Use of Diagnostic Criteria from ACR and EU-TIRADS Systems to Improve the Performance of Cytology in Thyroid Nodule Triage

Objective: The American College of Radiology (ACR) and the European Thyroid Association (EU) have proposed two scoring systems for thyroid nodule classification. Here, we compared the ability of the two systems in triaging thyroid nodules for fine-needle aspiration (FNA) and tested the putative role of an approach that combines ultrasound features and cytology for the detection of malignant nodules. Design and Methods: The scores obtained with the ACR and EU Thyroid Imaging Reporting and Data Systems (TIRADS) from a prospective series of 480 thyroid nodules acquired from 435 subjects were compared to assess their performances in FNA triaging on the final cytological diagnosis. The US features that showed the highest contribution in discriminating benign nodules from malignancies were combined with cytology to improve its diagnostic performance. Results: FNA was recommended on 46.5% and 51.9% of the nodules using the ACR and EU-TIRADS scores, respectively. The ACR system demonstrated a higher specificity as compared to the EU-TIRADS (59.0% vs. 52.4%, p = 0.0012) in predicting ≥ TIR3A/III (SIAPEC/Bethesda) nodules. Moreover, specific radiological features (i.e., echogenic foci and margins), combined with the cytological classes improved the specificity (97.5% vs. 91%, p < 0.0001) and positive predictive values (77.5% vs. 50.7%, p < 0.0001) compared to cytology alone, especially in the setting of indeterminate nodules (TIR3A/III and TIR3B/IV), maintaining an excellent sensitivity and negative predictive value. Conclusions: The ACR-TIRADS system showed a higher specificity compared to the EU-TIRADS in triaging thyroid nodules. The use of specific radiological features improved the diagnostic ability of cytology

Microsatellite instability evaluation by automated microfluidic electrophoresis: an update

A significant proportion (∼15%) of colorectal cancer (CRC), either sporadic or arising in the setting of the hereditary non-polyposis colorectal carcinoma syndrome, features microsatellite instability (MSI). Five MSI loci, either mononucleotide or dinucleotide repeats (Bat25, Bat26, D2S123, D5S346 and D17S250), are included in the Bethesda panel and capillary electrophoresis represents the usual gold standard technique

Nanoarchitectured thin film high entropy alloys with enhanced and tunable mechanical properties

International audienceThin film high entropy alloys (TF-HEAs) have recently gained interest for their large ductility and yield strength (up to 30% and 10 GPa respectively, for NbMoTaW) [1], as a results of the thickness confinement and the small grain size. In addition, the mechanical properties can be boosted by developing nanolaminate structures capable of blocking the propagation of dislocation and cracks [2]. However, the development of new TF-HEA architecture and the investigation of local mechanical properties exploiting in situ SEM techniques represent an open challenge.Here, we developed nanoarchitectured TF-HEAs by magnetron sputtering and pulsed laser deposition (PLD), enabling a fine control over the film morphology, and providing the possibility to design unique film architectures [3]. Firstly, we focus on the synthesis of nanostructured CoCrCuFeNi TF-HEAs. We report a compact to nanogranular transition for films deposited by PLD when the background pressure is >1 Pa (Fig.1).This results in a reduction of mass density (~15%) and elastic modulus (~8%), starting from 8.01 g/cm3 and 173 GPa respectively. Moreover, we show that TF-HEAs deposited by PLD have enhanced hardness (10.5 GPa) compared to magnetron sputtering (7.4 GPa), while showing exceptional ductility in tensile tests on polymer substrate (onset of crack formation 3.4%). In a second step, we fabricate Al/CoCrCuFeNi nanolaminates with a semicoherent interface (FCC/FCC) by PLD and sputtering, with a bilayer period (Λ) ranging from 2.5 to 200 nm. Despite a volume fraction of 50% for Al (H=1.5 GPa), nanolaminates by PLD are able to maintain high hardness up to 9.7 GPa (for Λ = 50 nm). Moreover, at smaller bilayer periods, we observe an inverse Hall-Petch effect, reducing hardness down to 8.4 GPa. Finally, I will present recent results involving the synthesis of new nanolaminates with an incoherent interphase, such as Al25CoCrCuFeNi/Al (BCC/FCC), while focusing on the development of in situ techniques such as micropillar compression (Fig.2) to understand the local deformation mechanisms

Diagnostic Performances of the ACR-TIRADS System in Thyroid Nodules Triage: A Prospective Single Center Study

Ultrasound scores are used to determine whether thyroid nodules should undergo Fine Needle Aspiration (FNA) or simple clinical follow-up. Different scores have been proposed for this task, with the American College of Radiology (ACR) TIRADS system being one of the most widely used. This study evaluates its ability in triaging thyroid nodules deserving FNA on a large prospective monocentric Italian case series of 493 thyroid nodules from 448 subjects. In ACR 1–2, cytology never prompted a surgical indication. In 59% of cases classified as TIR1c-TIR2, the FNA procedure could be ancillary, according to the ACR-TIRADS score. A subset (37.9%) of cases classified as TIR4-5 would not undergo FNA, according to the dimensional thresholds used by the ACR-TIRADS. Applying the ACR score, a total of 46.5% thyroid nodules should be studied with FNA. The ACR system demonstrated a sensitivity and specificity of 58.9% and 59% in the identification of patients with cytology ≥TIR3A, with a particularly high false negative rate for ACR classes ≥3 (44.8%, 43/96), which would dramatically decrease (7.3%, 7/96) if the dimensional criteria were not taken into account. In ACR 3–4–5, a correspondence with the follow-up occurred in 60.3%, 50.2% and 51.9% of cases. The ACR-TIRADS is a useful risk stratification tool for thyroid nodules, although the current dimensional thresholds could lead to an underestimation of malignant lesions. Their update might be considered in future studies to increase the screening performances of the system

Engineering new nanostructured metallic film by pulsed laser deposition

International audienceMaterials possessing sub-micrometer scale features often show unique mechanical properties combining large yield strength and ductility due to the activation of size effects [1]. However, the correlation between microstructure and mechanical properties is not fully grasped and the research of new nanostructures with unconventional properties or enhanced performances is subject of intense research. In this context, pulsed laser deposition (PLD) has great potential to tune the film nanoscale morphology and atomic structure (e.g. degree of disorder/crystallinity) by simply adjusting synthesis parameters, e.g. the deposition pressure, leading to atom-by-atom or cluster-assembled growth regimes, resulting in compact and nanogranular films, respectively [2]. Nevertheless, the use of PLD for the depositing nanostructured metallic films is still in a preliminary phase [3]. Here, I will show my results regarding two classes of films: thin film metallic glasses (TFMGs) and complex compositionally alloys (TF-CCAs). Firstly, I will cover the results involving the synthesis and the mechanical behavior of (ZrCu)100-xAlx TFMGs with different compositions (x = 0, 5, 8, 13 %at.) and morphologies i.e. compact and nanogranular. HRTEM shows a self-assembled nanolayered structure with local chemical enrichments alternating ZrCu and Al-rich nanolayers. This leads to large and tunable elastic modulus E and hardness H, up to 145 and 9.3 GPa, respectively. Furthermore, in situ SEM micropillar compression tests show that compact films have an outstanding combination of yield strength (3.2 GPa) and ductility (5%), among the highest values reported in literature, while nanogranular films show homogenous deformation after yielding (up to 6%) due to their structural heterogeneity which delays the maturation of shear bands like in nanoglasses [4]. Then, I will present results concerning Alx(CoCrCuFeNi)100-x TF-CCAs with different compositions (x = 0, 9, 16 %at.) and morphologies. CoCrCuFeNi films possess an FCC nanocrystalline structure leading to enhanced H (up to 12 GPa) with respect to sputter-deposited films. In addition, CoCrCuFeNi reports an exceptionally high (>3.5%) onset of crack formation when deformed on polymer substrates because of the high energy of the deposition process, leading to strong adhesion and preventing crack activation and percolation. Furthermore, HRTEM of Alx(CoCrCuFeNi)100-x reveals a nanolaminated structure alternating segregated Al (2 nm) and CoCrCuFeNi alloy (5 nm), which induces a slight decrease of E (from 175 to 160 GPa) and H (from 12 to 9.5 GPa) vs the base CCA due to a combination of the low mechanical properties of Al and, possibly, an inverse Hall-Petch effect caused by the low dimensions of the crystallites inside the nanolayers.Overall, the presented results show the potential of PLD to synthetize a novel class of nanostructured thin metallic films with large and tunable mechanical properties and potential interest as structural coatings.References:[1] M. Ghidelli et al., Acta Mater., 2017; [2] F. Di Fonzo et al., Nanotechnology, 2008;[3] M. Ghidelli et al., Acta Mater., 2021; [4] S. H. Nandam et al., J. Mater. Res., 2021

New synthesis methods for thin film high entropy alloys with tunable microstructure and enhanced mechanical properties

International audienceIn recent years, research on thin film high entropy alloys (TF-HEAs) has gained increasing interest due to the activation of mechanical size effects involving a combination of high ductility and yield strength (up to 30% and 10 GPa for NbMoTaW) [1]. One of the current challenges is to develop advanced techniques for synthesis of nanostructured TF-HEAs, while implementing nanoengineering design strategies such as multilayered systems, which are known to improve the mechanical properties by blocking the propagation of dislocations [2].CoCrCuFeNi is one of the first HEAs discovered, with an FCC structure and promising properties. It reports yield strength in compression of 450 MPa and 60% ductility [3], however very few studies focus on this alloy in thin film form. Here, we synthetized CoCrCuFeNi TF-HEAs and Al/CoCrCuFeNi multilayers by pulsed laser deposition (PLD), exploiting its large versatility providing different microstructures (i.e. compact and nanogranular) by simply varying the background gas pressure [2]. Our films show a transition from compact to nanogranular at ~1 Pa of He (Fig.1), as well as a loss of crystallographic texturing shown in SAED-TEM. Nanoindentation shows increased hardness in CoCrCuFeNi TF-HEAs from PLD (11 GPa) compared to magnetron sputtering (8 GPa), as a result of smaller domain size (10 nm) and compressive residual stresses. Nanogranular films report ~10% reduction of density and elastic constants due to the lower energy of the ablated species. Tensile tests on Kapton® show exceptional ductility of compact CoCrCuFeNi films, with an onset of crack formation of 3.4% decreasing for nanogranular films (vs ~2% from magnetron sputtering [4]). STEM-EDX of Al/CoCrCuFeNi multilayers (Fig.2) shows localchemical enrichments with ~2 nm Al layers separated by ~5 nm of the HEA with very little diffusion at the interfaces, showing good mechanical properties (H=9 GPa, E=157 GPa). Our results show that PLD is a powerful technique that enables a single step synthesis of advanced TF-HEAs with tunable microstructure and multilayering, leading to tunable mechanical properties with potential applications in microelectronics, MEMS or high performancecoatings

Identification of a novel 19 kDa Echinococcus granulosus antigen

By screening an Echinococcus granulosus cDNA library with IgG4 from patients with active cystic echinococcosis (CE), we identified a cDNA encoding a protein of 19.0 kDa (Eg19). Eg19, in 12% SDS-PAGE in reducing and non-reducing conditions, showed several bands between 19 and 100 kDa. Immunoblotting(IB) analysis detected total IgG, IgG1 and IgG4 specific to the 38/40 kDa band of Eg19 in the 10% of patients' sera. The percentage of total IgG, IgG1 and IgG4-positive sera were significantly higher in sera from patients with active disease and cyst in multiple sites than from patients with inactive disease and cyst in the liver (p < 10(-4)). ELISA analysis disclosed that during the follow-up anti-Eg19 antibody concentration decreased over the course of treatment in sera from patients with cured disease. Even if Eg19 appear to have no benefit in the diagnosis of the disease, our data, confirming the presence of antigens inducing both IgG1 and IgG4 during active development of CE, suggest that Eg19 might be a marker of disease status. (C) 2009 Elsevier B.V. All rights reserved

Synthesis and mechanical behavior of nanostructured high entropy alloy thin films by pulsed laserdeposition

International audienceHigh entropy alloy thin films (HEA-TFs) have become object of intense research in the last yearsdue to the mutual combination of large strength and ductility, overcoming traditional bulkmaterials [1]. However, the field of thin film HEAs is still at its early stage and the effects ofnanostructure on mechanical behavior have not been studied yet. In this context, pulsed laserdeposition (PLD) offers the ability to control the morphology of the films by simply playing withthe pressure during the deposition by adding an inert gas or by changing the laser wavelengthand fluence (J/cm2) [2]. Here, we investigate the structure and mechanical properties ofAlxCoCrCuFeNi thin filmsdeposited by PLD investigatingthe effects of laser wavelength(1064 and 532 nm), depositionpressure (vacuum and 5 Pa He) aswell as the Al content (from 0 upto 16 %at.). In addition, a secondseries of samples was grown bymagnetron sputtering forcomparison purposes. We show inFig. 1 that CoCrCuNiFe films deposited in vacuum and at 5 Pa He are, respectively, compact andnanogranular. Moreover, we show that addition of Al (AlxCoCrCuFeNi) is responsible of a phasetransition from FCC to BCC (at 16% at. Al), possessing a unique atomic structure alternating Alrichand CoCrCuNiFe nanolayers. The Young’s modulus and hardness of PLD films (175 and 10.8GPa) are ~10% larger than magnetron sputtered films with a slightly decrement by addition ofAl and for nanogranular film [3]. Tensile test on polymeric substrate (Kapton®) show thatcompact films have an outstanding onset of crack initiation up to ~3.5% which is higher vsliterature (~2% [4]) and slightly decreasing by adding Al. The larger mechanical properties of PLDfilms can be related to the high energies of deposition and nanolayered structure. Overall, weshow that PLD has the potential to synthetize a novel class of HEA-TFs with tunable mechanicalproperties and potential interest as structural coatings.References[1] Zou, Y. et al., Nat. Commun. 6, 2015. [2] M. Ghidelli et al., Acta Mater. 213, (2021).[3] Braeckman, B., Ghent University, (2016). [4] Li, C. et al., Surf. Coat. 402, (2020)