical imaging.

Purpose: To conduct a quantitative analysis of the quality of irradiation planning for patients with metastatic lesions of the spine, to assess the dose load on critical organs for this category of patients, to establish the relationship between patient survival and the homogeneity index.
Material and methods: A quantitative analysis of stereotactic irradiation plans for 65 treated patients with simultaneous integrated boost (SIB) was performed. Plans (not implemented) were simulated for a group of patients with an increased prescribed dose to the affected vertebra, including an invisible expected zone of microscopic spread of malignant cells. Dose loads in critical organs for irradiation plans using IMRT and VMAT technology with metastatic lesions of the spine were estimated for both groups. Homogeneity indices were calculated.
Results: The results of the quantitative analysis of the plans for stereotactic irradiation of patients showed that the doses in critical organs in the simulated irradiation plans slightly exceed the same doses, but, nevertheless, are comparable with the characteristics of the integrated boost (SIB) technique and fit into the tolerable dose values in accordance with international criteria. The characteristics are also comparable in terms of the homogeneity index. The hypothesis of the effect on the life expectancy of patients after RT, including the value of the homogeneity index as one of the factors affecting survival times, was not statistically confirmed. The simulated irradiation plans for patients with an increased prescribed dose to the affected vertebra, including an invisible expected zone of microscopic spread of malignant cells, can be applied to the implementation and treatment of patients with metastatic lesions of the spine. Homogeneity indices H I were calculated. It was shown that the survival time for patients with a dose to the PTV of 25 Gy with HI ≥ 0.15 is limited to 18 months, and for HI ≤ 0.15 it increases to 29 months with a statistical significance level of p = 0.647. Similarly, the survival time for patients with a dose to the PTV of 30 Gy with HI ≥ 0.15 is limited to 16 months, and for HI ≤ 0.15 it increases to 29 months with a statistical significance level of p = 0.936, which reflects the absence of differences between the groups.
Conclusions: The obtained results indicate that the hypothesis about the influence of the homogeneity index on life expectancy is not confirmed. For final conclusions, it is necessary to continue the study, possibly with an increase in the sample or the inclusion of additional influencing factors.

Purpose: To investigate the structure of adverse post-radiation reactions occurring after radiosurgical treatment of cavernous malformations (CMs) and to identify factors influencing their frequency.
Material and methods: Between September 2005 and September 2020, 123 patients with single CMs of the brain (a total of 123 CMs) were irradiated at the center. The final analysis included 67 patients. Dose distribution data were subjected to regression analysis.
Results: Nineteen cases of post-radiation edema (28.3 %) and two cases of post-radiation necrosis (2.9 %) were identified. During the observation period, ten patients experienced hemorrhage from the irradiated CM (14.9 %). The dose received by 50 % of the target volume (including the planning target volume) was determined to be the most significant predictor of post-radiation edema development in patients after radiosurgery for single cavernomas.
Conclusion: In cases of deep-seated CMs, microsurgical removal is associated with a high risk of complications. In such cases, radiosurgery can be offered as a safe alternative to microsurgery.

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system, primarily affecting individuals with severe immunosuppression. Its subacute onset, nonspecific clinical manifestations, and MRI findings complicate accurate and timely diagnosis. This review provides a brief overview of the etiology and fundamental pathogenesis of the disease, demonstrating through a clinical case the importance of a multimodal approach and the potential challenges in the differential diagnosis of PML.

Introduction: Crohn’s disease (CD) and ulcerative colitis (UC) are included in the group of inflammatory bowel diseases (IBD) and belong to the group of potentially disabling diseases with an unknown etiology.
Study objective: Determine the most significant differential diagnostic ultrasound signs of Crohn’s disease and ulcerative colitis.
Material and methods: Based on morphological data, the analysis of diagnostic and treatment results of 142 patients was performed. According to the nosological form and stage of the disease, the patients were divided into 3 groups and several subgroups: Group 1 (n = 84) — patients with UC; Group 2 (n = 58) — patients with CD; Group 3 (control) (n = 27) — somatically healthy volunteers. The main method of radiation diagnostics was ultrasound.
Results: In primary diagnostics, the most informative ultrasound signs of IBD are: thickening and decreased echogenicity of the colon wall, loss of colon haustration, increased echogenicity of paracolic tissue, multiple blood flow loci in the colon wall during CDC — the sensitivity of signs in patients with UC was 94.5 %, specificity 97 %, in CD 94 % and 97 %, respectively (p < 0.001). The most significant differential diagnostic ultrasound criteria for CD are identified: local thickening of the colon wall by more than 10 mm, intestinal lumen narrowed by less than 3 mm, regional lymph nodes more than 10 mm; and ulcerative colitis — local thickening of the colon wall from 3 to 10 mm, dilated intestinal lumen (more than 15 mm), regional lymph nodes from 8 to 10 mm (p < 0.001). When conducting ROC analysis, the threshold value of the “wall thickness” criterion in the differential diagnosis of CD and UC, with the maximum specificity of the test was 10.5 mm (sensitivity 97 %, specificity — 100 %); “lumen diameter”— 13 mm (sensitivity 80.6 %, specificity — 97 %), respectively.
Conclusions: The obtained results allow us to recommend transabdominal ultrasound of the intestine as the method of choice for timely non-invasive diagnosis of patients with the most common forms of IBD.

Purpose: To evaluate machine-learning radiomics based models on enhanced MR images in diagnostics of early HCC.
Material and methods: Data from 72 patients with 93 masses who underwent Gadoxetic acid-enhanced MRI scans was retrospectively analyzed.
Results: Binary classification models were produced for the differential diagnosis of regenerative and dysplastic nodes, early HCC and HCC nodes with an atypical enhancement with high discriminatory capabilities; the area under the ROC-curve ranged from 0.89 to 0.95 in various models.
Conclusion: The performed radiomic models can be used as an effective method for differential diagnostics of HCC with typical and atypical enhancement, dysplastic and regenerative nodes.

Relevance: Esophageal cancer is the eighth most common cancer in the world. Improving the algorithm for visualization of esophageal cancer through the use of modern magnetic resonance imaging (MRI) techniques along with traditionally used methods of radiological diagnostic methods (endoussis, MSCT, PET/CT), is an important purpose of choosing the optimal way of treatment for various categories of patients.
Purpose: To determine the possibilities of MRI in comparison with other methods (CT and Endoscopic Ultrasound) in the diagnosis of esophageal cancer.
Material and methods: 125 people with suspected esophageal cancer were examined. All patients underwent MRI, 121 (96.8 %) of which also underwent esophageal CT, and 82 (65.6 %) EUS. All cases were histologically verified.
Statistics: Categorial data processing was carried out using statistical techniques: frequency tables, conjugacy tables, χ² criteria or Fisher’s exact criteria (in the case of a small sample number). The differences were considered statistically significant at values of p < 0.05.
The results: Mostly the use of an optimized MRI protocol in the diagnosis of esophageal tumors demonstrated predominantly high sensitivity, specificity and accuracy in determining T and N criteria (72.8 %, 89.3 % and 85.7 % for the T-criterion, 70.4 %, 87.3 % and 83.9 % for the N-criterion, respectively) in comparison with CT methods (57.0 %, 83.7 % and 77 % for the T-test, and 73.6 %, 88.7 % and 85.6 % for the N-test, respectively) and endo-ultrasound (75.6 %, 83.3 % and 85.2 % for the T-test, 67.1 %, 86.7 % and 81.1 % for the N-test, respectively).
Conclusion: The use of an optimized MRI protocol in determining the T and N criteria for esophageal cancer when compared with other modalities of radiation diagnosis showed: significant advantages of MRI in determining the T and N criteria compared with CT, moderate compared with endo-ultrasound for the T criterion, and comparable for the N criterion. The data obtained indicate the prospects for in-depth study and implementation of MR esophageal examination in clinical practice.

Introduction: The percentage of cases of neuroendocrine tumors (NET) is growing every year. Moreover, the diagnosis is often made in the later stages, when the disease manifests itself with manifestations of carcinoid syndrome (CS) and its accompanying indications. Today, there is a need to systematize approaches to diagnosis and individual groups of patients with unresectable metastatic lesions of NETs.
Material and methods: A retrospective assessment of the results of treatment of patients with bilobar metastatic liver disease NET on the background of uncontrolled CS was performed in the period from 2010 to 2023. The study included 10 patients with NET G1 — 4 patients, G2 — 6. The sampling structure according to the location of the primary lesion was divided into: pancreas (n = 7), small intestine (n = 3). Before the start of regional chemotherapy, the primary lesion was removed in 1 patient. The average age of the patients in the sample was 31.3 years.
In order to evaluate the results, patients underwent SCT of the abdominal cavity and chest with intravenous enhancement, PET/CT of the whole body with ⁶⁸Ga-DOTA TATE/NOC. All patients in the group received therapy with long-acting somatostatin analogues. Two of them additionally received everolimus 10 mg per day.
The leading method of embolization is oil TACE with a suspension of doxorubicin 50–100 mg or mitomycin C 10–20 mg with superfluid lipiodol 5–8 ml, then adding a collagen sponge 0.25–0.5 cm³ into the tumor vessels until blood flow is reduced. Courses were held once every 2 months. The evaluation of the treatment was carried out according to an objective examination (ECOG 0), the nature of the complaints, and instrumental diagnostic data (CT with intravenous contrast).
Results: Evaluation after regional chemotherapy: partial response in one patient; stabilization in seven; progression in two patients (according to mRECIST). The average serotonin level before CEPA was 936.5 ng/ml; after two courses there was a significant decrease to 282.1 ng/ml (p < 0.05). After stabilization of the disease, the primary lesion was removed in 6 patients; patients underwent cytoreductive atypical liver resection (n = 4) and MVA (n = 1). Currently, three patients have died, the average life expectancy of the deceased is 64 months. Seven patients were alive for periods ranging from 30 to 134 (median 84) months.
Conclusions : TACE in the treatment of patients with NETs that cause hyperproduction of hormones, manifested by CS and not relieved by somatostatin analogues, provides clinical and radiological improvements in 80 % of patients. Further cytoreductive interventions can extend the median overall-survival (OS) to 84 months.

Metastatic castration-resistant prostate cancer (mCRPC) is the final stage of this disease. Modern approaches to the treatment of the mCRPC patients include a wide range of drugs (hormonal therapy, chemotherapy, PARP inhibitors, radionuclide therapy with the osteotropic drug radium chloride ²²³Ra and target radioligands (¹⁷⁷Lu-PSMA and ²²⁵Ac-PSMA). The clinical example presented in the article shows the consistent application of various methods (lines) of radionuclide therapy in the treatment of a mCRPC patient. The possibility of successful use of radioligand therapy ²²⁵Ac-PSMA in patients with significantly reduced hematological parameters against the background of a significant increase in the level of PSA.

The article is dedicated to one of the outstanding Russian scientists — Georgy Artemyevich Zedgenidze, a man of extensive scientific knowledge, administrator, teacher, who has gained great authority in the country and abroad. The contribution of the outstanding scientist, radiologist, health care organizer, academician of the USSR Academy of Medical Sciences G.A. Zedgenidze to the development of domestic y-ray radiology is presented. The main periods of the scientist’s life and work are reflected. Little-known facts from the long and eventful life of G.A. Zedgenidze are given. He is deservedly considered the most prominent specialist in the field of y-ray diagnostics of bone and joint diseases. G.A. Zedgenidze supervised the work of radiologists of the active fleets during the Great Patriotic War. During the Great Patriotic War, he developed issues of organizing y-ray care in the Armed Forces in peacetime and wartime. It is noted that G.A. Zedgenidze was always distinguished by high integrity, humanity, commitment, modesty, caring and benevolent attitude towards employees, students and fellow workers. These traits earned him sincere love and deep respect from others.