Medical Radiology and Radiation Safety. 2022. Vol. 67. № 5

DOI: 10.33266/1024-6177-2022-67-5-75-79

V.I. Busurin, P.S. Kudryavtsev

APPLICATION OF ULTRASONIC OSTEOMETRY
METHOD FOR SCREENING-DIAGNOSIS AND EFFICIENCY
OF THE OSTEOPOROSIS THERAPY

Moscow Aviation Institute, Moscow, Russia

Contact person: V.I. Busurin, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRUCT

Purpose: Development of an algorithm screening diagnostics of osteoporosis with use of ultrasonic osteometers based on complex data analysis of external instrumental investigations and the anamnesis data.

Material and methods: The material including data of complex researches of 53 women aged from 20 up to 75 years, such as results of external inspection and anamnesis and data of instrumental researches was used: ultrasonic osteometry of a calcaneal bone and two energy x-ray densitometry inspection of lumbar area.

Results: The developed complex processing procedure of data based on data of external inspection, the anamnesis and an ultrasonic osteometry leads to the acceptable level of false-negative and false positive errors of diagnostics when comparing with data of x-ray two-energy densitometry.

Conclusions: The comparative analysis of accuracy of assessment of patient’s distribution on risk groups based on data of external inspection and the anamnesis with data densitometry is carried out. The comparative analysis of accuracy on risk groups based on data of an ultrasonic osteometry with data densitometry is carried out. It was shown that the level of errors when using these two tool techniques is rather high. The complex rule of creation of risk groups based on data of external inspection, the anamnesis and an ultrasonic osteometry which showed good correlation with data of measurements with use two-energy x-ray densitometry is developed. The conversion function given the received complex decisive rule in the T scale – parameter, compatible to the estimates received at two-energy x-ray densitometry is constructed.

Keywords: ultrasonic osteometry,  two-energy x-ray densitometry, screening diagnostics, decision rule, risk group

For citation: Busurin VI, Kudryavtsev PS. Application of Ultrasonic Osteometry Method for Screening-Diagnosis and Efficiency of the Osteoporosis Therapy. Medical Radiology and Radiation Safety. 2022;67(5):75–79. (In Russian). DOI: 10.33266/1024-6177-2022-67-5-75-79

References

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2. Lesnyak O.M. A New Paradigm in Diagnostics and Treatment of Osteoporosis. Osteoporoz i Osteopatii = Osteoporosis and Bone Diseases. 2012;1:23-28 (In Russ.).

3. Joint Venture 2.6.1.2612-10. The Basic Health Regulations of Ensuring Radiation Safety (OSPORB – 99/2010). In Edition of Changes No. 1. Moscow Publ., 2013. 77 p. (In Russ.).

4. Skripnikova I.A., Abirova E.S., Alikhanova N.A., Kosmatova O.V. Vascular Rigidity, Calcification And Osteoporosis. General Pathogenetic Links. Kardiovaskulyarnaya Terapiya i Profilaktika = Cardiovascular Therapy and Prevention. 2018;17;4:95-102 (In Russ.).

5. Chechurin R.Ye., Ametov A.S., Rubin M. Comparative Assessment of X-Ray Densitometry of an Axial Skeleton and Ultrasonic Densitometry of a Calcaneal Bone. Osteoporoz i Osteopatii = Osteoporosis and Bone Diseases. 1999;4:7-10 (In Russ.).

6. Laugier P., Berger G., Giat P., Bonnin-Fayet P., Laval-Jeante J. Ultrasound Attenuation Imaging in the OS Calcic: An Improved Method. Ultrasonic Imaging. 1994;16:65-76. 

7. Hans D., Baim S.. Quantitative Ultrasound (QUS) in the Management of Osteoporosis and Assessment of Fracture Risk. J.Clin. Densitom. 2017;20;3:322-333. 

8. Ayvazyan S.A., Bukhshtaber V.M., Yenyukov I.S., Meshalkin L.D. Prikladnaya Statistika. Klassifikatsiya i Snizheniye Razmernosti = Applied Statistics. Classification and Decrease in Dimension. Moscow, Finansy i Statistika, 1989. 607 p. (In Russ.).

9. Bishop C. Pattern Recognition and Machine Learning. Springer, 2006. 703 p.

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.06.2022. Accepted for publication: 25.08.2022.

Medical Radiology and Radiation Safety. 2022. Vol. 67. № 5

DOI: 10.33266/1024-6177-2022-67-5-86-93

W.Yu. Ussov^{1, 2}, S.P. Yaroshevskii^{2, 3}, E.E. Bobrikova^4,,
V.E. Sinitsyn⁵, Yu.B. Lishmanov²

PREDICTIVE ROLE OF CEREBRAL BLOOD FLOW STRESS-TEST
WITH ADENOSINTRIPHOSPHATE QUANTIFIED
WITH ^99m TC-HMPAO SPECT IN PATIENTS WITH
CAROTID ATHEROSCLEROSIS

¹Cardiology Research Institute, Tomsk National Medical Research Center, Tomsk, Russia

²National Research Tomsk Polytechnic University, Tomsk, Russia

³Loukh Central District Hospital, Karelia, Russia

⁴E.N. Meshalkin National Medical Research Center, Novosibirsk, Russia 

⁵M.V. Lomonosov Moscow State University, Moscow, Russia

Contact person: W.Yu. Ussov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Introduction: Previously, a functional test with intravenous administration of adenosine triphosphate (ATP) was proposed to assess the reactivity of cerebral circulation and the functional significance of internal carotid artery stenoses, with evaluation by brain SPECT (neuroSPECT) with ^99mTc-HMPAO. The types of the reaction of the cerebral blood flow during it were identified, with different ratios of internal carotid artery stenoses and the degree of ischemic brain damage assessed according to brain MRI data. However, the prognostic value of the results of the ATP test of cerebral blood flow in relation to disorders of cerebral circulation (NMC) remains unknown.

Purpose: In a retrospective study, we tried to study the prognostic value of the ATP test of cerebral blood flow in relation to the risk of subsequent disorders of cerebral circulation.

Material and methods: The retrospective study included 37 patients with atherosclerotic stenosis of the carotid arteries, who in 2002–2005 underwent functional studies of cerebral blood flow with a sample with intravenous administration of ATP solution. Brain damage was quantified according to MRI data (Magnetom Open, Siemens) in a T₂-weighted mode, according to a previously developed technique. Denoting I_liq – the intensity of the T₂ signal from the cerebrospinal fluid in the ventricles of the brain, I_insult – in the area affected by ischemia, and
I_norm – in the area of the unaffected brain, the volume of the damaged tissue (VDT) was calculated as the sum taken from all sections i, where the area of brain damage is visible: VDT=Σ_id·S_i∙[(I_insult ‒ I_norm)/(I_liq ‒ I_norm)]_i, where d is the thickness of the slice, and S_i is the area of the ischemia area on the slice i. The quota of damaged tissue in the physical volume of the lesion area is then obviously eqal to : QD={Σ_id·S_i∙[(I_insult ‒
I_norm)/(I_liq ‒ I_norm)]_i}/{Σ_id·S_i}. NeuroSPECT with ^99mTc-HMPAO (540 MBq) in each patient was carried out at rest and with intravenous administration of ATP solution (100 μg / kg of weight, intravenously slowly for 1 min under ECG control). The asymmetry of the cerebral blood flow was evaluated at rest and in a sample with ATP as the ^99mTc-HMPAO accumulation asymmetry index (AI) – the interhemispheric ratio of the average ^99mTc-HMPAO absorption score in the middle cerebral artery basin.

Results: In accordance with the previously presented classification, patients were assigned to one of three groups – with different types of brain blood flow reaction to a stress test with ATP.

In 14 individuals (type 1), a symmetrical distribution of blood flow at rest was noted (AI=0.98±0.01), while the ATP test caused an asymmetry in the uptake of ^99mTc-HMPAO (AI=0.91±0.04), due to a decrease on the side of the stenosis-dependent hemisphere (unilateral stenosis of the common and/or internal carotid arteries, exceeding 55 %), without signs of damage to the cerebral cortex.

In 11 patients with previous ischemic brain injuries (type 2), proven by MRI, the carotid arteries were patent, including after carotid endarterectomy (5 patients) or after correction of stenosis with a stent (three). Rest asymmetry of blood flow was present (AI=0.92±0.03). The ATP test increased blood supply on the side of injury if, according to T₂-weighted MRI in the ischemic area, QD<0.35. Due to this, in general, there was a significant decrease in the absorption asymmetry of ^99mTc-HMPAO (AI=0.96±0.03) during the ATP test.

In 12 patients (type 3) with predominantly unilateral 50‒90 % carotid artery stenosis and ischemic stroke on the same side (group III), the hemispheric asymmetry of blood supply to the brain, noted already at rest (AI=0.96±0.03), increased (AI=0.93±0.03) with an adenosine test.

When analyzing the results of a two-year follow-up, it turned out that frequent transient ishemic attacs, minor strokes and strokes developed only in patients in whom the adenosine test induced or increased the interhemispheric asymmetry of ^99mTc-HMPAO accumulation by more than 5 % – four with type 1 reactivity, and three with type 3 reactivity

Conclusions: Thus, perfusion neuroSPECT with ^99mTc-HMPAO and ATP stress-test can be employed to identify patients with a reduced reserve of cerebral perfusion, who have an increased risk of ischemic stroke. Quantitative analysis of T₂-weighted MRI gives an estimate of the proportion of viable brain tissue in the focus of the past ischemia, in which reactivity is preserved.

Keywords: ^99mTc-HMPAO, ATP test, neuroSPECT, cerebral blood flow, carotid atherosclerosis, ischemic stroke, prognosis

For citation: Usov WYu, Yaroshevskii SP, Bobrikova EE, Sinitsyn VE, Lishmanov YuB. Predictive Role of Cerebral Blood Flow Stress-Test with Adenosintriphosphate Quantified with ^99mTc-HMPAO SPECT in Patients with Carotid Atherosclerosis. Medical Radiology and Radiation Safety. 2022;67(5):86–93. (In Russian). DOI: 10.33266/1024-6177-2022-67-5-86-93

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7. Usov V.Yu., Plotnikov M.P., Shipulin V.M. Functional Gamma-Tomographic Assessment of Cerebral Circulation in Atherosclerosis of Brachiocephalic Arteries: Radiopharmaceuticals, Methodology, Clinical Significance. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 1997;42;4:35-47 (In Russian).

8. Kulikov V.P., Kalanova L.A., Tregub P.P. Potentiation of the Protective Effect of Hypercapnic Hypoxia in Combination with Pharmacological Neuroprotective Agents. Patologicheskaya Fiziologiya i Eksperimentalnaya Terapiya = Pathological Physiology and Experimental Therapy. 2021;65;3:21-25. DOI: 10.25557/0031-2991.2021.03.21-25 (In Russian).

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11. Ussov W.Yu., Vorozhtsova I.N., Shipulin V.M., Lishmanov Yu.B., Plotnikov M.P. Detection of Cerebrovascular Disease by Adenosine [Tc-99m]-HMPAO SPET Test in Asymptomatic Carotid Stenosis. Eur. J. Nucl. Med. 1995;22;9:32.

12. Usov V.Yu., Vorozhtsova I.N., Krivonogov N.G., Krylov A.L., Lishmanov Yu.B., Plotnikov M.P., Shipulin V.M. Single-Photon Emission Tomography of the Brain with ^99mTc-HMPAO in Combination with an Intravenous Adenosine Test in Patients with Stenosis of the Internal Carotid Artery. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety 1996;44;3:51-54 (In Russian).

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17. Soricelli A., Postiglione A., Cuocolo A., De Chiara S., Ruocco A., Brunetti A., Salvatore M., Ell P.J. Effect of Adenosine on Cerebral Blood Flow as Evaluated by Single-Photon Emission Computed Tomography in Normal Subjects and in Patients with Occlusive Carotid Disease. A Comparison with Acetazolamide. Stroke. 1996;26;9:1572-1576. 

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22. Bukhovets I.L., Maksimova A.S., Plotnikov M.P., Kozlov B.N., Vorozhtsova I.N., Usov V.Yu. Ultrasonic Control of Cerebral Blood Flow in Patients with Stenosis of Brachiocephalic Arteries before and after Carotid Endarterectomy. Angiologiya i Sosudistaya Khirurgiya = Angiology and Vascular Surgery. 2018;24;1:66-71 (In Russian).

23. Kulikov V.P., Grechishnikov V.N., Sidor M.V. The Reaction of Cerebral Hemodynamics to Combined Stress Effects. Patologicheskaya Fiziologiya i Eksperimentalnaya Terapiya = Pathological Physiology and Experimental Therapy. 2005;49;1:7-8 (In Russian).

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25. Ussov W.Y., Plotnikov M.P., Yaroshevsky S.P., Shipulin V.M., Sokolov A.A. Evaluation of Hemodynamic Effects of Extracranial Carotid Stenoses by Adenosine-Induced Vasodilatation in Combination with ^99mTc-HMPAO SPECT. Nuclear Medicine Review of Central and Eastern Europe. 1999;2;1:15-19.  

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.06.2022. Accepted for publication: 25.08.2022.

Medical Radiology and Radiation Safety. 2022. Vol. 67. № 5

DOI: 10.33266/1024-6177-2022-67-5-80-85

V.I. Chernov^{1, 2}, E.A. Dudnikova¹, V.E. Goldberg¹, A.V. Goldberg¹,
T.L. Kravchuk¹, A.V. Muravleva¹, R.V. Zelchan^{1, 2}, A.A. Medvedeva¹,
O.D. Bragina^{1, 2}, A.N. Rybina¹

SINGLE-PHOTON EMISSION COMPUTERIZED TOMOGRAPHY
WITH ^99mTC-1-THIO-D-GLUCOSE IN THE STAGING
OF LYMPHOMAS

¹Cancer Research Institute, Tomsk National Research Medical Center, Tomsk, Russia

² Research Centrum for Oncotheranostics, Research School of Chemistry and Applied Biomedical Sciences,
Tomsk Polytechnic University, Tomsk, Russia

Contact person: V.I. Chernov, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To study the possibility of using SPECT with a new radiopharmaceutical ^99mTc-1-thio-D-glucose (^99mTc-TG) for staging lymphomas.

Material and methods: The study included 53 patients with a verified diagnosis of lymphoma (38 people – the main group) and adenopathy of non-tumor origin (15 patients - the comparison group). All patients of the main group underwent ^99mTc-TG SPECT, CT of the chest, abdominal organs and all interested areas, ultrasound, and biopsy followed by histological and immunohistochemical studies. Five patients underwent additional ¹⁸F-FDG PET/CT. The reference verification methods were histological and IHC examination or, if it was impossible to perform it, clinical observation of the patient for a year with standard control instrumental studies, ¹⁸F-FDG PET/CT and ^99mTc-TG SPECT. In the comparison group, ^99mTc-TG SPECT was performed once before the biopsy.

Results: It was shown that ^99mTc-TG SPECT made it possible to identify hypermetabolic foci in 75 % of the affected lymph nodes and in
81 % of extranodal formations established by reference diagnostic methods. The low sensitivity ^99mTc-TG SPECT are due to the low diagnostic efficiency of the method in detecting lesions in the abdominal cavity and are associated with a high background blood activity and a physiological increase in the accumulation of ^99mTc-TG in the kidneys and bladder. However, the method allowed additional visualization of nodal and extranodal lesions in 7 and 9 % of cases, respectively. However, the method allowed additional visualization of nodal and extranodal lesions in 7 % and 9 % of cases, respectively. A study of persons in the comparison group showed that ^99mTc-TG SPECT has a high specificity (93 %) in the diagnosis of lymphomas.

Conclusion: The ^99mTc-TG SPECT with has a high specificity (93 %) in the diagnosis of lymphomas and can be used as an additional method of investigation in the staging of lymphoproliferative diseases.

Keywords: lymphomas, Hodgkin’s lymphoma, non-Hodgkin’s lymphomas, single-photon emission computed tomography, ^99mTc-1-Thio -D-glucose

For citation: Chernov VI, Dudnikova EA, Goldberg VE, Goldberg AV, Kravchuk TL, Muravleva AV, Zelchan RV, Medvedeva AA, Bragina OD, Rybina AN. Single-photon Emission Computerized Tomography with ^99mTc-1-Thio-D-glucose in the Staging of Lymphomas. Medical Radiology and Radiation Safety. 2022;67(5):80–85. (In Russian). DOI: 10.33266/1024-6177-2022-67-5-80-85

References

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2.Barrington S.F., Mikhaeel N.G., Kostakoglu L., Meignan M., Hutchings M., Müeller S.P., et al. Role of Imaging in the Staging and Response Assessment of Lymphoma: Consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J. Clin. Oncol. 2014;32:3048–3058. DOI: 10.1200/JCO.2013.53.5229.

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5.Chernov V.I., Dudnikova Ye.A., Goldberg V.Ye., et al. Positron Emission Tomography in the Diagnosis and Monitoring of Lymphomas. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2018;63;6:41–50. DOI: 10.12737/article_5c0b8d72a8bb98.40545646
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7.Chanchikova N.G., Chernov V.I., Dudnikova Ye.A., et al. The Role of 18F-FDG PET/CT in Evaluation of Therapy Effectiveness and Prognosis of Lymphomas. Byulleten Sibirskoy Meditsiny = Bulletin of Siberian Medicine. 2021;20;2:120–129. DOI: org/10.20538/1682-0363-2021-2-120-129 (In Russ.).

8.Chernov V.I., Dudnikova Ye.A., Goldberg V.Ye., et al. Single-Photon Emission Computerized Tomography in the Diagnosis and Monitoring of Lymphomas. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2019;64;3:58–63. DOI: 10.12737/article_5cf3dfefe60b13.90120976 (In Russ.).

9.Zeltchan R., Medvedeva A., Sinilkin I., et al. Experimental Study of Radiopharmaceuticals Based on Technetium-99m Labeled Derivative of Glucose for Tumor Diagnosis // IOP Conference Series: Materials Science and Engineering. 2016. P. 012054. DOI. 10.1088/1757-899X/135/1/012054.

10.Zelchan R.V., Medvedeva A.A., Sinilkin I.G., et al. The Study of the Functional Suitability of the Tumoritropic Radiopharmaceutical 99mTc-1-Thio-D-Glucose in the Experiment. Molekulyarnaya meditsina = Molecular medicine. 2018.16;2:54–57. DOI: https://doi.org/10.29296/24999490-2018-03-11
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11.Chernov V.I., Medvedeva A.A., Sinilkin I.G., et al. Development Radiopharmaceuticals for Nuclear Medicine in Oncology. Meditsinskaya vizualizatsiya = Medical Visualization. 2016; 2:63-66 (In Russ.).

12.Chernov V.I., Dudnikova Ye.A., Zelchan R.V., et al. The First Experience of Using ^99mTc-1-Thio-D-Glucose for Single-Photon Emission Computed Tomography Imaging of Lymphomas. Sibirskiy Onkologicheskiy Zhurnal = Siberian Journal of Oncology. 2018;17;4:81–87. DOI: org/10.21294/1814-4861-2018-17-4-81-87 (In Russ.).

13.Dudnikova Ye.A., Chernov V.I., Muravleva A.V., et al. Metabolic Single-Photon Emission Computed Tomography with the New Radiopharmaceutical ^99mTc-1-Thio-D-Glucose In the Diagnosis and Monitoring of the Primary Breast Lymphoma (Case Report). Sibirskiy Onkologicheskiy Zhurnal = Siberian Journal of Oncology. 2020;19;5:145–153. DOI:  10.21294/1814-4861-2020-19-5-145-153 (In Russ.).

14.Muravleva A.V., Chernov V.I., Dudnikova Ye.A., et al. Metabolic Single-Photon Emission Computed Tomography with «^99mTc-1-Thio-D-Glucose» – New Possibilities for Hodgkin’s Limphoma Staging. Rossiyskiy Elektronnyy Zhurnal Luchevoy Diagnostiki = Russian Electronic Journal of Radiology. 2021;11;3:171–177. DOI: 10.21569/2222-7415-2021-11-3-171-177 (In Russ.).

15. Chernov V., Dudnikova E., Zelchan R., et al. Phase I Trial of ^99mTc-1-Thio-D-Glucose for Imaging of Lymphomas // Preprints. 2022. doi: 10.20944/preprints202205.0028.v1. 

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.06.2022. Accepted for publication: 25.08.2022.

Medical Radiology and Radiation Safety. 2022. Vol. 67. № 5

DOI: 10.33266/1024-6177-2022-67-5-94-97

V.D. Volodina¹, A.N. Bashkov², S.V. Lishchuk², A.P. Dunaev³,
Z.V. Sheykh³, M.V. Popov¹

CHONDROMYXOID FIBROMA OF THE TEMPORAL BONE SIMULATED CHRONIC INFLAMMATION (Case Report)

¹First I.M. Sechenov Moscow State Medical University, Moscow, Russia

²A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

³Moscow City Clinical Hospital № 62, Istra, Moscow Region, Russia

⁴Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Contact person: V.D. Volodina, е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To present a clinical case of a benign bone tumor of rare localization – chondromyxoid fibroma of the temporal bone, simulated chronic inflammation.

Material and methods: A clinical case of chondromyxoid fibroma of the right temporal bone is presented. X-ray computed tomography (CT) and magnetic resonance imaging (MRI) of the temporal bones were performed before and during hospitalization.

Results: Patient T., 29 years old, has been complaining about discomfort, congestion and noise in the right ear for the past 10 years without clear history of acute media otitis in anamnesis. According to the results of MRI of the temporal bones, a tumor of the right temporal bone was revealed. To clarify the diagnosis and for surgical treatment, the patient was referred to the clinic. During hospitalization CT of the temporal bones with contrast enhancement was performed and a tumor in the mastoid process of the right temporal bone with a ring-shaped accumulation of a contrast was determined, differential diagnosis included tumor and chronic abscess. According to the results of morphological examination after radical surgery of the temporal bone, chondromyxoid fibroma was diagnosed.

Conclusion: Localization of chondromyxoid fibroma in the temporal bone is extremely rare and having by chance some features can simulate chronic inflammatory process. The absence of a clear history of acute otitis allows more likely suggest the tumor.

Keywords: chonromyxoid fibroma, temporal bone, chronic inflammation, X-ray computed tomography (CT), magnetic resonance imaging (MRI)

For citation: Volodina VD, Bashkov AN, Lishchuk SV, Dunaev AP, Sheykh ZV, Popov MV. Chondromyxoid Fibroma of the Temporal Bone Simulated Chronic Inflammation (Case Report). Medical Radiology and Radiation Safety. 2022;67(5):94–97. (In Russian). DOI: 10.33266/1024-6177-2022-67-5-94-97

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.06.2022. Accepted for publication: 25.08.2022.