Purpose Automated 3D Breast Ultrasound (ABUS) as an adjunct to mammography is promising technology in screening especially in women with dense breast parenchyma. We aim to inquire numerically imaging performance of Invenia ABUS (GE Healthcare, WI, USA) in comparison to conventional handheld Ultrasound (US), just to check their similar malignancy detection rates [ [1] Drukteins Jennifer S. et al. Beyond Mammography: new frontiers in breast cancer screening. Am J Med. 2013; 126: 472-479 Google Scholar ]. Methods According to SIRM (Società Italiana di Radiologia Medica [ [2] Midiri M. Documenti SIRM: controlli di qualità in ecografia. Supplemento de “Il Radiologo”. 2004; 1: 1-16 Google Scholar ]), using a certified phantom it’s possible to provide a general judgment on the operation of the equipment. So we used a rubber-based tissue mimicking material shown in the figure, UC-551M (ATS Laboratories). This phantom allows to investigate every kind of parameters (line targets, axial and lateral resolution, anechoic targets structures of different sizes and gray scale target structures). The phantom acquisitions were made in clinical mode: ABUS select automatically depth of penetration 3,5/4/5 cm and frequency 10/9/8,18 MHz depending on the size of the breast (small/medium/large); conventional US depth has been optimized in the range 4–5 cm and 7,5–15 MHz by an experienced radiologist depending on the specific insert to display, as suggested by ATS Laboratory [ [3] ATS Laboratories, Manual of UC-551 ABUS Phantom 2015. Google Scholar ]. Results The preliminary results are shown in the table. Displayed dynamic range is optimal for all the ultrasound scanners (coefficient of determination R2⩾95%) and the maximum value is ABUS and Samsung score of 99%. Distance measures are coherent, there is no geometric distortion. The analysis of the Point Spread Function is underway with advanced mathematical methods. Conclusions Automated 3D Breast Ultrasound (ABUS) as an adjunct to mammography is promising technology in screening especially in women with dense breast parenchyma. We aim to inquire numerically imaging performance of Invenia ABUS (GE Healthcare, WI, USA) in comparison to conventional handheld Ultrasound (US), just to check their similar malignancy detection rates [ [1] Drukteins Jennifer S. et al. Beyond Mammography: new frontiers in breast cancer screening. Am J Med. 2013; 126: 472-479 Google Scholar ]. According to SIRM (Società Italiana di Radiologia Medica [ [2] Midiri M. Documenti SIRM: controlli di qualità in ecografia. Supplemento de “Il Radiologo”. 2004; 1: 1-16 Google Scholar ]), using a certified phantom it’s possible to provide a general judgment on the operation of the equipment. So we used a rubber-based tissue mimicking material shown in the figure, UC-551M (ATS Laboratories). This phantom allows to investigate every kind of parameters (line targets, axial and lateral resolution, anechoic targets structures of different sizes and gray scale target structures). The phantom acquisitions were made in clinical mode: ABUS select automatically depth of penetration 3,5/4/5 cm and frequency 10/9/8,18 MHz depending on the size of the breast (small/medium/large); conventional US depth has been optimized in the range 4–5 cm and 7,5–15 MHz by an experienced radiologist depending on the specific insert to display, as suggested by ATS Laboratory [ [3] ATS Laboratories, Manual of UC-551 ABUS Phantom 2015. Google Scholar ]. The preliminary results are shown in the table. Displayed dynamic range is optimal for all the ultrasound scanners (coefficient of determination R2⩾95%) and the maximum value is ABUS and Samsung score of 99%. Distance measures are coherent, there is no geometric distortion. The analysis of the Point Spread Function is underway with advanced mathematical methods.

Purpose To analyse setup accuracy for patients we use Octavius® (PTW Freiburg) 4D checks and post-treatment off-line images provided by Varian Aria (v.13.5). We focused attention on lung SBRT treatments with 6XFFF MV arcs delivered by Trilogy LINAC (Varian). An interesting case for quality assurance and SWOT (Strengths/Weaknesses/Opportunities/Threats) analysis is represented by multiple or bilateral diseases, that need more than one isocenter. The Aria system gives instructions to linac to manage plans with two isocenters as if dose distributions are disjointed. We would therefore like to avoid a dose increase between multiple isocenters (Threat). Methods Image Guided RT (IGRT) is particularly useful when high tumoricidal doses are prescribed with highly conformal treatment modalities, including SBRT [ [1] Franzone P. et al. Image-guided radiation therapy(IGRT): practical recommendations of Italian Association of Radiation Oncology (AIRO). Radiol med. 2016; 121: 958-965 Google Scholar ]. We retrospectively evaluated 55 consecutive patients that underwent Cone Beam Computed Tomography (CBCT) before each SBRT session and receive high dose in few fractions. Pre-treatment checks are evaluated with γ(3%;3 mm)-index. Forced compression method using a plate to compress abdomen is used in the 96% of treatments, in others a thermoplastic orfit is customized. We collect vertical, lateral and longitudinal shifts of the isocenter to calculate the 3D vector, defined as E = vert 2 + long 2 + lat 2 session by session [ [2] Jia-Zhu Wang et al. Evaluation of patient setup uncertainity of optical guided frameless system for intracranial stereotactic radiosurgery. J Appl Clin Med Phys. 2010; 11: 3181 Google Scholar ]. Results γ (3%;3 mm) is always 93%, instead the median E vector is 0,71 cm for a total of 44 treatments with single-isocenter and 0,36 cm for 27 multi-isocenter plans. An assessment of the dose changes of the recalculated plans on calibrated CBCT is underway preliminary results are shown in the table. Displayed dynamic range is optimal for all the ultrasound scanners (coefficient of determination R2 ⩾ 95%) and the maximum value is ABUS and Samsung score of 99%. Distance measures are coherent, there is no geometric distortion. The analysis of the Point Spread Function is underway with advanced mathematical methods. Conclusions Even if the dose from CBCT for patients with multi-isocenter plans increases proportionally to the number of isocenters, we can say that the quality of positioning seems to have really improved. To analyse setup accuracy for patients we use Octavius® (PTW Freiburg) 4D checks and post-treatment off-line images provided by Varian Aria (v.13.5). We focused attention on lung SBRT treatments with 6XFFF MV arcs delivered by Trilogy LINAC (Varian). An interesting case for quality assurance and SWOT (Strengths/Weaknesses/Opportunities/Threats) analysis is represented by multiple or bilateral diseases, that need more than one isocenter. The Aria system gives instructions to linac to manage plans with two isocenters as if dose distributions are disjointed. We would therefore like to avoid a dose increase between multiple isocenters (Threat). Image Guided RT (IGRT) is particularly useful when high tumoricidal doses are prescribed with highly conformal treatment modalities, including SBRT [ [1] Franzone P. et al. Image-guided radiation therapy(IGRT): practical recommendations of Italian Association of Radiation Oncology (AIRO). Radiol med. 2016; 121: 958-965 Google Scholar ]. We retrospectively evaluated 55 consecutive patients that underwent Cone Beam Computed Tomography (CBCT) before each SBRT session and receive high dose in few fractions. Pre-treatment checks are evaluated with γ(3%;3 mm)-index. Forced compression method using a plate to compress abdomen is used in the 96% of treatments, in others a thermoplastic orfit is customized. We collect vertical, lateral and longitudinal shifts of the isocenter to calculate the 3D vector, defined as E = vert 2 + long 2 + lat 2 session by session [ [2] Jia-Zhu Wang et al. Evaluation of patient setup uncertainity of optical guided frameless system for intracranial stereotactic radiosurgery. J Appl Clin Med Phys. 2010; 11: 3181 Google Scholar ]. γ (3%;3 mm) is always 93%, instead the median E vector is 0,71 cm for a total of 44 treatments with single-isocenter and 0,36 cm for 27 multi-isocenter plans. An assessment of the dose changes of the recalculated plans on calibrated CBCT is underway preliminary results are shown in the table. Displayed dynamic range is optimal for all the ultrasound scanners (coefficient of determination R2 ⩾ 95%) and the maximum value is ABUS and Samsung score of 99%. Distance measures are coherent, there is no geometric distortion. The analysis of the Point Spread Function is underway with advanced mathematical methods. Even if the dose from CBCT for patients with multi-isocenter plans increases proportionally to the number of isocenters, we can say that the quality of positioning seems to have really improved.

Purpose The purpose of the AIFM Pediatric Commission is to contribute to a better knowledge of the medical physics aspects of paediatric applications. The Commission will focus mostly on the study of quality and safety aspects, supporting the contacts between scientific associations, institutions and stakeholders, and promoting communication and shared projects. Methods The Commission will address three entities: 1) Scientific societies and institutions, to help coordinate initiatives and create synergies in medical physics applications in paediatrics; 2) the AIFM members, for whom the Commission should be a “reference point” for issues that are specific of paediatric applications; 3) The stakeholders and the population. We are planning the initial following actions: – A public event on dosimetric data in paediatrics, to be organized in 2018 together with the paediatric groups of other professional and scientific societies; – A national survey to collect numbers and procedures for paediatric patients across Italy; – For the AIFM members: a. a dedicated page on the web site, to openly expose goals and results of the Commission. The page will also be a virtual conference room to discuss paediatric topics, and a repository of guidelines and literature in the field; b. a dedicated e-mail address has been defined: commissionepediatrica@fisicamedica.it ; c. the Commission being the AIFM reference for all paediatric topics in medical physics, will propose Working Groups (WGs) on this subject. Our WGs will follow the standard procedure of any AIFM WGs. It is desirable that any other new paediatric group is initially submitted to the Commission, which will express its opinion to the AIFM Management Commitee. – In order to understand what AIFM can offer to the stakeholders and to the “outside world”, questions related to paediatrics and already submitted to the existing AIFM forum will be analysed. Results the results of the national survey will be presented (data collection is still ongoing); the architecture of the AIFM web page will be shown. Conclusions the congress will be an important moment to understand the members’ needs and interest on this topic.

Purpose To investigate the radiosensitizing capacity and therapeutic efficacy of the ataxia-telangiectasia mutated (ATM) inhibitor KU60019 on orthotopic glioblastoma (GB) driven by primary glioma initiating cells (GIC) with various p53 statuses. Methods Orthotopic GB have been developed in mice by intracranial injection of different GIC lines. Following tumor development, KU60019 was delivered to the site of the tumor [ [1] Vecchio D. et al. Pharmacokinetics, pharmacodynamics and efficacy on pediatric tumors of the glioma radiosensitizer KU60019. Int J Cancer. 2015; 136: 1445-1457 Crossref PubMed Scopus (44) Google Scholar ]. The irradiation of orthotopic GB was performed by an RS 2000 Biological Irradiator (Rad Source Technologies) whose delivered dose was verified by a RadCal Accu-Gold system (Monrovia) equipped with a 10X6-0.6 High Dose Rate Chamber. The dose was confirmed by radiochromic films (Gafchromic® EBT3) placed over and under the mouse head. The prescription dose ranged 0.5–2.5 Gy. MRI of the orthotopic tumors was performed by a clinical 3T scanner (Signa EXCITE®HDxT, GE, Milwaukee, USA) with mice positioned in a prototype coil (linear birdcage transmit/receive coil, Flick Engineering Solutions BV-General Electric). Tumor volumes were determined by a software for quantitative MRI (GRES) [ [2] Parodi R.C. et al. Growing region segmentation software (GRES) for quantitative magnetic resonance imaging of multiple sclerosis: intra- and inter-observer agreement variability: a comparison with manual contouring method. Eur Radiol. 2002; 12: 866-871 Crossref PubMed Scopus (18) Google Scholar ]. Results A limited, but significant, elongation of median animal survival was observed after one radiosensitization cycle performed with one KU60019 CED administration followed by three ionizing radiation (IR) fractions as compared to animals treated with vehicle + IR [101 vs 91 days – Hazard Ratio: 4.922]. Other irradiation schedules failed to improve survival of animals bearing orthotopic GBs. Conclusions Further research to determine general and effective conditions for radiosensitization of orthotopic GBs by ATM inhibitors is warranted. To investigate the radiosensitizing capacity and therapeutic efficacy of the ataxia-telangiectasia mutated (ATM) inhibitor KU60019 on orthotopic glioblastoma (GB) driven by primary glioma initiating cells (GIC) with various p53 statuses. Orthotopic GB have been developed in mice by intracranial injection of different GIC lines. Following tumor development, KU60019 was delivered to the site of the tumor [ [1] Vecchio D. et al. Pharmacokinetics, pharmacodynamics and efficacy on pediatric tumors of the glioma radiosensitizer KU60019. Int J Cancer. 2015; 136: 1445-1457 Crossref PubMed Scopus (44) Google Scholar ]. The irradiation of orthotopic GB was performed by an RS 2000 Biological Irradiator (Rad Source Technologies) whose delivered dose was verified by a RadCal Accu-Gold system (Monrovia) equipped with a 10X6-0.6 High Dose Rate Chamber. The dose was confirmed by radiochromic films (Gafchromic® EBT3) placed over and under the mouse head. The prescription dose ranged 0.5–2.5 Gy. MRI of the orthotopic tumors was performed by a clinical 3T scanner (Signa EXCITE®HDxT, GE, Milwaukee, USA) with mice positioned in a prototype coil (linear birdcage transmit/receive coil, Flick Engineering Solutions BV-General Electric). Tumor volumes were determined by a software for quantitative MRI (GRES) [ [2] Parodi R.C. et al. Growing region segmentation software (GRES) for quantitative magnetic resonance imaging of multiple sclerosis: intra- and inter-observer agreement variability: a comparison with manual contouring method. Eur Radiol. 2002; 12: 866-871 Crossref PubMed Scopus (18) Google Scholar ]. A limited, but significant, elongation of median animal survival was observed after one radiosensitization cycle performed with one KU60019 CED administration followed by three ionizing radiation (IR) fractions as compared to animals treated with vehicle + IR [101 vs 91 days – Hazard Ratio: 4.922]. Other irradiation schedules failed to improve survival of animals bearing orthotopic GBs. Further research to determine general and effective conditions for radiosensitization of orthotopic GBs by ATM inhibitors is warranted.

Purpose Quality assurance in advanced and quantitative magnetic resonance techniques is strongly recommended [ 1 Drost DJ et al. Proton MRS in the brain: report of AAPM TG 9. Med Phys 2002;29:2177–97. Google Scholar , 2 Jackson EF et al. Acceptance testing and QA procedures for MRI facilities. AAPM;2010. Google Scholar , 3 Tofts P, Quantitative MRI of the brain: measuring changes caused by disease. John Wiley and Sons; 2004. Google Scholar ]. The aim of this study was to propose and validate across various clinical scanner systems a straightforward quality assurance procedure for proton Magnetic Resonance Spectroscopy (MRS). Methods Eighteen clinical 1.5 T and 3 T scanners for MRS were enrolled in the study. The protocol included 3 sets of single voxel PRESS acquisitions without water signal suppression, repeated 4/5 times within approximately 2 months and performed using a standard water phantom supplied to all centres. Water peak linewidth (LW), water peak area (AP) and phantom T2 were estimated. Results LW values ranged from 0.4 Hz to 1.6 Hz, with 3 T and 1.5 T scanner systems showing similar performances. Coefficient of variation (CV) of LW values for repeated measurements were lower than 35% (except for only 3 scanners). AP showed significant (p < 0.05) linear correlation with voxel volume (r > 0.99 and 0.95 for 1.5 T and 3 T scanner systems, respectively). CV of AP for different spatial positions was less than 25%, and no relevant difference was observed between 3 T and 1.5 T scanners. Mean phantom T2 value and CV for repeated measurements were 1147 ms and 4%, respectively, for 1.5 T scanners, and 1010 ms and 9%, respectively, for 3 T scanners. Conclusions We proposed a straightforward multiparametric and not time consuming quality control protocol for MRS, which can be included in routine quality assurance procedures. The protocol has been validated and proven to be feasible in a multicentre intercomparison study of 18 clinical 1.5 T and 3 T scanner systems. Quality assurance in advanced and quantitative magnetic resonance techniques is strongly recommended [ 1 Drost DJ et al. Proton MRS in the brain: report of AAPM TG 9. Med Phys 2002;29:2177–97. Google Scholar , 2 Jackson EF et al. Acceptance testing and QA procedures for MRI facilities. AAPM;2010. Google Scholar , 3 Tofts P, Quantitative MRI of the brain: measuring changes caused by disease. John Wiley and Sons; 2004. Google Scholar ]. The aim of this study was to propose and validate across various clinical scanner systems a straightforward quality assurance procedure for proton Magnetic Resonance Spectroscopy (MRS). Eighteen clinical 1.5 T and 3 T scanners for MRS were enrolled in the study. The protocol included 3 sets of single voxel PRESS acquisitions without water signal suppression, repeated 4/5 times within approximately 2 months and performed using a standard water phantom supplied to all centres. Water peak linewidth (LW), water peak area (AP) and phantom T2 were estimated. LW values ranged from 0.4 Hz to 1.6 Hz, with 3 T and 1.5 T scanner systems showing similar performances. Coefficient of variation (CV) of LW values for repeated measurements were lower than 35% (except for only 3 scanners). AP showed significant (p < 0.05) linear correlation with voxel volume (r > 0.99 and 0.95 for 1.5 T and 3 T scanner systems, respectively). CV of AP for different spatial positions was less than 25%, and no relevant difference was observed between 3 T and 1.5 T scanners. Mean phantom T2 value and CV for repeated measurements were 1147 ms and 4%, respectively, for 1.5 T scanners, and 1010 ms and 9%, respectively, for 3 T scanners. We proposed a straightforward multiparametric and not time consuming quality control protocol for MRS, which can be included in routine quality assurance procedures. The protocol has been validated and proven to be feasible in a multicentre intercomparison study of 18 clinical 1.5 T and 3 T scanner systems.

Introduction: Ankle motions are affected even in the early stages of neurological diseases and a functional evaluation could be useful for an early diagnosis. Here we present a custom-made MR-compatible device that allows for independent dorsi-plantar flexion of each ankle, while preventing the transmission of significant motion to the head, and a preliminary study involving healthy subjects.

This ongoing study investigates the neural correlates of ankle dorsi-plantar flexion in active, passive, and proprioceptive tasks. Specifically, we investigated two proprioceptive matching tasks that required a simple combination of active and passive ankle movements: (1) a memory-based ipsilateral matching task and (2) a contralateral concurrent matching task. As expected, during the passive tasks, subjects recruited the same brain areas involved in the correspondent active movements (primary motor cortex (M1), premotor cortex (PM) supplementary motor cortex (SMA) and primary somatosensory cortex (S1)), but the activations were lower. Instead, in both the proprioceptive matching tasks, subjects recruited more motor and sensory-motor areas of the brain and the activations were greater.