Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 20–27

DOI: 10.12737/1024-6177-2019-64-5-20-27

L.A. Suvorova, I.A. Galstian, N.M. Nadejina, V.Yu. Nugis, M.G. Kozlova,
I.E. Andrianova, V.N. Maltsev, B.B. Moroz

Characters of Oncohematological Disease Formation in Long Terms after Acute Radiation Sickness

A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

L.A. Suvorova – Leading Researcher, Dr. Sci. Med.;
I.A. Galstian – Head of Lab., Assoc. Prof., Dr. Sci. Med.;
N.M. Nadejina – Leading Researcher, PhD Med.;
V.Yu. Nugis – Head of Lab., Dr. Sci. Biol.;
M.G. Kozlova – Researcher;
I.E. Andrianova – Leading Researcher, Dr. Sci. Med.;
V.N. Mal´tsev – Leading Researcher, Prof., Dr. Sci. Med.;
B.B. Moroz – Head of Lab., Academician of RAS

Abstract

Purpose: To clarify the frequency, nosological forms, the timing of development and the features of the clinical course of developed oncohematological diseases on the basis of a retrospective analysis of the results of long-term follow-up of patients who underwent acute radiation syndrome (ARS).

Material and methods: An analysis of clinical histories from archives of A.I. Burnasyan Federal Medical Biophysical Center of 157 patients who underwent ARS of varying severity, and some scientific publications. Various oncohematological diseases developed in the long-term period in 8 patients with ARS I–III (IV) severity: in 5 patients – myelodysplastic syndromes (MDS), in 2 – chronic myeloid leukemia (CML) and in 1 – acute myelomonoblastic leukemia (OMML).

Results: The excess absolute risk of developing MDS and leukemia in the group is 7.2×10^–4 man-years/Gy. All patients underwent relatively uniform irradiation. MDS developed in 5 patients who underwent ARS as a result of a single acute gamma-beta- and gamma-neutron irradiation at doses of 1.2–5.0 Gy. Nosological forms of MDS: with unilinear dysplasia, with multilinear dysplasia (2 cases), with ringed sideroblasts, with excess blasts. The latency period lasted from 3 to 31 years. Age at the time of irradiation was 28–55 years. CML, Ph-positive form, was detected in 2 patients. Doses of gamma-beta-radiation were 2.0 and 4.3 Gy. Age of patients at the time of irradiation was 22 and 25 years. Diseases developed 3 and 15 years after the undergone ARS and were characterized by a long period of inactive phase (10 and 7 years), which resulted in a blast crisis. OMML in the patient, who suffered during the Chernobyl accident and since 1990 was observed in the URCRM, developed 11.8 years after irradiation at a dose of 3.0 Gy. An analysis of available clinical data makes it possible to question the diagnosis of acute leukemia, and to suppose that chronic myelomonocytic leukemia developed in this patient.

Conclusion: The obtained data indicate that chronic leukemia forms are characteristic for radiation leukemia, often with a long preceding cytopenic stage (MDS). An essential factor in the realization of the leukemogenic effect is the uniformity of the whole body exposure undoubtedly. In addition, it can’t be ruled out that the carriage of hepatitis B and C viruses also played a role in the formation of MDS.

Key words: acute radiation syndrome, radiation leukemia, myelodysplastic syndrome, erythremia, chronic myeloid leukemia, acute myelomonoblastic leukemia, blast crisis, anemia, thrombocytopenia

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For citation: Suvorova LA, Galstian IA, Nadejina NM, Nugis VYu, Kozlova MG, Andrianova IE, Maltsev VN, Moroz BB. Characters of Oncohematological Disease Formation in Long Terms after Acute Radiation Sickness. Medical Radiology and Radiation Safety. 2019;64(5):20-7. (in Russian).

DOI: 10.12737/1024-6177-2019-64-5-20-27

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Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 35–41

DOI: 10.12737/1024-6177-2019-64-5-35-41

R.V. Zelchan, I.G. Sinilkin, A.A. Medvedeva, O.D. Bragina, V.I. Chernov

Study of Pharmacokinetics of a New Radiopharmaceutical on the Basis of Technetium-99m Labeled Glucose

Cancer Research Institute, Tomsk National Research Medical Center, Tomsk, Russia. Е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

R.V. Zelchan – Radiologist, PhD Med.;
I.G. Sinilkin – Senior Researcher, PhD Med.;
A.A. Medvedeva – Senior Researcher, PhD Med.;
O.D. Bragina – Junior Researcher, Radiologist, PhD Med.;
V.I. Chernov – Head of Dep., Dr. Sci. Med.

Abstract

Purpose: To study the features of the distribution and removal of a new radiopharmaceutical (RPH) on the basis of a labeled ^99mTc glucose derivative for radionuclide diagnostics of oncological diseases in the body of experimental animals.

Material and methods: The main stage of the study was performed on 65 mature conventional outbred white rats and 9 rabbits of the Soviet Chinchilla breed. To study the dynamics of changes in the concentration of the studied RPH in the blood plasma and its distribution in the main organs and tissues, as well as to study the metabolic features of the drug and its excretion, the RPH studied was administered intravenously, once in activity of 20 MBq. Multiple introduction of the RPH was performed in order to study the cumulative properties of the study drug, and to elucidate the possibilities of predicting the cumulation processes from the data obtained with a single administration of RPH. For this purpose, intravenous RPH was administered at the same time 1 time / day for 5 days, at a dose of 20 MBq. To confirm the theory of linearity of the pharmacokinetics of the RFP studied, three groups of laboratory animals received the drug in three activity levels – 10, 20 and 40 MBq were used. After euthanasia, the animals were autopsied and removed the necessary organs and tissues. The prepared and washed organs were placed in tubes for further radiometry in order to study the concentrations of the RPH in the bioassay.

Results: It has been established that the RPH being studied practically does not accumulate in the main organs and tissues, accumulating mainly in the kidneys and bladder. The main organs of elimination of the test drug are the kidneys, and the main excreta are urine. The half-life of the drug from the blood was 10 minutes. Pharmacokinetics of the drug is linear and does not depend on the administered activity, and the drug itself does not possess cumulative properties.

Conclusion: A study of the pharmacokinetics of the RPH ^99mTc-1-Thio-D-glucose showed that the preparation possesses optimal properties for the diagnostic agent. The drug stably does not accumulate in the main organs and tissues, which allows it to be reused, for example at the stages of dynamic observation of cancer patients.

Key words: radiopharmaceutical, pharmacokinetics, technetium-99m, labeled glucose

REFERENCES

1. Chernov V, Sinilkin I, Choynzonov E, Zelchan R, Medvedeva A, Bragina O. Comparative evaluation of 99mTc-Al2O3 and 99mТc-fitat nanocolloids for sentinel lymph nodes, visualization in patients with cancer of larynx and hypopharynx. Europ J Nucl Med Mol Imaging. 2015;42:704.
2. Chernov VI, Sinilkin IG, Zelchan RV, Medvedeva AA, Bragina OD, Varlamova NV et al. Experimental study of 99mTc-aluminum oxide use for sentinel lymph nodes detection. AIP Conf Proc. 2016;1760.020012.
3. Chernov VI, Medvedeva AA, Sinilkin IG, Zelchan RV, Bragina OD, Skuridin. Experience in the development of innovative radiopharmaceuticals in Tomsk Research Institute of Oncology. Siberian Oncol J. 2015;2:45-7. (in Russian).
4. Zeltchan R, Medvedeva A, Sinilkin I, Chernov V, Bragina O, Dergilev A. Experimental study of radiopharmaceuticals based on technetium-99m labeled derivative of glucose for tumor diagnosis. IOP Conf Series: Materials Sci Eng. 2016;135(1):012054.
5. Welling MM, Alberto R. Performance of a 99mTc-labelled 1-thio-beta-D-glucose 2,3,4,6-tetra-acetate analogue in the detection of infections and tumors in mice: a comparison with [18F] FDG. Nuc. Med Commun. 2010;31(3):239-48.
6. Stasyuk ES, Skuridin VS, Ilina EA, Varlamova NV, Zelchan RV, Nesterov EA, et al. Development of new radiopharmaceutical based on 5-thio-d-glucose labeled technetium-99m. IOP Conf Series: Materials Sci Eng. 2016;135(1):012044.
7. Doroshenko A, Chernov V, Medvedeva A, Sinilkin I, Dergilev A, Zelchan R, et al. The first experience of using 99mTc-Al2O3 for the detection of sentinel lymph nodes in breast cancer. IOP Conf Series: Materials Sci Eng. 2016;135(1):012011.
8. Federal Target Program “Development of the pharmaceutical and medical industry of the Russian Federation for the period until 2020 and beyond”. Preclinical studies of radiopharmaceutical on the basis of labeled 99mTc glucose derivative for radionuclide diagnostics of oncological diseases. State contract No. 14.N08.11.0033 of 19.05.2015. (in Russian).

For citation: Zelchan RV, Sinilkin IG, Medvedeva AA, Bragina OD, Chernov VI. Study of Pharmacokinetics of a New Radiopharmaceutical on the Basis of Technetium-99m Labeled Glucose. Medical Radiology and Radiation Safety. 2019;64(5):35-41. (in Russian).

DOI: 10.12737/1024-6177-2019-64-5-35-41

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Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 28–34

DOI: 10.12737/1024-6177-2019-64-5-28-34

N.S. Yakovleva¹, V.I. Amosov¹, A.A. Speranskaia¹, V.P. Zolotnitskaia¹, V.A. Ratnikov²

Computed Tomography in the Diagnosis of Various Forms of Amiodarone-Induced Pulmonary Toxicity

1. I.P. Pavlova First St. Petersburg Medical State University, St. Petersburg, Russia. Е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ;
2. L.G. Sokolov Clinical Hospital No. 122, St. Petersburg, Russia

N.S. Yakovleva – Radiologist;
V.I. Amosov – Head of Dep., Dr. Sci. Med, Prof., Member ERS;
A.A. Speranskaia – Dr. Sci. Med., Prof., Member ERS;
V.P. Zolotnitskaia – Senior Researcher, Dr. Sci. Biol.;
V.A. Ratnikov – Vice-President, Med. Dep., Dr. Sci. Med., Prof., Member ERS, Member ESGE

Abstract

Purpose: To determine computed tomography subtypes of amiodarone-induced pulmonary toxicity (AIPT).

Material and methods: We included 214 CT exams of 110 patients with history of amiodarone use. AIPT was confirmed in 90 cases. In 81 % of patients we repeat CT exam 2–5 times, observation period till 1 month to 10 years. The mean age of patients was 71 years (21 females, 69 – males). In 52 % of patients lung scintigraphy was done. We included functional lung test, spirometry, heart ultrasound in diagnostic plan.

Results: Only in 3 % of cases we detected acute form of AIPT. In 68 % of patients subacute form was revealed, in that cases we indentified different patterns of lung defeat, which mimic oncology disease, different types of interstitial pneumonias, small vessel pulmonary embolism. In other cases chronic form AIPT was suspected. Unilateral changes and craniocaudal gradient were not pathognomic for AIPT. We did not identify consolidation zones and nodules. Honeycombing was not a typical feature of chronic form of AIPT. Appearance of ground-glass opacity pattern was feature of lung toxicity exaxerbation.

Conclusion: AIPT diagnose of exclusion because of it’s multiple radiological subtypes. There are no specific histological or cytological markers of the disease. Only CT could identify signs of active process and differentiate different subtypes of AIPT.

Key words: amiodarone, amiodarone-induced pulmonary toxicity, multislice computed tomography

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For citation: Yakovleva NS, Amosov VI, Speranskaia AA, Zolotnitskaia VP, Ratnikov VA. Computed Tomography in the Diagnosis of Various Forms of Amiodarone-Induced Pulmonary Toxicity. Medical Radiology and Radiation Safety. 2019;64(5):28-34. (in Russian).

DOI: 10.12737/1024-6177-2019-64-5-28-34

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Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 42–47

DOI: 10.12737/1024-6177-2019-64-5-42-47

Yu.A. Kurachenko¹, H.A. Onischuk^2,3, Eu.S. Matusevich³, V.V. Korobeynikov⁴

High-Intensity Bremsstrahlung of Electron Accelerator in Photoneutron and Radioisotopes Production for Medicine

1. Russian Institute of Radiology and Agroecology, Obninsk, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ;
2. Rosatom Technical Academy, Obninsk, Russia;
3. Obninsk Institute for Nuclear Power Engineering, NRNU MEPhI, Russia;
4. A.I. Leypunsky Institute for Physics and Power Engineering, Obninsk, Russia

Yu.A. Kurachenko – Chief Researcher, Dr. Sci. Phys.-Math.;
H.A. Onischuk – Postgraduate Student;
Eu.S. Matusevich – Professor of MEPhI, Dr. Sci. Phys.-Math.;
V.V. Korobeynikov – Chief Researcher, Dr. Sci. Phys.-Math.

Abstract

Purpose: To study the binary possibility of using the available linear electron accelerators for the neutron therapy and radioisotopes production. For both applications, calculations were performed and the results were normalized to the characteristics of the Mevex accelerator (average electron current 4 mA at a monoenergetic electron beam 35 MeV). It turns out that the production of both photoneutrons and radioisotopes is effective when using bremsstrahlung radiation generated in the giant dipole resonance of a heavy metal target.

Material and methods: The unifying problem for both applications is the task of target cooling: at beam power ~ 140 kW, half of it or more is deposited directly in the target. Therefore the liquid heavy metal was selected as a target, in order to conjoin high thermohydraulics quality with maximal productivity both bremsstrahlung radiation and photoneutrons. The targets were optimized using precise codes for radiation transport and thermohydraulics problems. The optimization was also carried out for the installations as a whole: 1) for the composition of the material and configuration of the photoneutron extraction unit for neutron capture therapy (NCT) and 2) for the scheme of bremsstrahlung generation for radioisotopes production.

Results: The photoneutron block provides an acceptable beam quality for NCT with a high neutron flux density at the output ~2·10¹⁰ cm^–2s–1, which is an order of magnitude higher than the values at the output of the reactor beams that worked in the past and are currently being designed for neutron capture therapy. As for radioisotopes production, using optimal reaction channel (γ, n) 43 radioisotopes in 5 groups were received. For example, by the Mo¹⁰⁰(γ,n)⁹⁹Mo reaction the precursor ⁹⁹Mo of main diagnostic nuclide ^99mTc with specific activity ~6 Ci/g and total activity of the target 1.8 kCi could be produced after 1 day irradiation exposure.

Conclusion: The proposed schemes of neutron and bremsstrahlung generation and extraction have a number of obvious advantages over traditional techniques: a) the applying of the electron accelerators for neutron production is much safer and cheaper than to use conventional reactor beams; b) accelerator with the target, the beam output unit with the necessary equipment and tooling can be placed on the territory of the clinic without any problems; c) the proposed target for NCT is liquid gallium, which also serves as a coolant; it is an “environmentally friendly” material, its activation is rather low and rapidly (in ~4 days) falls to the background level.

Key words: industrial electron accelerator, bremsstrahlung, photoneutrons, neutron capture therapy, radioisotopes for medicine

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For citation: Kurachenko YuA, Onischuk HA, Matusevich EuS, Korobeynikov VV. High-Intensity Bremsstrahlung of Electron Accelerator in Photoneutron and Radioisotopes Production for Medicine. Medical Radiology and Radiation Safety. 2019;64(5):42-7. (English).

DOI: 10.12737/1024-6177-2019-64-5-42-47

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