One of the serious complications of metastatic spine injury is the spinal cord compression syndrome. Refusal to conduct specific treatment leads to disability of the patient, due to the development of violations of the sensory and motor functions of the extremities, the function of pelvic organs, severe pain syndrome, which can be prevented by timely radiation therapy. Restoration of the nerve conduction of the spinal cord in the area of the development of its compression can significantly improve the quality of life of the patient, and also resume specific treatment, which often stops due to the severity of the patient’s condition.

In the article considers modern commercial method of production is demanded used in oncology medical product radiopharmaceutical ¹⁸F-fluorodeoxyglucose (2-fluoro-¹⁸F-2-deoxy-D-glucose, ¹⁸F-FDG), are presented the process steps and operation of synthesis, quality control procedures, briefly described the requirements for packaging and labeling of radiopharmaceutical.

Purpose: To reveal the potential of the method of combined PET/CT with ¹⁸F-FDG in the differential diagnosis of space-occupying lesions of the liver.

Material and methods: We selected patients for 5 years including PET/CT were detected space-occupying lesions of the liver (1101 patients). All patients underwent a combined PET/CT with ¹⁸F-FDG standard Protocol whole body with the multiphase contrast-enhanced. Indicators of informativeness of MSCT, PET and PET/CT methods (sensitivity, specificity and accuracy) were calculated using standard formulas.

Results: Metabolic active liver lesions were revealed in 777 patients. At the same time, despite the predominance of malignant tumors among them (in 99.5 % of patients), we also met metabolic active lesions /foci of FDG hypermetabolism, which belonged not to neoplastic lesions (in 0.5 % of patients). Metabolically inactive liver lesions were detected in 324 patients. Prevailed benign and not neoplastic lesions (in 79.3 % of patients). However, in 20.7 % of patients metabolically inactive liver lesions were malignant (metastatic lesion, metabolically inactive after the conducted chemotherapy in 58 patients, metastases of malignant tumors of the kidney – in 8, high-grade differentiated HCC – in 1). When calculating the indicators of informativeness of MSCT, PET and PET/CT methods, PET was more sensitive (97 %) and more accurate (97 %) than MSCT (93 % and 96 %, thus), MSCT showed higher specificity (98 %) than PET (97 %), but the indicators of informativeness of the PET/CT method were the highest (sensitivity and accuracy reached 98 %, and specificity – 99 %).

Conclusion: Based on the results obtained, for the purpose of differential diagnosis of liver lesions, it is recommended to perform PET/ CT with ¹⁸F-FDG with bolus contrast enhancement, because in some cases the liver malignant tumors may be metabolically inactive. PET/ CT has higher rates of informativeness than each of the methods (PET and MSCT) separately, but in some cases, using PET/CT is not always possible to reliably differentiate the malignant and benign lesions (according to our data – 2 %).

Purpose: To define the diagnostic capabilities of SPECT/CT in comparison with whole body scintigraphy (WBS) in patients with bone metastases.

Material and methods: It was included 67 patients with bone metastases of breast cancer, prostate cancer and other tumors. The evaluation was included WBS and SPECT/CT.

Results: Аll patients were divided into 2 groups – those with single and multiple metastases. SPECT/CT showed higher efficiency in detecting bone metastases than WBS. The full detection of bone metastases with WBS ranged from 31 to 56 % compared to SPECT/CT for groups respectively. In some cases (for groups respectively: 4 to 9.5 % depending on the number of metastases and their localization) of WBS was not informative, recorded the absence of lesions.

Conclusion: SPECT/CT can improve the diagnosis of bone metastasis.

Purpose: Optimization of treatment efficacy assessment in non-small cell lung cancer (NSCLC) patients by RECIST 1.1 and PERCIST 1.0 criteria.

Material and methods: 33 patients were included in prospective study. PET/CT was performed before treatment, after first cycle of chemotherapy and at the end of treatment.

Results: The progression of disease by metabolic and anatomic criteria was confirmed in 3 patients (9.1 %). In group with stable disease by RECIST 1.1 criteria (42.4 %) three types of metabolic response were performed: metabolic progression (9.1 %), stable metabolic disease (6.1 %), partial metabolic response (27.2 %). Group of patients with partial response by RECIST 1.1 criteria (48.5 %) was performed in two types of metabolic response: partial metabolic response (42.4 %) and complete metabolic response (6.1 %). Almost in all cases with partial response and disease progression (78.9 %) anatomic results after the 4 cycles of chemotherapy corresponded to the first assessment (after the first cycle) by PERCIST 1.0 criteria.

Conclusion: Assessment of metabolic response offers early efficacy prognosis.

Based on the analysis of own observations and literature data, the article presents the possibilities of ultrasound imagine in the detection and evaluation of the dissemination of tumor diseases. The ultrasound semiotics of involvement of lumbar lymph nodes in the tumor process for various cancers is described

Purpose: Improvement of primary liver cancer diagnostics using liver parenchyma qualitative and quantitative evaluation by means of noninvasive ultrasound investigation method. Comparative analysis of tumor and normal tissue mechanical properties is carried out in the experiment in the gross specimen.

Material and methods: Standard ultrasonic inverstigation (USI) in B-mode added by elastometry and elastography was carried out in all patients. A standard investigation included also evaluation of α-fetoprotein, X-ray computed tomography, liver MRI and morphologic verification.

Results: In vivo, mean values of shear wave velocity (SWV) were as follows: in unchanged liver parenchyma the values varied from 1.88 to 2.99 m/s, in tumor tissue they ranged from 1.45 to 2.65 m/s. Ex vivo, SWV in unchanged liver parenchyma varied from 1.91 to 2.81 m/s, in tumor tissue – from 1.62 to 2.73 m/s.

Conclusion: New methods of US-diagnostics allow us to give qualitative and quantitative assessment of tumor structure which can be confirmed by comparing these data with morphological examination. In diagnostics of hepatocellular carcinoma, sensitivity of UST in combination with methods of elastometry and elastography is 98.6 %, accuracy is 98.6 %. Thus, results obtained in our trial are comparable with data from the world literature. Complex USI in combination with elastometry and elastography allows to increase the primary liver cancers noninvasive diagnostics level.

Purpose: To determine the tactics of ultrasound studies in the diagnosis of postoperative complications of oncological patients with localization of the disease in the hepatobiliary zone.

Material and methods: 127 patients with hepatocellular carcinoma, 90 patients with cholangiocellular carcinoma, 34 – gall bladder cancer, 518 people with metastatic liver involvements were examined. For all the patients after the surgical treatment, ultrasound with a dynamic control of the revealed complications was repeatedly performed.

Results: The ultrasound examination influenced the tactics of conducting the postoperative period for 32.3 % of patients with HCC, 31.1 % of patients with HCC, 20.5 % of patients with RVF and 19.9 % of patients with metastatic liver damage. More often complications were found out by US studies if the research was undertaken within first two days and in a week after operation.

Conclusions: Ultrasound diagnostics is a highly effective method for diagnosing postoperative surgical complications, and its results have a decisive influence on the tactics of conducting the postoperative period for patients after surgical treatments of hepatobiliary tumors.

Purpose: To determine the effectiveness of apparent diffusion coefficient (ADC) for the purpose of normal and diseased lymph nodes (LN) differentiation in HL by DWI MRI.

Material and methods: To determine the effectiveness of ADC for the purpose of normal and diseased LN differentiation in HL was compared ADC values of LN in 27 apparently healthy individuals and in 41 patients with verified HL.

Results: 95 % confidence intervals showed that values of ADC in normal LN ranged from 1.00 to 1.73 . 10^–3 s/mm² and were significantly higher (p < 0,05), than in LN affected by HL (ADC from 0.59 to 0.94 . 10^–3 mm²/s). Cut off point of normal and lymphomatous-LN ranged from 0.94 to 1.00 . 10^–3 mm²/s. Therefore, LN with ADC below 0.94 . 10^–3 mm²/s could be interpreted as affected by HL.

Conventional neuroimaging techniques (MRI, CT) have difficulties in brain microhemorrhage diagnosis. Application of new MRI modalities has significantly improved detection and qualitative assessment of microbleedings in different brain regions. Susceptibility weighted imaging (SWI or SWAN) refers to such technologies. SWI (or SWAN) has been more sensitive in microhemorrhages detection compared with conventional T₂ * pulse sequence. We retrospectively assessed the ability of SWAN pulse sequence in detection of brain microhemorrhages caused by different reasons (hypertensive microangiopathy, amyloid microangiopathy, mild and severe traumatic brain injury, etc.). We compared the obtained SWAN results with conventional 2D T₂ *-weighted pulse sequence and CT data in cases when it was possible to do. The results have demonstrated high sensitivity and accuracy of SWAN in assessment of location, amount and distribution of brain microhemorrhages compared with CT and conventional MRI, including 2D T₂ *-weighted imaging. We recommend to include SWI (or SWAN) pulse sequence into the primary brain MRI protocol in patients with different pathologies.

Diagnosis of neoplasms, especially malignant, of the larynx and pharynx and their differential diagnosis with non-tumor lesions is one of the most urgent and socially significant problems in modern oncology. Over 3000 patients with suspected cancer of the larynx and pharynx were examined in the Moscow Regional Research and Clinical Institute over the last 10 years. In most cases a CT scan was performed. Rare non-tumor diseases were confirmed in 0,5 % of the cases. In all the cases further clinical laboratory tests were carried out after the radiation examination, confirming the non-tumor nature of the identified changes, which fundamentally changed the tactics of treatment.

Purpose: To determinate the accuracy percutaneous methods breast biopsies in the diagnosis of DCIS.

Material and methods: We reviewed a series of 30 women with DCIS who performed breast biopsy under mammographic and ultrasonographic guidance. The biopsy findings were compared with surgical biopsy.

Results: Vacuum-assisted breast biopsy is an accurate diagnostic alternative to surgical biopsy in patients with noninvasive carcinoma. The accuracy of fine needle aspiration is relatively low. The accuracy for core biopsy was significantly lower than that of vacuum-assisted biopsy (66.7 % versus 96 %).

Conclusion: Rational using imaged-guided breast biopsy allows to determinate strategy of the treatment patients with DCIS.

Purpose: To assess the effectiveness of minimally invasive treatment of fibrocystic mastopathy according to multivarametric ray imaging data.

Material and methods: Since September 2017, 35 patients with mammary gland cysts have been minimally invasive, using two methods of treatment: interstitial laser therapy and sclerotherapy with an ozone-oxygen mixture. The effectiveness of the treatment was assessed using a set of methods of radiation diagnosis, namely ultrasound in the B-mode, ultrasonic dopplerography, compression elastography, shear wave elastography (2DSWE) in a standardized manner, X-ray mammography according to indications.

Results: Based on the results of the study, conclusions were drawn about the efficacy of interstitial laser photocoagulation and sclerotherapy with the ozone-oxygen mixture, as well as the need for careful multiparametric examination of patients using radiology methods at preand postoperative stages in order to prevent complications and achieve optimal therapeutic effect.

Brain metastases are the most common intracranial tumors in adults. The approach to and management of brain metastases have evolved significantly in recent years due to several reasons. These include advances in neurosurgical and radiotherapeutic techniques, improved systemic therapy options offering better systemic and intracranial disease control and prolongation of survival as a result of these improvements, making side-effects of proposed therapies (e.g. neurocognitive decline from whole brain radiotherapy) an important consideration. In this article, we review the primary therapeutic approaches to the management of brain metastases, namely, surgery, stereotactic radiosurgery, and whole brain radiation therapy and the primary factors dictating choice.

A critical analysis of terms and concepts in medical radiology, radiation safety and medical physics in a multilingual dictionary developed within the framework of the international project EMITEL2 and included in the Encyclopedia of Medical Physics, accessible via the Internet. The same analysis was carried out for the three-language dictionary on radiology and radiation physics of the International Electrotechnical Commission, issued as GOST R IEC 60050-881-2008. Based on the results of the analysis, a short English-Russian dictionary of terms difficult to translate on medical physics, radiation protection, radiation therapy, nuclear medicine and radiation diagnostics was developed. Its main difference is the presence in it only of those terms, the literal translation of which from English into Russian either causes lexical difficulties, or is erroneous, or leads to ambiguity of terminable concepts. In addition, the dictionary includes those terms, the interpretation of which is debatable for professional professionals and erroneous for non-specialist users.

Primary B-cell cardiac lymphoma of the heart refers to rare tumors. The article presents a clinical case of diagnosis and treatment of lymphoma of the right heart in an HIV-infected patient. The use of modern diagnostic methods of research can achieve a clinical effect in this category of patients.

Relevance: Tumors of the pancreas occupy the 6th place among men and the 7th place among the female population. Not the specificity of the symptoms of this type of tumor causes the diagnosis of the disease in the later stages. In almost 50 % of patients, at the time of primary diagnosis, the tumor extends beyond the body, a third identified distant metastases. The clinical picture depends on the location of the tumor. The diagnosis of this pathology presents certain difficulties and is based on a comprehensive analysis of the results of laboratory, instrumental and radiological studies, history and examination of the patient. High metabolic activity of pancreatic tumors allows the use of PET/CT examination in diagnosis and / or in determining the prevalence of the process.

Description: The clinical case demonstrates the course of the disease, manifested from remote metastases, without the identified primary focus. Symptoms of pancreatic malignancy are not specific and are not expressed. The diagnosis of this pathology presents certain difficulties and is based on a comprehensive analysis of the results of laboratory and radiological studies, anamnesis and patient examination data. Held instrumentalno-diagnostic measures to identify the primary tumor in this situation were unsuccessful. It was possible to identify the primary focus only at the autopsy.

Conclusions: Pancreatic tumors are one of the most aggressive current and poorly diagnosed formations. Massive generalization, mainly occurs with large sizes of the primary focus and / or progression of the process after the treatment. In this clinical situation, we can talk about the acultural form of pancreatic cancer with a massive generalization of the process. The pancreas lesion was not detected by any of the instrumental diagnostic methods of the study, nor in the course of open biopsy of retroperitoneal and liver formations.