Objectives: The aim of this study was to present the baseline results of a pilot project conducted to evaluate the effectiveness of lung cancer screening using low-dose chest computed tomography (CT) in regions with excessive radon levels in the Republic of Kazakhstan.Methods: In total, 3671 participants were screened by low-dose chest CT. Current, former, and never-smokers who resided in regions with elevated levels of radon in drinking water sources and indoor air, aged between 40 and 75 with no history of any cancer, and weighing less than 140 kg were included in the study. All lung nodules were categorized according to the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS 1.0).Results: Overall, 614 (16.7%) participants had positive baseline CT findings (Lung-RADS categories 3 and 4). Seventy-four cancers were detected, yielding an overall cancer detection rate of 2.0%, with 10.8% (8/74) stage I and a predominance of stage III (59.4%; 44/74). Women never-smokers and men current smokers had the highest cancer detection rates, at 2.9% (12/412) and 6.1% (12/196), respectively. Compared to never-smokers, higher odds ratios (ORs) of lung cancer detection were found in smokers (OR,2.48; 95% confidence interval [CI], 1.52 to 4.05, p<0.001) and former smokers (OR, 2.32; 95% CI, 1.06 to 5.06, p=0.003). The most common histologic type of cancer was adenocarcinoma (58.1%).Conclusions: Implementation of low-dose CT screening for lung cancer in regions with elevated radon levels is an effective method for both smokers and never-smokers.

Cystic echinococcosis (CE) is a parasitic zoonosis caused by E. granulosus primarily affecting the liver and lungs. CE of the bone is by far the most debilitating form of the disease and is very difficult to manage as it mimics malignant tumors. We reviewed bone CE cases admitted to a reference oncological hospital in Kazakhstan from January 2010 to February 2017. Among eight patients, the mean age was 33.5 years, and the male/female ratio was 1 : 3. Patients were examined by X-ray (8/8), CT (7/8), and MRI (3/8). CE was in the spine (2 cases), pelvis (3 cases), and long bones (humerus, tibia, and femur; one case for each). All patients were treated surgically. No perioperative albendazole was administered. No patient received albendazole afterwards. The mean hospital stay was 25 days. Interventions are urgently needed to assess the burden of CE in Kazakhstan and to inform clinicians of the existence of the disease.

Background. Breast cancer is the most common cancer in women worldwide. Despite advances in treatment of breast cancer, early-stage breast cancer detection is limited by screening mammography and often requires additional breast imaging.The purpose of the study was to analyze available data on modern imaging techniques of additional breast visualization used for improving breast cancer screening.Material and methods. The review includes data from randomized controlled trials and meta-analyzes on the effectiveness of breast imaging techniques for early-stage breast cancer detection. The search was carried out in pubmed, Web of science, scopus and cochrane library databases. Out of 100 publications published over the past 7 years, 51 were included in the presented review.Results. Breast cancer screening using various imaging techniques has been carried out in the world for more than 30 years, and over the past 10 years significant progress has been made in improving X-ray, ultrasound and magnetic resonance technologies in the early breast cancer detection. At present, healthcare organizers are faced with the question of choosing a vector for improving the breast cancer screening program by introducing digital tomosynthesis, contrast spectral mammography, or accelerated mri. According to the current results of the analysis of literature data, contrast spectral mammography and accelerated mri have the highest sensitivity, but studies of sensitivity, specificity, positive and negative predictive values (ppv, npv) are ongoing.Conclusion. The data presented in the review confirm the necessity for finding the vector for improving the breast cancer screening program using multicenter prospective trials.

Background/Aims: The aim of our study was to determine the efficacy of computed tomography colonography (CTC) in screening for colorectal cancer (CRC).Methods: A total of 612 females and 588 males aged 45 to 75 years were enrolled in CTC screening. CTC was performed following standard bowel preparation and colonic insufflation with carbon dioxide. The main outcomes were the detection rate of CRC and advanced adenoma (AA), prevalence of colorectal lesions in relation to socio-demographic and health factors, and overall diagnostic performance of CTC.Results: Overall, 56.5% of the 1,200 invited subjects underwent CTC screening. The sensitivity for CRC and AA was 0.89 and 0.97, respectively, while the specificity was 0.71 and 0.99, respectively. The prevalence of CRC and AA was 3.0% (18/593) and 7.1% (42/593), respectively, with the highest CRC prevalence in the 66-75 age group (≥12 times; odds ratio [OR], 12.11; 95% confidence interval [CI], 4.45-32.92). CRC and AA prevalence were inversely correlated with Asian descent, physical activity, and negative fecal immunochemical test results (OR=0.43; 95% CI, 0.22-0.83; OR=0.16; 95% CI, 0.04-0.68; OR=0.5; 95% CI, 0.07-3.85, respectively).Conclusions: Our study revealed high accuracy of CTC in diagnosing colonic neoplasms, good compliance with CTC screening, and high detection rate of CRC.

Relevance: The incidence of malignant neoplasms of various localizations is growing worldwide and in Kazakhstan. The mortality rate from oncological diseases is also alarmingly high. To facilitate early diagnosis and optimal therapy, scientists are exploring molecular diagnostics, including PET/CT, using various markers, like 18F-fluorodeoxyglucose, widely used in oncology but lacking specificity for certain types of tumors. The finding of Fibroblast Activation Protein (FAP) has sparked interest in FAP-targeted radiolabeled inhibitors (FAPI), which could serve as a universal marker for diagnosing different types of cancer. Various FAP markers for PET/CT are being studied, with special attention given to 68Ga-FAPI. The study aimed to analyze the potential value of FAPI PET/CT for detecting malignant tumors. Methods: A literature review was conducted using the MEDLINE, Embase, Scopus, PubMed, and Cochrane Central Register of Controlled Trials databases for the past decade using the following keywords: “malignant lesions,” “PET/CT,” and “FAPI.” This review analyzes 48 literature sources with A1-level evidence dedicated to the 68Ga-FAPI PET/CT diagnostic accuracy in detecting and staging malignant tumors and assessing treatment efficacy. Results: According to the analyzed sources, the 68Ga-FAPI PET/CT sensitivity and specificity in diagnosing cancer is 95% to 100% and 62% to 100%, respectively. However, clear indications for use in clinical practice require further study of 68Ga-FAPI PET/CT diagnostic capabilities on larger cohorts and more homogeneous datasets. Conclusion: The available literature data on FAPI PET/CT diagnostic capacity shows this marker’s potential in diagnosing oncological disorders. Information provided by 68Ga-FAPI PET/CT supplements the existing nuclear medicine methods and generally impacts the treatment strategy for each unique case.

Computed tomography volumetry is the standard method for preoperative estimation of liver volume. Despite the development of various software, the trend towards discrepancy in the calculation of liver volume compared with any of the methods and intraoperative graft weight remains. The aim of the study was to optimize the manual method of CT volumetry donor’ liver, determine its accuracy and compare it with the standard method. Material and methods. A single-center prospective study including data from 60 liver donors who underwent computed tomography, CT volumetry and liver transplantation at the National Scientific Surgery Center named after A.N. Syzganov for the period 2018-2022. Results. The Pearson correlation between the right liver lobe volume estimated by the standard method and the graft weight was 0.730 (p<0.01), the Pearson correlation between the liver volume calculated by the optimized method (-10 HU) and the graft was 0.757 (p<0.01), and the correlation between the optimized method (-20 HU) and graft weight – 0.860 (p<0.01). The Pearson correlation coefficient of the optimized method (-20 HU) is statistically significantly higher than the correlation coefficient of the standard manual method (p=0.026), the difference between the correlation coefficient of the optimized method (-10 HU) and the standard one is statistically insignificant (p=0.375). The degree of discrepancy between the optimized method (-20 HU) was 8.4%, manual method - 12.7%. There is a statistically significant difference between the degree of discrepancy between the standard manual and optimized method (-20 HU) (p=0.029). Conclusions. Optimization of the manual CT volumetry method with a decrease in the liver density threshold by 20 HU demonstrated a statistically significantly high correlation coefficient with the graft weight, and also significantly reduced the degree of discrepancy.