The majority of modern biomedical research is aimed at personifying the diagnosis and treatment of various diseases. An individual approach can be implemented using radiomics — the latest radiation diagnostics associated with the extraction of a large number (from hundreds to several thousand) of additional quantitative indicators from medical images using specialized software. The method is actively used in oncology to identify radiochemoresistant tumor zones, as well as non-invasive determination of the phenotype and genotype of the neoplasm. At the same time, the prospects for the application and clinical significance of this approach in cardiology have not yet been determined and have been the subject of active research in recent years. In this regard, the purpose of this review was to collect information from available databases and assess the degree of knowledge of the problem of radiomic analysis of heart images using various radiation modalities, as well as to determine the prospects for using this approach in clinical practice.

Background. Quantitative calculation of tissue blood flow by means of radionuclide emission tomography is of great importance in studies of myocardial blood supply. Quantifying blood flow with PET requires a medical cyclotron. 99mTc-Technetrile is a unique radiopharmaceutical (rfp) with a high and approximately the same extraction fraction by the myocardium and other tissues — chemical microspheres.Objective. Development of a technique for calculating tissue blood flow for a quantitative assessment of the blood supply to the heart muscle, according to the determination of tissue absorption of 99mTc-Technetrile during CardioSPECT.Design and methods. The distribution of rfp — chemical microspheres 99mTc-Technetrile in the body is proportional to blood flow. Determining the amount of accumulation of rfp in different regions can be performed using SPECT. Weused data of 14 patients with myocardial infarction, who underwent SPECT with 99mTc-Technetrile, with the calculation of tissue blood flow.Results. Evaluation of rMBF at rest in the area of unaffected myocardium revealed rMBF = 65±7 ml/min/100 g, in segments with the presence of viable myocardium according to the ultrasound test with dipyridamole rMBF = 53±7 ml/min/100 g, in postinfarction regions of the transmural damage to the left ventricular wall without viable myocardium rMBF = 27±8 ml/min/100 g.Conclusion. The calculation of tissue blood flow via CardioSPECT is useful for pathophysiological assessment of the blood supply to the heart muscle.

urpose.Using radiocardiopulmonography to evaluate the cardioprotective effectiveness of hypoxic preconditioning (HP) during myocardial revascularization under extracorporeal circulation (EC).Material and methods.A total of 63 patients (mean age of 52.8 ± 1.4 years) who underwent coronary bypass surgery (CABG) under EC condition were examined.All patients had chronic heart failure of NYHA class I-III.Patients were randomized into 2 groups: study group comprised 33 patients who received HP during CABG; comparison group comprised 30 patients.Patients of both groups were comparable in regard to clinical and intraoperative data.The preconditioning was performed as a single-cycle 10-minute hypoxemia session followed by 5-min period of reoxygenation before global ischemia.Radiocardiopulmonography with 99mТс-pertechnetate was performed before and 6-8 days after surgery with the calculation of the parameters of cardiopulmonary hemodynamics.Results.In the examined patients before CABG we observed a decrease in the mean values of the cardiac output (MO), cardiac index (HI), stroke index (SI) and circulation efficiency ratio (CER) as a consequence of a decrease in the pumping function of the heart, as well as an increase in the pulmonary circulation time (TPUL) due to both arterial and venous components, which indicated the development of pulmonary hypertension and venous congestion of the left heart.In the postoperative period, positive statistically significant change in most parameters of cardiopulmonary hemodynamics occurred as a result of successful myocardial revascularization in patients of both groups: the values of MO, SI, CER increased, and halfemptying period of the left and right ventricles and the value of TPUL decreased.It should be noted that the positive dynamics of these parameters was statistically more pronounced in the patients of the study group.Also, in contrast to the comparison group, the arterial component of circulation in the lungs and the half-emptying period of the right ventricle significantly decreased in patients with HP, which indicated a reduction in pulmonary hypertension and a regression of right ventricular failure.On day 2 after surgery blood levels of creatine-kinase (CK) and CK-MB were increased in patients of both groups.The mean level of CK-MB was significantly higher (by 33%) in the comparison group relative to the study group (p = 0.046825), and the relative index (RI = CK-MB/CK x 100) in the study group did not exceed 6%.This data suggested that HP increased the tolerance of the heart to the effects of "ischemia-reperfusion".Conclusion.Hypoxic preconditioning exerted cardioprotective activity in patients undergoing open-heart surgery under EC.

In the article possibilities of radionuclide methods of research are shown in prognostication of heart failure and estimation of efficiency of restoration treatment for patients, carrying the heart attack of myocardium.

A comparison of the possibilities of using various neurotropic radiopharmaceuticals for scintigraphic evaluation of cerebral perfusion. In the whole range of radiopharmaceuticals used to diagnose cerebral blood flow disorders, there are Ceretec (99mTc-hexamethylpropyleneamine) and Neurolite (N,N-1,2-ethylenediylbis-L-cysteine-diethyl ether), which are the most optimal agents. Due to their high cost and related radiation exposure, the radiopharmaceuticals 123І-IMP (123I-isopropyl-iodoamphetamine) and 201Tl-DDC (diethyldithiocarbamate) labeled with thallium-201 virtually minimize the possibilities of being used in daily clinical practice. Fixation of 99mTc-DDC in the brain proves to be short-term, which is insufficient for tomoscintigraphy studies. Literature has been sought in the Scopus, Web of Scince, Pubmed, EMBASE, and Russian Science Citation Index databases.

A comparison of the possibilities of using various neurotropic radiopharmaceuticals for scintigraphic evaluation of cerebral perfusion. In the whole range of radiopharmaceuticals used to diagnose cerebral blood flow disorders, there are Ceretec ( 99m Tc-hexamethylpropyleneamine) and Neurolite (N,N-1,2-ethylenediylbis-L-cysteine-diethyl ether), which are the most optimal agents. Due to their high cost and related radiation exposure, the radiopharmaceuticals 123 І-IMP ( 123 I-isopropyl-iodoamphetamine) and 201 Tl-DDC (diethyldithiocarbamate) labeled with thallium- 201 virtually minimize the possibilities of being used in daily clinical practice. Fixation of 99m Tc-DDC in the brain proves to be short-term, which is insufficient for tomoscintigraphy studies. Literature has been sought in the Scopus, Web of Scince, Pubmed, EMBASE, and Russian Science Citation Index databases.

Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

OBJECTIVE:By means of scintigraphic methods to assess alterations in cardiopulmonary haemodynamics and renal functional activity in patients with coronary artery disease (CAD) after endured coronary artery bypass grafting (CABG) performed in conditions of extracorporeal circulation (EC) and on the functioning heart.MATERIAL AND METHODS:We examined a total of 40 patients presenting with CAD (mean age 54.90±1.12 years) after endured CABG. All patients were subdivided into 2 groups: Group One consisting of 20 patients subjected to CABG performed on the beating heart with the use of myocardial "stabilizer" "Acrobat" (Study Group) and Group Two also comprising 20 patients but undergoing surgery with the use of extracorporeal circulation (Comparison Group). All patients included into the study were subjected to radiocardiopulmonography with (99m)Tc-pertechnetate and dynamic radionuclide renoscintigraphy with (99m)Tc-DTPA before and 6-7 days after operative treatment.RESULTS:In the early postoperative period after CABG, the patients of the both groups were found to have a significant increase in the minute volume, cardiac index, and circulation efficiency coefficient, accompanied by a significant decrease in the period of half-emptying of the left ventricle, thus suggesting improvement of LV contractility. Improved pulmonary microcirculation resulting from operative treatment in the compared groups of patients was confirmed by significantly shortened time of the indicator's passing through pulmonary vessels at the expense of both arterial (TAM) and venous (TVM) components. At the same time, a decrease in these parameters in the Study Group patients was more pronounced as compared with the Comparison Group patients. Thus, the means of the difference between the pre- and postoperative values of TAM and TVM in the Study Group amounted to 1.78 ± .40 s and 1.78 ± 0.32 s, and in the Comparison Group to 0.95 ± 0.22 s and 0.98 ± 0.16 s, respectively (p=0.029 and p=0.031 for TAM and TVM, respectively). The Comparison Group patients after CABG were found to have a significant decrease in the mean values of the total glomerular filtration rate (GFR) in combination with decelerated clearance of the indicator from blood. 30% of patients under the effect of nonpulsating blood flow developed relatively pronounced renal dysfunction (a decrease in the total GFR and/or GRF of one of the kidneys by 15% and more as compared with the initial level). Besides, these patients also demonstrated significant changes in the half-clearance of the radiopharmaceutical from the renal parenchyma and the index of cortical retention of the indicator on the both sides. Unlike the Comparison Group, in patients without EC the average values of the majority of parameters of renal filtration activity underwent no statistically significant alterations as compared with the baseline (prior to CABG) values.CONCLUSION:Coronary artery bypass grafting without cardiac arrest exerts less pronounced negative influence upon the state of the renal function as compared with the open-heart surgery with extracorporeal circulation, which may partially be conditioned by statistically more significant positive dynamics of microcirculation in the system of pulmonary circulation under the effect of myocardial revascularization with the use of the myocardial stabilizer "off-pump".

Basic scintigraphy data reflecting into lung microcirculation and ventilation were studied at 12 patients with chronic obstructive pulmonary disease (COPD) of I-II degree against the background of coronary artery disease (CAD). The bilateral increase in an apical-basal gradient of perfusion that signaled about redistribution of a pulmonary blood-groove in the top parts of lungs and development of pulmonary hypertension and also slowing-down of alveolar-capillary permeability (ACP) was revealed. The revealed violations indicate more expressed changes of pulmonary microcirculation and ventilation at patients with COPD in combination with CAD and promote timely pharmacotherapy correction of the specified combined disease. Pulmonary ventilation/perfusion scintigraphy with 99mТc-labeled macro-aggregates of serum albumin (MAA) and diethylene triamine pentaacetic acid (DTPA) acid have all necessary properties for receiving high-quality lung scan.

The article is devoted to the possibilities of radiocardiopulmonography with radiopharmaceutical "Sodium pertechnetate-Tc-99m, the extraction" produced at Tomsk Polytechnic University in the diagnostics, assessment of the severity and monitoring of pulmonary- heart disturbances in patients with coronary heart disease complicated by chronic heart failure of different functional classes.

The objective of this study was to identify the signs of the right ventricular dysfunction in patients with non-massive pulmonary artery thromboembolism (PE) using radionuclide gated blood pool SPECT (GBPS). The study included 55 patients: 40 with PE, and 15 - control group. Radionuclide studies included perfusion-ventilation scintigraphy and GBPS. GBPS results suggest that the signs of right ventricular dysfunction in PE are: the reduction in its stroke volume, as well as reduction in the peak filling and ejection rate. GBPS results allow distinguishing acute thromboembolism and chronic post-thromboembolic pulmonary hypertension.

Цель – изучить диагностические возможности пульмоносцинтиграфии в оценке нарушений легочной микроциркуляции и вентиляции при инфильтративном туберкулезе легких (ИТЛ), протекающем на фоне хронической обструктивной болезни легких (ХОБЛ), в сравнении с ХОБЛ. 30 пациентам обоего пола с верифицированными диагнозами ИТЛ на фоне ХОБЛ I–II стадии (n = 10) и ХОБЛ I–II стадии (n = 20) была проведена вентиляционно-перфузионная пульмоносцинтиграфия. Результаты: при ИТЛ на фоне ХОБЛ было обнаружено уменьшение апикально-базального градиента перфузии в обоих легких (р = 0,02 и 0,001), а также двустороннее повышение альвеолярно-капиллярной проницаемости (АКП) с первых минут исследования по сравнению с аналогичными показателями у больных ХОБЛ. Так, АКП в пораженном и интактном легких на 10-й мин исследования составила 47,05 (35,05–52,01) % и 33,35 (31,95–44,75) %, на 30-й мин – 52,65 (50,25–55,30) % и 50,01 (48,70–56,45) % соответственно (р = 0,00005 и 0,0004, 0,00006 и 0,00005). Таким образом, выявленные изменения показателей вентиляционно-перфузионной пульмоносцинтиграфии могут быть использованы в качестве дополнительных критериев в диагностике ИТЛ на фоне ХОБЛ.

According to the international registry ICOPER, right ventricular (RV) dysfunction is the most significant predictor of mortality in patients with pulmonary embolism (PE).

Aim: to study the ventilation-perfusion ratio (V/Q), apex-base gradient of ventilation (U/L-V) and perfusion (U/LQ) and alveolar-capillary permeability (ACP) in stage I-II COPD patients on the basis of scintigraphy data. Materials and methods: 35 people aged 38.4 (31.5-45.3) took part in the study: patients diagnosed with COPD (25) and healthy smoking volunteers (10). The scintigraphic studies were performed by means of Omega 500 gamma camera (Technicare, USA-Germany). The subject of the research was an examination of ACP in the right (RL) and left (LL) lungs in the process of radiopharmaceutical derivation, static conditions, during the 1st, 10th and 30th min after 99mTc DTPA inhalation. Results: COPD patients: V/Q in both RL and LL was not higher than 1.0 and amounted to 0.9 (0.7-1.2) in the RL and 0.9 (0.8-1.0) in the LL. These parameters did not differ from those of healthy volunteers (p=0.78 and p=0.55). U/L-V amounted to 0.6 (0.5-0.8) in the RL and 0.6 (0.4-0.9) in the LL. It was lower than that of healthy people (p=0.23 and 0.47). U/LQ amounted to 1.0 (0.8-1.1) in the RL and 0.9 (0.8-1.1) in the LL. This parameter was higher than that of healthy people (p=0.005, p=0.01). ACP in the RL amounted to 10.5% (10.2-10.9%) and 21.4% (19.8-22.9%) during the 10th and 30th minutes of the study, respectively; it was slowed down during the 10th and 30th minutes (p=0.002 and p=0.001). ACP in the LL amounted to 11.3% (10.1-12.5%) and 23.5% (22.3-24.8%) during the 10th and 30th minutes of the study, respectively; it was slowed down during the 10th and 30th minutes of the study (p=0.001 and p=0.001). Conclusions: The study findings may serve as additional scintigraphic criteria for COPD diagnostics.

The aim of this study were to develop a radionuclide method for quantitative estimation of the myocardial blood flow (MBF). Twelve patients with suspected coronary artery disease underwent both Tc-99m-methoxyisobutylisonitrile (MIBI) imaging and coronary arterial injection of Tc-99m-radioalbumin macroaggregates (MAA). The myocardial uptake and MBF obtained using radionuclide angiocardiography and relative distributions of Tc-99m-MIBI were compared with the obtained using whole body with MAA as the gold standard. The myocardial uptake and MBF measured by MIBI imaging showed a good linear correlation with the myocardial uptake and MBF measured by MAA. These results indicate that MBF may be estimated by Tc-99m-MIBI imaging and can be used for the early detection and estimation of the functional severity of coronary lesions.