Institute Of Radiology Research Articles

Overall survival of children with brain tumors after radiation therapy in Kazakhstan.

e22011 Background: Tumors of the central nervous system in children occupy the 2nd place in frequency in the structure of malignant neoplasms of childhood and the 1st place among solid tumors. They make up about 20% of all malignant neoplasms of childhood and are mainly represented by brain tumors. The purpose of the study was to analyze the survival rate depending on various factors during radiation therapy (RT) of brain tumors in children. Methods: Retrospective study included 277 patients who received RT from 2016 to 2020 at the Pediatric Oncology Center of the Kazakh Research Institute of Oncology and Radiology. The average follow-up time was 34.3 months. The median age was 9.5 years. RT was performed on a linear accelerator “TrueBeam”, in a single dose of 1.8 Gy, total 50.4-54.0 Gy, 5 fractions per week. Survival distributions was estimated by Kaplan and Meier curves and survival differences were evaluated using the log-rank test. IBM SPSS Statistics V23 was used for statistical analyses. Results: The overall survival (OS) rate of 277 patients was 70.8%, with an average life time of 55.6 months, 95% confidence interval (CI) (51.9 - 59.2). Children under 10 years of age showed a 12.5 % worse OS compare to children after 10 years of age. In patients with unconfirmed morphological verification, OS is 31.5% worse than in children with confirmed morphological verification. In children with grade I-II tumor differentiation, OS was 30.6% higher than in children with grade III-IV tumors. The method of RT (conformal RT, IMLT), gender of patients did not have a statistically significant effect on OS. Conclusions: Our study showed that OS rate depends on various factors, such as age, presence of morphology verification, and the degree of tumor differentiation. RT allows to achieve better survival in patients older than 10 years who received RT with a morphologically confirmed diagnosis of GI-II. RT is one of the main treatments for brain tumors in children.[Table: see text]

229P Efficiency of SARS-CoV-2 vaccines in breast cancer patients: Single institutional experience from Institute for Oncology and Radiology of Serbia (IORS)

Cancer patients are more sensitive to infection induced by SARS-CoV-2, especially ones with impaired immune response. Vaccines are approved as safe and effective, and they are recommended in oncology patients. The aim of our study was to see the percentage of reinfections after second dose of vaccines against SARS-CoV2.

Assessment of Diagnostic Accuracy of Real Time Shear Wave Elastography in Detecting Liver Cirrhosis Keeping Histopathology as Reference Standard

Objective: To determine the diagnostic accuracy of real-time Shear Wave Elastography (SWE) in detecting liver cirrhosis among patients suffering from diseases predisposing to it, keeping histopathology as the reference standard.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi, from Jan 2018 to Jul 2018.
 Methodology: A total of 114 patients were recruited, and relevant history taken from patientsreal-time shear wave elastography (SWE) of the liver was performed, followed by USG guided liver biopsy. Patients having clinically suspected diseases predisposing to hepatic fibrosis were sent to the Radiology department for ultrasound or ultrasound-guided liver biopsy. Elasticity values using sheer waves of 14.9 kPa (2.23m/s) or more was taken as suggestive of cirrhosis. Elastography findings were compared with histopathology findings.Results: Real-time SWE showed high diagnostic accuracy for detecting liver cirrhosis with sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 92.86%, 89.66%, 89.66%, 92.86% and 91.23%, respectively.
 Conclusion: This study concluded that the diagnostic accuracy of RTSW elastography in detecting liver cirrhosis is relatively high.

New Explainable Deep CNN Design for Classifying Breast Tumor Response Over Neoadjuvant Chemotherapy.

To reduce breast tumor size before surgery, Neoadjuvant Chemotherapy (NAC) is applied systematically to patients with local breast cancer. However, with the existing clinical protocols, it is not yet possible to have an early prediction of the effect of chemotherapy on a breast tumor. Predicting the response to chemotherapy could reduce toxicity and delay effective treatment. Computational analysis of Dynamic Contrast-Enhanced Magnetic Resonance Images (DCE-MRI) through Deep Convolution Neural Network (CNN) has proved a significant performance in classifying responders and no responder's patients. This study intends to present a new explainable Deep Learning (DL) model predicting the breast cancer response to chemotherapy based on multiple MRI inputs. In this study, a cohort of 42 breast cancer patients who underwent chemotherapy was used to train and validate the proposed DL model. This dataset was provided by the Jules Bordet institute of radiology in Brussels, Belgium. 14 external subjects were used to validate the DL model to classify responding or non-responding patients on temporal DCE-MRI volumes. The model performance was assessed by the Area Under the receiver operating characteristic Curve (AUC), accuracy, and features map visualization according to pathological complete response (Ground truth). The developed deep learning architecture was able to predict the responding breast tumors to chemotherapy treatment in the external validation dataset with an AUC of 0.93 using parallel learning MRI images acquired at different moments. The visual results showed that the most important extracted features from non-responding tumors are in the peripheral and external tumor regions. The model proposed in this study is more efficient compared to those proposed in the literature. Even with a limited training dataset size, the developed multi-input CNN model using DCE-MR images acquired before and following the first chemotherapy was able to predict responding and non-responding tumors with higher accuracy. Thanks to the visualization of the extracted characteristics by the DL model on the responding and non-responding tumors, the latter could be used henceforth in clinical analysis after its evaluation based on more extra data.

Fibroscan Compared to Aspartate Aminotransferase to Platelet Ratio Index (APRI) and Aspartate Aminotransferase to Alanine Aminotransferase Ratio (AST to ALT) in the Assessment of Liver Fibrosis in Patients with Non Alcoholic Fatty Liver Disease in a Terti

Objectives: To compare the extent of liver fibrosis using fibroscan and subsequently compare it with AST/ALT ratio and AST to platelet ratio index (APRI).
 Study Design: Comparative cross-sectional study.
 Place and Duration of Study: Chemical Pathology Department, Military Hospital Rawalpindi in collaboration with Armed forces institute of Radiology & Imaging and Gastroenterology Department, Military Hospital Rawalpindi from Jan to Apr 2021.
 Methodology: A total of 50 patients in group-1 and 24 healthy subject participants in group-2 as controls were studied. Serum AST, ALT, platelet count, APRI and AST to ALT ratio were assessed along with fibroscan results to determine stages of liver fibrosis and results were compared for the association.
 Results: There were 49 (66%) males and 25 (34%) females included in the study with the mean age of 49.77 ± 8.3 years. 11 (14.9%) patients had advanced fibrosis. There was a significant negative relationship (p-value <0.001 and r = -0.637) between platelet count and increasing fibroscan score (F1, F2) and a significant positive correlation between fibroscan score and AST (pvalue <0.001 and r=0.623), ALT (p-value <0.001 and r=0.596), fibroscan result and APRI (p-value < 0.001 and r=0.771) and fibroscan scores and AST/ALT ratio (p-value= 0.037 and r=0.243). One third of the study subjects had fibrosis in early and relatively advanced stages (F1, F2 respectively) correlating with serum and blood markers.
 Conclusion: Early fibro scan testing and serum markers can help in early diagnosis and timely initiation of treatment.

The Accuracy of Transabdominal Ultrasound (TAUS) in Detection of Choledocholithiasis Keeping Magnetic Resonance Cholangiopancreatography (MRCP) as Gold Standard

Objective: To assess the diagnostic accuracy of trans-abdominal ultrasound (TAUS) in detecting choledocholithiasis, keeping MRCP as the gold standard.
 Study Design: Cross-sectional study.
 Place and Duration of Study: Department of Magnetic Resonance Imaging, Armed Forces Institute of Radiology & Imaging, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun 2018 to May 2019.
 Methodology: 102 patients of either gender, age 20-85 years with the clinical suspicion of choledocholithiasis and obstructive jaundice were included. Trans-abdominal ultrasonography was performed for radiological detection of disease. All selected cases then underwent MRCP for confirmation of findings.
 Results: Mean age of the patients was 54.27 ± 15.14 years. 47 patients (46.1%) were males, and 55 (53.9%) were females. All patients were subjected to trans-abdominal ultrasound and MRCP. TAUS showed choledocholithiasis in 82 (80.3%) patients. MRCP confirmed choledocholithiasis in 81 (79.4%) cases, whereas 21 (20.5%) revealed no choledocholithiasis. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of TAUS were 96%, 80.9%, 95%, 85% & 87.86%, respectively.
 Conclusion: Diagnostic accuracy of trans-abdominal ultrasonography in detecting choledocholithiasis is significantly high enough to be used as a first-line imaging modality as MRCP is available only in specialised care centres.

Vittorio Maragliano (1878 -1944) in the history of European medicine: Grand master and pioneer of Italian radiology.

Vittorio Maragliano was born in Genoa in 1878. Fascinated since childhood by all things electric, he succeeded in installing the first radiological apparatus in 1896, only one year after the discovery of "Röntgen rays", and immediately began to make his first radioscopy observations. Having graduated from the University of Genoa in 1901 with a thesis on high-frequency currents, he continued assiduously to frequent the Department of Electrotherapy of the Medical Clinic, where he immediately became an assistant. A teacher of special medical pathology and physical therapy in 1910, Maragliano became tenured professor of electrotherapy and radiology in 1913, occupying one of the first three chairs in the history of Italian radiology, and later directed the Institute of Radiology of the Royal University of Genoa. In the same year, he co-founded, together with Aristide Busi, the Italian Society of Medical Radiology, one of Europe's first scientific societies of radiology.As a pioneer of radiology, Maragliano suffered serious injuries due to radiodermatitis from 1901 onwards, which required amputations and repeated skin transplants. His tireless scientific activity and his great success in the international scientific sphere, together with his copious publications, make Vittorio Maragliano one of the greatest pioneers of 19th-century radiology and a source of pride for the Genoese and Ligurian School of Medicine.

Positive predictive value of Birads IV Lesions on mammogram in detection of breast carcinoma.

To determine the positive predictive value of Breast Imaging Reporting and Data System category IV lesions, and to evaluate interobserver agreement among radiologists in interpreting the subcategories. The cross-sectional study was conducted at the Dow Institute of Radiology, Dow University of Health Sciences, Karachi, from September 2018 to February 2019, and comprised adult females aged 30-60 years diagnosed with Breast Imaging Reporting and Data System IV. Already diagnosed breast carcinoma patients were excluded. The positive predictive value of Breast Imaging Reporting and Data System category IV was calculated using histopathology findings as the gold standard. Data was analysed using SPSS 22. There were 191 patients with a mean age of 49.01±11.79 years. Positive family history of breast cancer was found in 33(17.3%) subjects. Category IV-A was noted in 53(28.0%) subjects, IV-B in 45(23.6%) and IV-C in 93(48.7%). The overall positive predictive value of category IV was 151(79.1%), IV-A 27(50.9%), IV-B 35(77.7%) and IV-C 89(95.6%). Malignant disease was significantly associated with architectural distortion and suspicious microcalcifications (p<0.001). A good agreement was observed in the categorisation of Breast Imaging Reporting and Data System category IV between observers 1 and 2 (kappa 0.85, 95% confidence interval: 0.70-0.99), between observers 1 and 3 (kappa 0.77, 95% confidence interval: 0.61-0.94), and between observers 2 and 3 (kappa 0.63, 95% confidence interval: 0.43-0.83). Breast Imaging Reporting and Data System BI-RADS IV was found to have a high positive predictive value in the diagnosis of breast cancer. Besides the interobserver agreement in terms of identifying BI-RADS IV subcategories was good.

In This Issue of the Journal

In This Issue of the Journal

PET/CT IN ASSESSING THE LYMPHOMA RESPONSE&#x0D; TO TREATMENT

Relevance: PET/CT has become an integral part of the diagnostic algorithm in lymphoma patients since lymphomas actively accumulate 18F-FDG. The high accuracy of PET/CT in patients with certain lymphoma types allows effective use of this method in clinical practice&#x0D; for diagnosis, staging, re-staging, evaluating the effectiveness of treatment, and determining further patient management tactics.&#x0D; The study aimed to evaluate the PET/CT capacity in assessing lymphoma treatment effectiveness.&#x0D; Methods: We conducted a retrospective analysis of PET/CT 18F-FDG results in 109 patients with a verified lymphoma diagnosis. The&#x0D; patients underwent PET/CT examinations at “Orhun Medical” PET/CT center based in the JSC “Kazakh Institute of Oncology and Radiology” (Almaty, Kazakhstan).&#x0D; Results: According to PET/CT results in assessing the lymphoma treatment effectiveness, the stabilization of the process was achieved&#x0D; in 38.5% of cases, progression – in 33.03%, a partial metabolic response – in 18.35%, and a complete response – in 10.09% of cases.&#x0D; Conclusion: PET/CT is the method of choice for evaluating the effectiveness of lymphoma treatment compared to other radiological&#x0D; techniques. PET/CT is based on determining metabolic treatment response, not only on size indicators. It plays an essential role in different&#x0D; stages of lymphoma treatment, providing new opportunities for personalized treatment

PET/CT IN ASSESSING THE LYMPHOMA RESPONSE TO TREATMENT

Relevance: PET/CT has become an integral part of the diagnostic algorithm in lymphoma patients since lymphomas actively accumulate 18F-FDG. The high accuracy of PET/CT in patients with certain lymphoma types allows effective use of this method in clinical practice&#x0D; for diagnosis, staging, re-staging, evaluating the effectiveness of treatment, and determining further patient management tactics.&#x0D; The study aimed to evaluate the PET/CT capacity in assessing lymphoma treatment effectiveness.&#x0D; Methods: We conducted a retrospective analysis of PET/CT 18F-FDG results in 109 patients with a verified lymphoma diagnosis. The&#x0D; patients underwent PET/CT examinations at “Orhun Medical” PET/CT center based in the JSC “Kazakh Institute of Oncology and Radiology” (Almaty, Kazakhstan).&#x0D; Results: According to PET/CT results in assessing the lymphoma treatment effectiveness, the stabilization of the process was achieved&#x0D; in 38.5% of cases, progression – in 33.03%, a partial metabolic response – in 18.35%, and a complete response – in 10.09% of cases.&#x0D; Conclusion: PET/CT is the method of choice for evaluating the effectiveness of lymphoma treatment compared to other radiological&#x0D; techniques. PET/CT is based on determining metabolic treatment response, not only on size indicators. It plays an essential role in different&#x0D; stages of lymphoma treatment, providing new opportunities for personalized treatment.

Spontaneous Pneumomediastinum in COVID-19 Pneumonia: A Rare Occurence.

Spontaneous pneumomediastinum with COVID pneumonia is a rare occurrence with or without accompanying subcutaneous emphysema or pneumothorax. The aim of this study was to establish relation of this complication to severity of lung disease and its clinical outcome. The study was conducted for a period of seven months from April to October 2020 in the CT Department of Armed Forces Institute of Radiology and Imaging (AFIRI), Rawalpindi, Pakistan. All COVID positive patients having spontaneous pneumomediastinum on high resolution CT (HRCT) chest were included (n=14). These patients were assessed for severity of lung disease as per CT severity score (CTSS), and were followed up for their clinical outcome. All patients with spontaneous pneumomediastinum had moderate to severe degree of COVID pneumonia; mortality in patients with pneumomediastinum was 50%; and was seen in those patients who had greater severity of lung disease as per the CTSS. Key Words: Spontaneous, Pneumomediastinum, COVID, Pneumothorax, Subcutaneous, Emphysema.

How Cancer Care Developed in India in 75 Years of Independence-Tamil Nadu Scenario.

Tamil Nadu has always been in the forefront in medical care. This is also true in the field of cancer care. The predecessor of present Bernard Institute of Radiology (BIR) the Government X-ray Institute Chennai, Premier Radiological Institute and Cancer Hospital, Chennai and CMC Vellore Radiation oncology unit were all started pre independence. In the first 25years after independence, other centres like Cancer Institute (WIA) Adyar, Chennai; Valavadi Narayanaswamy Cancer Centre Coimbatore and Government Erskines (Rajaji) Hospital, Madurai started functioning. BIR started the first diploma and degree course in radiotherapy. Asia's first cobalt therapy unit commenced function from the Cancer Institute in 1957. The country's first nuclear medicine department, medical physics department, paediatric oncology department and medical oncology department were all started in the Cancer Institute. Its founder Dr. Muthulakshmi Reddy was a great social reformer. She and her son Dr. Krishnamurthi were keen followers of Gandhiji. In the next 25years, two new state government centres came up. The first linear accelerator in the country started functioning in the Cancer Institute. MSc (Medical Physics), MCh surgical oncology and DM medical oncology courses were stated at the Institute. Presently, there are about 100 centres functioning in the state with more than 300 qualified surgical, medical and radiation oncologists. Apollo cancer hospitals have contributed for some facilities like PET scan and proton therapy units for the first time in the country. There are about 12 hospital-based cancer registries in the state. Tamil Nadu cancer registry covers the entire 77 million population of the state. Population census-based rural free cancer screening program is conducted in four districts by the Cancer Institute. Jeevodaya is the country's second hospice facility started functioning in the suburb of Chennai from 1990 onwards. At present, there are several centres spread across the state involved in palliative care.

Lead-rubber shielding effect on radiation dose to the gonads from a bilateral hand X-ray examination

IntroductionRecent guidance from the British Institute of Radiology (BIR) and the American Association of Physicists in Medicine (AAPM) focuses on cessation of patient Lead-rubber (Pb) shielding placed within the Field of View (FOV) that may influence image exposure or quality. Furthermore, the BIR assert shielding organs greater than 5 cm from the primary X-ray beam will have a negligible effect to the received radiation dose. Bilateral hand X-rays are frequently and repeatedly requested for the diagnosis and ongoing management of arthritic conditions. There is a lack of literature regarding the effect of Pb shielding during bilateral hand X-ray examinations. This research aimed to investigate the scattered secondary radiation dose to the gonads during a bilateral hand X-ray, with and without the use of Pb shielding outside the FOV at a greater distance than 5 cm from the primary beam. MethodsUsing an anthropomorphic phantom and constructed upper limbs, radiation was recorded to the male and female gonads. Thermoluminescent dosimeters (TLD's) (⅛" x ⅛" x 0.15″ TLD-100H) were placed in groups of three upon the testes and within the left and right ovary to record the ionising radiation dose. Three collimated exposures were completed using a standard clinical practice hand X-ray protocol of 60 kVp and 2.5 mAs with a source to image distance (SID) of 100 cm. The mean and standard deviation of the radiation dose was calculated for both with and without Pb shielding. A paired two-sample t-test was conducted to determine statistical significance (p ≤ 0.05). ResultsData analysis demonstrated dose measured to the testes of 5.3 μGy (SD 0.8) without Pb shielding and 2.3 μGy (SD 0.2) with Pb (reduction of 3 μGy; 56.6%). Left ovary doses measured 40.6 μGy (SD 1.2) without Pb shielding and 28.8 μGy (SD 1.7) with Pb (reduction of 11.9 μGy; 29.2%) and right ovary doses measured 39.5 μGy (SD 1.9) without Pb shielding and 26.6 μGy (SD 1.0) with Pb (reduction of 12.8 μGy; 32.4%). The paired two-sample t-test presented a statistically significant dose reduction (p = 0.0039). ConclusionThe study demonstrated dose limitation from scattered secondary radiation to the gonads when Pb shielding was used during a bilateral hand X-ray at distances greater than 5 cm from the primary X-ray beam on anatomy outside the FOV. Implications for practiceThe use of Pb shielding over the gonad area during a bilateral hand X-ray examination aligns to ALARP best practice and provides prospects for patient (male and female) dose reduction.

Current aspects of radiobiology in modern radiotherapy - our clinical experience

Personalized radiation treatment is an important goal in radiation oncology. As a result, one of the main challenges in radiobiology today is predicting a patient?s tissue radiosensitivity so that a personalized treatment can be tailored to that individual. For the first time since 2016, a group from the Institute of Oncology and Radiology of Serbia has begun performing translational research in the field of radiobiology. The aim of these studies is to identify molecular markers important for the prediction of radiosensitivity as well as the occurrence of toxic effects of radiotherapy. In the past five years, significant international cooperation has been established with the Radiogenomic Consortium, as well as leading European and world experts in this field. In addition, during this period, several significant and promising results in this field were published, and a Laboratory for Radiobiology was established at the Institute of Oncology and Radiology of Serbia.

CONTINUOUS INTRAVENOUS NIMODIPINE APPLICATION FOR PREVENTION OF VASOSPASM BEFORE ENDOVASCULAR TREATMENT OF RUPTURED CEREBRAL ANEURISMS

Early recognition of vasospasm (VS) in patients with aneurismal subarachnoid hemorrhage (aSAH) is an imperative for timely treatment and prevention of delayed cerebral ischemia (DCI). VS, the pathologic response of the vascular damage in aSAH, is the main risk factor for irreversible brain damage. The first step in successful solving of aneurismal bleeding is prevention and treatment of VS. The aim of this study is to determine whether medical treatment with continuous infusion of intravenous Calcium blocker Nimodipine, without radiology verified VS will impact the degree of arterial vasoconstriction during the endovascular aneurismal treatment (EVT). A total of 20 patients with aSAH, confirmed by CT-angiography and hospitalized in UC for Neurosurgery were included in the study. In 10 patients, a continuous iv Nimodipine infusion was initiated on admission, the other half remained on their own antihypertensive therapy. If signs of VS or neurologic deterioration had developed, iv vasodilator therapy would have been initiated. Control angiography and immediate EVT were performed on the 4th day of admission at Radiology Institute. Using angiography, the vascular diameter was measured and compared with the same vessel diameter on CTA, to determine whether iv Nimodipine is effective in the pretreatment period. In 8 of 10 treated patients with iv Nimodipine, VS resolved in preEVT period. Among the patients from the non-treated group, 1 had developed DCI, 1 had no VS, 6 had persistent and in 2 patients VS resolved spontaneously. The conclusion is that continuous iv Nimodipine in preEVT period has vasodilatory potency on the vascular pool. Key words: Aneurismal subarachnoid hemorrhage, vasospasm, intravenous Nimodipine, endovascular treatment

Morfometrijsko-anatomski parametri interkondilarne jame kolena kod odraslih osoba u Srbiji

Objective: The aim of this investigation was to examine normal intercondylar notch morphometry in Serbian population and to determine whether there are gender differences in anatomical parameters of the intercondylar notch among asymptomatic subjects without structural change. Method: The study included Mr images of 90 patients (45 men and 45 women) receiving a 1,5-T knee scan at our radiological institute after the approval from the Ethics committee, which were taken in the period from 2010 to 2017. The knee was placed in the neutral position, and Mr images were obtained using conventional spin echo techniques. The morphology of the intercondylar notch (Ushaped and A-shaped notch) was measured for each knee. Results: The measurements of parameters for intercondylar notch geometry were obtained by analyzing coronal Mr images. U-shaped intercondylar notch was found in 46 patients (51.2%) and A-shaped intercondylar notch in 44 (48.8%). There was no significant difference in the shape incidence in Serbian population (p&gt;0.05). According to the Notch width index (NWI) and the Notch shape index (NSI) criteria, we found U-shaped intercondylar notch with 24 men and 22 women and A-shaped intercondylar notch with 23 men and 21 women. There was no significant difference in incidence between the genders (p&gt;0.05). Conclusion: We concluded that for all examined anatomical parameters of the intercondylar notch there were no significant differences in Serbian population. According to our findings in this study, we concluded that there was no sexual dimorphism for anatomical parameters of intercondylar notch in Serbian population.

Značaj i primena dokumentacije "proces zdravstvene nege" u kabinetu za endoskopiju

Any systematic and high-quality work in any profession is based on well-designed documentation. In the nursing profession, mistakes and omissions are not allowed precisely because their work is focused on the care of persons who represent a particularly vulnerable category, namely users of health services. In order to implement nursing interventions as efficiently and comprehensively as possible, the implementation of the nursing process is important, which requires a well-organized system of documentation, which is available to all members of the nursing team. The nursing process documentation is a standardized documentation that has been developed, modified and improved since the 1950s. Over time, it has been adapted to meet the needs of different health institutions and health services. The documentation of the nursing process is most often applied in health institutions where secondary and tertiary health care is provided, as well as in work with students of academic institutions of the health profession. Documentation of the nursing process in the Republic of Serbia is rarely used in primary health care, and it is also not fully implemented in secondary and tertiary health care institutions. Practical experience confirms that it is most often implemented in departments of internal medicine, while it is rarely used in departments of surgery or radiology, and its implementation is completely omitted in day hospitals and cabinets that are integral parts of these institutions, or in dispensaries of primary health care institutions. Precisely for these reasons, the aim of this paper was to assess the importance and implementation of nursing process documentation in the Endoscopy Cabinet for patients of the Institute of Oncology and Radiology of Serbia.

Feature analysis of computed tomographic signs of hepatocellular carcinoma in multiphase studies

Hepatocellular carcinoma is one of the actual problems in the structure of oncological pathology in the world and in Kazakhstan. In the diagnosis of hepatocellular carcinoma, the use of multiphase computed tomography is generally accepted. The article describes the analysis of the results of multiphase computer tomography with the correlation of cytological and histological studies in the diagnosis of hepatocellular carcinoma. Present study aimed to conduct a retrospective analysis of the results of multiphase computer tomography in patients with hepatocellular carcinoma Analyzed the archival data of 50 patients with malignant liver tumors, who received specialized treatment at the A.N. Syzganov National scientific center of surgery and Kazakh Scientific Research Institute of Oncology and Radiology in the period 2014 - 2017. All patients underwent multiphase computed tomography. The examination was carried out in 4 phases: native, arterial, port-venous and delayed. The scan was performed on the 30th, 60th and 120 second (respectively) after the administration of contrast agent. The nodular form was detected in 76% of cases. If in 60% of cases the tumor was localized in the right lobe of the liver, and in 18% of cases - in the left, the lesion of both lobes was observed in 22% of cases. The sizes of the tumors were from 1 cm to 21.1 cm, and the average size of all nodes was 10.6 cm. The outlines of the tumors were uneven, but clearly defined in 92% of cases. In 94% of cases, the density of the formations was hypodense, the structure was heterogeneous with areas of increased and decreased density. The presence of central necrosis in the form of an “asterisk” was visualized in 8% of cases. The non-intensive inhomogeneous hyperenhancement in the arterial phase, with complete “washout” into the porto-venous phase, as well as in the porto-venous and delayed phases, was observed in 6% and 12% cases, respectively. In 80% of cases, hyperenhancement was observed in the arterial and venous phases. At the same time, complete erosion in the delayed phase was observed in 60% of cases, and incomplete leaching - 20%. In cytological studies, hepatocellular carcinoma was confirmed in 69.7% of cases. In 93.1% of cases, hepatocellular carcinoma was confirmed in histological studies. The nodes of hepatocellular carcinoma in most cases were characterized by clear, uneven contours, hypodense density, heterogeneous structure due to foci of necrosis and cystic component. When the tumor was bolus contrasted, hyperenhancement was in the arterial and port-venous phases, with “washout” in the delayed phase in most cases. According to the received data it can be said that multiphase computed tomography has high information value in the diagnosis of hepatocellular carcinoma.

Scientifi c Research of the SI “Institute of Nuclear Medicine and Diagnostic Radiology of the National Academy of Medical Sciences Of Ukraine” in 2021: Artifi cial intellect and postprocessing

Researchers of the Institute performed the applied scientific research "To develop technology for digital processing of radiological diagnostic images based on elements of artificial intelligence in diffuse liver pathology in patients of different ages" (funded from the budget of NAMS of Ukraine) in conjunction with SI "Academician O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the National Academy of Medical Sciences of Ukraine ” together with the National Technical University of Ukraine “Igor Sikorsky Kyiv Polytechnic Institute ». When performing research, the most important results are: investigations in patients with nonalcoholic fatty liver disease demonstrated that the modern algorithm of radiological examination allows to determine not only the features of the structural structure of the body in the age aspect, in particular to characterize the fat component and information on the acoustic stiffness of the parenchyma, but is an important prerequisite for further monitoring of the effectiveness of diffuse liver disease treatment; methods for rapid diagnosis of diffuse liver disease based on the artificial intelligence elements application have been developed and implemented into the examination algorithm, which improves the level and speed of liver disease diagnosis at the stages of primary examination by 30% and allows to develop a differentiated approach in the application of other (high-cost) methods of radiological diagnostics. Protocols for post-processing of pancreatic diseases were developed together with the SI " O.O. Shalimov National Institute of Surgery and Transplantology of the National Academy of Medical Sciences of Ukraine”. Scientists of the Institute together with the Ukrainian Military Medical Academy took part in the development of the complex of radiological methods for the diagnosis of thoracic gunshot wounds, visualization of wound canals in case of gunshot and mine-explosive injuries.