Purpose: To familiarize radiation oncologists and specialists of related specialties with various aspects of a promising, comprehensive approach to patients with locally advanced pancreatic cancer.
Materials and methods: The review includes data from domestic and foreign articles found in PubMed/MEDLINE, as well as a clinical case.
Results: As a clinical example, patients with locally advanced pancreatic cancer who received chemotherapy followed by radiation therapy are presented, and the immediate results of treatment are demonstrated.
Conclusions: Despite the predominant role of chemotherapy and surgery in the treatment of pancreatic cancer, radiation therapy still plays an important role in the comprehensive treatment of this disease as a method that improves local control in resectable, borderline resectable, locally advanced, and recurrent pancreatic cancer. However, there is a lack of data on the methods, target volume determination, and fractionation schemes.

Introduction. Head and neck cancer is characterized by a high rate of locoregional relapses. Treatment of progressive disease is ineffective, which significantly reduces the prognosis. The importance to study boron neutron capture therapy (BNCT) as a promising method capable of providing selective destruction of tumor cells with minimal damage to surrounding tissues.
The aim of this systematic review was to comprehensively evaluate the efficacy and safety of BNCT in locally advanced recurrent head and neck cancer.
Materials and methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a systematic search of PubMed for all articles up to January 2025.
Results: 22 studies were included in the systematic review: 8 phase I/II studies and one phase II study, as well as 11 retrospective studies. The search identified 680 patients with recurrent or locally advanced unresectable head and neck cancer. The analysis showed that BNCT demonstrates promising efficacy in various cancer types with a manageable safety profile. Conclusions: BNCT shows significant promise as a treatment modality, offering potential benefits with acceptable safety. However, further research is needed to improve its clinical application and ensure its safety and efficacy.

The primary obstacle to the widespread clinical implementation of Boron Neutron Capture Therapy (BNCT) for malignant tumors is the lack of highly efficient tumor-targeted boron delivery agents. Clinically approved compounds – boronophenylalanine (BPA) and sodium borocaptate (BSH) – exhibit significant limitations, necessitating the development of novel boron pharmaceuticals. This review surveys current research directions in boron-containing drug development for BNCT, focusing on preclinical studies in laboratory animals. Three principal strategies are analyzed: targeted agents (antibody- or ligand-based constructs targeting tumor receptors: EGFR, VEGFR, etc.); natural and unnatural boronated amino acids; nanocarrier-based systems – boron-loaded nanoparticles and liposomes. Effective BNCT agents must demonstrate selective tumor accumulation, achieving intratumoral boron concentrations ≥20 μg/g cancer tissue during neutron irradiation while minimizing accumulation in healthy tissues. We critically evaluate the boron delivery efficacy, the prospects, and limitations of each approach. Current evidence indicates that metabolismdriven delivery systems, such as unnatural cyclic amino acids and transferrin conjugates, show the greatest therapeutic potential. Conversely, receptor-mediated agents (ligands/antibodies) have yet to demonstrate sufficient tumor boron accumulation for clinical BNCT efficacy.

According to state-of-art clinical guidelines, the leading method of treatment for de novo metastatic breast cancer is systemic therapy. However, the possibility and feasibility of performing local methods in treating the primary lesion in the above mentioned patients, such as surgery and radiation therapy, is currently being actively studied. This article provides a review of modern literature data related to the issues of external beam radiation therapy in patients with de novo metastatic breast cancer and presents our own clinical observations.

Purpose: To study the diagnostic value of PET/CT with 18F-FDG in evaluation of metastases in lymph nodes of esophageal cancer.
Materials and methods: The retrospective study included 70 patients with squamous cell esophageal cancer. All patients underwent PET/CT with 18F-FDG from 2020 to 2024 in the N.N. Blokhin National Medical Research Center of Oncology. Metastases in the regional lymph nodes were-evaluated by PET/CT with 18F-FDG. Histological verification was performed in all cases.
Results: PET/CT with 18F-FDG demonstrated sensitivity 86 % and specificity 78 % of visualization of metastases in the regional lymph nodes.
Conclusion: PET/CT with 18F-FDG is a promising imaging method in evaluation of cancer extent squamous cell esophageal carcinoma, detecting metastases in unchanged lymph nodes. PET/CT limitations require a comprehensive diagnostic approach.

Purpose: Assessment of the diagnostic value of CT and MRI in determining the malignancy grade of pancreatic neuroendocrine tumors (NETs).
Materials and methods: The study included 89 patients with pancreatic NETs. The diagnosis was established based on morphological examination after surgery or tumor biopsy. 54 patients underwent CT with contrast agent, 71 patients underwent MRI with MR contrast agent (MRCA). Based on CT and MRI data, the size, shape, structure, and signs of tumor necrosis were assessed, and quantitative indicators of density on CT and signal intensity on MRI in tumor tissue in different contrast phases were measured, and the absolute and relative percentages of contrast agent washout were calculated. Additionally, the presence of calcifications in NETs was determined using CT data, IS on T2-weighted images (WI), on diffusion-weighted images (DWI) with a b-factor of 50, 400 and 800 s/mm2 was determined using MRI data, and the value of the apparent diffusion coefficient (ADC) was measured on ADC-maps.
Results: The analysis of CT and MRI data revealed that the tumor size did not depend on the degree of malignancy and did not correlate with the Ki-67 index. The number of nodes statistically significantly differed: multiple lesions were more common in Grade 1, and solitary ones in Grade 2. The shape and contours of the tumors also depended on the degree of malignancy: oval or round tumors with clear contours prevailed in Grade 1, while irregularly shaped tumors with unclear contours prevailed in Grade 3, which was accompanied by a higher Ki-67 level. Contrast agent accumulation decreased with increasing malignancy degree, especially in the arterial and venous phases according to CT data, while an inverse relationship with the Ki-67 index was observed. Contrast agent washout according to CT was significantly lower in Grade 3. No significant differences in contrast agent washout and ADC values were found in MRI, with the exception of a moderate inverse relationship between MRCA accumulation on T1-WI FS and Ki-67. MRCA accumulation and washout were inversely correlated with Ki-67.
Conclusion: CT and MRI can be used to assess the grade of pancreatic NETs, improving preoperative risk stratification. The most reliable imaging markers of aggressiveness include poor margins, irregular shape, hypovascularity, severe necrosis, poor or negative washout, and decreased SI on T1-WI FS.

Purpose: To evaluate the effectiveness of a contrast-enhanced ultrasound (CEUS) training programmed that incorporates a phantombased learning module.
Materials and methods: Twenty-four participants (13 practicing sonographers, 6 residents, 5 senior medical students; clinical experience 0–21 years) completed a one-day, 10-hour learning CEUS course. Hands-on practice was performed on a proprietary Russian dual-circuit phantom (patent RU 2611905 C2) that reproduces normal perfusion and three focal lesions—aneurysm, cavernous haemangioma and hyper-vascular metastasis—using standard microbubble contrast agents. Training efficacy was assessed pre- and post-course with a multiple-choice test, a 10-item practical checklist (0–20) and the Team Performance Observation Tool (team index 1–5).
Results: All metrics improved significantly: test 5,0 ± 1,0 → 8,0 ± 1,0 (Δ = +3,0; p < 0,001; d = 2,0); checklist 7,0 ± 2,0 → 17 ± 1,0 (Δ = +10,0; p < 0,001; d = 6,3); team index 2,0 ± 1,0 → 4,0 ± 1,0 (Δ = +2,0; p < 0,001; d = 1,0). The pass threshold (≥ 70 % test and ≥ 80 % checklist) was reached by 22/24 (92 %) participants (McNemar χ² = 20.2; p < 0.001). Internal consistency was good (Cronbach’s α = 0.80 for the test, 0.86 for the checklist); inter-rater reliability of the checklist was excellent (ICC = 0.92; 95 % CI 0.86–0.97). The correlation between years of experience and practical score decreased from ρ = 0.45 (p = 0.03) pre-course to ρ = 0.28 (p = 0.18) postcourse; one-way ANOVA revealed no post-course differences across four experience groups (p > 0.10). Overall satisfaction (VAS) was 9.1 ± 0.7, with highest ratings for “phantom practice” (9.5) and “mentor feedback” (9.3).
Conclusion: A single-day, 10-hour module based on the first domestic CEUS phantom produces a large gain in theoretical knowledge and practical skills and enables rapid attainment of Level 1 competence specified by EFSUMB/WFUMB guidelines. The Russian-made phantom is less expensive than imported analogues, is exempt from Government Decree No. 616 import restrictions, and can be recommended as a mandatory simulation stage in the certification of ultrasound physicians learning CEUS.

Introduction: Hepatocellular carcinoma (HCC) is associated with high mortality due to challenges in early diagnosis, the subjectivity of imaging assessments, and the lack of reliable, non-invasive methods for predicting tumor aggressiveness and treatment response.
Purpose: To evaluate the potential and evidence base of radiomic image analysis in addressing key clinical challenges in HCC.
Materials and methods: A review of current scientific literature, including Russian and international studies from 2023 to 2025, was conducted. The methodology of radiomics and its effectiveness were analyzed for the following applications: differential diagnosis of HCC, prediction of microvascular invasion (MVI), and evaluation or prediction of the effectiveness of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA).
Results: Radiomic models demonstrated high accuracy (with sensitivity up to 96 %) in the differential diagnosis of HCC. The integration of 3D radiomic features with clinical and laboratory data enabled the prediction of MVI, achieving sensitivity rates of 76–82 % and specificity of 82–85 %. Combined clinical–radiomic models showed strong performance in predicting response to TACE (AUC up to 0.92) and RFA (AUC up to 0.87), as well as in assessing recurrence risk—outperforming traditional approaches.
Conclusion: Radiomic analysis is a promising non-invasive tool for assessing HCC aggressiveness and guiding treatment selection. It outperforms conventional imaging in predicting MVI and therapeutic response to local treatments such as TACE and RFA.

Leontiasis ossea (lion’s face) is a specific form of hyperostosis of the bones of the cranial and facial skull, which often leads to disfigurement. The term leontiasis is a collective concept. Changes are most often caused by fibrous dysplasia, but can be observed in Peget’s disease, Recklinghausen’s disease and renal osteodystrophy (Siglyker syndrome).
The article presents comparative clinic-anatomical and laboratory parameters that are important in identifying the cause of leontiasis ossea. It also presents data on the nature of radiographic changes in the bones of the skull in the above diseases, approaches to differential radiographic diagnostics and the choice of further diagnostic tactics.
The above observation emphasizes the importance of radiographic examination, especially in cases of primary radiodiagnostics, assessment of the nature of changes in the bones of the skull in patients with leontiasis ossea.

Purpose: To present the experience of chemoembolizations of extrahepatic feeders to malignant hepatic tumors performed in a single oncological center.
Materials and methods: One hundred and twenty six transarterial chemoembolizations(TACE) were performed in 69 patients with hepatocellular carcinoma (HCC) and other malignant hepatic tumors. Chemoembolization with drug-eluting microspheres (DEMTACE) was performed in 77 (61.9 %) cases, conventional chemoembolization with lipiodol/chemotherapeutic drug emulsion (cTACE) in 45(35.7 %) and bland embolization in 4(3.2 %). TACE of extrahepatic feeders (TACE EHF) was carried out with TACE of hepatic artery branches at the same session in 78(61.9 %) cases. TACE of single EHF was performed in 100 (79.4 %) cases, two feeders in 24(19 %) and three in 2(1.6 %). The branches of following arteries were EHF to the tumors: inferior phrenic artery 71(56.3 %), cystic artery — 23(18.3 %), omental branch from the gastroepiploic artery –18(14.3 %), inferior right intercostal arteries — 10(7.9 %), left inferior phrenic artery — 7(5.6 %), right and left internal thoracic arteries — 4(3.2 %), gastroduodenal artery — 4(3.2 %), left gastric artery — 3(2.4 %), superior mesenteric artery — 3(2.4 %), right renal capsular artery — 3(2.4 %), right inferior adrenal artery — 3(2.4 %), right middle adrenal artery — 1(1.6 %) and right first lumbar artery — 1(1.6 %) case.
Results and discussion: After TACE EHF to hepatic tumors 14(11.1 %) complications occurred. Severe pain with irradiation to the right shoulder was observed in 10 procedures after TACE of the inferior phrenic artery (Grade 3 a — 6, Grade 2 — 4 cases according to CIRSE Classification System for Complications). Permanent skin erythema in the area supplying by an artery (grade 4) took place in 4 cases after TACE of the right intercostal arteries, right internal thoracic artery and left gastric artery branches. In the group of 36 patients with HCC treated only by TACE median overall survival from the time of first TACE EHF was 13.7 months, overall cumulative survival rates were 72.2±7.5 % (at 6 months), 55.6±8.3 % (at 1 year), 26.7±7.5 % (at 2 years), 17.8±6.5 % (at 3 years), 11.9±5.5 % (at 5 years). Median overall survival from the time of first TACE was 20.9 months, overall cumulative survival rates were 77.8±6.9 % (at 6 months), 72.2±7.5 % (at 1 year), 38.9±8.1 % (at 2 years), 30.6±7.7 % (at 3 years), 18.5±6.6 % (at 5 years). Based on own experience and literature data a review of all possible complications and techniques to avoid its was performed. Causes and imaging of extrahepatic blood supply were observed. The possibility to perform not only cTACE but DEM-TACE too was emphasized. The feature of our group was the presence of a relatively large number of patients with hepatic metastases in contrast to literature data based on analysis of treatment outcomes only of HCC.
Conclusion: Extrahepatic blood supply to hepatic tumors is frequently encountered in large tumors, peripherally located tumors and after repeated TACE. It can be observed not only in HCC but in other hepatic tumors even hypovascular ones. TACE EHF allows to continue endovascular management of hepatic tumors and to improve treatment outcomes.

Introduction: Postoperative radiotherapy (RT), including adjuvant (ART) and salvage (SRT), widely used for treatment for prostate cancer (PCa) after radical prostatectomy (RP). The low α/β ratio of PCa provides a rationale for dose hypofractionation; however, data on its efficacy and safety in the postoperative setting are limited.
Purpose: To evaluate the efficacy and safety of combined hormone-radiotherapy using a moderately hypofractionated dose regimen to the prostate bed (PB) and pelvic lymph nodes (PLN) with a sequential boost to the PB in PCa patients.
Materials and methods: A retrospective analysis of 64 patients who received postoperative RT combined with androgen deprivation therapy (ADT) between 2020 and 2023 was performed. RT was delivered in two phases: irradiation of the PB and PLN (fraction dose 3 Gy, total dose 39 Gy, 13 fractions) followed by a boost to the PB (fraction dose 3 Gy, total dose 18 Gy, 6 fractions). Biochemical control, radiation toxicity, and quality of life dynamics were assessed.
Results: The median follow-up was 36.5 months. Biochemical recurrence was observed in 17.2 % of patients. Acute grade III genitourinary (GU) toxicity occurred in 4.7 % of patients, while gastrointestinal (GI) toxicity of this grade was absent. Late grade III GU toxicity(urethral strictures, macrohematuria) was recorded in 4.7 % of patients; grade III GI toxicity was not registered. Despite baseline urinary incontinence in 57.8 % of patients, the level of quality of life remained stable throughout the observation period.
Conclusion: Postoperative combined hormone-radiotherapy for PCa using a moderately hypofractionated dose regimen demonstrates high efficacy and a favorable safety profile while preserving quality of life.

Lipomas of large central veins are rare. The most common localization of these tumors is the inferior vena cava (LVA), where they are found in about 0.5 % of the general population during contrast-enhanced computed tomography (CT). Currently, no clinical cases of lipomas in the brachiocephalic vein have been published in the literature, which would have been detected during PET/CT examination. Here is a clinical case of a patient with primary multiple metachronous tumor processes: prostate cancer, breast cancer, kidney cancer, that has undergone PET/CT scan with 18F - PSMA-1007.