Citation: News of Beam Diagnostics Belarus 2001 1-2: 2-3
40th Anniversary of the N.N. Alexandrov Scientific
Research Institute of Oncology and Medical Radiology.
Golub G. D., Vaganov Yu. V.
The N.N. Alexandrov Sscientific Research Institute of Oncology and Medical Radiology, Minsk.
(Translated from the Russian by Sue-Ann Harding)
The 40th anniversary is a significant milestone in the history of the leading scientific research institute of Belarus. Over the years, competent and enterprising doctors (radiologists), including I.I. Neverovsky, M.F. Libman, M.E. Fisher, E.Ya. Chyorny, E.K Getsman, A.M. Shapiro, V.A. Trusevich, L.L. Avdei, E.A. Rutskaya, M.M. Kovshik, A.V. Malakhov, N.N. Vasilteva and V.I. Nikolaev have served not only in the practical diagnostic work of the institute but have also devoted much time to scientific research.
The Department of Diagnostic Radiology is the oldest in the institute. Its principal areas of scientific research are the development of new and the refinement of existing methods of diagnosis of neoplasms of the internal organs (G.D. Golub, T.N. Serova, Yu.V. Vaganov, D.D. Demeshko, O.Yu. Komarova, E.V Bogushevich, N.V. Titkova, V.V. Astrometskaya and V.P. Dyuban); the breast (A.G. Ilkevich); bones and the osteoarticular system (T.A. Kuznetsova and D.G. Yarosh); and the use of X-ray, ultrasound and angiography (V.S. Dudarev, V.V. Akinfeev, L.B. Bashkevich and E.M. Zholnerovich) and computer assisted tomographic semiology to define such neoplasms more precisely.
These integrated programmes which include methods of radiation and non-radiation introscopy have proved highly effective (88-96%) in the diagnosis of several types of tumours including early stage neoplasms.
With the aim of increasing the quality of the investigation of patients with suspected cancer of the stomach, our institute worked with the SRI of Introscopy to design the first Belarussian gastrofluorograph and developed the standardized two-stage procedure of investigation. With these it has been proved that a sure diagnosis of cancer of the stomach can be established in 93-96% of cases. It has also been established that gastrofluorography can successfully replace traditional radiological investigation, significantly reducing the exposure of the patient and personnel to radiation without lowering the quality of the investigation. Today gastrofluorographs are also used in irrigoradioscopy.
Abdominal sonography, a non-invasive, non-radiation component of gastrological diagnostics, is also included in the diagnostic chain, using a method developed in the department, the principal advantage of which is the absence of radiation load on the patient and medical staff. Abdominal echography may be used to screen for neoplasms of the stomach, not as an alternative but supplementary to the endoscopic and radiological method.
The integrated use of modern diagnostic methods such as X-ray computer assisted tomography, ultrasound investigation and radionuclide investigation with 99Ts(tetrasodium)-pyrophosphate significantly increases the effectiveness of the diagnosis of malignant bone tumours. The SRI has also developed a method of radiological investigation which increases the accuracy of diagnosis of melanoma of the skin and includes a high degree of reliability in assessing the local distribution of the condition.
Due to the improvement of our technical base, the introduction of new methods of investigation and the training of specialists in leading clinics in France and Austria, diagnostic resources for breast disease have been substantially broadened. A combination of diagnostical measures carried out in the department allows us to detect breast cancer and obtain materials for histological verification, including tumours symptomatic of early forms of cancer. Particular attention is paid to the diagnosis of nonpalpable forms of breast cancer and to the more precise definition of their radiological symptoms. The application of preoperative marks of such tumours allows us to determine more precisely the scope of surgical operations. An algorithm of investigation depending on the age of the patients and the nature of the pathology has also been developed.
The Department of Diagnostic Radiology was the first in the country to acquire and has the most extensive experience of the use of X-ray equipment with remote control and digital processing images. Particularly important for oncological X-ray is the method of digital tomography, widely used in pulmonology and osteology. The possibility of being able to select investigation projections and adjust the positioning of the patient under X-ray monitoring with the highest quality imaging, provides tomographic images of any segmented bronchia regardless of their spatial direction, detection of single low-intensive shadows in the lungs from 3mm and well-defined localisation of interlobar pleura relative to pathological conditions. It is possible to detect small sections of change and degeneration in bone tissue, even in those parts that are usually awkward to investigate such as the breast bone, rib cage, spinal column and facial bones of the skull. With digital radiography and tomography, the reliability of diagnosis is increased, both in the initial determination of the extent of the tumour and also in verifying the results of treatment as part of dynamic observation. The diagnostic accuracy of lesions of the bronchopulmonary lymph nodes for example, increased from 38-74%.
Thus, a new method of traditional diagnostics has appeared in the arsenal of radiologists, which has increased the possibilities of early detection of oncological diseases. At the same time, world and our own experience attests to the superiority of computer assisted and magnetic resonance tomography in determining the extent of the spread of tumours in the breast, the abdominal cavities, the retroperitoneal space, the small pelvis and the skull.
In view of the particular situation in Belarus brought about by the accident at the Chernobyl atomic power station, the reduction of radiation dosage during radiological investigative procedures is of enormous importance. The Department of Diagnostic Radiology has participated in the development and medical trials of “Pulmoscan-760”, the first system of digital radiology in the country. Today it is widely used not only in Belarus but is also recognised in countries abroad.
Today the Department of Diagnostic Radiology is engaged in scientific research
in the following areas:
• The development of new digital radiography equipment
• The use of modern technology in the development of new and the refinement of existing methods of diagnostic radiology of tumours of the internal organs, the breast and the osteoarticular system
• The development of standardised programmes of investigation for the early and opportune diagnosis of tumours.
And so it is with a thorough understanding of the scientific and practical tasks before them that the staff from the Department of Diagnostic Radiology are celebrating the 40th anniversary of the institute.