Role of Strain Elastography and Shear-Wave Elastography in a Multiparametric Clinical Approach to Indeterminate Cytology Thyroid Nodules

BACKGROUND In thyroid nodules with indeterminate cytology, further clinical assessment aimed at ruling out malignancy is often mandatory. Ancillary imaging techniques and genetic mutation analysis can improve the risk stratification of such lesions, thereby facilitating the clinician's decision to undertaken surgery or simple follow-up. The aim of this study was to evaluate the diagnostic performance of shear-wave elastography (SW), strain elastography (ELX 2/1), conventional ultrasound (US), contrast-enhanced ultrasound (CEUS), and BRAF V600E mutation analysis in the aforementioned lesions. MATERIAL AND METHODS We enrolled 81 patients, each with 1 indeterminate-cytology thyroid nodule. Thyroid function, thyroperoxidase antibodies and calcitonin were known in each case. SW, ELX 2/1, US, CEUS, and BRAF mutation analysis were subsequently performed, followed by a second FNAB. If the lesion was not downgraded to benign, surgery was recommended and histological reports collected. RESULTS There were 28 nodules (34%) that proved benign on the second FNAB; 38 nodules (47%) underwent surgery (17 benign, 21 malignant), and 15 nodules (19%) refused surgery. The only techniques related to histological outcome were US (AUC=0,766), ELX 2/1 (AUC=0.701), and BRAF analysis (AUC=0.762). ELX 2/1 and SW reports were not correlated with each other (P=0.45). A scoring system taking into account all the variables considered performed better than the single variables alone (AUC=0.831). CONCLUSIONS In indeterminate-cytology thyroid lesions, repeating FNAB can avoid unnecessary surgery. ELX 2/1 seems to perform better than SW in distinguishing malignancy; these techniques could, however, be complementary in describing such lesions. A multiparametric approach appears the most accurate in predicting nodule histology

A Decision Support System Based on BI-RADS and Radiomic Classifiers to Reduce False Positive Breast Calcifications at Digital Breast Tomosynthesis: A Preliminary Study

Digital breast tomosynthesis (DBT) studies were introduced as a successful help for the detection of calcification, which can be a primary sign of cancer. Expert radiologists are able to detect suspicious calcifications in DBT, but a high number of calcifications with non-malignant diagnosis at biopsy have been reported (false positives, FP). In this study, a radiomic approach was developed and applied on DBT images with the aim to reduce the number of benign calcifications addressed to biopsy and to give the radiologists a helpful decision support system during their diagnostic activity. This allows personalizing patient management on the basis of personalized risk. For this purpose, 49 patients showing microcalcifications on DBT images were retrospectively included, classified by BI-RADS (Breast Imaging-Reporting and Data System) and analyzed. After segmentation of microcalcifications from DBT images, radiomic features were extracted. Features were then selected with respect to their stability within different segmentations and their repeatability in test–retest studies. Stable radiomic features were used to train, validate and test (nested 10-fold cross-validation) a preliminary machine learning radiomic classifier that, combined with BI-RADS classification, allowed a reduction in FP of a factor of 2 and an improvement in positive predictive value of 50%

Radio frequency over fiber technology for SKA-low receiver

The signal reception chain is an essential element for achieving the square kilometer array-low (SKA-low) system requirements in terms of high sensitivity and dynamic range. The balance between gain, linearity, and low power consumption, as well as the cost, are fundamental parameters that influence the selection of the most suitable technology for SKA-low. Further factors, such as low self-generated radio frequency (RF) interference, high reliability, robustness under extreme environment, and last but not least, the distance between the antennas and the acquisition systems, have impacts on the selection for both architecture and receiver system design. The selected technology for the SKA-low RF signal transportation is RF-over-fiber systems, where the preamplified RF signal picked up by the antennas is carried via analogue modulation over optical fiber. The rationales behind the selection are reported, along with descriptions on the development of the receiver prototypes. The prototypes were deployed and installed on the demonstrator arrays at the selected SKA-low site in Western Australian. Particular attention has been put on the thermal characterization of the receiver system under the actual operating temperature on site, especially when both transmitting part and the optical medium are subjected to external ambient temperature variations. Performance issues encountered in the demonstrator arrays are also discussed along with some proposals for future activities

Test-Driven Design of an Active Dual-Polarized Log-Periodic Antenna for the Square Kilometre Array

An active dual-polarized Log-Periodic antenna has been designed to meet the requirements of the low-frequency (50 - 350 MHz) radio telescope of the Square Kilometre Array (SKA). The integration of antenna and low noise amplifier has been conceived in order to achieve a high degree of testability. This aspect has been found to be crucial to obtain a smooth frequency response compatible with the SKA science cases. The design has also been driven by other factors such as the large-volume production (more than 130 000 antennas will be built) and the environmental conditions of the harsh Australian desert. A specific verification approach based on both wideband radiometric spectral and spatial measurements in relevant laboratory and in-situ conditions has been developed. Electromagnetic analyses and experimental results exhibit a very good agreement. In December 2019, this antenna was part of the reference solution for the System Critical Design Review of the SKA

Preliminary tests to design an ad hoc signal acquisition chain for the Sardinia Aperture Array Demonstrator

The Sardinia Aperture Array Demonstrator (SAD) is an Italian facility, which is composed of 128 prototypical Vivaldi antennas, specifically designed to operate across the 50-500 MHz frequency range. As well known, one of the major burden at low frequency are the radio frequency interferences, thus after several accurate measurement campaigns we realized that a specific signal conditioning is needed in order to feed the digital beamformer with the proper signal level. In this paper, we report the results of the preliminary tests that we carried out in order to design an ad hoc receiving chain for the SAD array

Procedura di montaggio del sistema di movimentazione e controllo del ramo N/S per il sistema BIRALES

Lo scopo di questo documento è quello di descrivere la procedura dell’installazione del nuovo sistema di movimentazione delle antenne cilindrico paraboliche del ramo Nord/Sud del radiotelescopio “Croce del Nord”, studiato per venire incontro alle esigenze del programma “Space Surveillance and Tracking”, oltre a programmi scientifici quale la ricerca degli FRB. Oltre alla procedura di installazione, è indicata la lista del materiale necessario alla replicazione e i disegni costruttivi, e viene inoltre descritta la procedura di manutenzione

MRI versus mammography plus ultrasound in women at intermediate breast cancer risk: study design and protocol of the MRIB multicenter, randomized, controlled trial

In women at high/intermediate lifetime risk of breast cancer (BC-LTR), contrast-enhanced magnetic resonance imaging (MRI) added to mammography ± ultrasound (MX ± US) increases sensitivity but decreases specificity. Screening with MRI alone is an alternative and potentially more cost-effective strategy. Here, we describe the study protocol and the characteristics of enrolled patients for MRIB feasibility, multicenter, randomized, controlled trial, which aims to compare MRI alone versus MX+US in women at intermediate breast cancer risk (aged 40-59, with a 15-30% BC-LTR and/or extremely dense breasts). Two screening rounds per woman were planned in ten centers experienced in MRI screening, the primary endpoint being the rate of cancers detected in the 2 arms after 5 years of follow-up. From July 2013 to November 2015, 1254 women (mean age 47 years) were enrolled: 624 were assigned to MX+US and 630 to MRI. Most of them were aged below 50 (72%) and premenopausal (45%), and 52% used oral contraceptives. Among postmenopausal women, 15% had used hormone replacement therapy. Breast and/or ovarian cancer in mothers and/or sisters were reported by 37% of enrolled women, 79% had extremely dense breasts, and 41% had a 15-30% BC-LTR. The distribution of the major determinants of breast cancer risk profiles (breast density and family history of breast and ovarian cancer) of enrolled women varied across centers

Axillary lymphadenopathy at the time of COVID-19 vaccination: ten recommendations from the European Society of Breast Imaging (EUSOBI).

Unilateral axillary lymphadenopathy is a frequent mild side effect of COVID-19 vaccination. European Society of Breast Imaging (EUSOBI) proposes ten recommendations to standardise its management and reduce unnecessary additional imaging and invasive procedures: (1) in patients with previous history of breast cancer, vaccination should be performed in the contralateral arm or in the thigh; (2) collect vaccination data for all patients referred to breast imaging services, including patients undergoing breast cancer staging and follow-up imaging examinations; (3) perform breast imaging examinations preferentially before vaccination or at least 12 weeks after the last vaccine dose; (4) in patients with newly diagnosed breast cancer, apply standard imaging protocols regardless of vaccination status; (5) in any case of symptomatic or imaging-detected axillary lymphadenopathy before vaccination or at least 12 weeks after, examine with appropriate imaging the contralateral axilla and both breasts to exclude malignancy; (6) in case of axillary lymphadenopathy contralateral to the vaccination side, perform standard work-up; (7) in patients without breast cancer history and no suspicious breast imaging findings, lymphadenopathy only ipsilateral to the vaccination side within 12 weeks after vaccination can be considered benign or probably-benign, depending on clinical context; (8) in patients without breast cancer history, post-vaccination lymphadenopathy coupled with suspicious breast finding requires standard work-up, including biopsy when appropriate; (9) in patients with breast cancer history, interpret and manage post-vaccination lymphadenopathy considering the timeframe from vaccination and overall nodal metastatic risk; (10) complex or unclear cases should be managed by the multidisciplinary team

Developments of FPGA-based digital back-ends for low frequency antenna arrays at Medicina radio telescopes

In radio astronomy Field Programmable Gate Array (FPGA) technology is largely used for the implementation of digital signal processing techniques applied to antenna arrays. This is mainly due to the good trade-off among computing resources, power consumption and cost offered by FPGA chip compared to other technologies like ASIC, GPU and CPU. In the last years several digital backend systems based on such devices have been developed at the Medicina radio astronomical station (INAF-IRA, Bologna, Italy). Instruments like FX correlator, direct imager, beamformer, multi-beam system have been successfully designed and realized on CASPER (Collaboration for Astronomy Signal Processing and Electronics Research, https://casper.berkeley.edu) processing boards. In this paper we present the gained experience in this kind of applications