Three-dimensional printing (3D printing, additive manufacturing, rapid prototyping) is a technology of a physical object creation from digital model by layered addition of material. Additive technologies differ from mass production by personalization, customization and relative simplicity of 3D-models creation. 3D models ability to  demonstrate heart anatomy is of use in cardiac surgery, primarily during the educational process and preoperative planning and, less common, for implantable devices testing and hemodynamic modeling. Although the role of 3D models in clinical practice is not currently defined, 3D printing mass application can provide important advantages to solve a number of diagnostic and therapeutic issues. The article presents the revue of scientific publications describing the use of physical three-dimensional heart models in cardiac surgery.

Due to the widespread introduction of CT in clinical practice, the issue of reducing the radiation dose remains one of the most urgent. One of the ways to reduce radiation exposure is to improve the reconstruction algorithms of CT images. When using model interactive reconstruction, images are repeatedly processed to maximize the elimination of digital noise, which allows lowdose studies to be performed without compromising visual quality. The literature review presents the possibilities of applying model iterative reconstruction in CT studies of various organs and systems, including low-dose studies with a radiation exposure of less than 1 mSv, assessment the quality of studies and visualization of the pathology of various organs and systems. The most popular new technique is for screening studies, for example, for LDCT screening of lung cancer, and studies that require high resolution, for example, for CT-coronarography.

The latest recommendations of the American Thyroid Association have caused serious disagreements between the  nuclear medicine and endocrinologist communities regarding the radioactive iodine use. In 2018 eighteen experts  from 8 countries and 4 leading organizations (ATA, EANM, SNMMI and ETA) met for the first time to establish mutual understanding in the role of radioiodine therapy for differentiated thyroid cancer. After much discussion and exchange of experience, the participants developed a consensus document based on the so-called nine principles of  Martinique. We present an overview of the article published 2019 in Thyroid, entitled «Controversies, consensus, and collaboration in the use of 131I therapy in differentiated thyroid cancer: a joint statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association».

Introduction. Preoperative fMRI often shows a reduced BOLD response in the areas located perifocal to brain tumors caused by pathological vasoreactivity as a result of neurovascular uncoupling.

The aim of this study was an accurate identification of the eloquent cortical areas near brain tumors by measuring vasoreactivity using the breath holding test.

Material and methods. 23 patients with brain tumors located near eloquent cortical areas underwent fMRI mapping of the language and / or motor cortical areas depending on the location of the tumor. Breath hold test was  also included, the design of which coincided with motor and language block paradigms.

Results. A statistical dependency between motor, speech tasks and breath-hold BOLD-response was included into the BOLD analysis using coherence. fMRI activation maps generated by this method showed activation in the eloquent areas adjacent to brain tumors which were not detected by the standard analysis. This study shows that neurovascular uncoupling affects the accuracy of BOLD fMRI in brain tumors.

Conclusion. The results of fMRI mapping can be partially improved by the incorporating vasoreactivity measurements into a standard analysis.

Introduction. Pneumoconiosis is a disease caused by exposure industrial dust.

The aim of the work was to determine the diagnostic effectiveness of radiation research methods in its diagnosis and systematize CT semiotics.

Materials and methods. 105 mining and metallurgical workers were surveyed. All patients underwent a clinical and radiological examination.

Results. In addition to focal and interstitial changes, nodular changes were detected, and the presence of a cavity was not always a sign of tuberculosis. The sensitivity of CT was 98,94%, the specificity was 90,0%.

Conclusion. CT is necessary for all patients with suspected pneumoconiosis. The combination of the disseminated process in the lungs and professional harmfulness is not decisive in making a diagnosis, a comprehensive approach is necessary.

The aim of the current study was to assess the physical and technical image quality parameters of the CT images obtained on low-dose chest protocols.

Materials and methods. The study was performed using the ACR CT PHANTOM on the Philips Ingenuity 128 CT unit. The following parameters were selected for the assessment of image quality: Hounsfield unit accuracy, image noise, contrast to noise ratio and spatial resolution.

The results of the study indicate the lack of significant differences between the selected low-dose protocols.  Additionally, the correlation between the results of the assessment of physical and technical parameters of CT  images and expert image quality evaluation was weak. That does not allow implementing the low-dose protocols  into clinical practice based solely on the assessment of the physical and technical parameters.

The aim of the study. Investigation of the potential of diffusion-weighted magnetic resonance imaging (DW-MRI) with apparent diffusion coefficient (ADC) evaluation for differential diagnosis of mediastinal lymphadenopathy in lymphoma and sarcoidosis.

Materials and methods. The study included 15 patients with sarcoidosis and 7 patients with lymphoma. In each patient ADC values of 3 largest lymph nodes were measured.

Results. Differences of mean ADC values in lymphoma (1,01±0,3×10-3mm2/s) and sarcoidosis (1,51±0,25×10-3mm2/s) were significant, p<0,0001. Optimal cut-point value for ADC of ≤1,1×10-3mm2/s differentiated lymphoma from sarcoidosis with sensitivity of 76,2%, specificity of 97,8% and accuracy of 90,9%, the area under the ROC-curve was 0,89.

Conclusion. Preliminary results of the study have demonstrated the potential of DW-MRI in differential diagnosis of lymphoma and sarcoidosis and expediency of the further study.

Introduction. Currently, the diagnosis of papillitis with the establishment of the degree of severity of the lumen of the large duodenal papilla is still difficult. Verification of changes in papilla tissues by morphological methods is not sufficient to determine therapeutic tactics.

The goal is to compare the results of radiation methods for diagnosing primary papillitis of the Fater’s papilla. 

Materials and methods. The patients with chronic OPI-storchosis. Diagnostic features were studied by the analysis of medical documentation of 384 patients with opisthorchiasis cholangitis. We paid attention to direct and indirect signs of papillitis according to ultrasound, direct contrast of the bile ducts, computer and magnetic  resonance imaging.

Results. Analysis of the features of the methods allowed us to determine their positive and negative sides in the  diagnosis of papilla disease. The high resolution allows to obtain not only an accurate topography of the lesion, but  also to visualize changes in the structure of papillary tissues and periprotoxic structures in opisthorchiasis papillitis.

Conclusions. If possible, priority should be given to methods of transduodenal ultrasound and magnetic resonance cholangiopancreatography.

Introduction. Hepatomegaly is the most frequent and easily detectable, sometimes the only chronic liver disease symptom. An objective assessment of liver size with ultrasound is complex.

Aim. To assess the intra- and inter-research reproducibility of ultrasound liver linear measurements.

Materials and methods. To study the reproducibility of liver measurements, each patient was examined by two specialists of ultrasound diagnostics performing 24 liver measurements twice.

Results. The average errors for all left lobe measurements for more experienced doctor vary from 4 to 13,5% and  for less experienced — from 5 to 22%. When examining the right lobe, the average errors for both sonographers  don’t exceed 10%.

Conclusion. The anteroposterior size of the left lobe and maximum craniocaudal size of the right lobe are the most reproducible. We recommend obtain liver measurements of the right lobe at the anterior axillary line due to the lower bulge of the chest, which allows the transducer to be installed parallel to the sagittal plane.

Introduction. One of the reasons for errors in x-ray diagnostics of longitudinal flatfoot is a violation of the method of performing the study.

Aim of the study. To identify the x-ray signs that allow to determine the violation of the method of performing the study.

Materials and methods. There were analyzed the X-ray images of the feet of 53 patients sent for expert evaluation. Ultrasound examination of the soft tissues of the feet was performed for 10 volunteers.

Results. There were identified the signs that allow to assess the compliance of the x-ray examination technique, when the presence of longitudinal flatfoot is suspected.

Conclusion. The assessment of compliance of the x-ray examination technique allows to avoid diagnostic errors, especially at the» borderline « values of the flatfoot degree.

Introduction. The investigation is devoted to the possibility of application of computed tomography for forensic examination of skeletal human remains.

Aim of study: to evaluate the CT scanning application to skeletons with poor preservation state of bone tissue; to find out the possibility to describe the traumatic lesions on bones; to examine the density of bone tissue.

Material and method. The skeletonized remains of General Guden, the participant in the Napoleonic campaign of 1812 were studied by CT scanner «Philips Medical Systems».

Results. Antemortem and postmortem traumas are described as well as bone tissue density.

Conclusion. Postmortem tomography is the best non-invasive method to study skeletonized human remains in bad preservation state, which allows to define the antemortem and postmortem traumas.

Carney’s triad is a rare syndrome, comprising of the GIST of the stomach, functioning extra-adrenal paraganglioma and pulmonary chondroma. We present a case of a young woman diagnosed with gastric GIST, mesenteric  paraganglioma and two giant chondromas of the left lung. Due to the rapid growth of pulmonary neoplasms and  their potential malignant behaviour, the left pneumonectomy was performed.

Introduction. Radiosurgical treatment is the method of choice for brain metastases. In clinical practice, there are tumors with a relatively small frequency of secondary brain damage, for which the use of stereotactic radiosurgery has not been studied enough. One example of such diseases is malignant tumors of the female reproductive system.

Materials and methods. We described the application of stereotactic radiosurgery of ovarian cancer metastases to the brain using a three-fold hypofractionated stereotactic radiosurgery. We resorted to this method in order to reduce the negative effect on the functional area of the brain and preserve the performance of radiation in the treatment of metastasis located in the subcortical nuclei. To evaluate the results, were performed magnetic  resonance imaging and volumetry of pathological volume in the program for planning stereotactic radiosurgery Leksell Gamma plan® 10.1.

Results. Long term local control was observed on the part of all irradiated tumors with the same results of single irradiation and hypofractionated radiosurgery. Discussion. If there is a restriction to conduct a stereotactic radiosurgery associated with the localization of a pathological focus in the eloquent zone of the brain, it is possible to irradiate it in the hypofractionation mode. The method provides local control of tumor growth without a high risk of radiation toxicity.

Introduction. An analysis of the regulatory documentation for the procedure for radiological examination of the breast in Russia.

Materials and methods. 17 by-laws of the Ministry of Health of the Russian Federation, law enforcement agencies and individual large departments.

Results. Lack of a unified approach to the procedure and algorithm for conducting radiation examinations of the breast among the female population of the country.

Conclusions. The introduction of a single interdepartmental regulatory document governing the algorithm for  radiation examination of the mammary glands will reduce the number of shortcomings and defects in the provision  of medical care.