Division for Research in Radiation Oncology and Diagnostic Radiology

In field of radionuclide diagnostic imaging, close attention is now being focused on the assessment of the role of the methods for identifying individual tracts of lymphatic drainage from neoplasms at various sites in order to select the most effective treatment plan and determine the adequate volume of radiation in each specific case. The fact that the Center has a new Symbia T16 SPECT/CT system that combines a gamma camera with an X-ray computed tomographer allows to explore the capabilities of molecular imaging for early detection and staging of malignant tumors. The Division has initiated a study into the possible use of X-ray computed tomography combined with single-photon emission computed tomography, used in conjunction with tumoritropic radiopharmaceutical agents to stage lung and breast cancer, and malignant lymphomas. The Division has been innovating and implementing into clinical practice the techniques for sentinel lymph node biopsy in cases of neoplasms of the breast and the gastrointestinal tract, and cancers and neoplasms of the prostate.

A high priority is given to the development of techniques for molecular testing for primary breast cancer and its regional metastases, using modern tumoritropic agents, which allows to use a patient-specific approach to treatment.

A special focus is paid to translating the techniques for diagnosing and treating non-small cells lung cancer to clinical applications. Since the Center has a system that combines X-ray computed tomography with single-photon emission computed tomography, it can use the techniques of molecular imaging and diagnostic radiology to make an initial diagnosis and to stage a neoplastic process.

Brachytherapy is also one type of radiation therapy used at the Center to treat prostate cancer by placing a source of radiation inside or next to the area requiring treatment. The procedure involves placing brachytherapy needles with a radiation source (Ir-192) directly into the prostate, using a special ultrasonography apparatus to help guide the procedure. To treat prostate cancer, the Center is planning to use high-intensity focused ultrasound therapy combined with an MRI scanner to enable guidance of the treatment and monitoring.

A new program of pre-surgical radiation therapy is being developed at the moment, which will include remote and intraluminal brachytherapy to treat rectal cancer. The use of this technique will make it possible for most inoperable cancer patients to undergo potentially radical surgical treatment, and create situations when some patients will have an option of undergoing sphincter-preserving surgeries.

In treating esophageal cancer, the Center heavily exploits the techniques of combination palliative radiotherapy; and its first priority in this area is to improve the techniques of intraluminal brachytherapy by using argon plasma recanalization before the procedure, which would ensure that intraluminal brachytherapy is provided in the way that is best suited for a patient.

The research and application activities in the field of diagnostic radiology are focused on ensuring the use of high-tech techniques of detection of malignant tumors. The main areas of priority are:

• to develop an optimal procedure for the use of diagnostic radiology techniques in order to more accurately assess the local spread of a neoplastic process to be able to devise a more detailed plan of complex surgical interventions;
• to perfect cytomorphology analysis by performing needle biopsy guided by ultrasound, X-ray or computed tomography;
• to perform comprehensive assessment of the results of various types of surgical treatments, chemotherapy and radiation therapy, including the evaluation of the efficacy of radiofrequency ablation of tumor masses in the liver and other parenchymatous organs, by mainly using the modern high tech imaging techniques, such as ultrasound, CT and MRI.
• to assess the efficacy of the use of organotropic contrast agents for nuanced magnetic resonance diagnostic imaging of primary and secondary tumors of parenchymatous organs;
• to diagnose breast tumors (screening and detection of nonpalpable neoplasms, using stereotaxic biopsy), malignant lymphomas, bone and soft tissue sarcomas, and tumors of the reproductive organs;
• to make a transition to digital technologies via the use of flat panel detectors which allow to increase the quality of pictures by eliminating the dependence on the photochemical process, to reduce the patient's radiation dose and to facilitate storage and transportation of medical images;
• to use angiographic techniques that allow to plan and perform intravascular interventions, such as chemoembolization of an artery directly supplying the tumor, stenting of blocked arteries, and placement of intravascular filters;
• to explore MRI techniques which allow to obtain functional characteristics of a tumor tissue (diffusion weighted imaging, MR spectroscopy, perfusion imaging);
• to explore new paramagnetic contrast media that are highly tissue-specific and tumoritropic;
• to investigate dual energy computed tomography techniques which ensure superior lesion detection and characterization, lower radiation exposure of a patient and less image noise in dynamic contrast‐enhanced perfusion.

Today, positron emission tomography combined with CT or MRI is vastly used to diagnose cancer patients. The use of this technique is a must for any oncological institution that wants to be in compliance with the international medical equipment standards in the field of oncology.