JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
Six issues of the journal are published per year, the volume is 13.5 conventional printed sheets, 88 printer’s sheets, 1.000 copies. The journal has an identical full-text electronic version, which, simultaneously with the printed version and color drawings, is posted on the sites of the Scientific Electronic Library (SEL) and the journal's website. The journal is distributed through the Rospechat Agency under the contract № 7407 of June 16, 2006, through individual buyers and commercial structures. The publication of articles is free.
The journal is included in the List of Russian Reviewed Scientific Journals of the Higher Attestation Commission. Since 2008 the journal has been available on the Internet and indexed in the RISC database which is placed on Web of Science. Since February 2nd, 2018, the journal "Medical Radiology and Radiation Safety" has been indexed in the SCOPUS abstract and citation database.
Brief electronic versions of the Journal have been publicly available since 2005 on the website of the Medical Radiology and Radiation Safety Journal: http://www.medradiol.ru. Since 2011, all issues of the journal as a whole are publicly available, and since 2016 - full-text versions of scientific articles. Since 2005, subscribers can purchase full versions of other articles of any issue only through the National Electronic Library. The editor of the Medical Radiology and Radiation Safety Journal in accordance with the National Electronic Library agreement has been providing the Library with all its production since 2005 until now.
The main working language of the journal is Russian, an additional language is English, which is used to write titles of articles, information about authors, annotations, key words, a list of literature.
Since 2017 the journal Medical Radiology and Radiation Safety has switched to digital identification of publications, assigning to each article the identifier of the digital object (DOI), which greatly accelerated the search for the location of the article on the Internet. In future it is planned to publish the English-language version of the journal Medical Radiology and Radiation Safety for its development. In order to obtain information about the publication activity of the journal in March 2015, a counter of readers' references to the materials posted on the site from 2005 to the present which is placed on the journal's website. During 2015 - 2016 years on average there were no more than 100-170 handlings per day. Publication of a number of articles, as well as electronic versions of profile monographs and collections in the public domain, dramatically increased the number of handlings to the journal's website to 500 - 800 per day, and the total number of visits to the site at the end of 2017 was more than 230.000.
The two-year impact factor of RISC, according to data for 2017, was 0.439, taking into account citation from all sources - 0.570, and the five-year impact factor of RISC - 0.352.
Medical Radiology and Radiation Safety. 2026. Vol. 71. № 1
DOI:10.33266/1024-6177-2026-71-1-90-95
O.A. Afukova1, M. Yu. Fedyanin2, 3, 4, A.L. Yudin1, A.S. Vinokurov1, 3, 5,
A.S. Kovaleva3, 6, E.V. Kotova4, N.S. Donchenko3
Accidental Detection of Pulmonary Embolism According To CT in Cancer Patients with Low and Intermediate Risk of Thrombosis – Features of Radiology Diagnosis and Risk Factors
1 N.I. Pirogov Russian National Research Medical University, Moscow, Russia
2 N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
3 Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia
4 N.I. Pirogov National Medical and Surgical Center, Moscow, Russia
5 City Hospital № 24, Moscow, Russia
6 Sechenov First Moscow State Medical University, Moscow, Russia
Contact person: O.A. Afukova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Purpose: To evaluate the factors associated with asymptomatic pulmonary embolism (PE) in oncology patients with low/intermediate risk (Horan scale), as well as to determine the methodological features of CT, which make it possible to identify CT signs of PE in the absence of clinical symptoms.
Material and methods: Out of 104 patients who underwent contrast-enhanced CT, 65 with low and intermediate risk on the Horan scale were selected, in which the data were evaluated: gender, age, ECOG scale, tumor localization and stage, type of antitumor drug therapy, taking glucocorticosteroids and anticoagulants before PE was detected, the timing of PE detection, the presence of thrombosis of any localization, hospitalization in the previous 3 months before PE detection for any reason, surgical benefits, injuries and fractures in the anamnesis, a new coronavirus infection (with laboratory confirmation), radiation therapy, varicose veins of the lower extremities, diabetes mellitus, chronic kidney disease, coronary heart disease, hypertension, the presence of a venous port for chemotherapy. Laboratory parameters were evaluated: the level of hemoglobin, leukocytes, platelets, D-dimer, the risk of thrombosis was assessed according to the following scales: Korana, PROTECHT, CONCO, Vienna CATSCORE, ONCOTEV, COMPASS, as well as survival after PE detection.
Results: When distributing patients according to the risk of thrombosis, when using the COMPASS scale, patients at high risk of thrombosis in this sample were more often identified (87.7 %). The remaining scales considered classified patients at high risk from 9.2 % to 41.5 %. The median overall survival was 16 months. Correlation evaluation of the Horan, PROTECHT, CONCO, Vienna CATSCORE, ONCOTEV, and COMPASS scales revealed that all scales except COMPASS VTE significantly correlated with each other. During the correlation analysis, a moderate (k=0.243) correlation of the COMPASS scale with the PE index (Quanadli) was noted with a significance of p=0.055. The tumor T index correlated (k = –0.288, p=0.025); endocrinotherapy (k=0.283, p=0.025); radiation therapy (k=0.257, p=0.042); an increase in the level of D-Dimer (k=0.309, p=0.015). However, no influence of factors on the PE index was noted during the regression analysis. The most reasonable protocol for CT patient contrast to detect asymptomatic PE is the split-bolus technique.
Keywords: CT, CT-angiopulmonography, split-bolus, contrast enhancement, pulmonary thromboembolism, oncology, thrombosis
For citation: Afukova OA, Fedyanin MYu, Yudin AL, Vinokurov AS, Kovaleva AS, Kotova EV, Donchenko NS. Accidental Detection of Pulmonary Embolism According To CT in Cancer Patients with Low and Intermediate Risk of Thrombosis – Features of Radiology Diagnosis and Risk Factors. Medical Radiology and Radiation Safety. 2026;71(1):90–95. DOI:10.33266/1024-6177-2026-71-1-90-95
References
1. Ozkurt Н., Ozdogan S., Camurcuoglu E. Split Bolus Method in Computerized Tomography. Med Bull Sisli Etfal Hosp. 2023;57;1:18-24. Doi: 10.14744/SEMB.2022.17003.
2. Pietrasik A., GƒЕsecka A., Kurzyna P., et al. Cancer-Associated Thrombosis: Comparison of Characteristics, Treatment, and Outcomes in Oncologic and Nononcologic Patients Followed by a Pulmonary Embolism Response Team. Pol Arch Intern Med. 2023;30:16421. Doi: 10.20452/pamw.16421.
3. Эрлих А.Д., Барбараш О.Л., Бернс С.А. и др. Тромбоэмболия легочных артерий у пациентов с онкологическими заболеваниями. Данные регистра СИРЕНА // Флебология. 2021. Т.15. №3. С. 179‑186 [Erlikh A.D., Barbarash O.L., Berns S.A., et al. Pulmonary Embolism in Patients with Cancer. Data from the SIRENA Registry. Flebologiya = Journal of Venous Disorders. 2021;15;3:179-186 (In Russ.)]. Doi: 10.17116/flebo202115031179.
4. Розанов И.Д., Семашкова А.Е., Балканов А.С. и др. Тромбоэмболия легочной артерии: некоторые вопросы эпидемиологии и лечения у онкологических пациентов // Альманах клинической медицины. 2015. №41. С. 97-102 [Rozanov I.D., Semashkova A.Ye., Balkanov A.S., et al. Pulmonary Embolism: Some Issues of Epidemiology and Treatment in Cancer Patients. Al’manakh Klinicheskoy Meditsiny = Almanac of Clinical Medicine. 2015;41:97-102 (In Russ.)].
5. Шкуропатов Ю.Ф. Тромбоэмболия легочной артерии при злокачественных новообразованиях различной локализации // Поволжский онкологический вестник. 2017. Т.2. №29. С. 44-47 [Shkuropatov Yu.F. Pulmonary Embolism in Malignant Neoplasms of Various Localizations. Povolzhskiy Onkologicheskiy Vestnik = Oncology Bulletin of the Volga Region. 2017;2;29:44-47 (In Russ.)]
6. Федоткина Ю.А., Фролкова О.О., Каннер Д.Ю. и др. Характеристика пациентов с активным онкологическим процессом и венозными тромбоэмболическими осложнениями, получающих курс химиотерапии (по данным реальной клинической практики ГБУЗ «МГОБ №62 ДЗМ») // Атеротромбоз. 2021. №2. С. 44–54 [Fedotkina Yu.A., Frolkova O.O., Kanner D.Yu., et al. Characteristics of Patients with an Active Oncological Process and Venous Thromboembolic Complications Receiving a Course of Chemotherapy (According to Real Clinical Practice Data of the State Budgetary Healthcare Institution «MCOH No.62 of the Moscow Health Department»). Aterotromboz = Atherothrombosis. 2021;2:44–54 (In Russ.)].
7. Khorana A.A., Cohen A.T., Carrier M., et al. Prevention of Venous Thromboembolism in Ambulatory Patients with Cancer. ESMO Open. 2020;5;6: e000948. Doi: 10.1136/esmoopen-2020-000948.
8. Hans-Jonas M., Wienke A., Surov A. Incidental Pulmonary Embolism in Oncologic Patients – a Systematic Review and Meta-Analysis. Support Care Cancer. 2021;29;3:P.1293-1302. Doi: 10.1007/s00520-020-05601-y.
9. Silva P., Rosales M., João Milheiro M., Luísa L. Santos. Pulmonary Embolism in Ambulatory Oncologic Patients. Acta Med Port. 2015;28;4:463-468. PMID: 26574981.
10. Samra S.R., Mohamed S.A., Hamouda Elsayed D., et al. The Incidence and Clinical Characteristics of Pulmonary Embolism in Oncologic Patients. The Egyptian Journal of Bronchology. 2022:16:64. Doi: 10.1186/s43168-022-00167-1.
11. Ахметзянов Ф.Ш., Камалов И.А. Тромбоэмболия легочной артерии и рак // Поволжский онкологический вестник. 2017. Т.2. №29. С. 4-7 [Akhmetzyanov F.Sh., Kamalov I.A. Pulmonary Embolism and Cancer. Povolzhskiy Onkologicheskiy Vestnik = Oncology Bulletin of the Volga Region 2017;2;29:4-7 (In Russ.)].
12. Lawson P., Raskin S., Soffer S., et al. Incidental Pulmonary Embolism in CT Scans of Oncological Patients with Metastatic Disease Undergoing Clinical Trials: Frequency and Linkage with Onset of Disease Progression (PE-PD association). Br J Radiol. 2020;93;1115:20200591. Doi: 10.1259/bjr.20200591.
13. Schmid J., Nagy E., Kaufmann-Bühle A-K., et al. Diagnosing Pulmonary Embolism With Computed Tomography Pulmonary Angiography Diagnostic Accuracy of a Reduced Scan Range. J Thorac Imaging. 2022;1;37;5:323-330. Doi: 10.1097/RTI.0000000000000664.
14. Галкин В.Н., Партс С.А., Осипов И.С. и др. Методика «расщепленного контрастирования» («раздвоенного болюса», бифазного контрастирования, «сплит-болюса», «split-bolus») при проведении мультиспиральной компьютерной томографии органов грудной полости, брюшной полости и малого таза: Методические рекомендации. М.: ГКБ им. С.С.Юдина, 2025. 15 с. [Galkin V.N., Parts S.A., Osipov I.S., et al. Metodika «Rasshcheplennogo Kontrastirovaniya» («Razdvoyennogo Bolyusa», Bifaznogo Kontrastirovaniya, «Split-Bolyusa», «Split-Bolus») pri Provedenii Mul’tispiral’noy Komp’yuternoy Tomografii Organov Grudnoy Polosti, Bryushnoy Polosti i Malogo Taza = The Technique of “Split Contrast” (“Biphasic Contrast”, “Split-Bolus”) in Multispiral Computed Tomography of the Chest, Abdominal and Pelvic Organs. Methodological Recommendations. Moscow, GKB im. S.S.Yudina Publ., 2025. 15 p. (In Russ.)].
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Afukova O.A. – collection and analysis of literary material, writing the text; Fedyanin M.Yu. – development of the research concept. Scientific editing of the text; Yudin A.L. – scientific editing of the text; Vinokurov A.S. – development of the research concept, writing the text; Kovaleva A.S. – development and modification of research methods; Kotova E.A. – statistical data processing; Donchenko N.S. – development of the research design.
Article received: 20.11.2025. Accepted for publication: 25.12.2025.