Millimeter-wave breast cancer imaging by means of a dual-step approach combining radar and tomographic techniques: preliminary results.

Breast cancer is one of the most diagnosed forms of cancer among women worldwide. However, the survival rate is very high when the tumor is diagnosed early. The search for diagnostic techniques increasingly able to detect lesions of the order of a few millimeters and to overcome the limitations of current diagnostic techniques (e.g., the X-ray mammography, currently used as standard for screening campaigns) is always active. Among the main emerging techniques, microwave and millimeter-wave imaging systems have been proposed, using either radar or tomographic approaches. In this paper, a novel dual-step millimeter-wave imaging which combines the advantages of tomographic and radar approaches is proposed. The goal of this work is to reconstruct the dielectric profile of suspicious regions by exploiting the morphological information from the radar maps as a priori information within quantitative tomographic techniques. Promising preliminary dielectric reconstruction results against simulated data are shown in both single- and dual-target scenarios, in which high-density healthy and tumor tissues are present. The reconstruction results were compared to the dielectric characteristics of human breast exvivo tissues used in the simulated models. The proposed dual-step approach allows to distinguish the nature of the targets also in the most challenging case represented by the co-presence of high-density healthy tissues and a malignant lesion, thus paving the way for a deeper investigation of this approach in experimental scenarios. Clinical Relevance-The proposed dual-step approach in the millimeter-wave regime allows to improve the reliability of the diagnostic technique, increasing its specificity.

Off-Label Use of Sirolimus and Everolimus in a Pediatric Center: A Case Series and Review of the Literature.

BACKGROUND: It has been 15 years since sirolimus, an mTOR inhibitor, received Food and Drug Administration approval to prevent acute rejection in kidney transplantation, and 8 years since its analog everolimus acquired the same status. Since then, these drugs have become more and more utilized and their immunosuppressive and antiproliferative properties have been tested in a great variety of clinical conditions, often achieving excellent results. Despite such positive evidence, the on-label indications for these rapalogs are still very restrictive, especially in children. AIMS: The aims of this study were to describe our center's experience with sirolimus and everolimus in managing rare pediatric conditions for which mTOR inhibitors have been reported as a therapeutic option, although without conclusive approval from regulatory agencies, and to evaluate safety and tolerability of the treatment at the prescribed doses. METHODS: All the subjects who received off-label sirolimus or everolimus at the Pediatric Department of the IRCCS Burlo Garofolo in the last 13 years were included. For each disease found in our case series, we reviewed the current scientific literature. RESULTS: Off-label treatment with rapalogs was prescribed in 16 children (11 males, 5 females, median age of 9.5 years, range 1-16 years). Seven had immunologic disorders: four autoimmune lymphoproliferative syndrome (ALPS), one multicentric Castleman disease (mCD), one activated PI3K delta kinase syndrome (APDS), and one immunodysregulation with polyendocrinopathy enteropathy X-linked (IPEX). Eight had proliferative disorders or vascular anomalies: one cystic lymphangioma, two Bannayan-Riley-Ruvalcaba syndrome (BRRS), one blue rubber bleb nevus syndrome (BRBNS), two tuberous sclerosis complex (TSC), and one low-flow mixed arterial and venous malformation. One case had congenital hyperinsulinism (CHI). The average dosage administered was 1 mg/m2 for sirolimus and 7 mg/m2 for everolimus. We experienced a good measurable clinical improvement in 14 patients. Nobody experienced serious adverse events (SAEs). The therapy was interrupted in two cases, for lack of efficacy and poor tolerance in one case and for occurrence of bacterial pneumonia in the other one. A review of the literature identified 101 published reports that met our inclusion criteria. CONCLUSIONS: Although use of mTOR inhibitors has been considered to be complicated, our experience shows that, using low dosages, it is possible to obtain relevant clinical improvements, with a good profile of safety and tolerability.

Improved TV-CS Approaches for Inverse Scattering Problem.

Total Variation and Compressive Sensing (TV-CS) techniques represent a very attractive approach to inverse scattering problems. In fact, if the unknown is piecewise constant and so has a sparse gradient, TV-CS approaches allow us to achieve optimal reconstructions, reducing considerably the number of measurements and enforcing the sparsity on the gradient of the sought unknowns. In this paper, we introduce two different techniques based on TV-CS that exploit in a different manner the concept of gradient in order to improve the solution of the inverse scattering problems obtained by TV-CS approach. Numerical examples are addressed to show the effectiveness of the method.