The aim: Assessment of a possibility of performing differential diagnostics of the post-beam radio necrosis (PBRN) and the local recurrence (LR) after the carried-out stereotaxic radio surgery (SRS) according to perfusion on the basis of non-contrast pulse arterial backs markings (PASL). Materials and methods: In our research, we consider results of the stereotactic radiosurgery (SRS) which is carried out to 20 patients with the diagnosis the malignant glioma of a brain (MGB) in respect differential diagnostics of a local tumor recurrence and radionecrosis according to perfusion non-contrast MRT of a research on the basis of the sequence of PASL. The diagnosis of MGB before carrying out SRS was established to all 20 patients on the basis of a histologic research on data of a biopsy. From them the anaplastic astrocytoma (AnASTs, grade III) and at 14 – a glioblastoma was diagnosed for 6 patients (GBM, grade IV). Confirmations of the post-beam diagnosis it was carried out on the basis of a histologic research on results of a stereotactic biopsy or a surgical resection. Traditional methods of medical statistics were applied to processing of the statistical information obtained in a research at all its stages (calculation of average and relative sizes with their errors), also graphic and tabular methods were applied to rational evident statement of the received results. Results: The diagnosis of a local tumor recurrence according to a relative regional blood-groove on the basis of PASL was exposed to 8 patients and confirmed histologically (to 5 patients underwent surgical resection, 3 – according to biopsy data). Patients with a confirmed diagnosis of relapse according to biopsy were performed in 1 case, repeated radiosurgery and in 2 cases (with a diagnosis of multifocal continued growth of glioblastoma) – irradiation of the entire brain. Radionecrosis was diagnosed in 12 cases. In 6 cases, it was confirmed on the basis of clinical diagnostic data of dynamic observation of patients, in 3 cases – according to surgical resection, and in 3 cases – according to stereotactic biopsy. According to our data, the average rrCBF based on arterial spin labelling (PASL) rTPmean ≤ 0.8ml / 100g / minute most likely testified in favor of radionecrosis, average ≥ 1.5ml / 100g / min – in favor of tumor progression, the maximum rTPmax ≤ 1.3ml / 100g / min most likely testified in favor of radio-necrosis, the maximum indicator rTPmax≥ 1.8ml / 100g / min – in favor of tumor progression. Conclusions: According to a relative regional blood flow of rrCBF based on non-contrast PASL perfusion, it is possible to reliably carry out a differential diagnosis of radionecrosis and local tumor recurrence in patients undergoing radiosurgical treatment for malignant gliomas of the brain.

The aim: To assess the state of the immune system in patients before radiation therapy and radiosurgery and compare the features of immunity in metastatic and glial brain tumors. Materials and methods: Our study presents the results of immunograms of 41 patients. Of these: 18 patients with primary glial tumors and 23 patients with secondary metastatic tumors to the brain. The results of 20 conditionally healthy patients who did not have cancer are presented as a control group. The age of patients was 24-75 years. All patients have histological confirmation of the tumor diagnosis. Surgery was performed 1.0-3.0 years before the examination. Results: When comparing the immune parameters of the number of T and B subpopulations of lymphocytes in patients with primary malignant brain tumors and secondary metastatic tumors, no statistically significant difference was found between these indicators. Glioblastomas show higher levels of IgG and IgA than other tumors, while the concentration of IgM is almost at the same level in all three groups of patients. There is a tendency to decrease the level of IgG and IgM in the blood of patients with metastatic tumors. In the study group of patients there is an inhibition of myeloperoxidase activity of neutrophils on the background of maintaining the function of NBT cell activity. Conclusions: Both metastatic and primary malignant glial have partial changes in various parts of the immune system.