Purpose: To develop and implement clinical radiotherapy protocols at the aimed at standardizing all stages of the treatment process and improving the quality of radiotherapy care.

Materials and methods: As part of the federal program “Fight Against Oncological Diseases,” a large-scale equipment upgrade was carried out, requiring revision of treatment planning approaches and staff training. The developed protocols cover the entire radiotherapy workflow — from CT simulation to treatment delivery — and include detailed recommendations for target volume delineation, organs-at-risk definition, dose constraints, and treatment plan quality criteria. Based on international standards (IAEA, ICRU, RTOG, TG 263), unified structure nomenclature, color coding, and dosimetric evaluation criteria were implemented.

Results: The implementation of 157 clinical protocols enabled acceleration of the treatment planning process, reduction of inter-observer variability, and improvement in the reproducibility of treatment outcomes. Standardization of clinical workflows contributed to reducing the probability of errors, simplifying the training of new staff members, and creating conditions for the automation of several procedures. The introduction of clinical protocols into radiation oncology practice improved the quality and safety of radiotherapy, enhanced team coordination, and contributed to better clinical outcomes for patients.

Relevance: Despite the global expansion of PET/CT diagnostics, systematic data on its regional distribution and operational dynamics in the Russian Federation remain lacking.

Purpose: To conduct a comprehensive analysis of quantitative and qualitative indicators of the «PET-Technology» PET/CT network performance in Russia from 2021 to 2024.

Materials and methods: A complete enumeration observational study was performed using data from 29 regions across 6 federal districts, focusing on key indicators: trends in imaging volumes, equipment density by federal district, distribution of clinical diagnostic purposes, and the spectrum of radiopharmaceuticals used.

Results: Absolute imaging volumes demonstrated growth; however, relative accessibility indicators significantly declined (p < 0.05), reflecting deepening regional disparities. Clinical practice aligns with international standards. More than 35 % of studies are dedicated to therapy monitoring in malignant neoplasms. Non-oncological indications are virtually absent (<0.3 %). Furthermore, 98.7 % of PET/ CT studies were performed using ¹⁸F-FDG.

Conclusions: These findings may serve as a reference for private-sector planning and as a catalyst for establishing a national PET/CT monitoring system, optimizing territorial resource allocation, and improving equity in access to nuclear diagnostics.

In most cases, the detection of focal liver changes in patients with systemic lymphoproliferative disease by imaging methods is associated in the mind of a radiologist with organ damage, which, accordingly, significantly affects the determination of the stage and treatment strategy. The PET/CT method is recognized as the most informative in determining the prevalence of the pathological process in Hodgkin’s lymphoma [1]. When determining the nature of focal changes in the liver parenchyma, the diagnostician is faced with the need to differentiate organ damage by a systemic process from pseudolesions. The picture of these processes in ultrasound (ultrasound), computed tomography (CT), and magnetic resonance imaging (MRI) has been studied for a long time, and data on the capabilities of PET/CT in combination with other imaging methods have not been sufficiently studied.

Purpose. To introduce colleagues to a special type of selective accumulation of ¹⁸F-FDG in the liver, a trap that can become a source of misinterpretation and compare PET data with other imaging methods.

Introduction: The effectiveness of adjuvant radiation therapy used to consolidate the effect of chemotherapy in patients with

Purpose: To familiarize readers with the diverse imaging features of renal oncocytomas as seen on 4-phase CT/MRI contrast-enhanced study.

Materials and methods: This article is based on one of the largest clinical data, reflecting the wide variety of imaging features of renal oncocytoma in 61 patients who underwent preoperative 4-phase CT/MRI contrast-enhanced study of the abdomen, followed by surgical intervention (resection or nephrectomy) and morphological examination of the resected specimens.

Results: The significant diversity in the imaging patterns of oncocytomas depends on the heterogeneity of their morphological structure: marked differences in tumor cellularity, the volume of stroma, and the presence of hemorrhagic and/or cystic elements. This is why their imaging manifistations can overlap with the features of various types of renal cell carcinoma (clear cell, chromophobe cell, etc.), which significantly complicates the accurate preoperative diagnosis of oncocytoma using standard imaging methods (ultrasound, CT, MRI). The well-known and characteristic oncocytoma’s pattern “a spoke-wheel-like enhancement” we observed in only 4 of 61 patients.

Conclusion: Differential diagnosis between oncocytoma and renal cell carcinoma based on CT/MRI findings can be extremely difficult in most cases, but is still possible in a few patients.

Relevance: Breast diseases remain one of the leading causes of cancer morbidity among women, which necessitates improvement of early diagnostic methods and differential assessment of pathological changes. Dynamic contrast-enhanced magnetic resonance imaging (MRI) plays a key role in detecting focal and infiltrative breast lesions, especially in patients with dense breast tissue and elevated oncologic risk. The update of the BI-RADS v2025 system requires reconsideration of MRI interpretation criteria and their clinical application.

Purpose: To analyse and systematise criteria and uncertainties in MRI assessment for diagnosis and differential diagnosis of breast diseases considering updated BI-RADS v2025 recommendations.

Materials and methods: Publications from 2021–2025 indexed in PubMed, Scopus and eLibrary were analysed. Methodological aspects of multiparametric breast MRI were reviewed, including dynamic contrast enhancement, diffusion-weighted imaging with ADC calculation and morphological assessment according to BI-RADS v2025.

Results: Updated BI-RADS v2025 MRI descriptors improve reproducibility and diagnostic specificity through standardisation of imaging parameters, refinement of margin and peripheral enhancement criteria and formalisation of T2 signal characteristics. MRI demonstrates high sensitivity in detecting both focal and infiltrative breast cancers. Integration with vacuum-assisted biopsy optimises diagnostic and treatment algorithms in indeterminate cases.

Conclusion: Breast MRI remains a key modality for personalised breast diagnostics, surpassing traditional imaging methods in sensitivity. BI-RADS v2025 contributes to reduced interpretation variability, decreased overdiagnosis and expandedclinical application in screening, differential diagnosis and treatment monitoring.

Relevance: Thyroid nodules are detected in 40–50 % of the population, but only 5–10 % are malignant. Multiparametric risk stratification systems, such as the McGill Thyroid Nodule Score+ (MTNS), incorporate 23 criteria, including 7 ultrasound features. Evaluating the diagnostic value of these features remains relevant.

Purpose: To analyze the contribution of ultrasound parameters to thyroid nodule risk stratification using the MTNS scale.

Materials and methods: A retrospective analysis included 211 patients with thyroid nodules divided into three groups: colloid goiter (n = 91), adenomas (n = 60), and thyroid cancer (n = 60). All patients underwent multiparametric ultrasound (B-mode, color Doppler, power Doppler) with assessment of 7 ultrasound features according to MTNS. Statistical analysis included χ², t-test, and ROC analysis.

Results: Patients with colloid goiter scored 2–11 points, those with adenomas 4–28 points, and those with thyroid cancer 12–31 points. Microcalcifications (AUC = 0.836; χ² = 23.854; p < 0.0001) and the “taller-than-wide” shape (χ² = 57.296; p < 0.0001) showed the highest diagnostic significance for malignancy. Macrocalcifications were more frequent in benign nodules (χ² = 6.366; p = 0.0116). Firm nodule consistency on palpation significantly distinguished cancer from adenomas (p < 0.0001). Nodule size alone had no prognostic value (p = 0.2562).

Conclusions: Ultrasound features, especially microcalcifications and the “taller-than-wide” shape, contribute substantially to the final MTNS score and enable accurate differentiation of malignant nodules. The scale is recommended for guiding treatment decisions, particularly in cases with indeterminate cytology.

Relevance: Cutaneous melanoma is characterized by high metastatic potential, and regional lymph node involvement is a key prognostic factor.

Purpose: To develop and evaluate a logistic regression model for predicting regional lymph node metastases.

Materials and methods: A single-center retrospective study included 121 patients with morphologically verified lymph node status. Clinical, ultrasound, elastography, scintigraphy, and pathological data were analyzed.

Results: The model demonstrated high discrimination (ROC AUC ≈ 0.95). At p = 0.272 sensitivity was ~0.85 and specificity ~0.96. A four-level risk stratification system was developed.

Conclusion: The model can be used for risk stratification and decision-making regarding invasive nodal staging.

Relevance: Despite their relative accessibility to imaging, head and neck tumors are often diagnosed at late stages. Treatment of this pathology presents challenges in choosing a treatment strategy. Intra-arterial chemotherapy is a promising treatment option for these patients.

Purpose: To study the effectiveness of intra-arterial chemotherapy in an oncology clinic and to evaluate the tumor blood supply patterns.

Materials and methods: Between 2024 and 2025, 51 patients with locally advanced head and neck tumors were treated. Of these, 44 had primary tumors and 7 had recurrent tumors or prior systemic chemotherapy. The study evaluated the effectiveness of this method in 44 patients at the Tula Regional Oncology Clinic. All patients received intra-arterial chemotherapy with cisplatin 75 mg/ m², administered proportionally into each tumor-feeding vessel, followed by intravenous docetaxel 75 mg/m². A key feature of the study was the prevalence of stage 4 disease, accounting for 61.4 %.

Results: The treatment achieved an objective response rate of 86.8 %. A complete response was achieved in 31.8 % of cases, and a partial response was achieved in 55 %. No stage 3–4 toxic complications were identified. Furthermore, these tumors were found to have two or more vessels supplying blood in 77.3 % of cases, with bilateral blood supply characteristic of 43.2 %.

Conclusions: Based on the data obtained, it was concluded that the method is highly effective and readily available not only in research institutes but also in regional oncology centers. Furthermore, a predominance of multivessel blood supply was demonstrated in locally advanced tumors.

Relevance: The growing burden of central nervous system tumors increases the need for accurate and minimally invasive intraoperative imaging and navigation technologies. Flat-detector computed tomography (FDCT) provides volumetric and crossectional CT-imaging directly in the angiography suite and can be integrated with fluoroscopy and navigation.

Purpose: To assess the capabilities and principal applications of flat-detector computed tomography in neuro-oncology based on the experience of a single tertiary cancer center.

Materials and methods: A single-center retrospective descriptive analysis included 207 interventional procedures performed in 207 patients at the N.N. Petrov National Medical Research Center of Oncology from November 2021 to December 2025. Procedures were carried out using an Artis Zee Floor angiographic system (Siemens). Statistical analysis was performed with Microsoft Excel 2016 and STATISTICA 12.

Results: The median patient age was 58 years (45; 69); 95 patients were men and 112 were women. FDCT was used for stereotactic brain tumor biopsy (n = 159), diagnostic cerebral angiography (n = 14), drainage of tumor cysts (n = 11), Ommaya reservoir implantation (n = 7), ventriculoperitoneal shunting (n = 6), vertebroplasty (n = 5), drainage of brain abscesses (n = 3), and preoperative meningioma embolization (n = 2). The technology provided real-time intraoperative three-dimensional visualization, navigation planning, instrument position control, and immediate assessment of procedural results. The most convincing advantages were observed in stereotactic brain tumor biopsy.

Conclusions: FDCT is a promising universal intraoperative platform for minimally invasive neuro-oncological procedures. Its use may improve procedural accuracy, controllability, and safety, with the strongest current rationale seen for stereotactic brain tumor biopsy.

Relevance: The effectiveness of adjuvant radiation therapy used to consolidate the effect of chemotherapy in patients with malignant lymphomas remains a subject of debate and intensive study. The usefulness of chemoradiotherapy has been proven for certain lymphoma sites (mediastinum, central nervous system, bone, gonads), but its role in follicular lymphoma with primary involvement of the abdominal and/or pelvic lymph nodes has been insufficiently studied.

Purpose: Determination of the effectiveness of chemoradiotherapy in primary patients with abdominal and pelvic nodal follicular lymphoma.

Materials and methods: We studied the immediate effect of treatment, 10-year local progression-free survival (LPFS) and progression-free survival (PFS) of 77 primary patients with follicular lymphoma of the abdominal and pelvic lymph nodes treated in 1985–2024 at the Russian Scientific Center of Roentgenology and Radiology. Chemoresistant patients were not included in the study. The main group (43 patients) underwent chemoradiation therapy (CRT) with adjuvant irradiation of initially massive conglomerates of abdominal and/or pelvic lymph nodes, while the control group (34 patients) received chemotherapy alone. Identical chemotherapy regimens ± rituximab immunotherapy were used in both groups. The differences between the groups were statistically insignificant in terms of the main parameters that are potentially important for treatment outcomes.

Results: Upon completion of radiation therapy in the main group, the rate of complete remissions statistically significantly increased from 23 % to 49 % (p = 0.014). The 10-year LPFS rate was statistically significantly higher in the CRT group as a whole (80 % vs 30 %, p = 0.00006), as well as in all analyzed subgroups, except for the subgroups of patients with a lesion size of 7 cm or less and patients with complete remission after chemotherapy. The 10-year PFS rate was statistically significantly higher in the CRT group as a whole (49.6 % vs 14.2 %, p = 0.0017), as well as in most compared subgroups and did not reach statistical significance in men, patients over 60 years of age, at local stages of the disease, in the high-risk group, patients treated without rituximab and patients with complete remission after chemotherapy.

Conclusions: In primary patients with nodal follicular lymphoma of the abdominal and pelvic localization who are sensitive to chemotherapy, chemoradiotherapy significantly compensates for the low efficacy of chemoimmunotherapy in relation to massive tumor foci, which is expressed in a statistically significant increase in the proportion of complete remissions, a decrease in the initially high risk of subdiaphragmatic progression, and the achievement of a 10-year period free from disease progression in half of the patients.

Gossypiboma (a retained surgical textile) poses significant challenges for preoperative diagnosis as it frequently mimics a tumor. This article presents three clinical cases of female patients in whom mass lesions were detected in the abdominal cavity and pelvis after previous laparotomies. These lesions were initially interpreted as neoplastic lesions. In all cases, the diagnosis of gossypiboma was established only intraoperatively and confirmed histologically. These cases underscore the critical importance of obtaining a thorough surgical history and recognizing characteristic imaging features to include gossypiboma in the differential diagnosis and prevent diagnostic errors.

Purpose: To demonstrate radiological manifestations of a rare benign disease of childhood.

Materials and Methods: The study included 7 cancer patients examined to rule out bone metastases. The sample was collected in 2024 and 2025. All patients underwent bone scans, supplemented by SPECT/CT.

Results: In all cases, classic manifestations of the condition described in the literature were observed.

Conclusion: Primarily due to its rarity, the syndrome can be challenging to differentiate from other conditions, including malignancies. Raising awareness will help avoid unnecessary treatment and diagnostic interventions.