Objective: to determine the possibilities of contrast-enhanced ultrasound (CEUS) in identifying and evaluating the efficiency of chemotherapy in patients with colorectal liver metastases (CLM).

Material and methods. The investigation enrolled 28 patients with CLM. The patients were divided into two groups: Group 1 – 15 pretreatment patients; Group 2 – 13 posttreatment patients with process stabilization. All the patients underwent standard B-mode ultrasound of the liver and that using the contrast agent SonoVue ® (Bracco, Italy), by recording and estimating the parameters of the intensity-time curve (CIV). Liver CEUS assesses the nature of contrasting metastases in three phases (arterial, venous, and delay ones).

Results. The investigators identified three types of contrast agent accumulation in CLM in the arterial phase: along the periphery of the lesions (in 60% of the patients of Group 1, in 76.9% in Group 2), homogeneously over the entire volume (in 26.7% in Group 1 and in 0.08% in Group 2), in parallel with intact liver parenchyma (13.3% in Group 1 and 23.02% in Group 2). In the delay phase, more metastases were detected in 4 cases (14.3%). Estimation of CIV parameters showed a difference at the beginning of contrast enhancement stages between the patients in both groups. Group 1 exhibited the early contrasting of liver metastases (19.3 sec); Group 2 displayed the late washout of a contrast agent (65.9 sec).

Conclusion. CEUS versus B-mode ultrasound improves the imaging of liver metastases. The change in the vascular architectonics and hemodynamics in CLM after chemotherapy is reflected in the alteration of the rate of contrast accumulation and washout from the metastases, which allows CEUS to be used in the evaluation of the efficiency of this treatment.

Objective: to compare the data of computed tomography (CT) and diagnostic laparoscopy (DL) in the preoperative estimation of the extension of gastric cancer.

Material and methods. Data on 51 patients with a histologically confirmed diagnosis of gastric cancer were analyzed. CT and DL were performed in all the patients at an interval of 1–2 days during their preoperative examinations to determine the stage of a tumor process. Of the 51 patients, 34 (66.7%) were found to have no distant abdominal metastases and underwent radical surgery. CT and DL revealed distant abdominal organ metastases in 17 (33.3%) of the 51 patients. To evaluate the diagnostic efficiency of CT and DL, the investigators calculated the main characteristics (sensitivity, specificity) and auxiliary criteria (accuracy, positive (PPV) and negative (NPV) predictive values.

Results. The findings suggested that the diagnostic efficiency of CT in determining the T category was a sensitivity of 86% and a specificity of 92%; and that of DL was 83% and 87%, respectively. CT in diagnosing a regional lymph node metastasis had a higher sensitivity than DL (88% vs. 63%), but a lower specificity than DL (80% vs. 90%). CT diagnosis of peritoneal carcinomatosis exhibited a sensitivity of 46%, a specificity of 97.4%, an accuracy of 84.3%, PPV of 85.7%, and NPV of 84.1%. The symptoms of peritoneal carcinomatosis were ascites, soft tissue nodules along the peritoneum, diffuse induration and thickening of abdominal tissue planes, and increased mesenteric vascularity.

Conclusion. The combined use of CT and DL is a current algorithm for examining patients with gastric cancer. It makes it possible to obtain complete information about the extension of the process, to increase the accuracy of preoperative diagnosis and to form a group of patients to undergo radical surgery.

Objective. At the present stage of medicine development, the use of X-ray contrast agents tends to grow constantly and more than 60 million doses of radiopaque compounds (ROCs) are annually used.
The objective of the study was to investigate adverse reactions (ARs) arising from the use of ROCs in patients living in the Republic of Crimea.

Material and methods. The objects of the study performed were 69 notification cards on ARs to ROCs, which were registered in the regional database (registry) of spontaneous messages called ARCADe (Adverse Reactions in Crimea, Autonomic Database) in 2009–2018.

Results. A larger number of cases of ARs identified in the Republic of Crimea were due to the administration of water-soluble low-osmolar ROCs (iohexol, iopromide, iodixanol) to patients for kidney examination. The main clinical manifestations were immediate hypersensitivity reactions. The number of ARs posing a threat to a patient’s life exceeded 30% of all cases of ARs registered in the Republic of Crimea. Twelve patients (17.4%) required hospitalization or its prolongation to relieve an emerging AR; temporary disability due to ARs to ROCs were observed in 2 cases. The measures to reduce the severity of ARs included drug discontinuation and correction in 65 cases (94.2%). A drug suspected of causing ARs was not discontinued in 3 cases (4.3%); however, additional drugs were needed to correct the ARs.

Conclusion. Investigating the safety of ROCs on the basis of analyzing the notification cards on ARs registered in the Republic of Crimea in 2009–2018 could confirm the severity and seriousness of these reactions established by other researchers, which requires an individual approach to choosing a ROC, its dose, as well as monitoring of a patient’s health status both during the administration of agents and soon after the end of diagnostic procedures using ROCs.

Primary cardiac tumors occur quite rarely, while the symptoms in patients with this pathology are very nonspecific. The data of physical examination and the results of electrocardiography and radiography are often less informative. In this connection, modern high-tech medical imaging tools play a very important role in the identification and differential diagnosis of this category of space-occupying lesions. The paper describes a case of right ventricular hamartoma diagnosedd in an adult patient with the long-term asymptomatic course of the disease.

The paper describes a clinical case of hypersensitivity pneumonitis in a young patient during the COVID-19 pandemic when the patient having complaints of dyspnea and interstitial lung changes as ground glass opacity was initially unambiguously diagnosed with viral COVID-related bilateral pneumonia. The chief computed tomography manifestations in the lung were infiltrative inflammatory changes as numerous areas of predominantly interstitial infiltration by the type of ground glass, with consolidation areas and reticular changes, varying in extent, peripheral localization, mainly in the lower lobes and with the 25–50% involvement of the right and left lung parenchyma. The diagnosis of hypersensitivity pneumonitis was confirmed by cytological and histological examinations of the biopsy material obtained during bronchoscopy using a set of biopsies and endobronchial cryobiopsy.
This clinical case demonstrates that the chest computed tomography detection of pulmonary ground glasstype changes is a reason for further patient examinations and requires morphological verification of the diagnosis, since the cost of a diagnostic error is the life of a patient.

The first paper of a series of three publications briefly presents the characteristics a proton beam, as well as the information of companies producing noncommercial techniques for photon and proton therapies. The following second and third parts will briefly consider the clinical and economic efficiency of proton versus photon radiotherapy in the treatment of cancer patients and prospects for its development in oncological practice.

An increase in the level of prostate-specific antigen requires additional examination of the patient in order not to subject him to unnecessary treatment in case of clinically insignificant prostate cancer and, conversely, to carry out the necessary volume of measures in case of clinically significant prostate cancer. The paper presents the modern solutions for effective usage of diagnostic methods in visualization of clinically significant prostate cancer. To assess the advantages and disadvantages of various methods for diagnosing prostate cancer a search of publications for 2014–2020 period was conducted based on the Scopus, Web of Science, PubMed databases. The request included keywords: prostate cancer, multiparametric MRI, multiparametric ultrasound, PSMA PET/CT. We selected 27 articles. The review includes guidelines from the European Association of Urology, the American Urological Society, the American College of Radiology, and one practice recommendation.