Purpose: Analyze the technique of irradiation of metastases in the scalp on the example of a clinical case from the point of view of dose distribution and tissue tolerance to radiation.

Material and methods: Analysis of dose distributions in the Eclipse radiotherapy planning system (Varian). The techniques of irradiation with IMRT and RapidARC modulated intensity beams with and without boluses are considered. The analysis of dose distributions took into account the limitations of the planning systems when calculating doses in the vicinity of the interfaces between the heterogeneities and used data on the properties of dose distributions.

Results: Demonstrated the need to use boluses. In this case, a high uniformity of dose distribution in the target is achieved. To protect the brain, it is necessary to use irradiation with intensity modulated beams. Irradiation in the RapidARC technique compared with IMRT gives the best dose distribution and the exposure session is shorter in time. Dose loads on the skin at a therapeutic radiation dose of 39 Gy in 13 fractions do not exceed the tolerant levels given in the literature. The irradiation of the presented patient passed without complications.

Conclusion: Irradiation of metastases in the scalp at a dose of 39 Gy in 13 fractions is safe and effective, if sutisfy two rules. You must use a bolus about 0.5 cm thick, the irradiation technique should be rotational beams of modulated intensity (RapidARC, VMAT).

The work represents an analytical review of current status of proton therapy in the world and in Russia and advanced developments in the field of accelerator technology, dose delivery technology to target, methods of dose calculating. The main sections of the article are preceded by a brief description of the interactions of protons with the matter, which is then used to explain the distinctive features of proton therapy compared with other options of radiation treatment.

¹⁸⁸Re is attractive isotope for therapeutic needs, due to its unique combination of nuclear-physical properties. It is safe for patients, personal and environment due to its relatively short half-life – 17 hours, high energy of β-particles (2.11 MeV) provides required absorbed doses in pathological foci. β-particles can reach tumor cells, because its average range in tissues is 3.1 mm, maximum range is 10.4 mm. ¹⁸⁸Re also has its γ-emission of 155 keV which can be registered and used for image acquisition. Generator produced ¹⁸⁸Re is very fitful for inhouse radiopharmacy: half-life of maternity ¹⁸⁸W is 69.4 days, so ¹⁸⁸W/¹⁸⁸Re generator can be used for several months. ¹⁸⁸Re obtained from the generator is source of different radiopharmaceuticals. Radiopharmaceuticals based on ¹⁸⁸Re can palliate painful bone metastases, the most common one is ¹⁸⁸Re‑HEDP. It is used nearly two decades and demonstrated efficacy in reducing of bone pain and good tolerability. There are some investigations revealed that repeated cycles of therapy may have an advantage in overall survival compared with single injection in cases of castration resistant prostate cancer. There is analogue of ¹⁸⁸Re-HEDP in Russia which is demonstrated very similar properties to the original one. New bone seeking radiopharmaceutical, ¹⁸⁸Re-zoledronic acid demonstrated preferable pharmacokinetics with relatively low absorbed doses to bone marrow. ¹⁸⁸Re-lipoidol can be used for radioembolization in cases of hepatocellular carcinoma or liver metastases. This kind of therapy is useful in developing countries with high incidence of hepatocellular carcinoma. Patches or cream with ¹⁸⁸Re is used for brachytherapy of skin cancer or keloids. This kind of non-traumatic procedure is an effective alternative to surgical intervention in sites like ear, nose or genitals. There are investigations in field of radioligand and peptide receptor therapy with ¹⁸⁸Re based radiopharmaceuticals, for example, ¹⁸⁸Re-PSMA.

The article presents the analytical report of the radiology service in 2010–2016 concerning the employment and logistics of radiological procedures in medical organizations of state and municipal health sector. Studied data based on quantitative composition and staffing radiologists, radiologists, ultrasound specialists and radiographers, the materials of the Ministry of Health for 2010–2016. It is shown that the number of specialists in the field of radiological diagnostics is constantly slowly growing, however there is a high percentage of part-time. Increases number of instruments for medical imaging, a growing amount of research being conducted, with the most pronounced of these trends in ultrasound diagnostics, x-ray computed tomography and magnetic resonance imaging. However, a qualitative improvement of the diagnostic process, which is reflected in the low level of contrast enhancement in CT and MRI, a low share of a special tomographic imaging including cardiovascular CT and abdominal MRI. The results of the study indicate the necessity of improvement of personnel policy in the field of the medical imaging.

Traditionally, pulmonary CT-angiography is a part of preoperative assessment of patients with centrally located lung cancer. ECG-synchronized CT-angiography allows to asess coronary arteries in such patients. Evaluation of coronary arteries with atherosclerotic changes by ECG-synchronized CT-angiography influences the management of patients with centrally located lung cancer.

Purpose: To assess the possibility of using modern ultrasonic technologies (elastography, elastometry, shear wave) in assessing the effectiveness of radiation therapy in patients with cervical cancer.

Material and methods: To achieve this goal, the results of examination of 96 patients diagnosed with cervical cancer after radiation therapy were analyzed. As the primary diagnostic method used in ultrasonic research with application of modern ultrasonic technology.

Results: With the progression of cervical cancer at the term of 6 months. and more from the end of treatment, statistically significant (р < 0.05) a sign installed V elastotype. In quantitative elastography, the progression of the disease in 1 year after treatment is characterized by an increase in the strain ratio twice compared to the unchanged cervix, and its average value was 2.1±0.1. For a full treatment effect after 1 year characteristic IV elastotype in elastography the strain ratio is 1.1±0,1. For metastatically altered lymph nodes, the shear wave was 2.9±0.24 m/s, for hyperplastic lymph nodes – 1.3±0.1 m/s.

Purpose: To determine the possibility of interventional radiology correction of postoperative non-tumor urinary tract strictures in the surgical treatment of prostate and bladder cancer.

Material and methods: The results of interventional radiology treatment of 10 patients with non-tumor local non-traumatic urinary tract strictures were subjected to a retrospective analysis. In 6 cases, patients had strictures of the cystourethral anastomoses, in 3 cases – strictures of the ureteral orifices after paraostial transurethral resection of the bladder, in 1 cases – a stricture of the ileoureteral anastomosis after orthotopic ileocytoplasty. All patients underwent balloon dilatation of strictures with antegrade or retrograde access. The target criterion was the disappearance of the waist of a balloon with a diameter of 8 mm at a pressure of from 3 to 12 atm with an exposure of 5 minutes. The intervention was completed frame drainage zone of the anastomosis.

Results: We observed no complications associated with the intervention technique. Immediate success was achieved in all 10 patients. Recurrent stricture occurred in 3 patients with a cystourethral anastomosis stricture and 1 patient with a ureteral orifice stricture between 1 year and 3 years and required repeated interventional radiology treatment. The maximum term of recurrence-free observation was 5.5 years.

Conclusion: Balloon dilatation of postoperative urinary tract strictures is the method of choice in the staged treatment of patients with bladder or prostate cancer, primarily from the standpoint of its safety for the patient and the possibility of re-intervention in recurrent stricture.

Results of the study of pharmacokinetic properties of the novel radiopharmaceutical, ¹⁵³Sm-labelled thermosensitive copolymer, designed for local radiotherapy of solid tumors are presented. We studied the pharmacokinetic properties of a new radiopharmaceutical based on a temperature-sensitive copolymer and samarium-153 (CASP‑CM, ¹⁵³Sm – Collapsing Aqueous Solution of Polymer, Chelated by Samarium-153) for local radiotherapy of solid tumors. The biodistribution study was conducted on F1 and C57Bl/6 mices with S37 implanted subcutaneously with sarcoma and B16 melanoma, respectively, with intratumoral administration of the drug. In addition, biological studies of the local irritating action, acute and subchronic toxicity of the non-radioactive analogue CASP-CM, ¹⁵²Sm are presented. The results showed that the greatest amount of activity was observed in the tumor tissue (i.e. at the injection site). 7 days after the injection, the activity level in the sarcoma S37 tissue was 57.2 % of the administered dose, and in the B16 melanoma tissue – 42.2 % of the administered dose. At the same time, the retention of the labeled drug with tumor tissue of S37 sarcoma is higher than with B16 melanoma tissue, especially in the later stages of the study. The peak activity in the liver was 1.14 %/g. A transient increase in the concentration of the labeled drug was observed in the stomach (up to 4.22 %/ g after 5 min), lungs (up to 1.15 %/ g after 1 h) and skin (up to 1.34 %/g after 1 h), however then the concentration rapidly decreased. An increased level of activity was observed in the kidneys, since most of it was excreted through the urinary system. The concentration of activity in the thyroid gland, spleen, heart, brain, small intestine, muscle tissue and femur was below 1 %/g throughout the study period. Statistically significant differences between the levels of activity in the internal organs and tissues in mice with S37 sarcoma and B16 melanoma were practically not detected. The study of local tolerance, acute toxicity and subchronic toxicity of a model non-radioactive preparation using different routes of administration (subcutaneous and intramuscular) in mice, rats and rabbits showed that the model preparation CASP-CM,¹⁵²Sm, when administered subcutaneously, does not lead to the development of pronounced local pathological reactions; according to the degree of danger of acute and chronic toxic action, it is of low toxicity. On the basis of the data obtained, it is also possible to make a conclusion about the safety of the polymer carrier of samarium isotope based on poly-N-isopropylacrylamide. In conclusion, the presented results allow us to suggest that the radiopharmaceutical has exciting potential for local tumor therapy.

Increased efficacy of radiotherapy is one of the primary objectives of modern healthcare. Binary radiotherapy is one of the approaches that is used to reach this goal. This review focuses on contrast enhanced radiotherapy as one of the methods of binary radiotherapy. The principals and physics of this methods, as well as the primary findings of experiments currently done are discussed in this review. The results show the antitumor efficacy of this method and confirm the promise of this therapy as a treatment of malignant tumors.

Purpose: To present rare clinical observation of MALT-lymphoma with damages of lung pleura and mediastinum lymph nodes.

Conclusion: Showed that the lack of specific character of complaints, the low value of roentgenologic examination do not allow to unequivocally express on pathology and only after morphological and immunohistologic study the lymphoma with impairment of lung, pleura and mediastinum lymph nodes could be finally diagnosed.