Оn March 27, 2023, а multidisciplinary Advisory Board meeting was held in Moscow with the participation of Е.V. Artamonova, Е.А. Busko, V.V. Didenko, А.D. Zikiryakhodzhaev, М.S. Karpova, G.Е. Kvetenadze, P.V. Krivorot’ko, М.L. Mazo, А.V. Petrovsky, О.S. Puchkova, S.V. Serebryakova under the chairmanship of I.Е. Tyurin and N.I. Rozhkova. The participants discussed different issues of early diagnostics and treatment planning of breast cancer. We present the conclusion made by the Advisory Board.

Background. Cardiovascular diseases remain a pressing issue associated with great economic burden and loss of earning capacity. Among them, thoracic aortic aneurysms pose a serious threat as they commonly develop asymptomatically. Patients with aneurysms are often diagnosed late, which contributes to higher mortality rates due to complications. For this reason, conducting new epidemiological studies on this problem in our country is relevant.

Objective: to study the prevalence of pathological dilatation of the thoracic aorta in Moscow by means of artificial intelligence technologies (AITs) using chest computed tomography (CT) data.

Material and methods. A retrospective analysis of chest CT data from 227,149 patients obtained in the period from October 2022 to October 2023 was performed using AITs.

Results. The analysis revealed that 13.3% of patients exhibited signs of thoracic aortic dilatation, while 0.8% had aneurysm signs. The prevalence of thoracic aortic aneurysms in Moscow was 12.4 cases per 100,000 individuals. Males were more susceptible than females; aneurysms of the descending aorta were more typical for them, while aneurysms of the ascending aorta were more common in females. The incidence of thoracic aortic dilatation increased with age. Potential causes and strategies to minimize AIT errors were discussed.

Conclusion. The results highlight the importance of opportunistic screening for thoracic aortic aneurysms to ensure timely detection and prevention of complications. It would be especially beneficial to men and elderly population. The effectiveness of AITs to support decision-making by radiologists analyzing chest CT results was confirmed. The study provides an important update to the data on the prevalence of thoracic aortic aneurysms in asymptomatic patients in Russia. The identified features make it possible to direct the diagnostic and prevention efforts more effectively.

Objective: to assess the possibilities of using low-dose computed tomography (LDCT) in children and adolescents with pulmonary tuberculosis (TB).

Material and methods. The design of the study, which included patients aged 2–17 years with active pulmonary TB and post-TB changes treated in Central Tuberculosis Research Institute in 2021–2023, consisted of two parts as follows: part 1 (a prospective selective study) – independent assessment of LDCT vs standard-dose CT (SDCT) diagnostic accuracy by two radiologists in 44 patients with TB process stabilization; part 2 – cohort one-time assessment of LDCT image quality in 144 patients at different phases of TB treatment. LDCT was performed on the Somatom Emotion 16 CT scanner (Siemens, Germany) by filtered backprojection algorithm; SDCT was conducted on the Somatom go.Up CT scanner by iterative reconstruction algorithm. In patients aged 2–12 years, pediatric protocols, and in patients aged 13–17, standard protocols were used. Radiation exposure was evaluated considering the effective dose (ED).

Results. In patients aged 13–17 years, the noise level was lower and the signal-to-noise ratio was higher with LDCT for all anatomical structures, with the exception of pulmonary parenchyma. In patients aged 2–12 years, the signal-to-noise ratio was the same or slightly higher in SDCT. In the subjective assessment, good image quality was noted with a high correlation between the assessments of radiologists. ED was 2.17 times lower for LDCT than for SDCT in adolescents and 1.91 times lower in children. In patients aged 2–3 years, the quality essentially depended on their immobility during the procedure, though under sedation it was good in 92% of cases.

Conclusion. In conditions of sufficient immobility of the patient, LDCT provided good image quality of tuberculous changes with a decrease in ED compared to SDCT by 2.17 times in adolescents and by 1.91 times in children.

The article presents a detailed analysis of clinical observation of primary diffuse large B-cell lymphoma of the adrenal glands, a rare disease affecting less than 1% of patients with non-Hodgkin’s lymphomas. It describes the case of a 46-year-old man hospitalized with progressive limb paralysis, later diagnosed as paraneoplastic polyradiculoneuropathy associated with bilateral adrenal lymphoma. The diagnostic challenges of this pathology, including ambiguous imaging results and the need for histological verification to confirm the diagnosis are discussed. Special attention is paid to the uniqueness of clinical manifestations and the importance of early symptom recognition to improve prognostic outcomes in highly aggressive forms of the disease. The necessity of multidisciplinary approach in managing such patients with the participation of oncologists, endocrinologists, and neurologists to optimize diagnostic and therapeutic processes is also emphasized.

The article presents the possibilities of radiation methods in the diagnosis of spinal echinococcosis based on publications and our own clinical observation. An electronic literature search was conducted using PubMed/ MEDLINE, Cochrane Library, ResearchGate databases; the review included case reports, retrospective studies, and literature reviews published from 1991 to 2023. A clinical case of a patient with spinal echinococcosis was described showing that for this disease, a comprehensive radiation examination using radiography, computed tomography and magnetic resonance imaging (MRI) provides the necessary information. MRI is the most informative method, since it gives excellent visualization of spinal canal structures and allows detecting a number of spinal echinococcosis characteristic manifestations.

Solitary pulmonary nodule is a difficult case for differential diagnosis. The list of pathological processes manifested by pulmonary nodule is quite large, including organizing pneumonia, which has non-specific CT picture. A correct diagnosis requires comparing the radiation examination data with anamnesis, the results of invasive and morphological studies. The presented clinical case shows the difficulties of diagnosing a combination of pulmonary nodule and extensive renal mass.

Diagnostic imaging of oligometastatic disease is a difficult task, since it requires determining the exact locoregional stage of the underlying disease and assessing the condition of the entire body in terms of possible diffuse spread of distant metastases, which presupposes a fairly frequent combination of various instrumental methods. In each specific case, a more accurate imaging method is chosen depending on the type of tumor, time of diagnosis, possible previously implemented stage of special antitumor treatment, as well as the individual risk of developing distant metastases, the most characteristic for this type of tumor process. Today, along with some diagnostic techniques that were previously constantly used in everyday practice, but are gradually losing their long-standing clinical application, such imaging methods as contrastenhanced computed tomography (CT), magnetic resonance imaging, as well as metabolic and specific receptor imaging, for example, CT combined with positron emission tomography with ¹⁸F-fluorodeoxyglucose, are most commonly performed, alone or in various combinations.