In this paper, we present the efficiency estimations of active breathing control with usage ABC system to ensure accuracy and reproducibility of patient positioning for hypofractionated or radiosurgery treatment of solitary lung tumors. The treatment procedures were holding on Elekta Axesse linac. Patients were positioning as for CT pretreatment scanning in supine position with hands behind their head and with using additional fixation (usually, knee and head support cushions). Patient’s position corrections were done with usage 3D imaging system XVI (Elekta AB) and robotic couch HexaPod to match isocenters the treatment plan and linac. It’s considered the interfraction patients’ offsets due to inaccurate setup and respiratory movements. It’s developed a protocol of choosing CTV-PTV margins for use in clinical practice, which is 5-9 mm, depending on anatomical directions. The margins have the greatest value in vertical (SI) and much lesser in transverse (LR) and longitudinal (AP) directions.

Determination of the degree of radical removal of glial tumors, given the infiltrative growth and the absence of a clear boundary with intact brain tissue, is a very difficult diagnostic challenge. In the arsenal of modern techniques doctors intra and postoperative diagnosis are still in many cases are not able to definitely answer this question. The importance of a correct evaluation of the scope of existing remnants of tumor tissue is difficult to overestimate, as this information affects the further determine the effectiveness of adjuvant therapies, and hence the choice of the optimal tactics. The purpose of this publication was to compare the information content of different methods of evaluation of radical removal of glial tumors (opinion of the surgeon, intraoperative ultrasound navigation, postoperative MRI, evaluated visually or by semi-automatic segmentation). This article describes the results of the application of these methods with the index integral severity of patients, while it is determined that the evaluation of MR images by semi-automatic image segmentation, provides the most objective judgment on the amount of tumor tissue removed and the presence of residual tumor.

Objective: To study the hemodynamic malignant brain tumors before and after radiation or conducted postoperative chemoradiotherapy. Materials and Methods. Analyzed data from multislice computed tomography (CT) and CT perfusion imaging in 27 patients: a primary malignant glial brain tumors - 20 (74,1%) patients and the presence of secondary (metastatic) brain lesions - 7 (25,9%). The study was performed on a computer tomograph Toshiba Aquilion ONE-320, with an intravenous bolus injection of the contrast agent. The authors provide data on changes in indicators of perfusion imaging in the area of brain tumor on the background of the chemoradiotherapy. MSCT perfusion assessed opportunities in monitoring patients after treatment for early detection of recurrence or further growth tumor. Results. According to the results of a comprehensive analysis of the data MDCT with intravenous contrast after total removal of the tumor noted the presence of contrast agent accumulation zone at the periphery of the field of postoperative changes. After performing PCT in the area not noted significant increases in standard measures of perfusion, indicating the presence of glial scar formation zone, and not residual tumor. When PBC was a significant increase in tumor perfusion parameters nodes, both primary and secondary nature. In terms of up to 6 months after treatment, 18,5% noted a decrease in tumor size in the standard MSCT and a gradual decrease in the degree of hyperperfusion mainly in the central parts of the tumor by 50-90% relative to the original data. In all cases, the degree of reduction of hyperperfusion was preceded by a decrease in tumor size. Lack of dynamics of perfusion and tumor size was observed in 33,4% of patients tested, which was interpreted as the stabilization process. In 48,1% of patients experienced disease progression during the period from the end of treatment to 6 months, of whom 61,5% were identified indicators increase perfusion 45-70% relative to the original data, which was preceded by an increase in tumor size. The remaining 38,5% of the patients an increase in tumor size and increase perfusion parameters were detected simultaneously. In the study, 2 patients with secondary tumors identified areas without increasing perfusion imaging chamber with a standard CT examination in the future in these areas noted the emergence of a new hearth. Conclusions. Perfusion CT is a relatively simple, minimally invasive diagnostic method that allows us to judge the dynamic changes of brain tumors during treatment, to evaluate the effectiveness of treatment in the early stages and identify the disease progression.

One of complications after thyroid and parathyroid surgery is laryngeal recurrent nerve injury and subsequent vocal cords palsy. It is a serious complication with a frequency varying from 1% to 18,6%, considerably deteriorating patient’s quality of life, sometimes causing loss of patient’s work-status. That’s why it is of great importance its early detection and start of appropriate treatment. Despite laryngoscopy is a gold standard for evaluation of vocal cords mobility after thyroid and parathyroid surgery, it has several problems in permanent surgical practice. This work is focused on the possibility of using noninvasive method of visualization of vocal cords. Our results indicate that ultrasound method of evaluation of vocal cords mobility can be successfully applied in 85,9% of patients in preoperative and postoperative examination of patients. The best visualization has been achieved in female patients - in 90,6% of patients, and in male patients - only in 27,9% of patients. We consider reasonable to replace laryngoscopy by ultrasound in most cases.

According to literature data, the majority of patients after left ventricular reconstruction surgery (LVRS) for postinfarction left ventricular aneurysm, has improved the function of the LV regardless of the type of plastic that causes clinical enthusiasm, but in the articles on this topic are not reported or discussed the dynamics of stroke volume (SV), which more directly reflects the pumping function of the heart. In those works, which take into account the change SV, its dynamics shows ambiguous. Some researchers have noted a decline in SV, others increase it. The present study examines not only change after LVRS traditional volumetric and functional parameters obtained by MRI, but the magnitude and dynamics of SV and tries to establish its relationship with the original and the changed postoperative left ventricular volume and functional indicators.

Aneurism of the left ventricle (LV) is one of the most frequent complications of a transmurali myocardial infarction. Main objective of a surgical intervention is elimination of sites of an asynergia, decrease of volume of LV and recovery of its geometry. At the majority of patients when carrying out operation of reconstruction of LV its function improves; however the stroke volume (SV) which reflects pump function of heart more informatively, has ambiguous dynamics. The real research establishes connection between dynamics of SV and size of difference of the actual postoperative and theoretically calculated value of end diastolic volume.