The nuclear medicine phantom development is based on the step by step description of the computational and experimental biological object model. Computational phantoms are used for geometry of the object description and simulate physics of particle interactions with matter, while experimental phantoms are used for quality control tests and standardization of functional research protocols. Common examples are the dosimetry planning of radionuclide therapy and post-therapeutic scintigraphy with 131I. This review provides a list of methods for computational and experimental phantoms. Examples of existing phantoms created for the nuclear medicine tasks are also given.

RATIONALE: Insufficient world–wide clinical experience in radioiodine therapy (RIT) for Graves’ disease (GD) in children and adolescents, and limited knowledge of the predictors of RIT efficacy.AIMS: Analysis and identification of the most significant predictors of the efficacy of RIT in children and adolescents with Graves’ disease.MATERIALS AND METHODS: A total of 55 patients (48 females and 7 males) aged from 8 to 18 years receiving primary RIT for GD were enrolled. RIT planning was based on the dosimetric method. Analyzed parameters included gender, age, ultrasound thyroid volume before and 6 months after treatment, the presence of endocrine ophthalmopathy, duration of antithyroid drug (ATD) therapy, relapse of thyrotoxicosis after ATD dose reduction, blood fT3, fT4 and TSH levels initially and at 1, 3, 6 months after treatment, TSH receptor Ab initially and at 3 and 6 months after treatment, thyroid 99mTc–pertechnetate uptake at 10–20 minutes (%), maximum thyroid 131I uptake (%), specific 131I uptake (MBq/g) and therapeutic 131I activity (MBq). Fisher exact test, non–parametric Mann–Whitney test, Wilcoxon signed–rank test, logistic regression modelling, ROC–analysis, proportional hazard model (the Cox regression), the Kaplan–Meier method and log–rank test were used for statistical analysis as appropriate.RESULTS: Six months after RIT, hypothyroidism was achieved in 45 (81.8%), euthyroid state – in 2 (3.6%), and in 8 (14.6%) patients thyrotoxicosis persisted. On univariate statistical analysis, the smaller thyroid volume, higher fT4 and lower TSH receptor Ab levels, lower 99mTc–pertechnetate uptake and higher specific 131I uptake were associated with hypothyroidism. On multivariate logistic regression analysis, the older patient’s age (p=0.011), smaller thyroid volume (p=0.003) and higher fT4 (p=0.024) were independent predictors of RIT efficacy. Thyroid volume was also the only variable associated with achievement of hypothyroidism in time after RIT (p=0.011).CONCLUSION: The efficacy of dosimetry–based RIT in children and adolescents with GD 6 months after treatment was 81.2%. Older patients’ age, smaller thyroid volume and higher fT4 level were independent predictors of therapy success. Smaller thyroid volume was also a predictor of the favorable time–related outcome. Statistical models obtained in this work may be used to prospectively estimate the chance of efficient RIT for GD in pediatric patients.

В последнее десятилетие в ядерной медицине наметилась отчетливая тенденция к совершенствованию дозиметрического планирования радионуклидной терапии. Исторически в ядерной медицине сложился следующий алгоритм индивидуального расчета эффективной терапевтической активности: назначение фиксированной трейсерной активности радиофармпрепарата, изучение его индивидуальной радиобиокинетики с последующим математическим моделированием процессов переноса излучения и расчетом оптимальной терапевтической активности. Данный подход реализует концепцию тераностики в ядерной медицине. Разнообразие существующих протоколов дозиметрического планирования радионуклидной терапии является свидетельством того, что оптимальный алгоритм, учитывающий все индивидуальные параметры человека и параметры излучения (радиобиокинетика в мишени и в организме в целом, объем и функциональное состояние, влияние иных эндогенных факторов), пока не предложен. Разработка робастной модели дозиметрического планирования радионуклидной терапии требует учета всех факторов, независимо и значимо влияющих на формирование эффективной дозы облучения в очагах поражения, с одной стороны, и побочного облучения других органов и тканей, с другой стороны. Ключевые слова: исторический обзор; дозиметрическое планирование; математическое моделирование методом Монте-Карло; радионуклидная терапия.

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Introduction. Prostate cancer is one of the most common malignant neoplasms. Strategies to improve early diagnosis and subsequent therapy are being improved. An emphasis is placed on maintaining the quality of life and working capacity of patients after treatment. This can be achieved by improving methods of focal therapy, which depends on the accuracy of topical diagnosis and classification of the tumor. Hybrid molecular imaging (pet/ct and spect/ct) is used in addition to the methods of structural imaging (ultrasound, ct, mri). Intraoperative imaging using radionavigation systems is also used in open and endoscopic surgery for prostate cancer. Currently, it is a tool capable of reducing the invasiveness of surgery, localizing the area of metastatic lesions with a sensitivity and specificity of up to 95 %.Objective of the study: an overview of current and promising future methods of intraoperative radio navigation in the surgical treatment of prostate cancer.Material and methods. The review presents the methods of intraoperative radionavigation in the surgical treatment of prostate cancer. Radionavigation in the context of using tumarotropic radiopharmaceutical based on a prostate-specific membrane antigen, in which the drug accumulates in all tumor foci expressing this receptor, is also considered.Conclusion. The use of preoperative hybrid imaging and radio-guided surgery facilitate lesion identification and resection. Gamma probing allows detection of psma-positive tumor foci regardless of their depth. Fluorescence imaging methods (icg, photodynamic diagnostics, autofluorescence) are also used for intraoperative detection of pathological foci in real time. Multichannel gamma probing and cherenkov radiation detection, which combine the advantages of indirect and direct intraoperative imaging, have enormous potential.

We studied the incidence of genotypes of polymorphic alleles (-75)G>A and (+83)C>T of apolipoprotein A1 gene in healthy Russian adolescents, residents of East Siberia. Genotyping was carried out by PCR with subsequent restriction fragment length polymorphism analysis. The incidence of allele (-75)A was 22.5%, of allele (+83)T - 7.3%. Association of allele (-75) A with high blood cholesterol level was revealed.

Diagnosis of the causes of thyrotoxicosis (destruction or increased functional activity of the thyroid tissue in nodular and diffuse thyroid pathology) is a key point in determining the management of patients with this pathology. Scintigraphy is the method of choice in differential diagnosis of the causes of thyrotoxicosis assessing the functional state of the thyroid gland. According to variable medical interest, thyroid scintigraphy can be performed using 99mTc-pertechnetate or radioactive iodine isotopes (123I, 124I, 131I). For thyroid uptake evaluation used scintigraphy with 99mTc-pertechnetate radiopharmaceutical, which is not organificates and quickly excretes from thyroid tissue. In case of thyroid iodine pharmacokinetics investigation radiopharmaceuticals labeled by iodine isotopes (123I,131I, 124I) are used. The review includes original scintigrams, tables and diagrams. Article shows thyroid scintigraphy informativity analysis, evaluates the place and role of the thyroid scintigraphy examinations in modern diagnostic algorithms taking into account the history of the disease, laboratory tests, ultrasound (TIRADS) and result ofFNA (Bethesda). Additionally authors focused on existing clinical guidelines analysis. An optimized algorithm for the diagnosis and treatment of diffuse and/or nodular thyroid pathology associated with thyrotoxicosis is proposed.

Nowadays, Cushing's syndrome (hypercortisolism) and its manifestations are well studied. The main symptoms of hyper-cortisolism are obesity, osteoporosis, cardiomyopathy, muscle atrophy, skin thinning and purple stretch marks (striae) on the body. In practice, obesity and osteoporosis are the most frequent symptoms that are found in 90% of cases. However, there are some patients with an implicit clinical picture of hypercorticism. Some cases might concomitant with exophthalmos. This review describes a rare symptom of hypercortisolism — exophthalmos. Exophthalmos is a pathological protruding of eyeballs. This symptom is known in the context of TED that occurs most commonly in patients with Graves' disease. The article compares the mechanisms of development of eye symptoms in Cushing's syndrome and thyroid diseases, especially the Graves' disease. It discusses possible molecular mechanisms leading to exophthalmia in patients with Cushing's syndrome. Factors affecting adipogenesis in vitro and in vivo are studied, in particular factors leading to an increase of orbital fatty tissue against of elevated cortisol levels. Hormonal signaling and transcription cascades responsible for adipocyte differentiation into mature fat cells are presented. Other orbital manifestations of hypercortisolism, which occur relatively rare in practice, are also discussed in the article. These include glaucoma as well as cataract, Lisha nodules and central serous chorioretinopathy. Clinical cases of Cushing's syndrome with different ocular manifestations are considered and appropriate conclusions have been drawn.