Authors, including specialists in nuclear medicine, radiologist and neurosurgeon, offer a comprehensive approach to the challenges of brain tumor imaging in assessment of treatment response. Analysis of the vast raw material - PET with [¹¹C] methionine, MRI conducted in dynamics from 1038 patients with cerebral gliomas - allowed to divide the treatment control into 3 main tasks: control of tumor removal after surgery, assessment of the response to therapy and differential diagnosis of recurrent brain tumor and radiation-induced brain changes. The critical meaningful Macdonald criteria, recently proposed RANO criteria (2010) and basic principle that the metabolic changes in tumors revealed by PET using [¹¹C] methionine precede structural changes on MRI were the basis for solving the each problem. The article reviews the advantages and features of using PET in the assessment of glioma surgery and in early detection of glioma progression. Authors paid attention to the relatively new concept of «pseudoprogression» and «pseudoresponse» and formulated metabolic characteristics of these phenomena. Comparison of structural and metabolic parameters provides objective criteria for evaluating the effectiveness of individual treatment.

Evaluation of tumor treatment response plays an important role in oncology. There were no precise methods for preoperative assessment of tumor size until the wide introduction of CT and MRI. WHO criteria were introduced in 1979 were the first, but they had considerable limitations. It was the reason for creation of the relevant RECIST 1.0 and 1.1. With invention of new chemotherapy protocols approaches to treatment response assessment were changed. Therefore, new criteria of response to therapy for some specific histological types of malignant tumors were developed. During the last few years, a necessity for developing specific treatment response criteria using PET/CT emerged; PERCIST 1.0 criteria are a useful tool for evaluation of tumor response by PET/CT. Wide usage of PERCIST 1.0 allows improved assessment of therapy response in general.

Diagnostics of hip pain causes is rather difficult; X-ray radiography and computer tomography allow to estimate the degree of bone joint structures only. Magnetic resonance imaging is able to estimate the degree of alteration both: of soft-tissue structures of the joint and para-articular structures. It’s widely believed that para-articular structures pathology frequently causes hip pain syndrome, especially in the young. Early and exact diagnostics of causes of pain syndrome provides early and effective treatment, decrease of number of complications and causes of patient’s invalidization.

Treatment of primary and recurrent cancer of the trachea and main bronchi is a complex clinical problem. The article presents own experience of contact intraluminal radiation therapy in patients of this group. Efficacy and toxicity of this treatment was evaluated.

In acute leukemia (AL), central nervous system (CNS) is an area of increasing attention both in terms of lesion leukemic process, and in terms of the development of complications of treatment. Differentiated use of modern neuroimaging techniques allows to diagnose pathological changes in the CNS.

Intramedullary spinal cord neoplasms are rare, accounting for about 4-10% of all central nerve system tumors. Despite their rarity, they should always be kept in mind in case of focal spinal cord lesions detection. Magnetic resonance imaging is the study of choice to narrow the differential diagnosis between neoplastic and nonneoplastic lesions and guide surgical resection. The article presents a literature review of primary intramedullary spinal cord tumors and our own clinical observations.

Applying the advanced techniques in MRi diagnostic of multiple sclerosis (MS) open an opportunity to assess functional changes in tissue without anatomical changes that conventional MRi provides. One of this techniques is proton magnetic resonance spectroscopy (1H-MRS) that provides tissue metabolic information in volume of interest (voxel). Multi-voxel mode allows simultaneous acquisition of 1H-MRS data from multiple voxels not only in lesions, but also in the normal-appearing white matter. At the same time results of 1H-MRS researches of numerous groups are contradictory, in present study metabolite concentrations ratio of N-acetylaspartate (NAA) and choline (Cho) to creatine (Cr) in supraventricular plane were assessed by multi-voxel 1H-MRS in 10 patients with relapsing-remitting MS and 10 healthy subjects. Statistical analysis showed than metabolic changes occuring in patients with MS are inhomogeneous and depends on localization of volume of interest. This fact allow to explain inconsistency in literature results. 1H-MRS provides the existence of metabolic changes even in normal-appearing regions and demonstrate dissemination of pathological process outside lesions even on early stages of MS.

In the treatment of patients with primary brain tumors an important role takes postsurgical therapy. The choice of therapy after surgery is based on the prognostic group. In the work we allocated three prognostic groups: favorable (integrative prognostic index IPI<0,2), intermediate (IPI=0,2-1,0) and poor prognosis (IPI of<0,1). Prognostic factors include (in order of importance, from the highest to lowest) degree of malignancy of tumors, ECOG status, abundance, age, gender. Postoperative therapy (radiotherapy, chemoradiotherapy or chemotherapy) performs in view to the probability of developing late radiation damages and the sensitivity of tumors to chemotherapy. CT Perfusion and MRI with intravenous contrast enhancement are used for monitoring treatment outcomes.

The excision of sentinel lymph nodes has a growing relevance in the diagnostics of oral and oropharyngeal cancer in case of N0. The validity of sentinel node biopsy (SNB) was examined as single surgical staging tool. Within the framework of a multi-modality treatment scheme, SNB without elective neck dissection performed during surgery of the primary tumor in 70 previously untreated patients. Control of accuracy took place by observation of manifestation of neck node metastases in 45 patients who had not been postoperatively irradiated. 94% of sentinel nodes could be excised; nine patients (13%) had positive nodes and were undergone radical neck lymph nodes dissection. There were 2 neck lymph node metastases in the context of second primaries, all other patients remained regionally unconspicious (median observation time: 26 months). As staging tool assessing T1-3 N0 tumors, SNB could lead to a considerable reduction of the number of elective neck dissections. it could be integrated well into a multi-modality treatment scheme.

The purpose of this study was to evaluate the diagnostic value of SPECTon the topical diagnostic of the primary hyperparathyroidism. SPECT can accurately determine the localization of pathological parathtyroid glands. Clinical examples was showcases of the various display options of pathological parathyroid glands.

The article reviews the clinical symptoms, imaging techniques, histopathology, prognosis, and response to treatment of pulmonary manifestations of systemic lupus erythematosus. Manifestations directly associated to the disease include pleuritis, acute lupus pneumonitis, interstitial lung disease, pulmonary (alveolar) hemorrhage, pulmonary hypertension, pulmonary vasculitis and pulmonary thromboembolic disease. Shrinking lung syndrome, complications due to heart and renal failure, opportunistic pneumonia and drug toxicity are secondary manifestations. All clinical cases supplement own radiological observations.

In order to determine the indications for ambulatory surgery were examined 404 patients with tumors and tumor-like formations of soft tissues. We used Doppler ultrasound and elastography. All patients underwent a biopsy ultrasound which were followed by histological examination of biopsy. Benign tumors were found in 178 patients; malignant - in 8, tumor-like formation - in 218. Absolute contraindications for treatment in the outpatient conditions were malignant tumors, the large size of tumors and tumor-like formations, their location near to the neurovascular bundles and other structures, and tumors which is difficult to localize. In the outpatient conditions were operated 91% of patients. This allowed for effective treatment of patients and significantly reduce the economic costs.

The research is concerned with description of CT application aiming to approximate refinement of icon painting period using x-ray analysis of its material structure. Data received may provide the basis for works of art stratification.

Presented a clinical case paragangliomas in the neck. Marked by the difficulties of clinical and differential diagnosis, associated with the lack of adequate clinical manifestations. Shows the possibilities of the methods of radiology diagnostics in determining the location and extent of the process.

To assess the cost-effectiveness of digital X-ray in comparison with analogue were calculated costs of these procedures a year. Also compared the time spent on analog and digital studies of individual anatomical regions. As a result of the work found that the operation of the digital X-ray machines are more economical because it has eight more times and lower costs for consumables. Taking Digital Research most anatomical regions require significantly more time than analog, under conditions of incomplete radiological information system, in the absence of hospital information systems in the management of dual (paper and electronic) document. Time as film and digital research does not exceed the established standards for the procedure according to the Order number 132.