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3D computer NLS-graphy

AppLIcAtIoN oF tHree-DImeNSIoNAL NLS-DIAGNoStIcS IN oNcoLoGy. New treNDS AND proSpectS oF DeVeLopmeNt

V.I. Nesterova, L.V. Shaposhnikov, L.A. yankina, o.r. Kojemyakin
iagnostics and treatment of malignant neoplasms are the most urgent issues in modern medicine. Oncologists face not only problems of primary and updating diagnostics of tumoral diseases, but also evaluation of various methods of tumor treatment efficiency, well-timed diagnosing of recurrent tumors after treatment procedures. Introduction of new three-dimensional technologies of NLS-pictures acquiring into clinical practice allows solving of abovementioned diagnostic problems at qualitatively new and higher level. Application of three-dimensional visualization of organs and tissues significantly extended potential of NLS-diagnostics. Today we may speak about truly early diagnostics of tumoral diseases at the first, pre-clinic stage of patient examination. Three-dimensional NLSexamination allows not only revealing of minimal structural changes in organs and tissues, but precise evaluating of tumoral process spreading extent, also, together with use of spectral-entropy analysis, it makes possible to identify diseases stage and choose adequate method of patient treatment. The Institute of Practical Psychophysics has great experience of three-dimensional NLS-scopy application; it is not possible to describe it in proper manner in such small article. Due to this fact we decided to dwell on those issues of three-dimensional NLS-diagnostics, which have great practical importance, but still not widely spread in clinical practice. In group of malignant tumors of liver metastatic invasion hold leading positions. It is well known that

the most frequent reasons of liver metastatic disease are malignant tumors of large intestine, rectum, stomach, pancreas, mammary gland and lungs. At metastatic disease shape, structure, size of parenchyma and vascular pattern of liver are more or less changed, depending on duration of tumor existence, number and sizes of tumoral nodes. In addition to three-dimensional NLS-graphy, diverse variants of dopplerography, in the first place energy color mapping, may be used to solve problem of differential diagnostics of benign and malignant changes in liver parenchyma. three-dimensional NLS-graphy method allows visualizing of three-dimensional picture of vessels location and form, marking them by certain color at the background of organ usual picture. In this aspect the method is rather close to x-ray angiography method and makes possible to visualize accurately great and minute vessels. Vascular pattern at single metastases is broken due to constriction and dislocation of hepatic branches certain vessels. At massive affection significant breach of vascular pattern happens. In some cases a therapist may detect local, chaotic change of vascular pattern, when hypervascularization of tumoral nodes is present. However tumoral nodes at liver metastatic disease may have both increased and deceased vascularization. Due to this fact data acquired with NLS-graphy is not always sufficient and should be completed with results of -ray angiography. Differential diagnostics of tumoral affection of liver complicated by not only marked multiformity of changes, but also by its frequent combination with diffuse


and dystrophic changes of organs parenchyma. All abovementioned stipulates necessity in wide application of spectral-entropy analysis of affection nidus. Our experience proves that availability of NLS-diagnostics equipment makes possible detailed examination of

three-dimensional hepatic neoplasms sized less that 3 mm. Therefore at early stage of pathology development a clinician is able to update morphological substrate of detected changes and to acquire sufficient information for diagnosis updating.

Computed tomography scan of liver tumor nodes are marked by arrow signs
t is well known that one of the leading methods of solitary hepatic metastases treatment is surgical operation. Proof of operation efficacy is the absence of metastases in other parts of liver. This problem may be successfully solved by three-dimensional NLS-ultramicroscopy with application of spectralentropy analysis. For a long time wide application of ultramisroscopic NLS-examination was limited by absence of special equipment with high resolution. Nowadays devices with super-high frequency non-linear generator (40 GHz) are created, it makes possible to carry out threedimensional ultramicroscopic revision and evaluation of chromosomal aberrations of almost any cell in human organism. Three-dimensional NLS-research may help to specify character, localization and number of pathological nidi when clinician plans liver resection because of metastatic disease. Our experience shows that application of three-dimensional NLS-graphy at cancer metastases of large intestine allows detection of additional nidi, not registered by any type of introscopy, in 20% of cases. Data acquired at three-dimensional NLS-graphy of liver makes possible to evaluate extent of operation, avoid unjustified surgical intervention and decrease risk of post-operative complications development. Joint application of video-laparoscopy and NLSresearch allows therapist to combine proper examination

NLS-graphy of liver cancer

of abdominal organs and tissues with study of their structure by application of spectral-entropy analysis in selected areas, and to carry out updating diagnostics of tumoral diseases of abdominal cavity organs and retroperitoneal space. At stomach cancer number of mistakes at pre-operation diagnostics of liver metastatic disease reaches 25% 30%. The first application of such research technology proves that number of mistakes decreases to 3% 5%.

Ultrasound scan picture of liver tumor -8-

3D computer NLS-graphy

NLS-picture of liver cancer

owadays oncourology is the sphere where methods of three-dimensional NLS-graphy may also be widely applied. However until this day application of three-dimensional NLS-research of patients operated on urinary bladder tumor consisted in dynamic monitoring of organs condition in order to detect recurrent tumor and metastases at early stage. Introduction of threedimensional NLS-methods into clinical practice allow complete changing of point of view to this problem. We believe that this issue is really topical, because majority of surgically operated patients were subjected to traumatic transurethral resections. Three-dimensional NLS-research with application of spectral-entropy analysis, carried out during surgical oncotomy, allowed us to detect additional tumoral neoplasms, not registered by two-dimensional NLS

NLS-ultramicroscanning of hepatic tubules at liver cancer

research in 37% of patients. Application of threedimensional methods makes possible to specify extent of tumor process local spreading, control depth of urinary bladder wall resection and decrease risk of complication development during oncotomy. Diagnostics and morphological verification of rectum cancer does not present difficulties, as a rule. However evaluation of organs wall invasion degree is not always possible by standard methods of diagnostics. Traditional two-dimensional NLS-research is already widely used as diagnostics method of rectum recurrent cancer after organ extirpation. Nevertheless primary diagnostics of the disease by two-dimensional NLS-graphy is hindered due to several reasons. In the first place it is explained by the fact that at two-dimensional NLS-scanning rectum is visualized only partially (80% of whole organ surface area).

Ultrasound scan picture of urinary bladder (detection of tumor mass in urinary bladder) -9-

NLS. Tumor of urinary bladder

pplication of three-dimensional NLS-graphy makes possible to differentiate accurately all layers of rectum walls, and thus to diagnose depth of tumor infiltration and identify stage of the disease, using spectralentropy analysis. This method helps to detect changed lymph nodes sized above 1.5 mm at metastatic disease of pararectal lymph nodes. During monitoring of carried out pre-operational radiotherapy three-dimensional NLSgraphy helps to detect accurately decreasing of tumor sizes, identify changes in its structure, related to medical

pathomorphism, identify decreasing of pararectal tissues tumoral infiltration. Therefore three-dimensional NLSgraphy may be considered method of primary diagnostics of rectum cancer. It allows therapist to solve the most important diagnostic issues, related to identifying of tumoral process length, extent of tumor local spreading and monitoring of carried out pre-operative treatment efficiency. At organ preserving operations three-dimensional NLS-graphy may be used as efficient method of recurrent tumors early diagnostics in anastomosis area.

Rectum cancer

Rectum cancer at NLS-graphy

NLS-ultramicroscanning of rectum wall at cancer

NLS-analysis. Rectum cancer

n conclusion, as an outcome of short characteristics of modern three-dimensional NLS-graphy method, we want to emphasize that this method permits efficient

fulfillment of such objectives as detection of tumoral changes, identifying of diseases stage and qualitative evaluation of carried out treatment.