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ISSN 1024-6177 (Print), ISSN 2618-9615 (Online)

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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.

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Issues journals

Medical Radiology and Radiation Safety. 2018. Vol. 63. No. 3. P. 52-67

REVIEW

DOI: 10.12737/article_5b179d60437d54.24079640

Results of Randomized Studies on Hyperthermia in Oncology

O.K. Kurpeshev1, J. van der Zee2

1. A.F. Tsyb Medical Radiological Research Center, Obninsk, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. Erasmus Medical Centre, Cancer Institute, Rotterdam, the Netherlands

O.K. Kurpeshev – Head of Dep., Dr. Sc. Med., Member of European Society for Hyperthermic Oncology (ESHO); J. van der Zee – Ph.D., MD, Member of European Society for Therapeutic Radiology and Oncology (ESTRO), European Society for Hyperthermic Oncology (ESHO)

Abstract

The review presents statistics of published randomized phase III trials on the addition of hyperthermia (HT) to other cancer therapies, and analyzes the results of these trials. In total, 47 comparisons could be made for treatments with or without HT. These trials were done in a large variety of solid tumors, and in centers in Asia, Europe, North America and Australia. In general, these studies were relatively small – 17 studies included more than 100 patients. The total number of patients was 5099. In the majority of the studies, HT was applied with electromagnetic radiation. Most studies (74 %) have shown that additional HT significantly improves the results of radiation, chemo- and chemoradiotherapy in patients with, in general, locally advanced relapsed and metastatic forms of malignant tumors. Improved results were reported for complete and overall response, loco-regional tumor control, disease free and overall survival, and, in one study, for palliative effects.

In these randomized trials also acute and/or late toxicity has been investigated. In the majority of the trials, addition of HT did not result in significant increases of toxic effects. The economic consequences of HT as part of cancer treatment are discussed.

Twenty-six percent of the studies failed to show a significant beneficial effect of HT which are discussed in more detail. In 4 studies with a trend of a better outcome in the plus HT treatment arm, with an absolute difference of 10 % or more, the lack of significance is probably due to a low number of patients included. In other studies, there was an unbalanced distribution of tumor characteristics over the two study arms, with worse prognostic factors in the plus HT arm, inadequate techniques, using too high frequency of electromagnetic radiation, and/or a small applicator, and/or a short heating time, so that a sufficient energy deposition in the tumor volume could not be achieved. These results make clear that it is important to develop guidelines for the application of HT, in addition to the existing ones. In view of the different principles of operation of HT applicators, it is important that such guidelines will become available for each individual device. Further, it is important to conduct larger randomized trials. Larger studies would probably increase the number of significant and also more relevant outcomes, and promote a wider acceptance of HT as part of cancer treatment.

Key words: hyperthermia, randomization, radiation therapy, chemotherapy, thermoradiotherapy, thermochemotherapy, thermochemoradiation therapy

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For citation: Kurpeshev OK, van der Zee J. Results of Randomized Studies on Hyperthermia in Oncology. Medical Radiology and Radiation Safety. 2018;63(3): 52-67. Russian. DOI: 10.12737/article_5b179d60437d54.24079640

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Medical Radiology and Radiation Safety. 2018. Vol. 63. No. 3. P. 44-51

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DOI: 10.12737/article_5b179a86bf0387.39000853

Evaluating the Effectiveness of Somatostatin Receptors Scintigraphy with 111In-Octreotide in the Diagnosis of Neuroendocrine Tumors

A.A. Markovich, S.V. Shiryaev, M.O. Goncharov, A.S. Krylov, D.A. Komanovskaya, A.D. Ryzhkov

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.

A.A. Markovich – PhD Med, Senior Researcher; S.V. Shiryaev – Dr. Sc. Med., Head of Lab., President of the OSMI, Member of the EANMMI, Member of the ACNMMI, Member of the SNMMI; M.O. Goncharov – Radiologist; A.S. Krylov – PhD Med., Radiologist, Member of the EANMMI; D.A. Komanovskaya – Radiologist; A.D. Ryzhkov – Dr. Sc. Med., Leading Researcher

Abstract

Purpose: Exploring methods to improve diagnosis of neuroendocrine tumors (NET) in different locations using somatostatin receptors scintigraphy with 111In-octreotide.

Material and methods: The study included 125 patients with NET in different locations. Activity of injected 111In-octreotide was 200–250 MBq (effective dose – 0.054 mSv/MBq), which allows to carry out a planar study as and single photon emission computed tomography. The study was performed after 24 hours on intravenous injection of indicator on the combined SPECT/CT machine Symbia T2 (Siemens, Germany).

Results: In the sample of patients, NET distribution by localization is indicated in Fig. 1. The results of the study with 111In-octreotide are presented in the form of scintigrams in the whole body scanning mode and in the form of single-photon emission computer tomograms combined with CT. To determine the effectiveness of scintigraphy with 111In-octreotide, after a visual evaluation of the scintigrams obtained, the number of positive and negative results of the study was calculated. A comparison was made with the data of other methods and the number of TP, TN, FP, and FN results was determined. Further, the characteristic parameters of the method studied were calculated to determine its effectiveness. The study of values of characteristic parameters showed that the sensitivity was 73 % (95 % CI: 63–83 %), specificity – 97 % (95 % CI: 88–100 %) accuracy is 79 % (95 % CI: 71–87 %). The value of the positive predictive value of 99 % (95 % CI: 94–100 %), the predictive value of negative results – 55 % (95 % CI: 40–70 %).

While the study shows a high frequency of TP results, while the frequencies of the TN and FN results are not significantly different (the average frequency of the FN results falls within the confidence interval for the frequency of the TN results). The method has a high value of the prognostic value of the positive result, which gives the right to assert about the high probability of the presence of a neuroendocrine neoplasm in obtaining a positive result. In the present study, no FP results were obtained due to the presence of concomitant diseases, in which accumulation of used radiopharmaceutical is possible, since the data on the presence of such diseases were taken into account in the analysis of scintigrams. The data obtained in this paper are in good agreement with the data obtained by other authors, as well as early Russian publications. It is worth noting that the data of domestic authors were obtained on a small sample, without specifying confidence intervals; the injected activity was less than in this study. In addition, the possibility of obtaining more information than using classical imaging methods (for SPECT/CT, the tissue with the pathological accumulation of 111In-octreotide appeared to be intact on CT), allows us to recommend the method as a method of choice in the diagnosis of NET of different localization.

Conclusions: The method of somatostatin receptors scintigraphy using domestic analogue of somatostatin in the diagnosis of NET has a high efficiency (efficiency of the method, calculated as the average value of the parameters of sensitivity and specificity of 85 % (95 % CI: 66–100 %).

Keу words: 111In-octreotide, neuroendocrine tumors, somatostatin receptor scintigraphy

REFERENCES

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For citation: Markovich AA, Shiryaev SV, Goncharov MO, Krylov AS, Komanovskaya DA, Ryzhkov AD. Evaluating the Effectiveness of Somatostatin Receptors Scintigraphy with 111In-Octreotide in the Diagnosis of Neuroendocrine Tumors. Medical Radiology and Radiation Safety. 2018;63(3):44-51. Russian. DOI: 10.12737/article_5b179a86bf0387.39000853

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

Medical Radiology and Radiation Safety. 2018. Vol. 63. No. 3. P. 28-33

NON-IONIZING RADIATION

DOI: 10.12737/article_5b168a752d92b1.01176625

From Electromagnetic Smog to Electromagnetic Chaos. To Evaluating the Hazards of Mobile Communication for Health of the Population

Yu.G. Grigoriev

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.

Yu.G. Grigoriev – Leading Researcher, Dr. Sc. Med., Prof., the Deputy Chairman of the Scientific Council on Radiobiology of the Russian Academy of Sciences, President of the Russian National Committee on Protection from Non-Ionizing Radiation, Member of the WHO Advisory Committee on the International Program «EMF and Public Health», a Member of the International Commission on Electromagnetic Safety (ICES)

Abstract

Over the past 25 years, there has been a global change in the electromagnetic environment on the Earth, associated with the widest use of wireless communications by the population, which significantly changed the situation of artificial electromagnetic pollution of the external environment and the methodology for assessing the health risks of all population groups.

In these difficult conditions, nevertheless, many authors in their conclusions neglect the views established in radiobiology in assessing the danger of exposure to electromagnetic radiation of ultrahigh frequencies (EMR microwave), which is associated, for example, with the notions of a critical organ or critical system, the possibility of accumulating adverse effects and the formation of residual damage (long-term consequences). Almost daily brain irradiation of the EMR of the microwave does not attract their attention.

The work uses classical radiobiological approaches to assess the danger of electromagnetic radiation in the microwave range of low non-thermal intensities, including mobile communication for the population and presents some data on the negative impact on public health, including children – mobile phone users. On specific examples, the facts of the relative increase in the risk of developing brain tumors after a long period of active use of cell phones are considered. In many countries, there is a complete disregard for the precautionary principle proposed by the WHO. Children for the first time in the entire period of civilization are included in the risk group. At the same time, in many countries there is a complete disregard for this principle and the recommendations of the International Agency for Research on Cancer (IARC) are ignored.

Even before the era of the development of mobile communications, there were significant differences in the approaches to developing acceptable doses for microwave EMR, but discussions on the possible adverse biological effects of non-thermal low levels of these emissions are still ongoing. At the same time, we can note a positive trend associated with the fact that almost all the leading countries of Europe are already correctly assessing the real danger of the MP and have their own more stringent regulations than in Russia (Austria, France, Italy etc.).

At the same time, we observe the silence of some scientists and important officials in many countries about the possible danger to the population of EMP mobile communications. As a fact, opposite decisions are made about the prevention and protection of the population, including children. At present, the current situation can be described as electromagnetic chaos in the habitat of the population. In our opinion, in the conditions of the existing electromagnetic chaos, it is necessary to inform the population that mobile communication in the absence of self-limitation can be dangerous to health. The population should have an independent choice of the type and the mode of mobile communication. This choice is his voluntary risk.

Key words: electromagnetic radiation, microwave, mobile phones, standards, brain tumors, children in the group of risk, electromagnetic chaos, voluntary risk

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For citation: Grigoriev YuG. From Electromagnetic Smog to Electromagnetic Chaos. To Evaluating the Hazards of Mobile Communication for Health of the Population. Medical Radiology and Radiation Safety. 2018;63(3):28-33. Russian. DOI: 10.12737/article_5b168a752d92b1.01176625

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

Medical Radiology and Radiation Safety. 2018. Vol. 63. No. 3. P. 34-43

DIAGNOSTIC RADIOLOGY

DOI: 10.12737/article_5b179763e503b3.98376905

LEVELS OF TRACE ELEMENTS IN THE AFFECTED AREA OF BONE IN THE DIAGNOSIS OF OSTEOMYELITIS AND OSTEOGENIC SARCOMA

V.Ye. Zaichick

A.F. Tsyb Medical Radiological Research Center, Obninsk, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

V.Ye. Zaichick – Leading Researcher, Prof., Dr. Sc. Biol., PhD Tech., Fellow of the Royal Society of Chemistry, Chartered Chemist

Abstract

Purpose: Childhood bone cancer is often difficult to detect in its early stages. One of the most important differential diagnostics is between osteomyelitis (OM) and osteosarcoma (OS). To clarify the possible role of trace elements (TE) as osteosarcoma markers, a nondestructive neutron activation analysis were performed.

Material and methods: The Ag, Co, Cr, Fe, Hg, Rb, Sb, Se, and Zn contents were measured in three groups of samples: normal bone samples from 27 persons with intact bone, and also in samples, obtained from open biopsies or after operation of 10 patients with OM and 27 patients with OS. The difference in the results between TE contents in the three groups was evaluated by the parametric Student’s t-test and non-parametric Wilcoxon–Mann–Whitney U-test.

Results: In the OS tissue the mean mass fractions of Co, Fe, Se, and Zn are significantly higher (2.6, 2.6, 6.2, and 1.6 times, respectively) and the mean mass fraction of Rb is more than 2 times lower than in the inflamed bone. Different combinations of these TE mass fractions were checked as tumor markers.

Conclusion: It was shown that the level of SeZn mass fraction multiplication is the best tumor marker and can be recommended as an additional high informative test for differential diagnosis between OS and a normal or inflamed bone.

Key words: trace elements, human bone tissue, osteomyelitis, osteosarcoma, differential diagnostics, neutron activation analysis

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For citation: Zaichick V. Levels of Trace Elements in the Affected Area of Bone in the Diagnosis of Osteomyelitis and Osteogenic Sarcoma. Medical Radiology and Radiation Safety. 2018;63(3):34-43. DOI: 10.12737/article_5b179763e503b3.98376905

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Medical Radiology and Radiation Safety. 2018. Vol. 63. No. 3. P. 19–27

RADIATION EPIDEMIOLOGY

DOI: 10.12737/article_5b168903913783.42898182

Problems of Identifying Dose – Effect Dependence for Radiation Carcinogenesis

V.F. Demin1, A.P. Biryukov2, M.V. Zabelin3, V.Yu. Soloviev2

1. National Research Center “Kurchatov Institute”, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia; 3. Federal Medical Biological Agency of Russia, Moscow, Russia

V.F. Demin– Leading Researcher, Dr. Sc. Tech., PhD Phys.-Math., Assoc. Prof.; A.P. Biryukov– Head of Dep., Dr. Sс. Med., Prof.; M.V. Zabelin – Dr. Sc. Med., Prof.; V.Yu. Soloviev – Senior Researcher, Head of Lab., Dr. Sc. Biol., PhD Tech.

Abstract

Purpose: Analysis of actual unresolved problems in the field of radiation epidemiology associated with establishing the dose–effect relationship (DER).

Material and methods: The problem of establishing DER for ionizing radiation (IR) for the prognostic risk assessment based on the results of the performed biological and epidemiological studies is considered. The main characteristics of the cohorts, on which the epidemiological study (ES) was conducted, were analyzed. An algorithm is proposed for analyzing the statistical power of a real cohort in the plane with parameters accumulated dose – cohort strength, adjusted for the average duration of the cohort monitoring.

Results: It is shown that among all the analyzed cohorts the following ones respond the criterion of lifetime detection of radiation solid cancers with the 95 % confidence: the victims of the atomic bombing of Japanese cities (LSS), personnel of the Mayak Plant, members of the Branch Medical Dosimetric Register (BMDR). Limitation of the observation period to 30 year dramatically reduces the statistical power of the ES observed effects.

Overcoming of existing problems and improvement of quantitative presentation of the DER for IR can be achieved by a joint analysis of the results of already performed ES and (or) possible future ES. In this regard, it is very promising to carry out ES on the cohort of the Mayak personnel or BMDR as a whole.

Conclusion: When planning new ESs and joint analyzes, the purpose of which is to improve our knowledge of DER in the required form and quality, one should proceed from the following provisions:

– it is necessary to set the task for ES and, accordingly, for the construction of the DER model as a function of an age of exposure and an age of the oncological disease for a single exposure, taking into account the strict mathematical relationship between such dependencies of DER for single and extended impacts;

– at the initial stage of the ES it is necessary, with the proposed algorithm, to verify the possibility of a statistical justification of the expected ES results.

Averaged DER over the age of exposure is little suitable for predictive and comparative risk assessment.

Key words: radiation epidemiology, dose, radiation risk, cohort, morbidity, mortality, solid cancer, leukemia, statistical power

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For citation: Demin VF, Biryukov AP, Zabelin MV, Soloviev VYu. Problems of Identifying Dose – Effect Dependence for Radiation Carcinogenesis. Medical Radiology and Radiation Safety. 2018;63(3):19-27. Russian. DOI: 10.12737/article_5b168903913783.42898182

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