Objective: to improve the efficiency of differential diagnosis of chronic pulmonary aspergillosis (СPA) based on the assessment of its probability using a discriminant mathematical model. Material and methods. The prospective study included 74 patients with CPA (57% women, median age 53 years) meeting the ERS/ESCMID criteria (2016). The control group consisted of 35 patients with lung diseases without CPA. Clinical and anamnestic data, the results of computed tomography (CT), laboratory and instrumental methods of research were analysed. By means of stepwise discriminant analysis, the model was created in order to differentiate compared groups. Results. The main forms of CPA were simple solitary aspergilloma (n = 30, 40%) and cavitary CPA (n = 21, 28%). On CT scans, in patients with CPA pulmonary emphysema (n = 50, 74%; 95% CI 63–83), bronchiectasis (n = 42, 56%; 95% CI 44–67), pleura thickening (n = 40, 56%; 95% CI 42–65) were detected with a high frequency. The sensitivity and specificity of typical for CPA air sickle symptom were 66.2% and 74.29%, respectively. The diagnostic informativeness of laboratory methods was characterized by high specificity (85–100%), however, it had sensitivity 40–60%. A discriminant model was worked up. It included five variables: mycological confirmation of the diagnosis (р < 0.001), air sickle symptom on CT (p = 0.03), ground glass opacity sympton on CT (p = 0.017), accompanying rheumatological diseases (p = 0,031), positive Aspergillus antigen in bronchoalveolar lavage (p = 0.036). The resulting model of differential diagnosis is statistically significant (F = (5.102) = 27.291; p < 0.001). Conclusion. CT-patterns of CPA include typical (air sickle symptom) and nonspecific (pleura thickening, emphysema, bronchiectasis) changes. Separately taken laboratory indicators and CT-symptoms are not always the determining criteria for diagnosis; an integrated approach is required to make a diagnosis. The proposed model improves the accuracy of differential diagnosis between CPA and nonmycotic lung diseases: increases sensitivity to 82.43%, specificity to 94.28% in comparison with separately analyzed laboratory data and typical CT-pattern of air sickle symptom. As a whole this model allows to classify the CPA and nonmycotic lung disease in 86,23% of cases.

Objective: to conduct the study of age distribution of bone mineral density (BMD) by the database of dualenergy X-ray absorptiometry (DXA) and to compare it with datа of population NHANES study.
Material and methods. We used data from the densitometry of three-zone (total hip (TH), femoral neck (FN), and lumbar spine) measured by DXA from two outpatient clinics. The obtained data were compared with NHANES III for TH and FN and with NHANES 2005-08 for lumbar spine. The BMD value was corrected with the calibration coefficient for each DXA scanner. Adjustments were also made for the population distribution by sex and age.
Results. Compared with NHANES for FN and TH, the obtained BMD values were significantly decreased for patients aged less than 50 years (men and women). The BMD values for FN and TH were unsignificantly decreased in men older 50 years. In women older 50 years unsignificantly decreased BMD values for FN and a significantly increased BMD values for TH were observed. The BMD values were decreased for lumbar spine in men and women throughout this age interval (more than 50 years old).
Conclusion. The population BMD distribution in men and women was assessed by DXA method. The obtained dependence of the BMD for FN in women older 50 years was in good agreement with the results given by Russian and foreign authors.

Objective: to evaluate the potentials of contrast-free renal arterial spin labeling (ASL) perfusion during magnetic resonance imaging (MRI) for the diagnosis and dynamic follow-up of renal lesions in patients with diffuse liver diseases (DLD).
Material and methods. The prospective study enrolled 82 patients with various DLD: alcoholic, viral, druginduced, autoimmune and mixed etiology. Ultrasound examination with Doppler abdominal and renal ultrasonography was conducted using Apogee 5300 (SIUI, China); abdominal MRI with contrast-free renal ASL-perfusion was performed using Vantage Titan 1.5 T (Toshiba, Japan). The parameters of renal perfusion (renal blood flow, RBF) were measured when the patients were admitted to the hospital, then during dynamic follow-up for 18 months.
Results. Mathematical processing of results revealed normal RBF values (≥ 450 ml/100 g/min) and values associated with hepatorenal syndrome (HRS) (≤ 449 ml/100 g/min). High correlation between renal ASL-perfusion indicators and results of Doppler renal vessels ultrasonography was detected (r = 0,856). The diagnostic effectiveness parameters of contrast-free renal ASL-perfusion were: sensitivity 0.83, specificity 0.92, diagnostic accuracy 0.87. We created the algorithm of DLD patients examination for early HRS diagnosis and follow-up.
Conclusion. Contrast-free renal ASL-perfusion is an informative method for predicting, diagnosis and dynamic follow-up of renal lesions in patients with various DLD.

Background. Chest low-dose computed tomography (LDCT) is used in lung cancer screening, but the study data can also be used to assess the liver condition, including the hepatic steatosis (HS) detection. However, radiologists often do not pay attention to liver changes due to the focus on the chest.
Objective: to determine the prevalence of HS during chest LDST among lung cancer screening patients using a computer vision (CV) system.
Material and methods. For a retrospective study, 300 chest LDCT were taken from Moscow lung cancer screening in 2018–2020. Hepatic attenuation analysis was performed by CV, the values < 40 HU were considered as HS. The text protocols of CT scans were analysed and compared with decreased hepatic attenuation revealed by CV system.
Results. 291 patients were analysed, the median age for the sample was 65 [61; 70] years. The mean hepatic attenuation was 55.6 ± 14.8 HU. Hepatic attenuation < 40 HU was found in 13% patients (23 (16.1%) males and 14 (9.5%) females), a statistically significant difference was revealed among these patients (p = 0.04). Six (4.2%) males and 4 (2.7%) females were at risk for HS (40–45 HU). The examination of text protocols showed no pathology discovered in all cases.
Conclusion. The prevalence of CT signs for HS among the lung cancer screening group in Moscow was 13%. The absence of HS in text protocols highlights the importance of using CV systems in the routine practice.

Background. Self-expandable metal stents (SEMS) are widely used in gastrointestinal (GI) tract obstructive lesions. Planning and stent placement control can be performed with using roentgenological, endoscopic or combined method. The choice of the method depends on doctor’s preferences and clinic’s traditions, but endoscopic one is used more often. Comparison of the above methods efficacy in a single-institution material was not found in the literature.
Objective: to compare clinical and roentgenological results of GI stenting depending on the method used.
Material and methods. In 2016–2021, 267 cases of GI stenting were performed in Botkin Municipal Clinical Hospital. In 70 (26%) of them an endoscopic method was used, in 97 (36%) – a roentgenological one, and in 100 (37%) – a combined one. All patients underwent X-ray control postop. Results were analyzed statistically.
Results. The implementation of X-ray diagnostics solo or in combination with endoscopy in GI SEMS planning and placement provided better results in comparison with endoscopic method only. Total SEMS expansion was achieved in 99% of cases versus 79% after only endoscopic procedures, correct stent placement – in 98% and 75%, respectively, evacuation was restored in 98% and 70%, respectively. All differences were statistically significant (p < 0.001). It is evident that X-ray methods are not useful for preliminary marking in decompensated patients with GI stenosis. But after elimination of such cases from analysis, the difference between the groups remained statistically significant (p < 0.05).
Conclusion. The data obtained substitute expediency of X-ray method solo or with endoscopic one. Significant improvement of the results can be referred to more exact preoperative selection of SEMS type and size with X-ray method.

Multiple myeloma (MM) is a malignant immunoproliferative disease involving plasma cells, leading to their malignant proliferation and the production of monoclonal paraproteins. Intracranial tumor spread in MM is very rare. This is a unique and infrequent localization, which makes it difficult to diagnose the disease. We report a rare case of treatment of a patient with MM intracranial spread, whose disease was presumably in remission and recurred as an intracranial plasmacytoma with a clinical picture of acute cerebrovascular accident. Surgical intervention was performed to remove the tumor, a histopathological analysis of the removed tissue was carried out. Even with early diagnosis, the prognosis remains bleak, with median survival rates of 3 to 6 months. However, aggressive multimodal treatment can prolong life by months.

A rare scintigraphic phenomenon of “superscan” is considered – an abnormally high diffuse accumulation of osteotropic radiopharmaceutical by all skeletal parts in combination with the absence of kidney and tissue background imaging. This feature reflects a generalized bone system lesion of metastatic, metabolic or hematological nature. We present a clinical observation and retrospective assessment of scintigraphic data obtained during controlling androgen deprivation therapy in a patient with prostate cancer. Based on the analysis of “superscan” signs, including ^99mТс-pyrophosphate hyperfixation by skull bones, as well as concomitant levels of prostatic specific antigen and parathyroid hormone (PTH), it was suggested that the identified scintigraphic phenomenon had metabolic nature, and its occurrence was possibly due to ectopic production of both PTH and parathyroid hormone-related protein, playing a well-known role in prostate cancer genesis.

Background. Due to intensive blood supply to the red bone marrow, as well as high adhesive abilities of tumor cells, bone tissue is a perfect structure for the metastatic process. Timely identification of the pathological process is highly relevant, since data from numerous sources on the use of radiation methods at later stages indicate the development of severe pathological conditions leading to neurological deficiency and significant decrease in a patient’s quality of life.
Objective: to summarize data on the diagnostic effectiveness of osteoscintigraphy (OSG), as well as to conduct a comparative analysis of various diagnostic methods in bone metastases detection.
Material and methods. The review was performed according to PRISMA standard (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). It included only full-text articles published in the period from 2015 to 2022, as well as particularly important publications from 2005 to 2014. The search for articles was carried out independently using CyberLeninka, eLibrary, Google Scholar, PubMed/MEDLINE databases, by key terms without the use of language restrictions: “osteoscintigraphy”, “radiology’, “tumors”, “bones”, “diagnosis”.
Results. The final analysis included 56 scientific articles by a qualitative indicator. The advantages and disadvantages of the methods, as well as indications for the use of various diagnostic techniques in bone metastatic lesions detection were presented. It was shown that OSG will cost 6 times cheaper than positron emission tomography (PET), and 3 times cheaper than magnetic resonance imaging (MRI). The analysis of using radiation methods demonstrated that the specificity of computed tomography and radiography was at a high level, but this techniques had less pronounced sensitivity, and MRI, OSG and PET had greater sensitivity, but insufficient specificity. In the initial stage of the disease, OSG is one of the main methods of metastatic lesions visualization, but not the only way of diagnosis in diversification strategy aspect.
Conclusion. OSG is an effective and informative technique for early detection of bone metastases, allowing to assess the functional state of the tumor and its surrounding tissues, even before the appearance of structural disorders visible by other diagnostic methods. To improve the accuracy of the study, it is advisable to use a set of radiation diagnostic techniques. The choice of a particular method is determined by its technical capability and financial availability. 

A review of current foreign and Russian literature on automated breast ultrasound (ABUS) is presented. The publications were searched in PubMed/MEDLINE and eLibrary databases. Hand-held breast ultrasound and ABUS are discussed, the ABUS technique is described. Addition of ABUS to screening mammography demonstrates increase in detection of early invasive node-negative forms of breast cancer (pT1_a-bN0M0). The possible place of ABUS in the screening setting supplemental to mammography in women with dense breasts is considered. 

Prostate cancer (PСa) is one of the leading causes of cancer morbidity in men. The incidence of localized PCa is higher in high-income countries. There are different types of treatment for localized PCa: from active surveillance to focal therapy or radical treatment. Both patients and urologists are interested in minimizing side effects of treatment, so focal therapy is an alternative option. Magnetic resonance imaging is one of the leading tools either for primary diagnosis or for following evaluation of treatment efficacy, including focal therapy. Therefore, we summarized literature data published on this topic.