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UJR 2013, vol XXI, # 3

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THE CONTENTS

 

2013, vol XXI, # 3, page 267

Vinnikov Volodymyr Anatoliyovych, Maznyk Nataliya Oleksandrivna, Sypko Tetyana Serhiyivna, Pshenichna Nataliya Dmytrivna

The cytogenetic damage in gynecologycal cancer patients during radiotherapy.

II. The comparison of the genotoxicity of different Irradiation schemes

Objective: To compare the relative genotoxicity of different schemes of radiotherapy (RT) of gynecological cancers by the dynamics of cytogenetic damage yields in patients’ blood lymphocytes.

Material and Methods: Cytogenetic study was carried out in 53 female patients with uterine cancer (UCa), 5 cervical cancer patients (CCa) and 12 ovarian cancer patients (OCa), who underwent standard cources of telegammatherapy (TGT, 38 persons), intracavitary brachytherapy (ICBT, 10 persons) or a combination of both (CRT, 22 persons). Conventional cytogenetic analysis, aimed at recording chromosomal aberrations and genomic abnormalities, was performed in 50-h lymphocyte cultures, set up from samples collected before irradiation and throughout the radiotherapy (RT) course; in total 186 individual examinations was done. The individual yields of ACsunst in each group were plotted against the number of RT fractions and fitted to a linear regression. The same was done for the ACsunst yield kinetics, which was preliminary assessed in each patient.

Results: Any studied RT scheme produced a significant elevation of cytogenetic damage yield in patients’ lymphocytes. Individual aberration yields formed clusters at the starting stages of TGT, in the middle and at the end of the TGT and CRT course. The group regressions of ACs accumulation were essentially overlapped in TGT and CRT groups, and in both cases markedly exceeded the level of damage in ICBT group.

The averaged linear coefficients, describing the increase of the ACsimst yield (per 100 cells) per 1 RT fraction, were: 0.85 for UCa ICBT, 1.68 for OCa TGT, 2.65 for CCa and UCa CRT and 3.24 for CCa and UCa TGT. Pre-radiation surgery did not affect the cytogenetic indices. Chemotherapy had no clastogenic impact on the pre-radiation cytogenetic damage level, but noticeably reduced the accumulation rate of radiation-induced ACsuns, during radiation treatment.

The gradual decrease in the kinetics of aberration accumulation during the RT showed that the most adequate model for describing the time-course of the aberration yield in gynecological cancer patients seems to be a multicomponent function, which provides a plateau in the second half of the treatment course.

Conclusion: For the first time the genotoxicity of the telegammatherapy, intracavital brachytherapy and their combination was compared by the in vivo patterns of aberration yields measured in the representational groups of gynecological cancer patients. For the first time the specific characteristics of the kinetics of cytogenetic damage yield were assessed depending on the scheme of therapeutic irradiation. These quantitative data can be used for developing of a prognostic model of cytogenetic damage dynamics during RT.

Key words: chromosome aberrations, radiotherapy, uterine cancer, ovarian cancer.

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2013, vol XXI, # 3, page 278

Sharmazanova Olena Petrivna, Myronova Yuliya Anatoliyivna, Kovalenko Yuriy Mykolayovych, Balashov Serhiy Volodymyrovych

Diagnosis of bone growth zones injuries using digital microfocus radiography (experimental research)

Objective: То evaluate experimentally the imaging capabilities of traumatic injuries of the elbow growth zones using digital microfocus radiography.

Material and Methods: Digital x-ray diagnostic complex, microfocus x-ray unit and tissue-equivalent phantom with simulated fractures of the growth zone of the elbow joint were used.

Results: Digital radiography of tissue-equivalent phantom was done as the first stage of the investigation, which did not allow seeing on the digital radiograph fracture of the olecranon growth zone. Digital microfocus radiography of the damaged area without magnification and with a 7-fold primary magnification was done as the second step, which allowed visualization of the growth zone fracture line. The results were repeated in a series of experiments and were confirmed by morphological study.

Conclusion: The use of magnified microfocus radiography in diagnosis of olecranon growth zone injuries significantly increases the probability of correct diagnosis.

Key words: injuries, growth zone, digital microfocus radiography.

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2013, vol XXI, # 3, page 284

Slavnov Valentyn Mykolayovych, Savytskyy Serhiy Yuriyovych

Assessment of the state of renin-angiotensin-aldosterone system in patients with arterial hypertension using radioimmunoassay

Objective: То assess functional state of renin-angiotensin-aldosterone system (RAAS) in patients with arterial hypertension (AH) depending on basal levels of plasma renin activity (PRA). 24-hours rhythm and reaction of RAAS on furosemide loading in patients with AH and primary hyperaldosteronism (PHA) were defined.

Material and Methods: 145 patients with stage II essential hypertension (EH) and 15 patients with PHA aged 17- 60 were included in the study. To evaluate the functional state of RAAS renin plasma activity and aldostrone concentration (AC) were detected in peripheral blood and in the blood obtained from renal and suprarenal veins. RPA and AC were controlled by radioimmunoassay.

Results: In patients with low renin essential hypertension PRA reduction correlated with normal AC in blood from suprarenal veins, but 24-hour rhythm was impacted and AC reaction on furosemide loading was absent. High levels of PRA and AC in the morning hours were observed in patients with high renin EH. Response to furosemide loading was not observed. Physiological 24-hour rhythm of PRA and AC was impaired and effect of furosemide loading was not revealed in PHA patients.

Conclusion: Investigation of 24-hours rhythm of RAAS and its reaction on furosemide loading in patients with AH is a good tool for appropriate substantial treatment.

Key words: essential hypertension, primary hyperaldosteronism, renin-angiotensin-aldosteron system, radioimmunoassay.

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2013, vol XXI, # 3, page 289

Sukhina Olena Mykolayivna, Slobodyanyuk Olha Volodymyrivna, Sukhin Vladyslav Serhiyovych, Tarasova Oksana Mykolayivna, Skrypnik Larysa Dmytrivna, Lanko Liliya Gryhorivna

Individual analysis of the tumor marker CA-125 in the course of neoadjuvant chemotherapy in patients with advanced ovarian cancer

Objective: То assess the dynamics of the level of the tumor marker CA-125 depending on the disease stage and histology of the tumor during neoadjuvant chemotherapy in ovarian cancer patients.

Material and Methods: The initial level of CA-125 was investigated in 36 patients with ovarian cancer aged 30-79, of them 20 (55.6%) patients with stage III (T3cNxM0) and 16 (44.4%) with stage IV ( T3cNxMl) disease. The first stage of treatment consisted of 1-3 cycles of neoadjuvant chemotherapy. Depending on the degree of differentiation of the tumor the patients were divided as follows: highly differentiated cysta-denocarcinoma in 9 (33.4%) patients, moderately differentiated in 11 (40.7%), poorly differentiated 7 (25.9%). Blood serum tumor marker CA-125 was determined by immunoenzyme method using a test system and a photometer Sunrise.

Results: Mean level of the tumor marker CA-125 demonstrated a clear dependence on the stage of ovarian cancer. The minimum value of the index CA-125 returned to normal after the 1st cycle of neoadjuvant chemotherapy, decreased 4.7 times. The maximum value of the marker CA-125 decreased after each cycle of chemotherapy and decreased after the third cycle 22.5 times compared to the initial. In 13 (36.0%) patients, the level of marker CA-125 increased after the first cycle of neoadjuvant chemotherapy or was maintained at a high level. The value of the tumor marker CA-125 was significantly higher in moderately differentiated tumors and minimal in highly differentiated.

Conclusion: Initial level of the tumor marker CA-125 in the blood serum in patients with advanced stages III-IV ovarian cancer depends on the stage of the disease, in stage IV it is 2.7 times higher than in stage III. The level of tumor marker CA-125 depends on the degree of tumor differentiation: the lowest mean and median values are observed with highly differentiated tumors (448.56 and 138.88 U / ml), while the highest in moderately differentiated ones (837.11 and 400.00 U / ml). Neoadjuvant chemotherapy contributes to the normalization of the tumor marker CA-125 in all patients with highly differentiated tumors, the initial level of which is <500 U / ml and moderately differentiated tumors regardless of the initial level of the marker. Minimal effect of neoadjuvant chemotherapy was observed in poorly differentiated and undifferentiated ovarian cancer.

Key words: ovarian cancer, tumor marker CA-125, neoadjuvant chemotherapy.

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2013, vol XXI, # 3, page 295

Sukhin Vladyslav Serhiyovych, Sukhina Olena Mykolayivna, Slobodyanyuk Olha Volodymyrivna

The results of the multimodality treatment of uterine leiomyosarcoma

Objective: Retrospective analysis of the combination treatment of leiomyosarcoma of the uterus.

Materials and methods: Retrospective results of treatment of 41 patients with stage IB-II, III, IV leiomyosarcoma referred to S.P. Grioriev Institute for Medical Radiology in 1998-2012 were investigated.

In all cases, morphological diagnosis of malignant tumors of the uterus corresponded to leiomyosarcoma. All patients underwent surgery, radiotherapy and chemotherapy. VAC protocol was used in 61.0%, CAP in 24.4%, and in a few observations other combinations were used.

Effectiveness of treatment was assessed by immediate and long-term results of therapy.

Results: Eighteen of 41 (43.9%) patients demonstrated manifestation of the disease: in 4 patients (22.2 ± 1.0) % locoregional recurrence of the tumor, in 14 patients (77.8 ±1.0)% distant metastases. With IB disease, recurrence of the tumor was detected in 11 (37.9 ± 9.2)% of 29 patients, at stage II in 3 (37.5 ± 1.8)% of 8 patients. In stage III and IV all four (100.0)% patients had tumor progression. The mean time to tumor recurrence was 16.94 months, median - 12.50 months. The values of one-year survival of patients with TlbNxMO and T2NxM0 tumors were identical and amounted to 86.2 ± 6.5% and 87.5 ± 1.3%, respectively, not differing from one another, falling after 5 years to (62.1 ± 9.2%) and (62.5 ± 1.8)%. At T3NxM0 one-year survival of patients with the tumor was significantly lower than in stages I and II, accounting (50.0 ±5.0)%, without changes during 4 years of follow-up. Five-year survival equaled zero.

Conclusions: The frequency of relapses after multimodality treatment of patients with stage I-IV leiomyosarcoma of the uterus is 43.9: 22.2% locoregional tumor recurrence, 77.8%-distant metastases. Depending on the stage of the disease this figure corresponds to: at stage I - 37.9%, stage II - 37.5%, and stage III-IV - 100.0% when observed up to 60 months. In general, without regard to the stage of the process 5-year survival was 56.1% . At T2NxMl did not continue over a year.

Key words: leiomyosarcoma of the uterus, relapse, treatment Results.

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2013, vol XXI, # 3, page 301

Vikman Yan Eduardovych, Fedulenkova Yuliya Yanivna

Comparative assessment of informativity of ultrasound diagnosis and computed tomography in assessment of the liver morphofunctional state at complex treatment for breast cancer

Objective: То compare informativity of СТ and US at revealing early signs of diffuse liver pathology in patients with breast cancer (BC) to control and correct the course of chemotherapy.

Material and Methods: The authors analyzed 120 case histories of patients aged 24-75 who underwent complex treatment. The controls comprised 30 healthy women without liver pathology.

All patients underwent clinical examination as well as CT with contrast and US before and after the course of chemotherapy. Ultrasound investigation was performed using multifrequency probe in standard sections in energetic, color and pulsed Doppler mode considering the position, dimensions, outlines, echostructure, echogenicity, interrelation of the structures and large vessels. CT considered position, dimensions, outlines, structure, and density of tissue and interrelation of the organs.

Results: The results of the liver investigation with CT and US were compared; their diagnostic value was assessed when revealing the early signs of diffuse liver pathology. The most effective was US investigation in pulsed Doppler mode.

Conclusion: It was determined that CN and US allow to characterize the morphofunctional state of the liver, but only ultrasound allows real time determining of portal blood flow velocity, which is critical in diagnosis of early manifestations of chronic diffuse liver diseases.

Key words: computed tomography, ultrasound investigation, diffuse liver disease.

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2013, vol XXI, # 3, page 306

Sorochan Pavlo Pavlovych, Gromakova Iryna Andriyivna, Prokhach Nataliya Eduardivna, Kuzmenko Olena Viktorivna, Gromakova Inna Serhiyivna

Daily production of melatonin and cortisol in patients with cancer of the uterine body on the stages of the multimodality treatment

Objective: То study the daily changes in production of melatonin and cortisol in patients with cancer of the uterine body (CUB) at the stages of multimodality treatment.

Material and Methods: Cortisol and melatonin levels were determined in 30 patients with stage I-II CUB at three stages of examination: prior to treatment, after surgery and after a standard course of radiation therapy. Cortisol levels in the serum collected at 8 a.m. and 4 p.m., were determined using immunoassay kit «ЕІА-steroid cortisol-01» (Russia, Alkor Bio). The levels of melatonin excretion at day and night time were determined by fluorimetric method.

Results: In patients with CUB disorders in the rhythm of production of melatonin and cortisol occurred before the therapy. Surgical and radiation therapy affected the circadian rhythms of hormone production. Three groups of patients with similar changes were distinguished.

Conclusion: Patients with CUB demonstrate distinct group differences in the circadian production of melatonin and cortisol. The majority of patients with CUB, the rhythm of melatonin excretion is disturbed prior to the treatment. After antitumor therapy the rhythm of melatonin excretion restores in more than half of the patients with initially impaired rhythm. During the treatment, in one third of the patients, cortisol levels and the ratio of the morning and afternoon hormone production are not substantially altered. At the same time, a group of patients in whom the rhythm of cortisol production is restored, and a group of those with the difference between the morning and afternoon production of the hormone after the treatment is smoothed was detected.

Key words: cancer of the uterine body, cortisol, melatonin, radiotherapy.

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2013, vol XXI, # 3, page 311

Research and practice conference with international participation “Contemporary Achievements of Nuclear Medicine”

September 9-10,2013, Ivano-Frankivsk

Conference Proceedings

 

2013, vol XXI, # 3, page 312

Gulevatyy Serhiy Vasylovych, Sovenko Tetyana Kostyantynivna, Voskobiynyk Larysa Hryhorivna, Markov Valentyn Vasylovych

The results of treatment for distant metastases to the lungs in patients with papillary thyroid carcinoma

Summary. Post-Chernobyl thyroid carcinomas are the subject of numerous studies, however, evidence of effectiveness of their treatment, such as cases with distant metastases to the lungs, is lacking. Therefore, we evaluated the results of treatment of thyroid PC with distant metastases to the lungs (159 cases). It was determined that efficiency of treatment of pulmonary metastases of thyroid PC is high, complete remission of the disease is observed in more than 60% of patients, regardless of their age and the fact of radiation exposure.

Key words: papillary thyroid carcinoma, metastatic disease, radioiodine therapy.

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2013, vol XXI, # 3, page 313

Zelinska Ganna Volodymyrivna, Markov Valentyn Vasylovych, Kulinichenko Galyna Mykolayivna, Gulevatyy Serhiy Vasylovych, Ustymenko Ganna Yakivna, Motornyy Yevhen Olehovych

Cytology achievements in prognosis of radioiodine resistance of papillary thyroid cancer to help radiologists

Summary. Some new cytological methods of pre-operative prediction radioiodine resistance of papillary thyroid cancer by detection of immunocytochemical markers in puncture material are reported. Determination of cytokeratin 17 is performed in punctates of primary papillary carcinomas. This allows to predicts the likelihood of radioiodine resistant metastases. Determination of thyroid peroxidase is carried out in the punctates of metastases identified in the post-operative period, which allows to determine the state of these metastases in relation to radioiodine before using it.

This will allow clinicians to choose the right tactics of treatment (radioiodine therapy only or surgical removal of the metastasis).

Key words: papillary thyroid carcinoma, cytological diagnosis, prognosis, radioiodine resistant metastases, cytokera-tin-17, thyroid peroxidase.

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2013, vol XXI, # 3, page 315

Kmetyuk Yaroslav Volodymyrovych, Moskalets Oleksandr Ivanovych, Ashykhmin Andriy Valeriyovych, Shcherbina Oleh Volodymyrovych

Positron emission tomography in diagnosis of malignant lymphomas

Summary. PET / CT investigation was performed in 520 patients with different types of malignant lymphomas, including 230 patients with Hodgkin’s lymphoma and 290 with non-Hodgkin’s lymphomas. The findings of the investigation are reported. Semiotics of different types of lymphomas at different stages of the disease was determined.

Key words: positron emission tomography, computed tomography, 18F-fluorodeoxyglucose, malignant lymphoma, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma.

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2013, vol XXI, # 3, page 317

Kopylova Olha Vasylivna, Stepanenko Olha Arkadiyivna

Puberty dyspituitarism as a risk factor for disorders of lipid and carbohydrate metabolism in children born to parents who suffered as a result of Chornobyl accident

Summary. To study the effect dyshormonal disorders of puberty on formation of diseases associated with abnormalities in lipid and carbohydrate metabolism in children born to the parents who suffered as a result of Chornobyl accident, 112 children with manifestations of puberty dyspituitarism and 38 controls were examined. Clinical, anthropometric and hormonal tests were performed. The changes, which may explain the impaired neuroregulation, which are clinically evident and hormone disorders of lipid and carbohydrate metabolism, namely development of insulin and leptin resistance, were revealed.

Key words: dyshormonal disorders of puberty, parents who suffered from Chornobyl accident.

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2013, vol XXI, # 3, page 319

Korol Pavlo Oleksandrovych, Kosyakov Oleksandr Mykolayovych, Bondar Vitaliy Kazymyrovych, Ponomarenko Nataliya Mykolayivna

The algorithm of bone scan application in revision grafting of hip joints

In order to determine the algorithm of bone scan application in different stages of revision hip joint grafting bone scan was used in 92 patients with coxarthrosis aged 31-75. The work allowed to establish that bone scan can be used to determine the stage of the pathological process in the hip joint components. Bone scan is a priority method to determine the degree of inflammation in the hip joint, especially in the early stages of the process. The algorithm of bone scan application in revision grafting plays a key role in determining the criteria for operability of the hip joint.

Key words: bone scan, hips, revision grafting.

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2013, vol XXI, # 3, page 320

Kukushkina Mariya Mykolayivna, Sukach Georhiy Georhiyovych, Solodyannykova Oksana Ivanivna, Korovin Serhiy Ihorovych

The method of radionuclide detection of sentinel lymph nodes in skin melanoma

Summary. Biopsy of sentinel lymph nodes (SLN) in skin melanoma is a routine diagnostic procedure. SLN are detected using radionuclide methods, lymphotropic staining, and their combination. The authors present the experience of the SLN detection in 168 patients with malignant melanoma of the skin by radionuclide techniques.

Key words: skin melanoma, sentinel lymph node biopsy, radionuclide detection, 99mTc.

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2013, vol XXI, # 3, page 322

Kundin Valeriy Yuriyovych, Satyr Maryna Volodymyrivna, Noverko Iryna Vasylivna

Scintigraphy with somatostatin receptor analogs in the diagnosis of neuroendocrine tumors and their metastases

Summary. The authors present the effectiveness of scan with somatostatin receptor analogs (radiopharmaceutical Tc-Tectrotyd) in diagnosis of neuroendocrine tumors (NET) and their metastases. The study involved 28 patients with NETs. In 24 patients (87.5%) the presence of NEO and tumor metastases was determined. High-quality diagnostic images were obtained. The authors conclude about high diagnostic value of investigation with 99mTc-Tectrotyd to determine NEO, as well as their regional and distant metastases.

Key words: scintigraphy with somatostatin receptor analogs, 99mTc-Tectrotyd, neuroendocrine tumors.

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2013, vol XXI, # 3, page 325

Luchytskyy Yevhen Vasylovych, Zubkova Galyna Anatoliyivna, Luchytskyy Vitaliy Yevhenovych, Rybalchenko Viktor Mykhaylovych, Bondarenko Volodymyr Oleksandrovych, Markov Valentyn Vasylovych, Gulevatyy Serhiy Vasylovych, Spivak Ganna Serhiyivna

The functional state of pituitary-reproductive system in men with thyroid cancer

Summary. Thyroid cancer (TC) is one of the most common cancers of the endocrine system. Among the male population of Ukraine TC is predominantly diagnosed in the age group over 25 years, which is considered to be the most reproductively active one. The results of the investigation of the levels of sex hormones and pituitary axis indicate the possibility of disorders of the functional state of the pituitary-reproductive system in male patients with TC and development of androgen deficiency syndrome. Further research on more representative groups of patients with functional tests to determine the mechanisms of the disorders is necessary.

Key words: thyroid cancer, male, testosterone, pituitary gland.

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2013, vol XXI, # 3, page 328

Mazur Anastasiya Gennadiyivna, Myronova Olena Valeriyivna, Tkachenko Mykhaylo Mykolayovych, Goryainova Nadiya Valeriyivna

Investigation of beta-2 microglobulin and thymidine kinase as prognostic markers in acute lymphoblastic leukemia and chronic lympholeucosis

Summary. The authors present the results of determining the levels of TK and P„-MG in the blood serum of patients with ALL and CLL during the treatment. It is proved that TK is an independent predictor of malignancy course of ALL and an important criterion for effectiveness of therapy, and P„-MG is not. Its level has no differential diagnostic value in identification of individual variants of ALL, but can be used as a criterion for completeness of remission and early detection of recurrence. At the same time, (3,-MG is an independent predictor of the course of CLL, which even at the stage of diagnosis of the disease can establish risk groups. The values of TK and |32-MG did not correlate with the number of leukocytes in the blood and the number of blast cells in the bone marrow neither in ALL, nor CLL. It was found that the lower the initial value of TK and P,-MG, the higher the likelihood of remission. At incomplete remission their levels decrease but do not reach the standard. The increase of concentration of TK and PZ-MG after treatment predicts a further progression of the disease in the nearest future.

Key words: tumor markers, prognostic factors, thymidine kinase, beta-2 microglobulin, myeloblastic acute leukemia, chronic lymphocytic leukemia, prognosis, chemotherapy, remission, relapse

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2013, vol XXI, # 3, page 330

Makeyev Serhiy Serhiyovych, Zalisna Yulianna Dmytrivna, Murashko Nataliya Kostyantynivna

The peculiarities of regional volume brain blood flow in patients with hypertensive encephalopathy with moderate cognitive disorders

Summary. The findings of single photon emission computed tomography (SPECT) suggest that the patients suffering from hypertensive encephalopathy (HE), vascular factor plays an important role in development of mild cognitive disorders.

Key words: single photon emission computed tomography, hypertensive encephalopathy, mild cognitive disorder, cerebral perfusion.

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2013, vol XXI, # 3, page 332

Mechev Dmytro Serhiyovych, Tkachenko Mykhaylo Mykolayovych, Babiy Yakiv Stepanovych

The changes in the system of post-graduate training of radiologists in Ukraine after introduction of residency in radiology

Summary. This paper presents a wide professional discussion of the project of the Ministry of Health of Ukraine on reforming and improving post-graduate education and continuous professional development of doctors and pharmacists by introducing in addition to internship (1 year in radiology), residency (2 years in in x-ray diagnosis, ultrasound diagnosis, radionuclide diagnosis, radiation therapy).

Key words: radiology, internship, residency, training time.

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2013, vol XXI, # 3, page 334

Nikolov Mykola Oleksandrovych, Kundin Valeriy Yuriyovych, Kaminska Albina Leonidivna, Romanenko Ganna Oleksandrivna, Suprunyuk Dmytro Oleksandrovych

Assessment of diagnostic significance of specific renal parenchyma function by the findings of dynamic kidney scan with 99mTc-MAG3 (preliminary investigation)

Summary. The purpose of the work was to evaluate the diagnostic value of specific secretory function of the kidneys. Dynamic kidney scan with 99mTc-MAG3 was done in 142 children with vesicoureteral reflux. It is shown that progression of the pathological changes in the urinary tract, specific function of the renal parenchyma are not identical with the trend of the integrated function. The quantitative criterion for the classification of hyper-and hypofunctional state of the renal parenchyma was suggested.

Key words: dynamic kidney scan, radiopharmaceuticals, effective renal plasma flow, vesicoureteral reflux.

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2013, vol XXI, # 3, page 336

Satyr Maryna Volodymyrivna, Solodyannykova Oksana Ivanivna, Kundin Valeriy Yuriyovych

The findings of three-phase bone scan in patients with metastases and benign lesions of the skeleton

Summary. This study presents the features of metabolic changes in the structures of the musculoskeletal system at malignant (metastatic), infectious-inflammatory and osteo-arthritic lesions. Three-phase bone scan (BS) was performed in 40 patients, 15 of them with skeletal metastases, 10 with infectious and inflammatory processes in the bone tissue and 15 with osteoarthritis.

The features of angiographic phase in malignant and benign foci, as well as changes in the early and late static scans were analyzed. It is concluded about the possibility of three-phase bone scan in differential diagnosis of benign and malignant lesions of the musculoskeletal system.

Key words: three-phase bone scan, skeletal metastases, infectious and inflammatory diseases of the bones, osteo-arthritic processes.

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2013, vol XXI, # 3, page 339

Smolanka Ivan Ivanovych, Solodyannykova Oksana Ivanivna, Sklyar Svitlana Yuriyivna, Golovko Tetyana Serhiyivna, Kostryba Oleksiy Ivanovych

Detection of sentinel lymph nodes at surgery for breast cancer. Modern approach to the problem

Summary. The article presents a modern approach to the problem of lymphodissection at surgery for breast cancer. The recommendations, indications, contraindications, techniques for the detection of sentinel lymph nodes are presented. These data of the literature and the experience of the National Cancer Institute are reported.

Key words: breast cancer, sentinel lymph node, gamma counter, radiopharmaceutical, lymphoscintigraphy.

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2013, vol XXI, # 3, page 345

Solodyannykova Oksana Ivanivna, Danylenko Viktoriya Viktorivna, Sahan Danuta Lutsianivna, Sukach Heorhiy Heorhiyovych, Tratsevskyy Volodymyr Volodymyrovych, Choban Volodymyr Illich

New capabilities of features of radionuclide therapy for metastatic bone disease (the state of the problem and the original data)

Summary. This paper analyzes the literature on the state of radionuclide therapy for metastatic bone lesions in various malignancies. A historical review of radiopharmaceuticals used in treatment of secondary bone lesions is made, the advantages and limitations of various radionuclides are described. The use of the drug of last generation of samarium-153 Oksabifor, which, according to various authors, has the most pronounced analgesic effect and minimal side effects, is featured.

The results of the first clinical cases of administration of Oksabifor samarium-153 in patients with bone metastases against a background of breast and colon cancer are presented.

Key words: samarium-153 Oksabifor, metastatic bone disease, radionuclide therapy.

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2013, vol XXI, # 3, page 351

Strohanova Ninel Pavlivna, Babiy Liana Mykolayivna

The peculiarities of cardiodynamics after myocardial infarction of various localization (radionuclide ventriculography finding)

Summary. The study involved 93 patients with myocardial infarction (MI) 2-3 months after the disease onset. Equilibrium radionuclide ventriculography was performed. The changes in ejection fraction (EF), functional volume of the left ventricle (LV), maximum velocity and time of ejection achievement were expressed in greater degree in patients with anterior MI localization. A certain level of LV systolic function (ejection fraction value) in patients with MI is due to the ratio of hypokinetic segments and severity of contractile function reduction of inormo- and hyperkinetic segments. Differences in formation of the structure of development of EF-dependent localization of myocardial infarction. Hyperkinetic segments are the major factor in adaptation of the damaged heart, and their compensatory significance decreases with asynergy reduction.

Key words: myocardial infarction, cardiodynamics, regional myocardial contractility.

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2013, vol XXI, # 3, page 354

Tkachenko Gryhoriy Ivanovych, Vasylyev Leonid Yakovych, Lukhovytska Nataliya Ihorivna, Grushka Ganna Vasylivna, Astapyeva Olha Mykolayivna

Recurrent differentiated thyroid cancer: prognostic factors, diagnosis, treatment

Summary. Seventy one patients were selected of 200 patients with differentiated thyroid cancer (DTC), which were treated in Department of Nuclear Medicine (SI «S.P. Grigoriev IMR»), or are in the process of monitoring. The features of the clinical course of recurrent DTC were investigated. It was found that almost the same number of cases of thyroid cancer recurrence can be both local and distant, their combinations are possible. The dependence between the recurrence of DTC and dissemination of the primary tumor was determined. It was proved that DTC recurrence depended on the morphological characteristics of the primary tumor aggressiveness and was not related to the volume of the previous surgery and total ablative radioiodine activity.

Key words: differentiated thyroid cancer recurrence, diagnosis, thyroglobulin.

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2013, vol XXI, # 3, page 357

Tkachenko Gryhoriy Ivanovych, Astapyeva Olha Mykolayivna, Grushka Ganna Vasylivna, Lukhovytska Nataliya Ihorivna, Tkachenko Yuriy Gryhorovych, Spuzyak Roman Mykhaylovych, Paskevych Olha Ivanivna, Riyako Viktoriya Mykolayivna

Retrospective analysis of the course of thyroid cancer with metastases to the lungs after radioiodine therapy

Summary. The aim was to study the effectiveness of radioiodine treatment for metastases of thyroid cancer to the lungs.

Clinical, laboratory and radiological techniques were used. The study included 64 patients of SI "S.P. Grigoriev Institute for Medical Radiology" with metastases to the lungs, with all stages of the disease and different sizes of the primary thyroid tumor. After surgical treatment 131I sodium iodide was used in various doses of radioactivity.

Full therapeutic effect of radiotherapy was achieved in 5 patients (7.8%) over the З-year treatment period, and within a 5-year period in 28 (43.8%), stabilization or partial response were observed in 24 patients (37.8%), disease progression in 12 patients (18.8%). Deaths from disease progression was 12.5% .

Radioiodine therapy is an effective treatment of functionally active thyroid cancer metastases to the lungs.

Key words: differentiated thyroid cancer, metastases to the lungs, radioiodine therapy.

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2013, vol XXI, # 3, page 361

Tkachenko Mykhaylo Mykolayovych, Makarenko Anatoliy Viktorovych, Kaminska Albina Leonidivna

Dynamic hepatobiliscintigraphy in the diagnosis of post-cnolecystectomy state

Summary. The article shows the possibilities of dynamic hepatobiliscintigraphy to identify and follow-up the hepatobiliary system disorders in patients after cholecystectomy. The degree of residual lesions of the hepatobiliary system is directly dependent on the activity of the main process, its duration, and the advice of a doctor and administered subsequent drug therapy. It is necessary to assess the condition of the common bile duct to clarify its functional status and prognosis of the post-cholecystectomy syndrome in the patients.

Key words: postcholecystectomy syndrome, dynamic observation, dynamic hepatobiliscintigraphy.

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2013, vol XXI, # 3, page 364

Firsova Mariya Mykolayivna, Oliynichenko Olena Gennadiyivna, Polyakova Nina Ivanivna, Lola Olena Ihorivna, Kholodna Alina Vyacheslavivna, Kashchenko Oksana Volodymyrivna

Application of РЕТ-СТ in thyroid cancer patients

Summary. Combined positron emission and computed tomography (PET / CT) is important for monitoring of thyroid cancer patients after the treatment. The purpose of the work was to investigate the effectiveness of PET / CT in the postoperative period in patients who had high levels of thyroglo-bulin (TG) and negative results of 1-131 scintigraphy.

The results of the investigation of 21 patients allowed to clarify all questionable diagnoses and 100% were consistent with TG levels. Considering the literature data about application of PET / CT with 18-FDG in patients with medullary and anaplastic cancer, this method can be included in the examination protocol of such patients.

Key words: thyroid cancer, thyroglobulin, 1-131, PET / CT, 18-FDG.

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2013, vol XXI, # 3, page 367

Tserkovnyak Vitaliy Ihorovych, Makeyev Serhiy Serhiyovych

Radionuclide investigation of the parathyroid glands.

Literature review

Summary. The literature on radionuclide study of parathyroid glands is analyzed. The basic techniques used for this purpose (planar scintigraphy, SPECT and SPECT / CT) are described. The data on the use of different radiopharmaceuticals (123I, 99mTc-MIBI, 99mTc-pertechnetate) and different methodological approaches (single-phase, two-phase radionuclide scan, and their combination) are presented. Main diagnostic errors, the causes of false-positive and false-negative findings are shown.

Key words: parathyroid scan, parathyroid adenoma, 99mTc-MIBI, 99mTc-pertechnetate.

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