SCIENTIFIC AND INFORMATION-ANALYTICAL MAGAZINE

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. 2017. Vol. 62. No. 2. P. 79-82

DOI: 10.12737/article_58f0b95756aed8.04575649

Case of Inflammatory Myofibroblastic Tumor of Mesentery with Significant Fatty Component

A.N. Bashkov1, Z.V. Sheykh2, S.V. Cholakyan1, E.A. Ionova1, V.I. Doga1, М.А. Shabalin1, O.O. Grigor’eva1

1. A.I. Burnasyan Federal Medical Biophysical Center of FMBA, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. S.P. Botkin City clinical hospital Moscow, Russia

Bаshkov A.N. - Head of Radiology Department; Sheykh Z.V. - Dr. Sci. Med., Professor, Head of Radiology Department; Cholakyan S.V. - Surgeon; Ionova E.A. - Dr. Sci. Med.; Doga V.I. - Head of Rentgenology Department; Shabalin M.A. - Surgeon; Grigor’eva O.O. - Radiologist

Abstract

Purpose: To describe own observation of inflammatory myofibroblastic tumor (IMT) of mesentery with a significant fatty component, retrospectively evaluate the diagnostic capabilities of computed tomography (CT).

Material and methods: CT with bolus intravenous administration of 100 ml of contrast agent Ultravist-370 was performed by multislice computed tomograph Aquilion 64 Toshiba.

Results: Patient M., 55 years old, was admitted to the clinic in July 2016 for surgical treatment due to the tumor in the abdominal cavity, which was detected by CT in May 2016. From the history it is known that since January 2016 the patient began to complain of weakness and weight loss. There were no abnormalities during physical examination and in the laboratory data. For staging pathological process control CT of the abdominal cavity with intravenous contrast was performed and then compared with previous СT scan. On the images of CT examination in the May 2016 in the mesogaster to the right of the median line oval shaped mass was defined, its seizes were 51x55x58 mm. On the present images seizes have reduced by about 10mm, more significantly decreased the volume of the mass - from 87 ml to 54 ml. The tumor is located directly under the anterior abdominal wall, surrounded by a loop of the small intestine. The outlines of mass were clear and smooth. The structure was not uniform due to inclusions of areas of fat (-75 HU) ranging in size from 4 mm to 29?16 mm, soft tissue component demonstrated the accumulation of contrast agent from 35 HU in the native phase to a maximum of 74 HU in delayed phase. There were not any other changes in the abdomen.

So after 2 months at the control CT scan before the planned surgery we observed positive changes in the form of reducing the size and more significantly volume of the lesion. In the differential range we considered fat-containing tumors - teratoma and liposarcoma. We did not think about inflammatory myofibroblastic tumor (IMT) as well as gastrointestinal stromal tumor, since the guidelines for X-ray diagnostics and different overviews of these tumors does not mention the possibility of the presence of fat in their structure. However, there were not any pathognomonic features of teratoma like calcification, cystic component, levels of fat / liquid. The outline of the mass was smooth and clear, so we could suggest an expansive rather than infiltrative growth, which has also made the conclusion about liposarcoma unlikely.

After preoperative preparation surgery was performed in the amount of resection of the small intestine segment with tumor and making enteroenteroanastomosis «end to end». After the morphological and immunohistochemistry analysis IMT of mesentery of small intestine was diagnosed.

Conclusion: 1. Fatty component in the structure of lesion of the mesentery of the small intestine does not rule out IMT. 2. Theoretically we can assume the possible presence of fat in the structure of the IMT any location. 3. Consideration should be given by IMT in the case of spontaneous reduction of the size of the observed tumor.

Key words: inflammatory myofibroblastic tumor, mesentery, fatty component, computed tomography

REFERENCES

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For citation: Bashkov AN, Sheykh ZV, Cholakyan SV, Ionova EA, Doga VI, Shabalin МА, Grigoreva OO. Case of Inflammatory Myofibroblastic Tumor of Mesentery with Significant Fatty Component. Medical Radiology and Radiation Safety. 2017;62(2):79-82. Russian. DOI: 10.12737/article_58f0b9572d7131.31568909

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

Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 2. P. 13-27

DOI: 10.12737/article_58f0b957316ef3.36328519

Abel Julio González

THE DOSE AND DOSE-RATE EFFICIENCY FACTOR (DDREF): UNNEEDED, CONTROVERSIAL AND EPISTEMOLOGICALLY QUESTIONABLE

E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. , This email address is being protected from spambots. You need JavaScript enabled to view it.

Academician Abel Julio González is representative at UNSCEAR, member of the IAEA’ CSS and ex-Vice-Chairman of ICRP and IRPA. Autoridad Regulatoria Nuclear de Argentina (ARN) [Argentine Nuclear Regulatory Authority], Ciudad de Buenos Aires, Argentina

Abstract

Purpose: The aim of the paper is to review the genesis and evolution of the concept termed dose and dose rate effectiveness factor or DDREF, to expose critiques on the concept and to suggest some curse of action on its use.

Material and methods: Mainly using the UNSCEAR reporting and ICRP recommendations as the main reference material, the paper describes the evolution (since the 70’s) of the conundrum of inferring radiation risk at low dose and dose-rate. People are usually exposed to radiation at much lower doses and dose rates than those for which quantitative evaluations of incidence of radiation effects are available – a situation that tempted experts to search for a factor relating the epidemiological attribution of effects at high doses and dose-rates with the subjective inference of risk at low doses and dose-rates. The formal introduction and mathematical formulation of the concept by UNSCEAR and ICRP (in the 90’s), is recalled. It is then underlined that the latest UNSCEAR radiation risk estimates did not use a DDREF concept, making it de facto unneeded for purposes of radiation risk attribution. The paper also summarizes the continuous use of the concept for radiation protection purposes and related concerns as well as some current public misunderstandings and apprehension on the DDREF (particularly the aftermath of the Fukushima Dai’ichi NPP accident). It finally discusses epistemological weaknesses of the concept itself.

Results: It seems that the DDREF has become superseded by scientific developments and its use has turned out to be unneeded for the purposes of radiation risk estimates. The concept also appears to be arguable for radiation protection purposes, visibly controversial and epistemologically questionable

Conclusions: It is suggested that: (i) the use of the DDREF can be definitely abandoned for radiation risk estimates; (ii) while recognizing that radiation protection has different purposes than radiation risk estimation, the discontinuation of using a DDREF for radiation protection might also be considered; (iii) for radiation exposure situations for which there are available epidemiological information that can be scientifically tested (namely which is confirmable and verifiable and therefore falsifiable), radiation risks should continue to be attributed in terms of frequentistic probabilities; and, (iv) for radiation exposure situations for which direct scientific evidence of effects is unavailable or unfeasible to obtain, radiation risks may need to be inferred on the basis of indirect evidence, scientific reasoning and professional judgment aimed at estimating their plausibility in terms of subjective probabilities.

Key words: DDREF, low-dose, low-dose-rate, radiation-risk, linear-relationship, threshold-dose

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Для цитирования: Gonzalez AJ. The Dose and Dose-Rate Efficiency Factor (DDREF): Unneeded, Controversial and Epistemologically Questionable. Medical Radiology and Radiation Safety. 2017;62(2):13-27. DOI: 10.12737/article_58f0b957316ef3.36328519

PDF (ENG) Full-text article

Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 6. P. 51-57

NUCLEAR MEDICINE

DOI: 10.12737/article_5a2541849d5335.59531206

Effect of Correction of Gamma-Radiation Absorption in the Study of Myocardial Perfusion by SPECT/CT

E.A. Khachirova1, L.E. Samoylenko2, O.P. Shevchenko1

1. N.I. Pirogov Russian National Research Medical University, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. Russian Medical Academy of Postgraduate Education, Moscow, Russia

E.A. Khachirova – assistant; L.E. Samoylenko – Dr. Sc. Med., Prof.; O.P. Shevchenko – Dr. Sc. Med., Prof., Head the Department, Member of the European Society of Cardiology

Abstract

Purpose: Assessment of the impact of absorption correction (AC) on quantitative parameters of myocardial perfusion and determination of the extent of stress-induced myocardial microcirculation disorders on SPECT/CT in patients with chest pain and unchanged coronary arteries.

Material and methods: the study included 35 patients, each of whom was carried a selective coronary angiography and rest/stress SPECT/CT of the myocardium with 99mTc -MIBI with- and without AC.

Results: In all patients with stress-induced myocardial ischemia was detected both without and with AC images. However, quantitative parameters of myocardial perfusion were lower after the AC: SSS 6.9 ± 1.2 vs. 7.7 ± 1.1; SDS 4.0 ± 0.8 vs. 4.9 ± 0.6; Stress ext. Total 11.2 ± 1.8 vs. 13.0 ± 1.9; Stress TPD total 9.3 ± 1.2 vs.10.9 ± 1.2; TPDi 4.1 ± 1.0 vs.5.9 ± 0.9 (for all p < 0.05). For SRS, Rest ext. Total, and Rest TPD total difference was not significant. The number of hypoperfused segments, according to the segmental analysis, was less after AC and was 126 vs. 153 at rest, 242 vs. 177 under stress. In women, significant difference was obtained for all parameters, for men – only for the SSS, SDS, Stress ext. Total, Stress TPD total. In patients with BMI ≥25 significant difference for all parameters was obtained. However, patients with the normal BMI (18,5–24,9; WHO, 2004) significant difference was obtained only for Stress ext. Total, Stress TPD total.

Conclusion: The use of SPECT/CT with AC allow to detect microcirculatory violations of perfusion and myocardial reserve perfusion in patients with pain in the chest with the unchanged AC, as evidenced by indicators of the average values of quantitative parameters of perfusion scintigram. The most significant impact on the quantitative perfusion parameters was observed in women with well-developed breasts and obese patients. The findings give reason to assume the use of AC to avoid revaluation incidence and severity of stress-induced myocardial perfusion disturbances.

Key words: SPECT/CT, gamma-ray emission, absorption correction, microvascular angina, myocardial perfusion

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For citation: Khachirova EA, Samoylenko LE, Shevchenko OP. Effect of Correction of Gamma-Radiation Absorption in the Study of Myocardial Perfusion by SPECT/CT. Medical Radiology and Radiation Safety. 2017;62(6):51–7. Russifn. DOI: 10.12737/article_5a2541849d5335.59531206

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

Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 6. P. 58-74

REVIEW

DOI: 10.12737/article_5a2542f7216cb3.01677610

Radionuclide Diagnosis of Prostate Cancer: Positron Emission Tomography with 68Ga-PSMA Inhibitors and Their Pharmaceutical Development

A.A. Larenkov1,2, G.E. Kodina1

1. A.I. Burnasyan Federal Medical Biophysical Center of FMBA, Moscow, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; 2. M.V. Lomonosov Moscow State University, Moscow, Russia

A.A. Larenkov – PhD in Chem., Head of the Laboratory for Technology and Methods Of Monitoring Radiopharmaceuticals; G.E. Kodina – PhD in Chem., Head of the Department of Radiation Technologies for Medical Purposes

Abstract

This review is devoted to the synthesis of the main and most relevant data on the development and clinical use of radiopharmaceuticals (RPs) based on PSMA-inhibitors labeled with 68Ga for the diagnosis of prostate cancer (PC).

The generator method of 68Ga production, which ensures the wide availability of this radionuclide for medical organizations, is the reason for the permanent interest to the RPs based on 68Ga. The development of RPs based on inhibitors of the prostate-specific membrane antigen became the second wave of global excitement about 68Ga-RPs, after labeled derivates of the ocreotide for the diagnosis of neuroendocrine tumors.

PC is one of the most urgent problems of modern oncology. The place of prostate cancer in the structure of the oncological morbidity of the male population, as well as the significance of radionuclide diagnostics in the clinical staging of the disease and the strategy of therapy are considered.

Data on the structure and properties of the prostate-specific membrane antigen (PSMA), its role in the body and expression in the foci of pathological processes are presented. Known PSMA inhibitors and the dependence of their properties on structure are considered.

The main part of the review is devoted to the key results of the pharmaceutical development of RPs based on PSMA-inhibitors labeled with 68Ga. The effect of the fragments (ligand, linker and chelator) on the final radiopharmaceutical molecule on the pharmacokinetics is considered. The review also includes data on the clinical efficacy of PET with 68Ga-PSMA in the diagnosis of PC. Data on the availability of 68Ga-RPs in Russia today, as well as references to regulatory documents that allow the use of such RPs, are presented.

In conclusion, a brief summary of the literature data and conclusions on the most promising radiopharmaceuticals for the diagnosis and therapy of prostate cancer and further perspectives are presented.

Key words: PET, 68Ga, radiopharmaceuticals, PSMA, prostate cancer

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For citation: Larenkov AA, Kodina GE. Radionuclide Diagnosis of Prostate Cancer: Positron Emission Tomography with 68Ga-PSMA Inhibitors and Their Pharmaceutical Development. Medical Radiology and Radiation Safety. 2017;62(6):58-74. Russian. DOI: 10.12737/article_5a2542f7216cb3.01677610

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Medical Radiology and Radiation Safety. 2017. Vol. 62. No. 6. P. 46-50

NUCLEAR MEDICINE

DOI: 10.12737/article_5a264b638cb505.41456357

Possibilities of Using “Sodium Fluoride, 18F” for Diagnostics of Bone Tumors by Positron Emission Tomography (Experimental Study)

A.A. Stanzhevsky1, N.A. Kostenikov1, O.E. Klementyeva2, O.Yu. Mirolyubova1, E.G. Kovan’ko1, V.F. Dubrovskaya1, Yu.R. Iliushchenko1, O.V. Klestova1

1. Russian Research Center for Radiology and Surgical Technologies, Saint Petersburg, 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.

A.A. Stanzhevsky – Dr. Sc. Med., Director Deputy in Sci.; N.A. Kostenikov – Dr. Sc. Med., Шief of the Lab.; O.E. Klementeva – PhD Biol., Head of the Group; O.Y. Mirolyubova – PhD Med., Senior Researcher; E.G. Kovan’ko – PhD Med., Senior Researcher; V.F. Dubrovskaya – Dr. Sc. Med., Leading Researcher; Y.R. Iliushchenko – Research Worker; O.V. Klestova – PhD Med., Senior Researcher

Abstract

Purpose: To study the potential of using radiopharmaceutical Sodium Fluoride 18F in order to reveal foci of malignant tumors in animals’ bones by positron emission tomography (PET).

Material and methods: Two experimental models (human prostate adenocarcinoma PC 3 and Pliss lymphosarcoma) were used. Tumor cell PC 3 suspensions were injected under a hip periosteum of the BALB/c nude line mice or outbred rats (Pliss lymphosarcoma). Radiopharmaceutical was injected into a tail vein of animals with developed tumors. Then PET scanning was performed for these animals.

Results: Effective half-life of radiopharmaceutical from blood was 9.45 min, from skeleton bones - 77.5 min and tumors – 99 min. The hyperfixation level of radiopharmaceutical in the tumor was sufficient to image tumors by PET. In areas of the tumor from cells of prostate adenocarcinoma PC 3 and Pliss lymphosarcoma the uptake rate of radiopharmaceutical was quite high during an hour that resulted in a high contrast image of tumors in animals’ bones. T/NT ratio tumor/bone in rats with Pliss lymphosarcoma was increased in the first 20 min after administration of the radiopharmaceutical, and then slowly decreased. Nevertheless, in 40 minutes after injection of the radiopharmaceutical T/NT ratio tumor/bone remained quite high – more then 1.7, and T/NT ratio tumor/muscle exceeded to 9.0.

Conclusion: The uptake level and fixation time of the radiopharmaceutical in tumor foci, as well as low activity value and its rapid excretion from intact tissues show the expediency of the use of Sodium Fluoride 18F to diagnose intraosseous foci of malignant diseases.

Key words: Radiopharmaceutical, positron emission tomography, 18F-fluoride, tumors, bones, animals

REFERENCES

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For citation: Stanzhevsky AA, Kostenikov NA, Klementyeva OE, Mirolyubova OYu, Kovan’ko EG, Dubrovskaya VF, Iliushchenko YuR, Klestova O.V. Possibilities of Using “Sodium Fluoride, 18F” for Diagnostics of Bone Tumors by Positron Emission Tomography (Experimental Study). Medical Radiology and Radiation Safety. 2017;62(6):46-50. Russian. DOI: 10.12737/article_5a264b638cb505.41456357

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  1. 2017-6-Zaichik-eng
  2. 2017-6-Kochetkov-eng
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  4. 2017-6-Pronkevich-eng

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