Radiation therapy is the standard therapeutic option in patients with prostate cancer (PCa) after radical prostatectomy (RPE), the indications for which are a high risk of postoperative progression (adjuvant radiation therapy) or registration of biochemical (clinical) recurrence of the disease (salvage radiation therapy). In recent years, studies have been conducted to assess the efficacy and safety of the use of hypofractionated radiation regimens in this category of patients, which significantly reduce the duration of treatment. Starting from 2016, the regimen of extreme hypofractionation or stereotactic radiation therapy (STRT) to the prostate bed (PB) began to be used in world practice, which makes it possible to deliver the prescribed dose in five-seven fractions. Currently, the N.N. Petrov National Medical Research Center of Oncology has matured long-term (more than five years) experience in performing STRT to the PB. The purpose of this work — to inform oncourologists, radiation oncologists and specialists in related areas with various aspects of a new perspective approach to postoperative radiation to the PB.

Purpose: To study the diagnostic value of PET/CT with ⁶⁸Ga-FAPI compared with ¹⁸F-FDG in evaluation of cancer extent of esophageal. Materials and methods: The study included 15 patients (10 men, 5 women) with esophageal cancer. All patients underwent PET/CT with ¹⁸F-FDG and ⁶⁸Ga-FAPI-04 from January to December 2024. Primary tumor, metastases in regional lymph nodes were evaluated by PET/CT with ⁶⁸Ga-FAPI-04 and ¹⁸F-FDG. Histological verification was performed in all cases. Results: PET/CT with ⁶⁸Ga-FAPI-04 demonstrated high level of visualization of metastases in regional lymph nodes. The method finds a little more metastasis in regional lymph nodes in comparison with PET/CT with ¹⁸F-FDG. Conclusion: PET/CT c ⁶⁸GA-FAPI-04 demonstrates promising results in evaluation of cancer extent of esophageal. Further studies on large cohorts of patients are necessary to clarify the role of PET/CT with FAPI-04 for various histological types of esophageal cancer.

Introduction: Since 2016, peptide-receptor radionuclide therapy (PRRT) with ¹⁷⁷Lu-labeled somatostatin analogues has become a recognized treatment option in the second or third line of patients with progressive differentiated (grade G1–2) gastroentero pancreatic neuroendocrine tumors (GEP-NET) with radiopharmaceutical ¹⁷⁷Lu-DOTA-TATE. Based on the results of the NETTER-II study, PRRT is being actively introduced as a first-line therapy for GEP-NETs, as a neoadjuvant treatment. Purpose: Analysis of the effectiveness and safety of the peptide-receptor radionuclide therapy method ¹⁷⁷Lu-DOTA-TATE, according to world literature. Materials and methods: The search for literary sources was carried out in the period from 01.06.2024 to 12.12.2024 in the databases: Pubmed, Google Scholar, ELibrary using the search queries: ¹⁷⁷Lu-DOTA-TATE, ¹⁷⁷Lu and NET, peptid-receptor radionuclide therapy. Results: This method of radiotargeting therapy used to treat patients with metastatic and inoperable neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC) expressing type 2 somatostatin receptors (SSTR2) [1]. The increase in the incidence and prevalence of NET in recent decades [2], and the development of specific treatment methods and protocols, there is a growing use of this type of radiotargeted therapy ¹⁷⁷Lu-DOTA-TATE. Discussion: ¹⁷⁷Lu-DOTA-TATE approved by relevant foreign medical regulatory organizations: FDA, EMA [3, 4]. Analysis of the PRRT method, treatment results, and side effects characterizes this method of radionuclide therapy as safe and highly effective. Conclusion: The treatment of patients with NETs and NECs, including PRRT, requires a wide range of specialized clinical knowledge, which necessitates discussing patients in an expert multidisciplinary team of clinicians (oncologists, endocrinologists, chemotherapists, radiologists, radiotherapists, pathologists and other specialists).

Purpose: Improving the accuracy of pancreatic tumor detection and differential diagnosis of neuroendocrine neoplasia (NEN) with pancreatic adenocarcinomas using a two‑dimensional (2D) multivoxel hydrogen MR spectrometry protocol. Materials and methods: The study included 76 patients, including 47 cases of pancreatic tumors and 29 cases without pancreatic pathology. Pancreatic tumors were represented by 24 NEN (G1 = 4, G2 = 19, G3 = 1) and 23 adenocarcinomas. The diagnosis was established based on morphological examination after surgery or tumor biopsy. The levels of the following metabolites obtained by multivoxel MR spectrometry were determined: choline (Cho), creatine (Cr), glutamine/glutamate (Glx), N‑acetylaspartate (NAA), lactate (Lac) and their ratios Cho/Cr, Lac/Cr, Cho/NAA, Glx/Cr. Results: The results of the study showed a higher level of creatine in unchanged tissue compared to pancreatic tumors (p = 0.032): in unchanged pancreatic tissue — from 6.01 to 23 (median 12.4), in tumors — from 3.04 to 13.55. (median 6.01). At a threshold signal level from creatine of less than 16.1, the sensitivity in detecting pancreatic tumor was 70.9 %, specificity — 61.9 %. The Cho/Cr level was higher in tumors compared to unchanged pancreatic tissue (p = 0.031). It was also found that the presence of glutamate and glutamine in the tumor, recorded by MR spectrometry data, is more common in NEN compared to pancreatic adenocarcinomas (p = 0.029): the presence of glutamate and glutamine was noted in 66.7 % of NEN and in 34.8 % of pancreatic adenocarcinomas. The Glx/Cr level in NEN was also higher compared to adenocarcinomas (p = 0.026). Conclusion: MR spectrometry may be a useful adjunctive tool in the detection of pancreatic tumors and differential diagnosis of pancreatic adenocarcinomas and NENs, to improve the accuracy of pancreatic tumor detection and differential diagnosis of NENs with pancreatic adenocarcinomas using a two‑dimensional (2D) multivoxel 1H‑magnetic resonance spectrometry (MRS) protocol.

Purpose: To improve the diagnostic efficacy of ultrasound (US) in detecting tumor thrombi in the inferior vena cava (IVC) and refine ultrasonographic criteria for Budd–Chiari syndrome (BCS) in patients with high-grade occlusive tumor thrombi of the IVC. Materials and methods: The study included 112 patients (36–78 years) with high-grade occlusive IVC thrombi. Inclusion Criteria: 1. Primary tumors (e.g., IVC leiomyosarcoma, renal cell carcinoma) associated with IVC thrombosis. 2. Instrumentally confirmed partial or complete occlusion of hepatic vein ostia. Ultrasound Protocol:

• B-mode imaging: Evaluation of thrombus echogenicity, structure, and extent; assessment of hepatic veins, IVC, and portal system.
• Doppler ultrasound: Analysis of blood flow direction and velocity in hepatic veins, IVC, and portal vein; diagnosis of hepatic vein occlusion.
• Liver elastometry: Fibrosis staging using METAVIR (F0–F4). Additional verification methods: correlation with computed tomography (CT) or magnetic resonance imaging (MRI) data and histopathological confirmation (in postoperative patients). Results: Absolute contraindications to surgery were identified in 6.25 % of patients (n = 7):
• Occlusive IVC thrombosis with impaired hepatic venous outflow.
• Hepatomegaly with structural parenchymal changes.
• METAVIR F4 fibrosis (cirrhosis). Decompensated portal hypertension (ascites, splenomegaly). In 93.75 % (n = 105), absence of cirrhosis enabled radical surgical intervention (tumor resection with thrombectomy). Elastometry confirmed a direct correlation between fibrosis severity and BCS progression (F4 fibrosis as a key predictor of non-operability). Conclusions: Refined ultrasound criteria for Budd–Chiari syndrome in patients with inferior vena cava (IVC) tumor thrombosis not only enhance diagnostic accuracy but also minimize the risk of unnecessary surgeries. Elastography and portal hemodynamic assessment are pivotal components of the diagnostic algorithm, significantly influencing clinical outcomes. Implementing these strategies into clinical practice will improve survival rates and reduce postoperative complication rates.

Purpose: To improve ultrasound diagnostics of regional lymph nodes in skin melanoma: to develop a new Russian ultrasound classification of regional lymph nodes in melanoma (RUCL-M) to reduce hyperdiagnosis and reduce the number of unjustified biopsies. Materials and methods: A prospective study involving 85 patients with high–risk skin melanoma (according to AJCC criteria) who underwent sentinel lymph node biopsy (BSLU) with preliminary lymphoscintigraphy ( ^99mTc-Nanotop) and extensive excision of the primary tumor. Conclusion: RUCL-M is a step towards precision diagnostics, which retains the importance of BSLU in complex cases. Expands the possibilities of ultrasound for clinical decision-making. Saves resources by reducing overdiagnosis. Implementation requires training of doctors (emphasis on quantitative criteria), adjustment of clinical protocols, and monitoring of long–term outcomes (frequency of relapses or disease progression, especially in patients with high-risk skin melanoma who have not undergone BSLU)

Purpose: To conduct a comparative analysis of the diagnostic effectiveness of elastography and elastometry in detecting melanoma metastases in lymph nodes using histological examination of a macropreparation as a reference method. The data obtained can help in the development of algorithms for noninvasive diagnostics and reduce the number of unjustified surgical interventions. Materials and methods: A prospective study of 14 macro-preparations of metastatically affected lymph nodes removed from patients with skin melanoma during elective surgical interventions was conducted. Conclusion: An integrated ultrasound approach combining elastography and elastometry demonstrates high accuracy in detecting metastatic lymph node lesions in skin melanoma.

Purpose: Improved biopsy results of neuroendocrine neoplasia of the pancreas and neuroendocrine neoplasia of the gastrointestinal tract of other locations under ultrasound navigation. Materials and methods: The study included 56 CT scans with intravenous contrast and clinical and laboratory methods of examining neuroendocrine neoplasia of the pancreas. The results of biopsies of neuroendocrine neoplasia of the pancreas were analyzed under ultrasound navigation in the usual B-mode and in the B-mode with complex methods for determining the elasticity of pancreatic tumors (elastometry and elastography), doppler imaging and improved visualization in B-mode. Conclusion: Additional ultrasound techniques allow us to provide qualitative and quantitative criteria for the tumor structure, which technically allows us to obtain a high-quality biopsy and avoid unnecessary biopsies.

Purpose: To evaluate the tolerability and efficacy of transarterial chemoembolization (TACE) in the treatment of patients with metastatic liver disease from uveal melanoma. Materials and methods: From 2000 to 2024, 131 patients with uveal melanoma underwent liver TACE for metastatic liver disease at the N.N. Blokhin National Medical Research Center of Oncology of the Russian Ministry of Health. The treatment was carried out for multiple bilobar liver disease (110 patients) and solitary/single liver metastases (21 patients). A total of 283 TACEs were performed. The duration of observation after TACE ranged from 1 to 152 months. The median observation was 11 months. Results: TACE was technically successful in 100 % of cases. Postembolization syndrome of varying severity was observed in 82.4 %. Mortality 0 %. Local response (according to mRECIST) was observed in 75/131 (57.2 %) patients. Overall survival (OS) (n=131) was: 1-year — 78.5 %, 2-year — 47 %, %, 3-year — 17 %. Median overall survival was 23 months. In the group of patients who received only TACE (n=29): 1-year OS — 66 %, 2-year OS — 27 %, 3-year OS — 13 %. In the TACE + additional treatment group (n=102) — 1-year OS — 82.2 %, 2-year OS — 50.3 %, 3-year OS — 23.7 %. Conclusions: TACE is a safe treatment option for patients with uveal melanoma with different volumes of liver metastases. Local response in slightly more than half of patients indicates the need for a more rigorous definition of indications for this intervention. Ourresults with TACE indicate the need for further research to determine the optimal timing of the combination of regional interventional treatment with systemic drug therapy, surgery, and liver chemoperfusion.

Purpose: To evaluate the possibilities of ERUS and MRI in the preoperative diagnosis of early tumors of the rectum. Materials and methods: 53 patients with morphologically confirmed rectal tumor were included in the study. All underwent MRI of the rectum and ERUS. The final stage of the tumor process was determined after performing a pathoanatomic examination of the postoperative material, which was the gold standard. Results: Significant differences were found in both tumor detection (p = 0.006) The same is true for determining the stage (p = 0.019). ERUS surpassed MRI both in detecting tumors (100 % and 84.9 %) and in assessing locoregional prevalence (54.7 % and 31.9 %). Conclusion: ERUS is a valuable imaging method and has high clinical significance in the preoperative staging of early colorectal cancer.

The article presents a review of the literature concerning the assessment of the possibilities of ultrasound hybrid imaging methods in oncohepathology. Fusion imaging includes the combined use of computed tomography (CT) or magnetic resonance imaging (MRI) with greyscale ultrasound and contrast-enhanced ultrasound (CEUS). The main areas of application of ultrasound fusion imaging, such as differential diagnosis of liver lesions, navigation for biopsy and for thermal ablation. Fusion imaging in oncohepatology increases the sensitivity of the detection of liver lesions, assesses its structure and predicts the response of treatment

The article presents a rare form of pathological neoplasms — breast desmoid type fibromatosis. There are etiology and pathogenesis of the disease, clinical and morphological features, diagnostics and tactics of treatment of the disease. Widely covered clinical examples from the practice of a surgeon-oncologist. Desmoid fibromatosis (DF) is an aggressive non-metastatic mesenchymal formation that arises from musculoponeurotic structures. DF accounts for 0.03 % to 0.1 % of solid tumors and 3 % of mesenchymal tumors. Among breast pathology, this neoplasm is even rarer (0.2 %). Due to the rarity of such pathology, clinicians are not always able to correctly interpret the diagnostic picture and recognize the disease. The etiology and pathogenesis of the disease are also not fully understood, and therefore there are no standards for the treatment of desmoid fibromatosis. Surgical treatment remains the main one. To reduce the frequency of recurrence of the disease, the surgeon needs to achieve clean edges of the resection. Radiation therapy, hormone therapy, targeted therapy, and chemotherapy may additionally be considered as an alternative type of treatment. When the clean edges of the resection are reached, strict dynamic monitoring of pa is considered as further treatment.