Medicine has proven that not only weapons of mass destruction can be nuclear. Atomic diagnostics is used today when traditional methods are powerless. In what cases is it used? And what should the common man know about this little-known technology?

What it is?

The term "nuclear diagnostics" includes a number of methods for determining the patient's condition. All of these methods involve the use of radioactive isotopes. Just don't panic! They almost do not cause harm to the body, since they linger in it for two days at most. But they penetrate where other "rays" do not reach and allow you to make the most accurate diagnosis.

Oncology and PET

Today it is impossible to imagine oncology without nuclear diagnostics. The most common method is positron emission tomography (PET), which allows you to find the tumor and its metastases. Moreover, such a microscopic size (3-4 mm) that no other examination will reveal them. But after all, it is still necessary to obtain confirmation that the detected neoplasms are malignant. PET allows you to make sure of this one hundred percent.

Adjusted for the result

Fear has big eyes

Most of the people who need such a study are afraid of being irradiated. These fears are completely unfounded. As mentioned above, isotopes have a short lifespan, they quickly decay and are excreted from the body. Specialists are much more likely to observe bouts of claustrophobia in patients who are prescribed PET. The thing is that during the examination you need to lie in a small "sarcophagus", similar to a solarium, only closed on all sides. Not everyone likes it, so often a psychologist is involved in this analysis.

What is the price?

Today, the corresponding equipment is available in most hospitals. Therefore, PET/CT is no problem. Moreover, on an outpatient basis, this is available in many clinics. For those who are not going to wait in line for a long time, there is their own price list - the price of the service is in the range of 2500-7000 rubles, depending on the area of ​​\u200b\u200bthe body that needs to be examined. A complete “scanning” of the body will cost an order of magnitude more expensive - 25,000-35,000 rubles.

What are the diagnoses of nuclear diagnostics?

Heart - when it is necessary to reveal the hidden and determine the indications for coronary angiography (X-ray contrast research method).

Bones - analysis is done with the aim of early detection of tumors and bone metastases.

Kidneys - when to look for inflammatory diseases kidneys and tumors.

- when it is necessary to determine abnormalities in this organ at an early stage (including nodes, tumors, inflammations).

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But how to detect a small tumor in a large body? There is only one way - positron emission tomography (PET), which requires special equipment and special isotopes.

hot spots in the body

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Nuclear therapy is a form of radiation therapy that uses beams of high-energy protons, neutrons, or β-active ions to treat cancer. Types and methods of nuclear therapy in oncology. Currently, there are several types of nuclear therapy.

nuclear medicine is the direction modern medicine, which uses radioactive substances and the properties of the atomic nucleus for diagnosis and therapy (treatment). For example, one of the well-known methods of examination based on nuclear medicine

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Basically, we are talking about diagnostics, that is, about PET studies, with the help of which doctors see not only late anatomical changes under the influence of a tumor, but also early metabolic processes occurring at the molecular level. This requires PET scanners combined with computers, and preparations made on the basis of certain isotopes.

The drug is injected into the patient's body, and the scanner captures its radiation and transmits it to the computer. Since cancer cells have a much higher metabolism than normal cells, they "capture" more of the drug, and therefore appear brighter in the image. The presence of such "hot spots" indicates that the process of neoplasm is running. Thus, PET examination allows you to see it even before a tumor forms.

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A network of nuclear medicine centers is being created in Russia, using the most modern technologies for cancer diagnosis. The same goal is pursued by the entire project to organize a network of nuclear medicine centers in Russia, which is being implemented by the company.

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For fans of the House Doctor series, this is not from the field of supertechnologies - there, patients are sent for PET, as for an x-ray. And no one is afraid of it, because radiopharmaceuticals are introduced in indicator amounts and isotopes decay after a few hours. However, in our country this study is no longer too exotic - in Moscow, for example, it is included in the compulsory medical insurance program.

Russian potential

“The potential of the isotope complex of the Russian state corporation is the largest in the world, it is 10 enterprises,” says Alexei Vakulenko, 1st Deputy General Director of the Izotop association. - More than 200 clinics receive Russian radiopharmaceuticals. And raw materials in the form of radioactive and stable isotopes are supplied to 50 countries of the world.”

The Scientific Research Institute of Atomic Reactors (RIAR) sends to Russian and foreign medical institutions the highly demanded radionuclide molybdenum-99, which is used for about 80% of research. The production of other important medical isotopes is also developing: iodine-131, iodine-125, strontium-89, tungsten-188, lutetium-177. Some of them are used not only for diagnosis, but also for the treatment of oncological diseases.

Isn't it time to get checked out?

Nuclear medicine is one of the most innovative areas of medicine, where radioactive isotopes are used in the treatment and diagnosis. After all, even when doctors know that the patient has cancer, in order to prescribe proper treatment, it is important to determine the primary focus of the tumor.

Nuclear medicine is a branch of clinical medicine that deals with the use of radionuclide pharmaceuticals in diagnosis and treatment. Sometimes, external beam radiation therapy methods are also referred to as nuclear medicine. .

But the PET scanners in our clinics are still foreign. However, the nuclear state corporation has already presented a working model of a positron emission tomograph, and by the end of the year a prototype should be created at its Scientific Research Institute of Technical Physics and Automation (NIITFA). The start of production of Russian tomographs, as well as therapeutic accelerators, is not far off.

It is clear that new technologies for physicians require new knowledge and skills. The nuclear industry is ready to help in this too - on August 8, an agreement was signed between the IAEA, Rosatom and the Federal Medical and Biological Agency (FMBA) on an extrabudgetary contribution to the implementation of the action program for cancer treatment.

According to this document in 2016-2019. specialized training courses for experts from Russia and European countries will be organized under the auspices of the IAEA. And at the Federal Medical Biophysical Center. Burnazyan (a division of the FMBA) will undergo a quality assurance audit in accordance with the requirements of the IAEA in the field of radiation oncology.

Bring yourself.
Will Russian oncology be able to provide patients with foreign drugs

Using beams of high-energy protons, neutrons or β-active ions to treat cancer.

Types and methods of nuclear therapy in oncology

Currently, there are several types of nuclear therapy.

1. Proton therapy for cancer.
2. Neutron-isotope therapy.
3. Therapy with heavy ions.
4. SIRS therapy.

The main methods of nuclear therapy used in clinics abroad are proton therapy, heavy ion therapy and SIRS therapy.

Proton therapy

This type of cancer treatment has appeared relatively recently, but the number of proton therapy centers abroad is already in the dozens. Only in Europe today there are about 10 proton therapy clinics. Most of these centers have equipment manufactured by the Belgian company IBA Proton Therapy.

Proton therapy - what is it ?

The proton beam is accelerated using a cyclotron or synchrotron. The final energy of the emerging particle beam determines the depth of penetration and hence the location of the maximum impact energy. Since the beam can be easily deflected with electromagnets in the transverse direction, the raster scanning method can be used, that is, the beam can be quickly moved over the target area. And by varying the beam energy and therefore the penetration depth, the entire target volume can be covered in three dimensions, providing radiation that precisely matches the shape of the tumor. This is one of the main advantages of this method compared to conventional radiation therapy.

What is the essence of the method of proton therapy

Unlike x-rays or gamma rays, maximum dose Proton irradiation is created at a strictly defined distance from the radiation source. And after this maximum, the radiation completely dries up.

Due to this, it is possible to achieve maximum exposure in the tumor zone, without affecting healthy tissues located behind it in the course of radiation exposure.

Benefits of Proton Therapy

• Minimal impact on healthy tissues.
• Reducing the chance that radiation will cause a new cancer (secondary tumor).
• The most powerful effect on the tumor.
• More wide range indications for use.

Indications for the use of proton therapy

The effectiveness of proton therapy in glioblastoma, rectal and prostate cancer has been confirmed.

Proton therapy is especially indicated for the treatment of:

• cancer in children;
• row rare species cancers in adults for which there is none, such as tumors at the base of the skull, near the spine, or near the optic nerve.

side effects and effects of proton therapy

Despite the fact that proton therapy is the safest method of therapy in the United States, without certain side effects and it doesn't work here.

All consequences of the method can be divided into two types.

1. Effects associated with exposure to protons on healthy tissues located in front of the tumor along the proton beam - skin inflammation, hair loss, itching, numbness and rashes at the site of exposure to the beam.
2. The effects caused by the destruction of the tumor are general intoxication, fever, fatigue, allergic reactions.

The cost of proton therapy

The price of a proton therapy session is calculated in thousands (and sometimes tens of thousands) of euros. However, this is often quite justified, given its effectiveness, and sometimes there is no alternative. The nuance is that the price in different centers where you can get proton therapy can vary greatly, and you need to be very careful when choosing a particular clinic.

Heavy ion therapy

Carbon ion therapy uses more massive particles than protons or neutrons. Carbon ion radiotherapy is gaining more and more scientific attention as technological capabilities improve and clinical researches demonstrate its benefits in the treatment of many types of cancer, such as glioblastoma, locally recurrent rectal cancer.

The method also has clear advantages for treating otherwise difficult-to-treat hypoxic and radioresistant cancers.

By mid-2017, over 15,000 patients had been treated worldwide in 8 operating centers. There are currently five heavy ion radiotherapy units in operation (of which 2 in Europe) and there are plans to build more units in the near future.

Biological Benefits of Heavy Ion Therapy

All methods of treatment with heavy particles (protons, ion beams) demonstrate a certain maximum effect at a certain point in the body. Therefore, they provide the maximum lethal dose in or near the tumor. This minimizes harmful radiation to surrounding normal tissues.

Carbon ions are heavier than protons and thus provide a higher relative biological effectiveness (RBE). Their effect on tumor cells is both stronger and more accurate, which allows you to destroy the maximum number of atypical cells.

SIRS-therapy (SER-spheres)

The Y-90 SIR Sphere is a polymer artificial medical microdevice used in selective internal radiation therapy for the treatment of inoperable liver tumors.

The use of external radiation for the treatment of liver tumors is limited by the high sensitivity of healthy liver tissue to radiation. Selective internal beam radiation therapy using SIR-Spheres provides access to radiotherapy for inoperable primary and secondary liver tumors while protecting healthy cells.

Polymeric microspheres SER-spheres are a disposable nanoimplant. They contain the isotope yttrium-90 and have an average diameter of 32.5 microns.

Yttrium-90 is a high-energy beta-emitting isotope with no primary gamma emission. The maximum energy of beta particles is 2.27 MeV with an average value of 0.93 MeV. The maximum tissue emission range is 11 mm with an average value of 2.5 mm. The half-life is 64.1 hours.

These properties of SIR-Spheres polymeric microspheres cause the microspheres to preferentially settle in the microvasculature surrounding the tumor, maximizing anti-tumor therapeutic effects and minimizing the effect on healthy liver cells.

Nuclear Therapy with SIR-Spheres:

• lengthens interrecurrent intervals;
• increases overall survival;
• potentially reduces tumor size before surgery;
• alleviates the symptoms of the disease.

SR-spheres can be combined with modern or administered as monotherapy. Also, this method can be used as an alternative to local chemotherapy.

Learn more about the possibilities of nuclear therapy. Write to us or request a call back, we will provide you with all the necessary information.

Nuclear medicine and oncology: federal experts and Kuzbass oncologists discuss methods of fighting cancer

Novokuznetsk hosted a two-day interregional conference on the topic: “Development cancer care in Kuzbass. Nuclear medicine to fight cancer. The organizers were the Department of Health of the Kemerovo Region, Federal State Budgetary Institution “N.N. N.N. Blokhin, Russian Association of Oncologists and MedInvestGroup, Grand Medica clinic.

More than 250 experts and oncologists from Kuzbass and Moscow gathered at the conference. On the first day, the participants discussed the development of oncological care in Kuzbass, the implementation of the federal program to combat oncological diseases. Leading speakers of the conference - Ivan Sokratovich Stilidi, academician of the Russian Academy of Sciences, professor d.m.s. Sergey Anatolievich Ivanov, Director of the N.N. Tsyba, Doctor of Medical Sciences, Alexander V. Petrovsky, Deputy Director for the development of oncological care in the regions of the Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russia and Sergey Notov, President of the MedInvestGroup Group of Companies.

Within the framework of the conference, the Government of Kuzbass entered into a cooperation agreement with the National Medical Research Center of Oncology named after N.N. Blokhin. The signatures were put by Deputy Governor Elena Ivanovna Malysheva and Academician of the Russian Academy of Sciences, Director of the Federal State Budgetary Institution “N.N. N.N. Blokhin” of the Ministry of Health of Russia Ivan Sokratovich Stilidi. The parties agreed to cooperate in the field of organizing the procedure for providing medical care on the profile of "oncology", as well as in the field of training of relevant qualified specialists.

“Our center supervises oncological institutions of the Far Eastern, Siberian, and Ural federal districts. The signed agreement with the Kemerovo region is the second agreement that we have concluded with the regions of Russia. The document establishes the working order. But when working together, collegial and friendly relations are of great importance, which directly contribute to effective interaction. It is precisely such relations that we managed to build with Kuzbass,” said I.V. Stilidi.

According to Deputy Governor Elena Malysheva, within six years in Kuzbass it is planned to re-equip two oncological clinics and a children's oncology department based on the Novokuznetsk City Children's Hospital No. 4. It is planned to purchase about 331 units of medical equipment, which will allow early detection malignant neoplasms, provide the possibility of radical treatment, thereby saving the lives of Kuzbass residents.

Within the framework of the plenary sessions, an interregional exchange of experience took place. Minister of Health of the Novosibirsk Region Konstantin Khalzov and Minister of Health of the Omsk Region Dmitry Vyushkov shared strategies for fighting cancer in the regions. Dmitry Vyushkov said that in order to optimize the work of the oncological service in the Omsk region, a modular system "Workstation of an oncologist" was developed and implemented to connect the oncological dispensary (COD) with medical organizations areas in real time. “Today in the Omsk region there is a single information space for cancer patients. The base point is workplace an oncologist in the primary office, information about the patient is immediately entered into the system and then it is possible to track all steps on the patient in it - from diagnosis to monitoring treatment. This allows you to improve the quality of assistance provided, monitor the quality and quantity of the early diagnosis, medical examinations and in real time to have all the necessary information about the incidence,” commented Dmitry Vyushkov, Minister of Health of the Omsk Region.

Sergey Notov, President of MedInvestGroup, in his speech spoke about ways to solve the key problems facing oncology services in the regions. “First of all, it is necessary to centralize the oncological service of the region and create a centralized laboratory. These points imply the creation of a full-fledged infrastructure, and here cooperation between the state and private business is important. According to our estimates, at least 500 million rubles of private investment should fall on one region to create the necessary infrastructure. Of course, with the development of infrastructure, it is impossible not to touch upon the personnel issue. This problem is experienced by both public and private institutions. Our approach is to create an educational ecosystem that will allow training and developing teams of specialists of a fundamentally new level for the needs of oncology centers in sufficient volume. To improve the quality of medical care for the population, it is necessary to digitize processes and monitor the situation in the region in real time. Today, this can be done by the system of routing and monitoring of ONCOR patients. The program allows you to have in real time all the necessary information about the incidence in the region and about each patient in particular, to coordinate the work of the general medical network of the region at each stage of diagnosis and treatment with oncology dispensary control the execution of orders. These measures make it possible to reduce the duration of patient treatment and increase the number of cases of early diagnosis, which will lead to a decrease in mortality rates in the region,” Sergey Notov said in his speech.

The second day was devoted to the topic of diagnosis and treatment of cancer. More than 60 Kuzbass doctors and invited doctors from Moscow federal institutions discussed the use of PET / CT for diagnosing oncological diseases, evaluating the effectiveness of treatment (the method combines the capabilities of positron emission (PET) and computed tomography (CT). The method makes it possible to detect the smallest tumor foci on early stages of the disease and obtain a three-dimensional image of the human body with accurate data on the localization and boundaries of neoplasms.Among the leading speakers of the conference were Mikhail Borisovich Dolgushin, Head of the PET Department of the N.N.Blokhin National Medical Research Center of Oncology, Professor of the Russian Academy of Sciences , Doctor of Medical Sciences, Sergey Yuryevich Abashin, Expert of the Federal Network of Nuclear Medicine Centers "PET-Technology", Doctor of Medical Sciences, Ksenia Vladimirovna Vyalova, Chief Oncologist of the Kemerovo Region, Deputy Chief Physician for the Medical Department of GBUZ CO "OKOD" , Natalya Alexandrovna Falaleeva, head of department drug treatment MRNC im. A. F. Tsyba - branch of the National Medical Research Center of Radiology, MD At the Grand Medica clinic, doctors held master classes: laparoscopic prostatectomy, laparoscopic nephrectomy.