[First experience of using positron emission tomography with 11C-choline in prostate cancer (PC)].

Introduction into clinical practice of combined positron emission technology and computer tomography (PET/CT) allows in one study to identify structural and functional abnormalities. The study involves 32 patients who underwent PET/CT with "C-choline, including 5 patients with prostate cancer (PC), 3--with chronic prostatitis and 24--with biochemical PC recurrence. PET/CT with 11C-choline has a high diagnostic efficacy in detection of local recurrence and PC metastases in patients with biochemical PC recurrence. The results of visual analysis do not permit to distinguish PC from benign prostate diseases.

[The results of proton radiosurgery for pituitary endosellar adenomas].

465 patients with pituitary endosellar adenomas have passed irradiation on the synchrocyclotron PNPI (1000 MeV). Due to the high energy of the proton beam the rotating-convergent shoot-through technique was used. The single dose of 80-100 Gy was given. In patients with prolactin adenomas clinical remission was detected in 80%, and the stabilization of the disease was achieved in 15%. Pregnancies in 21 patients ended in the birth of healthy children, and 4 of them gave the birth twice. Complete clinical remission was observed in 92% of patients with Cushing's disease. Sustained recovery and full normalization of growth hormone level were observed during long-term follow-up in 86% of patients with acromegaly. There was significant reducing of the high hormone level on the fifth year of follow-up in any clinical form of pituitary adenomas while the development of the secondary hypopituitarism was not defected in the most of the patients. Clinical remission in patients with non-secreting adenomas was 95%. Irradiation by the proton beam was not accompanied by serious life-threatening complications. Thus this type of treatment for pituitary endosellar adenomas is highly effective and safe and, sometimes, the only method.

[The application of nuclear medicine imaging in neurology, neurosurgery and psychiatry].

Analysis of use of nuclear medicine imaging (positron emission tomography and single photon emission computed tomography) in diagnosis, differential diagnosis and evaluation of treatment efficacy of central nervous system diseases is presented in this review. The possibility of radionuclide imaging techniques in different variants of dementia, Parkinson's disease, brain tumors is demonstrated on the basis of personal authors experience and recent literature data. Results of PET application in evaluating of the effecacy of stereotactic interventions in patients with anxiety obsessive disorders are also described in the review.

[An experience with 100 cadaveric transplantations of the liver in the Russian Research Center of Radiology and Surgical Technologies].

The authors made an analysis of their first 100 transplantations of cadaveric liver made at the period from 1998 through 2011. Postoperative complications and long-term results of transplantations at the period to 13 years are described. Cumulative survival up to 12 months was 91%, to 36 months--83%. Retransplantation of the liver was performed on 5 patients, 2 of them being successful.

[Role of intrventional radiology in pre- and postoperative periods of liver transplantation].

The purpose of this study was to prove the use of interventional radiological procedures before and after liver transplantation (LT). Between 1998 and 2009 years, 54 LT were performed in 52 patients. 18 patients received 19 interventional radiological treatments including 11 preoperative (trans-catheter oily chemoembolization of hepatocellular carcinoma, n=3; transjugular intrahepatic portosystemic shunting, n=8) and 8 postoperative (drainage or stenting of biliary strictures, n=4; balloon dilatation and/or stenting of inferior vena cava or cava-caval anastomosis, n=3; splenic artery embolization in sleal syndrome, n=1). It is concluded that before LT, trans-catheter embolization delays the growth of hepatoma and prolongs time for donor liver waiting. Transjugular portosystemic shunt decreases the risk of fatal variceal bleeding. Post-LT complications such as vascular or biliary strictures and steal syndrome can be also effectively corrected by methods of interventional radiology.

[Influence of immunological parameters on the effectiveness of systemic and loco-regional immunotherapy in disseminated renal carcinoma].

Survival was assessed among patients with disseminated renal carcinoma from different prognostic groups as established by MSKCC protocol. Multivariate evaluation pointed to prognostic value of IL-6 (spontaneous and induced production), IL-8 (spontaneous and induced production),TNF-alpha (spontaneous production), IFN-gamma (induced production), TNK-cells (CD3+CD16+CD56+), and T-regulatory cells (CD4+CD25+Treg). It was demonstrated that additional criteria may be used to evaluate prognosis.

[Current possibilities of radiodiagnosis in liver tumors].

The report deals with potential of present-day techniques for radiological imaging, differential diagnosis and working out of modalities of treatment for primary and metastatic hepatic tumors. Results of complex examination (ultrasound, CT, MRI, PET using fluorine -18 FDG) of patients with benign and malignant tumors are discussed. Sensitivity and specificity of each procedure have been identified to be used in diagnosis of large-size tumors.

[Role of hormonal profile in adjusting therapy for prostate cancer].

Changes in testosterone, prolactin and estradiol levels were evaluated vis-a-vis outcome and different patterns of androgen suppression--continuous androgen blockade or intermittent therapy--for prostate cancer patients. There was a significant difference between pre- (3.4 +/- 0.5 mM/l) and post- (1.0 +/- 0.3 mM/l) treatment levels of testosterone in cases of tumor progression and that in patients with positive response--(9.1 +/- 0.6 mM/l) and (4.3 +/- 0.4 mM/l), respectively. Relatively low levels of testosterone involved tumor progression. Prolactin level was significantly higher in patients with multiple distant metastases--(18.6 +/- 1.2 microg/l) and isolated foci--(9.5 +/- 0.8 microg/l) while tumor progression was associated with enhancing correlation with PSA concentration. It was established that prolactin level can be used as a criterion for resumption or discontinuation of intermittent therapy. Estradiol dynamics was similar to that of prolactin. The difference between pre- (172.9 +/- 9.8 pM/l) and post- (246.5 +/- 12.8 pM/l) treatment levels of estradiol in cases of tumor progression was significantly higher than that in patients with positive response (85.0 +/- 3.8 pM/l) and (76.9 +/- 4.4 pM/l), respectively.

[Twelve years' clinical experience in using positron emission tomography: advances and prospects].

The paper describes 12 years' experience in using positron emission tomography (PET) at the Russian Research Center of Radiology and Surgical Technologies to detect cancer, cardiac, and psychoneurological diseases, to make their differential diagnosis, and to evaluate the efficiency of their treatment. It shows the capacities of PET using various radiopharmaceutical agents in a broad spectrum of the above abnormalities and defines prospects for further development of the technique.

[Positron emission tomography in oncourology].

The authors present the results of the examination of 61 patients with genitourinary space-occupying lesions, using 18F- fluorodeoxyglucose positron emission tomography (PET) in whole body mode. In all cases the diagnosis was verified morphologically. The results demonstrated high diagnostic accuracy of PET, including possibility to determine the extent of oncourological cancer. However, the method displays poor efficacy in cases of hypernephroid cancer due to low level of glycolysis in this type of tumor.

[Radiopaque oil chemical arterial embolization in treatment of pancreatic cancer].

The article is dedicated to a new method of treatment of pancreatic cancer, developed by researchers of St. Petersburg Research Institute of Roentgenology and Radiotherapy. The method consists in slowing down blood flow in the tumor by means of selective embolization of its arteries using a mixture of the chemiotherapeutic agent gemcitabine (Gemzar) in the oily radio-paque medium Lipodol Ultrafluid. Upon entering microcirculatory vessels, the agent diffuses into pancreatic tissue. This tumor chemoinfiltration provides prolonged contact between tumor tissue and the chemoembolization agent, thus allowing strong antitumor effect without high systemic toxicity. Experimental studies on 12 dogs have proved that oil arterial chemoembolization with lipiodol does not cause morphological changes in the pancreas, and is only manifested by short and reversible hyperenzymemia.

[The role of positron emission tomography with C18-Fluorodeoxyglucose in clinical oncology]. / Primenenie pozitronnoi émissionnoi tomografii C18-F-ftordezokcilgliukozoi v klinicheskoi onkologii.

The study was concerned with evaluation of the diagnostic potential of positron emission tomography (PET) with 18-FDG in clinical oncology and elucidation of its role in assessing therapy effectiveness. The Ecat Exact 47 and Ecat Exat HR+ (Siemens) insatllations were used to examine 674 patients, with Whole Body protocol used in 585. PET with 18-FDG proved highly effective in diagnosing malignancies of the breast, lung, liver, pancreas, testis, brain and lymphoma as well as evaluating the efficacy of therapy.

[Modern technologies of diagnosis and combined surgical treatment in liver tumors]. / Sovremennye tekhnologii diagnostiki i kombinirovannogo khirurgicheskogo lecheniia opukholei pecheni.

Modern technologies used at St. Petersburg Central Research Institute of Roentgenology and Radiotherapy of Russia's Ministry of Health in the diagnosis and treatment of malignant and benign liver cancers are surveyed in the paper. Apart from routine examinations, like ultrasound scanning, computer tomography, MRT, angiography, the below new technologies were widely used: multi-stratum spiral computer tomography, special MRT techniques and positron-emission tomography. The new methods enabled us to diagnose the tumor and its extension, to choose an optimal intervention technique, to make an objective assessment of the results and to correct the treatment strategy. Preoperative embolization of the portal-vein branches in the damaged hepatic lobe and postoperative adjuvant local chemotherapy of the hepatic artery and portal vein belong to the new combined surgical treatment scheme. The method of combined arterial-portal chemoembolization, used in unresectable malignant hepatic pathologies, extends the survival of patients by 3-5 times. Ferromagnetic embolization presupposes the administration of ferromagnetic, through the arterial bed or direct puncture, into the tumor with a subsequent SHF-current treatment which brings about a selective tumor hyperthermia without heating the normal hepatic parenchyma. Arterial embolization combined with local injection sclerotherapy in hemangiomas of the liver provides for a complete regeneration of benign tumors and can be regarded as a low-trauma alternative to liver resection. The use of new methods of diagnosis and treatment expands the possibilities of surgical care for patients with hepatic neoplasms and essentially improves the treatment results.