Clinical Breast MR Using MRS or DWI: Who Is the Winner?

Magnetic resonance imaging (MRI) of the breast gained a role in clinical practice thanks to the optimal sensitivity of contrast-enhanced (CE) protocols. This approach, first proposed 30 years ago and further developed as bilateral highly spatially resolved dynamic study, is currently considered superior for cancer detection to any other technique. However, other directions than CE imaging have been explored. Apart from morphologic features on unenhanced T2-weighted images, two different non-contrast molecular approaches were mainly run in vivo: proton MR spectroscopy (1H-MRS) and diffusion-weighted imaging (DWI). Both approaches have shown aspects of breast cancer (BC) hidden to CE-MRI: 1H-MRS allowed for evaluating the total choline peak (tCho) as a biomarker of malignancy; DWI showed that restricted diffusivity is correlated with high cellularity and tumor aggressiveness. Secondary evidence on the two approaches is now available from systematic reviews and meta-analyses, mainly considered in this article: pooled sensitivity ranged 71-74% for 1H-MRS and 84-91% for DWI; specificity 78-88% and 75-84%, respectively. Interesting research perspectives are opened for both techniques, including multivoxel MRS and statistical strategies for classification of MR spectra as well as diffusion tensor imaging and intravoxel incoherent motion for DWI. However, when looking at a clinical perspective, while MRS remained a research tool with important limitations, such as relatively long acquisition times, frequent low quality spectra, difficult standardization, and quantification of tCho tissue concentration, DWI has been integrated in the standard clinical protocols of breast MRI and several studies showed its potential value as a stand-alone approach for BC detection

Chest computed tomography of suspected COVID-19 pneumonia in the Emergency Department : comparative analysis between patients with different vaccination status

Purpose: To identify differences in chest computed tomography (CT) of the symptomatic coronavirus disease 2019 (COVID-19) population according to the patients' severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination status (non-vaccinated, vaccinated with incomplete or complete vaccination cycle). Material and methods: CT examinations performed in the Emergency Department (ED) in May-November 2021 for suspected COVID-19 pneumonia with a positive SARS-CoV-2 test were retrospectively included. Personal data were compared for vaccination status. One 13-year experienced radiologist and two 4th-year radiology residents independently evaluated chest CT scans according to CO-RADS and ACR COVID classifications. In possible COVID-19 pneumonia cases, defined as CO-RADS 3 to 5 (ACR indeterminate and typical) by each reader, high involvement CT score (≥ 25%) and CT patterns (presence of ground glass opacities, consolidations, crazy paving areas) were compared for vaccination status. Results: 184 patients with known vaccination status were included in the analysis: 111 non-vaccinated (60%) for SARS-CoV-2 infection, 21 (11%) with an incomplete vaccination cycle, and 52 (28%) with a complete vaccination cycle (6 different vaccine types). Multivariate logistic regression showed that the only factor predicting the absence of pneumonia (CO-RADS 1 and ACR negative cases) for the 3 readers was a complete vaccination cycle (OR = 12.8-13.1 compared to non-vaccinated patients, p ≤ 0.032). Neither CT score nor CT patterns of possible COVID-19 pneumonia showed any statistically significant correlation with vaccination status for the 3 readers. Conclusions: Symptomatic SARS-CoV-2-infected patients with a complete vaccination cycle had much higher odds of showing a negative CT chest examination in ED compared to non-vaccinated patients. Neither CT involvement nor CT patterns of interstitial pneumonia showed differences across different vaccination status

FIRST TESTS OF A TORALDO PUPIL OPTICAL MODULE FOR THE 32M MEDICINA ANTENNA

Toraldo Pupils can improve the angular resolving power of an optical instrument beyond the classical diffraction limit (hence the term “super-resolution”) using a filter consisting of finite- width concentric coronae with different amplitude and phase transmittance. Toraldo Pupils represent a viable approach to achieve super-resolution on antennas and radio telescopes. In this work we present a summary of the electromagnetic simulations and laboratory tests of a prototype optical module based on a Toraldo Pupil that has been field-tested on the Medicina 32-m radio telescope

The Sardinia Radio Telescope Front-Ends

The 64 m diameter Sardinia Radio Telescope (SRT) has recently started an early science program using three cryogenic front-ends covering four bands: P-band (305-410 MHz), L-band (1.3-1.8 GHz), high C-band (5.7-7.7 GHz), K-band (18-26.5 GHz). The L- and the P-bands can be observed simultaneously with a single coaxial receiver installed at the primary focus, while a seven beam K-band receiver and a mono-feed high C-band receiver are installed, respectively at the secondary and beam waveguide focus. Additional front-ends are under construction to further expand the telescope observing capabilities. We report on the design and performance of the front-ends already installed on SRT and give an overview of the new ones to be completed in the near future

Status of the radio receiver system of the Sardina Radio Telescope

In this article, we present the design and performances of the radio receiver system installed at the Sardinia Radio Telescope (SRT). The three radio receivers planned for the first light of the Sardinian Telescope have been installed in three of the four possible focus positions. A dual linear polarization coaxial receiver that covers two frequency bands, the P-band (305-410 MHz) and the L-band (1.3-1.8 GHz) is installed at the primary focus. A mono-feed that covers the High C-band (5.7-7.7 GHz) is installed at the beam waveguide foci. A multi-beam (seven beams) K-band receiver (18- 26.5 GHz) is installed at the Gregorian focus. Finally, we give an overview about the radio receivers, which under test and under construction and which are needed for expanding the telescope observing capabilities

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

SOUL at LBT: commissioning results, science and future

The SOUL systems at the Large Bincoular Telescope can be seen such as precursor for the ELT SCAO systems, combining together key technologies such as EMCCD, Pyramid WFS and adaptive telescopes. After the first light of the first upgraded system on September 2018, going through COVID and technical stops, we now have all the 4 systems working on-sky. Here, we report about some key control improvements and the system performance characterized during the commissioning. The upgrade allows us to correct more modes (500) in the bright end and increases the sky coverage providing SR(K)>20% with reference stars G$_{RP}$<17, opening to extragalcatic targets with NGS systems. Finally, we review the first astrophysical results, looking forward to the next generation instruments (SHARK-NIR, SHARK-Vis and iLocater), to be fed by the SOUL AO correction.Comment: 13 pages, 10 figures, Adaptive Optics for Extremely Large Telescopes 7th Edition, 25-30 Jun 2023 Avignon (France