Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 58–68

DOI: 10.12737/1024-6177-2019-64-5-58-68

A.Y. Bushmanov, O.E. Klementyeva, A.A. Labushkina, A.V. Tultaev, V.N. Korsunskiy, O.V. Kuznetsova

Actual Problems and Perspectives of the Application of Nuclear Medicine Techniques in the Diagnostic and Treatment of Hepatocellular Carcinoma: Analytical Review

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.

A.Y. Bushmanov – First Deputy Director, Dr. Sci. Med., Prof.;
O.E. Klementyeva – Нead of Lab., PhD Biol.;
A.A. Labushkina – Research Worker, PhD Med.;
A.V. Tultaev – Senior Researcher, PhD Tech.;
V.N. Korsunskiy – Leading Researcher, Dr. Sci. Med., Prof.;
O.V. Kuznetsova – Vice-Rector, PhD Biol.

Abstract

In the presented review of publications, together with a brief analysis of the incidence, risk factors for the occurrence and methods of diagnosis of hepatocellular carcinoma (HCC), current problems and prospects for the application of nuclear medicine methods in the diagnosis and treatment of this disease are indicated. Hepatocellular carcinoma is one of the most common malignant tumors of the liver and is characterized by a rapidly progressing course with an unfavorable life expectancy. A variety of clinical manifestations of the disease creates certain difficulties in the early diagnosis of HCC. Although HCC screening is most commonly used to determine the level of alpha-fetoprotein (AFP), ultrasound (US), bolus CT and MRI, experience in the use of radionuclide imaging diagnostics, including positron emission tomography, is important in clinical practice (PET), which, not being the main method of primary diagnosis of HCC, however, confirmed their relevance in the differential diagnosis between a benign tumor and metastasis with unclear diagnostic data, as well as in the process of monitoring treatment and in the diagnosis of distant metastases. Conceptual issues in determining the treatment strategy of patients with HCC, depending on the staging of the disease, the prospects for optimizing treatment strategies and traditional methods of treating HCC in detail and in depth are covered in various publications, including publications of domestic authors. Based on this, the authors of the article limited themselves to a brief analysis of the use of embolization and radiation therapy methods for treating HCC, the active development of which in the last decade, as well as promising early results of treatment, suggest that radiation therapy can be considered as the main treatment method for HCC traditional methods.

Further study and development of radionuclide methods for the diagnosis and therapy of HCC, as well as the search and study of new radiopharmaceuticals for diagnosis and regional intraarterial radiotherapy is one of the promising directions in modern approaches to the diagnosis and treatment of HCC.

Key words: hepatocellular carcinoma, nuclear medicine, radioembolization, chemoembolization, lipiodol, sorafenib, intraarterial radionuclide therapy

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For citation: Bushmanov AY, Klementyeva OE, Labushkina AA, Tultaev AV, Korsunskiy VN, Kuznetsova OV. Actual Problems and Perspectives of the Application of Nuclear Medicine Techniques in the Diagnostic and Treatment of Hepatocellular Carcinoma: Analytical Review. Medical Radiology and Radiation Safety. 2019;64(5):58-68. (in Russian).

DOI: 10.12737/1024-6177-2019-64-5-58-68

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Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 71–72

DOI: 10.12737/1024-6177-2019-64-5-71-72

А.S. Samoylov, Е.V. Goloborodko, T.A. Astrelina, E.V. Dedova, I.V. Chukovskaya, T.V. Gubaeva

Legal Aspects of Evaluating the Genetic Consequences of Medical Exposure

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.

A.S. Samoylov – Director General, Prof. RAS, Dr. Sci. Med.;
E.V. Goloborodko – Head of Dep., Scientific Secretary, PhD Med.;
T.A. Astrelina – Head of Center for Biomedical Technologies, Dr. Sci. Мed., Assoc. Prof.;
E.V. Dedova – Deputy Executive Director on Legal Issues;
I.V. Chukovskaya – Deputy Head of Legal Department;
T.V. Gubaeva – Legal Adviser

Contents

Introduction.
Legal aspects of the application of medical technologies related to the use of ionizing radiation sources.
Constitutional aspects of genetic research.
Problems of legal regulation of genetic risks.
Conclusion

Key words: medical exposure, nuclear medicine, patient safety, genetic consequences, legal aspects

REFERENCES

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For citation: Samoylov АS, Goloborodko ЕV, Astrelina TA, Dedova EV, Chukovskaya IV, Gubaeva TV. Legal Aspects of Evaluating the Genetic Consequences of Medical Exposure. Medical Radiology and Radiation Safety. 2019;64(5): 71-2. (English).

DOI: 10.12737/1024-6177-2019-64-5-71-72

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Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 69–70

DOI: 10.12737/1024-6177-2019-64-5-69-70

P.A. Kalinichenko, D.V. Ponomareva

Ethical and Legal Aspects of Regulating Genomic Research in International and Russian Practice

O.E. Kutafin Moscow State University of Law, Moscow, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

P.A. Kalinichenko – Professor of Dep., Dr. Sci. Law, Prof.;
D.V. Ponomareva – Lecturer, PhD Law

Abstract

Despite the UN efforts at the universal level, there are no legally binding instruments at this level devoted exclusively to biomedicine and genomic research. However, an experience in the field of protection against radiation exposure could be useful in this regard.

The active development of Biomedicine and genomic research has led to conflicts between ethics and law, which have been the subject of consideration in the higher courts, including at the supranational structures level, in particular, the Council of Europe and the European Court of human rights. Nevertheless, it should be noted that despite all the laws imperfections, Russia is building its approach within the existing system of international standards that allow for the national uniqueness of the regulation in the relevant sphere.

Key words: genomic research, DNA, Council of Europe, Russia, ECHR, international standards, radiation safety, judicial practice, medicine

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For citation: Kalinichenko PA, Ponomareva DV. Ethical and Legal Aspects of Regulating Genomic Research in International and Russian Practice. Medical Radiology and Radiation Safety. 2019;64(5):69-70. (in Russian).

DOI: 10.12737/1024-6177-2019-64-5-69-70

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Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 5. P. 76–80

DOI: 10.12737/1024-6177-2019-64-5-76-80

O.A. Kravets, A.V. Dubinina, E.V. Tarachkova, O.V. Kozlov, E.A. Romanova

Brachytherapy for Locally Advanced Cervix Cancer (Methodological Aspects)

N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia.
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

O.A. Kravets – Senior Researcher, Dr. Sci. Med.;
A.V. Dubinina – Post-Graduate Student;
E.V. Tarachkova – PhD Med.;
O.V. Kozlov – Medical Physicist;
E.A. Romanova – Post-Graduate Student

Abstract

Purpose: To increase local control of cervical tumors by developing and introducing into practice the optimization of dose distribution in the primary tumor during concomitant chemoradiation (CRT) and image-guided adaptive brachytherapy (IGABT) i.e. summing up the maximum dose to the tumor volume of HR-CTV> 85 Gy in the shortest possible period of time by the optimal fractionation regime, without increasing the tolerable doses to the organs of risk (bladder, rectum, sigmoid).

Material and methods: Data of the study was the of clinical observations of patients with locally advanced cervical cancer proven stage IIb–IIIb according to FIGO, treated with curative radiation therapy. After pelvic +/- para-aortic external-beam radiation therapy (2 Gy × 50 Gy with Cisplatin 40 mg/m² weekly), they received high-dose rate intracavitary brachytherapy or in combination with interstitial component following GEC-ESTRO recommendations.

Results: We managed to achieve maximum dose to the tumor volume of HR-CTV> 85 Gy without increasing the load on the risk organs. The Clinical Contouring at the time of primary diagnosis of cervical cancer and before brachytherapy session based on clinical and diagnostic data using MRI helps to optimize the brachytherapy process, develop patient management tactics and a clear sequence of actions in a complex program of brachytherapy.

Conclusion: The presented clinical cases indicate the prospects of using an individual approach in planning the brachytherapy of patients with locally advanced cervical cancer.

Key words: locally advanced cervical cancer, image-guided adaptive brachytherapy, MRI, CTV-HR

REFERENCES

1. Potter R, Knocke TH, Fellner C, Baldass M, Reinthaller A, Kucera H. Definitive radiotherapy based on HDR brachytherapy with iridium-192 in uterine cervix carcinoma: report on the Vienna University Hospital findings (1993–1997) compared to the preceding period in the context of ICRU 38 recommendations. Cancer Radiother. 2000;4:159-72.
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4. EMBRACE Study Committee. EMBRACE: An International Study on MRI-guided brachytherapy in locally advanced cervical cancer. Available at: https//www.embracestudy.dk/About.aspx. Accessed January 5, 2015.

For citation: Kravets OA, Dubinina AV, Tarachkova EV, Kozlov OV, Romanova EA. Brachytherapy for Locally Advanced Cervix Cancer (Methodological Aspects). Medical Radiology and Radiation Safety. 2019;64(5):76-80. (in Russian).

DOI: 10.12737/1024-6177-2019-64-5-76-80

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