Introduction: Neurocysticercosis is one of the most common helminthiases of the central nervous system, the frequency of which is increasing from year to year. Neuroimaging methods currently occupy a key place in the diagnosis of this pathology.

Objective: To demonstrate the importance of neuroimaging methods in radiation diagnostics in patients with neurocysticercosis, to highlight typical patterns of changes detected by computed tomography and magnetic resonance imaging.

Materials and methods: Our review presents data obtained from available PubMed and Scopus sources published up to and including December 2022. The search was performed using the keywords: neurocysticercosis, cysticercosis, diagnosis, CT, MRI in Russian and English.

Results: The literature review describes the diagnostic capabilities of neuroimaging methods in detecting neurocysticercosis of the central nervous system. Based on the results of the published scientific papers, the authors conclude that the use of diagnostic methods of computer and magnetic resonance imaging plays a key role in establishing the diagnosis of neurocysticercosis in the early stages and also allows for differential diagnosis.

Discussion: Neurocysticercosis is one of the most common helminthiases affecting the central nervous system. The prevalence of this disease is increasing from year to year, which, among other things, is due to the wider use and accessibility of neuroimaging methods. Neurocysticercosis affects mainly the young and able-bodied population, in some cases occurring without obvious clinical symptoms.

Conclusion: Neuroimaging techniques such as computed tomography and magnetic resonance imaging are an integral part of a comprehensive examination of patients with suspected neurocysticercosis, which undoubtedly affects the future management of such patients.

Introduction: Osteoporosis is characterized by a decrease in bone mass and deterioration of bone microarchitectonics. Osteoporosis often remains undetected until the first pathologic fracture of vertebrae, proximal femur or other bones. With the rapidly aging world population, early diagnosis of osteoporosis has become an important public health issue.

Objective: To present current data on the methods of radiologic diagnosis of osteoporosis using cone-beam computed tomography, magnetic resonance imaging, and texture analysis.

Material and methods: We searched for scientific publications and clinical recommendations in the information-analytical systems eLIBRARY.RU and PubMed for 2005–2024 using the following keywords: osteoporosis, cone-beam CT, magnetic resonance imaging, texture analysis, bone mineral density.

Results: A total of 454 articles were analyzed, 31 of which were used for the review.

Conclusions: The methods of radiologic diagnostics of osteoporosis presented in this review have their own prospects for development and improvement. The analysis of scientific data on the described methods shows the undying interest in each of the methods.

Introduction: Medullary thyroid cancer is a rare neuroendocrine tumor and occurs in hereditary and sporadic forms. As in other NETs, somatostatin receptors are overexpressed in the cell membrane in more than 75% of cases of medullary thyroid cancer. Therefore, in recent years, radioactively labeled somatostatin analogues have been considered not only for assessing the prevalence of the tumor process, but also for the treatment of this disease.

Objective: Аnalyze the global and domestic experience of using peptide receptor radionuclide therapy ¹⁷⁷Lu-DOTA-TATE in the treatment of patients with advanced medullary thyroid cancer.

Materials and methods: In the period from 01.03.2024 to 01.08.2025, data from more than 30 foreign literature sources relevant to this topic were analyzed in the Pubmed, Google Scholar and eLibrary databases.

Results: Of the studies confirm the feasibility of introducing ¹⁷⁷Lu-DOTA-TATE PRRT into clinical practice for certain groups of patients.

Discussion: PRRT ¹⁷⁷Lu-DOTA-TATE allows achieving disease control in most patients: it can maintain disease stabilization with a small number of side effects, and in some cases patients manage to achieve a complete response (CR) and partial response (PR) to treatment.

Conclusion: In order to introduce PRRT ¹⁷⁷Lu-DOTA-TATE into the broad clinical practice of treating metastatic prostate cancer, additional multicenter randomized controlled clinical trials are needed, as well as exploring the possibility of combining PRRT ¹⁷⁷Lu-DOTA-TATE with other treatment options such as ITC therapy, chemotherapy and immunotherapy, as well as radionuclide therapy with other RFLPs.

Introduction: Mucormycosis is a severe infection that mainly develops in immunocompromised patients. During the COVID- 19 pandemic, there was an increase in the incidence of mucormycosis, high prevalence was observed in many countries of the world, for example, in India. The number of publications on mucormycosis in electronic libraries has increased more than 1.5 times over the past four years. Patients with COVID-associated mucormycosis (COVID-M) predominantly develop lesions of the paranasal sinuses — up to 96%. Mucormycosis of the paranasal sinuses is characterized by high disability and mortality of up to 80%.

Objective: To analyze the results of multispiral computed tomography (MSCT) and magnetic resonance imaging (MRI) in patients with COVID-associated rhinocerebral mucormycosis to improve the effectiveness of disease diagnosis.

Materials and methods: The registry of patients with mucormycosis included 100 patients with COVID-associated paranasal sinus mucormycosis. The criteria of EORTC/MSG, 2020 were used to make the diagnosis of «invasive mycosis». Retrospectively, using the Weasis v4.5.0 program, the multispiral computed tomography data of 41 patients were analyzed in dynamics. The median age of the patients was 61 years (22–83), 56% of them men. CT-studies were performed using a GE Bright Speed 16 tomograph, GE Revolution HD, Philips Ingenuity Core 64, Aquilion PRIME 1. Statistics: Statistical data analysis was performed using the Microsoft Office Excel 2019. Survival analysis was performed using the Kaplan-Mayer method.

Results: The main clinical symptoms were swelling of the soft tissues of the face and eyes (93%), local pain syndrome (88%), facial numbness (78%), paresthesia (76%), visual impairment (66%). Thickening of the mucous membranes (100%) was observed in the nasal cavity with the formation of necrotic masses and a characteristic «black scab» (90%). The main radiological signs were: hypertrophy of the mucous membranes of the paranasal sinus — 100%, destructive changes in the walls of the sinuses and bones of the skull — 100%; edema, thickening of the soft tissues of the face, orbit and brain — 93%. Destructive changes of the maxillary sinuses were detected in 100% of patients, the walls of the orbits — 95%, the latticed bone — 93%, the maxilla — 85%, the walls of the main sinus and the sphenoid bone — 83%, the frontal sinuses — 37%. The lesion of the optic nerve is in 66%. According to the central nervous system, damage to the frontal lobe was detected in 32% of cases, damage to the temporal lobe — 15%. Cavernous sinus thrombosis — 46%. In case of orbital damage, CT-signs were determined on day 12 (median 12.5±4.9 days) from the onset of clinical manifestations, involvement of the optic nerve in the infectious process also on day 12 (median 12±4.1 days). CT-changes from the central nervous system were observed on day 18 (median 18±10.45 days). The survival rate of patients within 3 months was 88%, and within 1 year — 78%.

Discussion: The main underlying diseases in mucormycosis today are COVID-19 (46%) and oncohematological pathology (37%). When analyzing the risk factors for the development of rhinocerebral mucormycosis, the main importance is the presence of concomitant diabetes mellitus (88%), as well as long-term use of glucocorticosteroids (GCS) in high doses (90%). The main CT-signs of rhinocerebral mucormycosis were the destruction of the walls of the paranasal sinuses and cranial bones, which occurs on days 7–12 from the onset of the first clinical symptoms.

Conclusion: Radiation examinations are the leading imaging methods for rhinocerebral mucormycosis. The examination protocol must include a MSCT scan of the paranasal sinuses and an MRI scan of the brain. Early radiological diagnostics reduces mortality and disability of patients.

Introduction: Intraosseous gas is a rare but significant radiological sign, primarily associated with emphysematous osteomyelitis (EO). Despite descriptions of similar cases in long bones and the spine, data on maxillofacial region (MFR) involvement are lacking in the literature. This study aims to address this gap, as the presence of intraosseous gas may indicate the presence of special pathogens and require a different therapeutic approach.

Objective: To evaluate the frequency, radiological features, and clinical significance of intraosseous gas in patients with MFR osteonecrosis.

Materials and methods: 93 patients diagnosed with M86.6 «Other chronic osteomyelitis» of the MFR with osteonecrosis of different etiology types (medication-related, post-radiation, post-COVID-19) were included in this study and were referred for multi-slice computed tomography (CT, Philips Incisive 64, China) using dental protocol with slice thickness 0.67 mm. During hospitalization a bacteriological examination of exudate or wound contents was performed with verification of the pathogen and determination of sensitivity to antibiotics and antimycotics.

Results: Intraosseous gas was detected in 29% (27/93) of patients including: 100% (4 cases) — post-COVID-19 osteonecrosis (4 patients); 28.6% (4 cases) — post-radiation osteonecrosis (14 patients); 25.3% (19 cases) — medication-related osteonecrosis (75 patients) due to bisphosphonate and/or denosumab therapy. Gas was most frequently associated with Enterobacter cloacae (33.3%, 9 cases), Klebsiella pneumoniae (25.9%, 7), and Escherichia coli (11.1%, 3). In 96% (46/48) of patients with streptococci, the intraosseous gas was absent.

Discussion: Key finding: Intraosseous gas is associated with fermenting bacteria (Enterobacter cloacae, Klebsiella pneumoniae, Escherichia coli), as confirmed by microbiological data in our study. In contrast, streptococci and non-fermenting microorganisms (Acinetobacter, Pseudomonas) predominantly do not cause gas formation. Detection of gas on MSCT is a marker of fermenting microbiota and warrants targeted antibiotic therapy.

Conclusion: Intraosseous gas is a significant diagnostic criterion, observed in 29% of patients with MFR osteonecrosis. When the intraosseous gas is detected, mandatory bacteriological testing with a focus on fermenting bacteria is required for planning an antibiotic therapy.

INTRODUCTION: Accurate determination of the percentage of Renal contribution to their overall function is an important indicator when choosing clinical tactics for Renal transplantation and surgical interventions. The possibility of using nephroscintigraphy or complex alternative radiation methods is not always available.

OBJECTIVE: Development and validation of methods for assessing split Renal function in a standard CT scan with contrast based on specialized automatic segmentation programs or manual measurement data.

MATERIAL AND METHODS: The study included the results of a CT scan of the retroperitoneal space with contrast in 243 patients. 100 of them had nephroscintigraphy data. The Vitrea Advanced Visualization software was used for automatic segmentation of the renal parenchyma into the nephrographic phase. Data on volume (V) and average density (HU) were obtained. The values of renal parenchyma density in the native phase were performed manually. The split contribution of the Renals was determined based on the percentage ratio of the «mass» of the contrast agent in the parenchyma of each Renal, calculated as the product of the volume of the parenchyma and the average values of its density. The obtained results were compared with the nephroscintigraphy data.

To develop a manual method for calculating the volume of the renal parenchyma, three linear Renal sizes (width, thickness, and length) and three parenchymal thicknesses were measured. The average values of renal parenchyma density were obtained based on three measurements of the round ROI at different levels.

Statistics: The results obtained during the study were processed using statistical evaluation methods (correlation and covariance analysis).

RESULTS: Using data on the volume values of the Renal parenchyma obtained during automatic segmentation using regression analysis, formulas for calculating the volume of the parenchyma were obtained based on taking into account all six linear Renal sizes with additional coefficients: V=1/1000(0.92xyT–0.07y³+0.07yz²+0.19z²T), which demonstrated a high positive correlation and accuracy of the method (correlation coefficient — 0,99 (p<0,001), covariance coefficient — 0,94 (p<0,001)). When comparing two methods for determining the average values of renal parenchyma density (using round ROI and using manual circling on a coronal slice), the round ROI measurement method was chosen, which showed a slightly greater correlation with the data obtained with automatic segmentation (correlation coefficient — 0,988 (p<0,001); covariance coefficient — 0,76 (p<0,001)).

DISCUSSION: The conducted studies have confirmed the high effectiveness of the two proposed methods for assessing separate kidney function based on standard CT with contrast.

The automated method demonstrated a very high correlation with the results of dynamic nephroscintigraphy. This opens up the prospect of replacing radionuclide testing in a number of clinical situations, which will reduce radiation exposure and simplify patient examination.

An alternative manual method based on linear measurements of the kidney and the density of its parenchyma also showed high accuracy. The method is a clinically valuable solution for medical institutions that do not have expensive specialized 3D segmentation software.

CONCLUSIONS: The developed automated method of segmentation of the renal parenchyma and an alternative method based on manual measurement make it possible to obtain data on split renal function during a routine CT scan with contrast without additional radiation and financial burden on the patient.

Introduction: Patients with tumor thrombosis of the inferior vena cava leiomyosarcoma should not be considered inoperable; they are subject to radical treatment, which can significantly prolong their lives. Only a multiparametric approach to diagnosis will allow clinicians to have a complete picture of the severity of the patient’s condition in order to make a decision on the choice of the optimal treatment method.

Objective: Improvement of the results of ultrasound semiotics and the use of multiparametric ultrasound examination of tumor thrombosis of leiomyosarcoma of the inferior vena cava.

Materials and methods: The study included 26 leiomyosarcomas of the IVC identified by CT with intravenous contrast, and 14 of them were patients with tumor thrombosis of the IVC.

Results: In our observations, the main localization of the primary tumor of the inferior vena cava is the level of the infrarenal, cavarenal, and suprarenal segments of the IVC, and the upper border of the tumor thrombus is below the level of the diaphragm, and only in two cases there was an incomplete occlusion of the hepatic vein orifice. In all other cases, the apex of the tumor thrombus was determined at the level of the suprarenal segment of the IVC. The standard situation was the tumor germination of all layers of the IVC wall, regardless of localization and semicircle, the tumor thrombus in the IVC lumen originated from the main tumor mass and spread in the direction of blood flow. In the preliminary assessment, when comparing the data of complex ultrasound diagnostics (B-mode, shear pulse-wave elastography and elastometry) of the leiomyosarcoma of the IVC with tumor thrombosis and in comparison with the data of the study of the macropreparation — tumor and tumor thrombosis, there was a complete coincidence, where p<0.05. This suggests that the results obtained are statistically significant.

Discussion: Comprehensive ultrasound diagnostics, thanks to additional techniques, allows you to assess blood flow in the vessels affected by the tumor and in the formed collateral systems, assess the speed of blood flow, as well as the presence of parietal blood flow, allows you to assess the qualitative and quantitative characteristics of tumor thrombosis, differentiate the tumor thrombus of the VCI from hemorrhagic thrombosis, and also differentiate the leiomyosarcoma of the inferior vena cava from nonorgan tumors of the retroperitoneal space or extra-organ tumors originating from the right kidney, adrenal gland and liver.

Conclusion: Multiparametric ultrasound diagnostics allows to assess: the prevalence of leiomyosarcoma of the inferior vena cava, the presence of tumor thrombosis, its boundaries and nature (occlusive, floating), the spread of tumor thrombosis to other vessels (to the hepatic, renal, lumbar, iliac veins, gonadal veins) or in the heart cavity, the structure of the tumor thrombus (soft, loose, dense, mixed). Thanks to comprehensive ultrasound diagnostics it is possible to assess the development of Badda-Kiari syndrome, give clear criteria that can influence the tactics of surgical intervention (indications and contraindications to the operation), ultrasonic monitoring in the postoperative period, in the detection of postoperative complications.

Introduction: The use of deep learning in the detection of prostate cancer (PCa) based on multiparametric MRI (mpMRI) data is one of the most controversial areas of development of this technology in medicine. Despite high international interest in such systems, the number of thematic studies in the Russian Federation remains limited.

Objective: To describe the process of creating and validating a domestic medical decision support system (MDSS) designed to diagnose PCa based on mpMRI results using AI.

Materials and methods: Data on patients with a confirmed diagnosis who underwent radical prostatectomy were collected both retrospectively and prospectively. The patient sample was formed between January 10, 2023 and May 1, 2025. T2- weighted images (T2-WI) and measured diffusion coefficient (MDC) data were used as working sequences. Data annotation was performed manually by three specialists with more than 10 years of experience in independently performing and analyzing MR data of patients with suspected PCa. During the study, four different architectures were tested to evaluate their effectiveness and determine the most suitable one for the tasks at hand. The following metrics were used to measure accuracy: sensitivity, specificity, accuracy, area under the ROC curve (AUC), and Dice score (DSC).

Results: In accordance with the inclusion criteria, 441 studies performed on 19 different MRI scanners were collected. Validation of the most productive neural network architecture revealed the following indicators: accuracy — 73%, sensitivity — 71%, specificity — 71%, AUC — 0.70, DSC — 0.70.

Discussion: The work presented by us is aimed at familiarizing specialists with the intermediate results of the development of the first national MDSS, implemented according to a strategy of avoiding the shortcomings present in the works of other teams.

Conclusion: The results of testing the developed AI-based program for the detection and reconstruction of PCa on MRI images showed promising prospects for the domestic medical decision support system. To confirm the clinical applicability and effectiveness of the developed program, further multicenter studies are needed to assess its potential and feasibility for implementation in real clinical practice.

Introduction: Alterations in body composition (muscle and adipose tissue) can influence clinical outcomes of underlying diseases. Comprehensive assessment of body composition via instrumental diagnostics includes bioelectrical impedance analysis, dual-energy X-ray absorptiometry, computed tomography (CT), and magnetic resonance imaging (MRI). Although CT and MRI are considered gold-standard methods, their use is limited by challenges in manual segmentation and the lack of universally accepted diagnostic thresholds. Artificial intelligence (AI) can fully automate this process and facilitate the calculation of diagnostic threshold values in cross-sectional population studies.

Objective: To obtain data on the sex and age distribution of morphometric parameters of muscle and adipose tissue, assessed using AI-based software on CT scans capturing the region of interest (L3 vertebra level), in a generally healthy population in Moscow.

Materials and methods: A retrospective, observational, cross-sectional descriptive study was conducted across 65 medical institutions of the Moscow Department of Healthcare. CT data from generally healthy patients were selected through a multistage process, including assessment of anamnestic data. Participants were grouped by sex and age. Native CT images were analyzed using AI-based software for segmentation and calculation of the following parameters: skeletal muscle area (SMA), skeletal muscle index (SMI), radiological density of skeletal muscle (RDSM), subcutaneous adipose tissue area (SATA), visceral adipose tissue area (VATA), intramuscular adipose tissue area (IMATA), and its proportion (PIMAT). For each parameter, quantile regression models were constructed (5th, 25th, 50th, 75th, and 95th percentiles) with 95% confidence intervals. Statistics: Cut-off values for morphometric parameters were determined using a quantile regression model. T-test, one-way ANOVA, and Mann-Whitney tests were used for comparative analysis. Statistical analysis was performed using jamovi version 2.3.28 and RStudio 2024.12.1.

Results: After multi-stage analysis of CT images, text of their corresponding reports and electronic medical records according to inclusion and exclusion criteria, the final sample consisted of 900 patients (579 women (64.3%) and 321 men (35.7%)). SMA and SMI showed similar trends: a gradual increase to peak values followed by a decline, with minima in the «80 years and older» group. SMA, SMI, and RDSM were statistically significantly higher in men (p<0.001) and differed across age groups (p<0.001). Median peak SMA values: men — 41 years (168.77 cm2), women — 41 years (115.17 cm2). Median peak SMI values: men — 47 years (53.66 cm2/m2), women — 48 years (41.95 cm2/m2). SATA and VATA increased to peak values, with minima in the «18–29 years» group. SATA, VATA, IMATA, and PIMAT differed statistically significantly by sex (p=0.001 for PIMAT, p<0.001 for others) and age (p<0.001). Median peak SATA values: men — 63 years (177.93 cm2), women — 62 years (226.97 cm2). Median peak VATA values: men — 71 years (233.97 cm2), women — 71 years (169.26 cm2).

Discussion: Representative population data on the sex and age distribution of body composition morphometric parameters were obtained for conditionally healthy men and women in Moscow using AI-based software. These results enable further research on body composition changes in various pathologies and the diagnosis of sarcopenia through opportunistic analysis of previously performed CT scans including the region of interest. The observed distribution patterns of both muscle and adipose tissue parameters align with data from similar population studies in the literature. However, SMI values in the Moscow population were lower than those reported for american and dutch cohorts (statistically significant for women). These identified differences underscore the value of the obtained results for the specific population.

Conclusion: This study presents the first population data on the sex and age distribution of body composition morphometric parameters from CT images for Moscow, obtained using AI-based software. All parameters showed statistically significant differences across sex and age groups, with higher values of muscle and visceral adipose tissue in men, and higher subcutaneous and intramuscular adipose tissue in women. The lower SMI in the Moscow population compared to American and Dutch cohorts highlights the relevance of these data for CT-based sarcopenia diagnostics in the European part of Russia.

According to the 5th edition of the World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS), published in 2021, solitary fibrous tumor (SFT) has been established as a distinct nosological entity within the category of rare mesenchymal neoplasms, exhibiting a propensity for early recurrence and systemic dissemination.The limited prevalence of SFTs accounts for the scarcity of publications describing their specific neuroimaging patterns, while the clinicopathological features of this tumor have been well-characterized. The lack of robust diagnostic criteria poses significant challenges in differentiating SFTs from other intracranial neoplasms, which require fundamentally distinct therapeutic approaches. This report describes the clinical case of a 40-year-old male patient presenting with headache, systemic dizziness, recurrent syncopal episodes, and generalized tonic-clonic seizures over a two-month period. Brain MRI revealed an extra-axial mass in the left parasellar region, attached with its base to the dura mater, accompanied by perifocal edema, mass effect of the left temporal lobe, prominent vascularity, intense homogeneous contrast enhancement, and elevated perfusion values. The preoperative differential diagnosis included meningioma, schwannoma, dural metastatic lesion, chondrosarcoma, and MALT lymphoma. The «YinYang» sign emerged as the most significant diagnostic criterion, characterized by heterogeneous tumor signal intensity on T2- and T2-FLAIR sequences. The patient underwent microsurgical resection of the tumor. Histopathological examination confirmed the diagnosis of SFT. Thus, the use of a comprehensive multiparametric MRI protocol enables a high-probability preoperative suspicion of SFT, which is critical for surgical planning.

The described clinical case demonstrates the importance of multispiral computed tomography (MSCT) in the diagnosis of early laryngeal cancer using the developed form for assessing tumor resectability. The article presents the case of patient Ts. 68 years old with a verified diagnosis of stage 1 laryngeal cancer.In September 2024, complaints of hoarseness appeared, no treatment was carried out, in February 2025 the patient sought medical help from an ENT doctor. Suspected of malignant tumor, he was referred to GBUZ OOD. According to the results of the patient’s examination in a single diagnostic algorithm, assessment of the course of the tumor process according to MSCT data, with the joint activity of a radiation diagnostician and a surgeon, the option of surgical treatment by endolaryngeal resection (ELR) was chosen. To determine the resectability of the tumor process in the larynx, a detailed assessment of the tumor condition and its prevalence is necessary before surgical treatment in the form of endolaryngeal resection. MSCT makes it possible to quickly perform a study for calculating and performing minimally invasive surgery, improving oncological and functional results.