Communication by means of modulated Johnson noise.

We present the design of a passive wireless communication method that does not rely on ambient or generated RF sources. Instead, the method modulates the Johnson (thermal) noise of a resistor to transmit information bits wirelessly. By selectively connecting or disconnecting a matched resistor to an antenna, the system can achieve data rates of up to 26 bps and distances of up to 7.3 m. This communication method operates at very low power, similar to that of an RFID tag, with the advantage of not requiring a preexisting RF signal to reflect.

Characterisation of the interplay between microstructure and opto-electronic properties of Cu(In,Ga)S2solar cells by using correlative CL-EBSD measurements.

Cathodoluminescence and electron backscatter diffraction have been applied to exactly the same grain boundaries (GBs) in a Cu(In,Ga)S2solar absorber in order to investigate the influence of microstructure on the radiative recombination behaviour at the GBs. Two different types of GB with different microstructure were analysed in detail: random high angle grain boundaries (RHAGBs) and Σ3 GBs. We found that the radiative recombination at all RHAGBs was inhibited to some extent, whereas at Σ3 GBs three different observations were made: unchanged, hindered, or promoted radiative recombination. These distinct behaviours may be linked to atomic-scale grain boundary structural differences. The majority of GBs also exhibited a small spectral shift of about ±10 meV relative to the local grain interior (GI) and a few of them showed spectral shifts of up to ±40 meV. Red and blue shifts were observed with roughly equal frequency.

Evaluating climate change impacts on reef environments via multibeam echosounder and Acoustic Doppler Current profiler technology.

Crucial to the Earth's oceans, ocean currents dynamically react to various factors, including rotation, wind patterns, temperature fluctuations, alterations in salinity and the gravitational pull of the moon. Climate change impacts coastal ecosystems, emphasizing the need for understanding these currents. This study explores multibeam echosounder (MBES), specifically R2-Sonic 2020 instrument, offering detailed seabed information. Investigating coral reefs, rocky reefs and artificial reefs aimed to map seafloor currents movement and their climate change responses. MBES data viz. Bathymetry and backscatter were classified and acoustic doppler current profiler (ADCP) ground data were validated using random forest regression. Results indicated high precision in currents speed measurement i.e. coral reefs with 0.96, artificial reefs with 0.94 and rocky reefs with 0.97. Currents direction accuracy was notable in coral reefs with 0.85, slightly lower in rocky reefs with 0.72 and artificial reefs with 0.60. Random forest identified sediment and backscatter as key for speed prediction while direction relies on bathymetry, slope and aspect. The study emphasizes integrating sediment size, backscatter, bathymetry and ADCP data for seafloor current analysis. This multibeam data on sediments and currents support better marine spatial planning and determine biodiversity patterns planning in the reef area.

Squalene production under oxygen limitation by Schizochytrium sp. S31 in different cultivation systems.

The triterpene squalene is widely used in the food, cosmetics and pharmaceutical industries due to its antioxidant, antistatic and anti-carcinogenic properties. It is usually obtained from the liver of deep sea sharks, which are facing extinction. Alternative production organisms are marine protists from the family Thraustochytriaceae, which produce and store large quantities of various lipids. Squalene accumulation in thraustochytrids is complex, as it is an intermediate in sterol biosynthesis. Its conversion to squalene 2,3-epoxide is the first step in sterol synthesis and is heavily oxygen dependent. Hence, the oxygen supply during cultivation was investigated in our study. In shake flask cultivations, a reduced oxygen supply led to increased squalene and decreased sterol contents and yields. Oxygen-limited conditions were applied to bioreactor scale, where squalene accumulation and growth of Schizochytrium sp. S31 was determined in batch, fed-batch and continuous cultivation. The highest dry matter (32.03 g/L) was obtained during fed-batch cultivation, whereas batch cultivation yielded the highest biomass productivity (0.2 g/L*h-1). Squalene accumulation benefited from keeping the microorganisms in the growth phase. Therefore, the highest squalene content of 39.67 ± 1.34 mg/g was achieved by continuous cultivation (D = 0.025 h-1) and the highest squalene yield of 1131 mg/L during fed-batch cultivation. Volumetric and specific squalene productivity both reached maxima in the continuous cultivation at D = 0.025 h-1 (6.94 ± 0.27 mg/L*h-1 and 1.00 ± 0.03 mg/g*h-1, respectively). Thus, the choice of a suitable cultivation method under oxygen-limiting conditions depends heavily on the process requirements. KEY POINTS: • Measurements of respiratory activity and backscatter light of thraustochytrids • Oxygen limitation increased squalene accumulation in Schizochytrium sp. S31 • Comparison of different cultivation methods under oxygen-limiting conditions.

Automatic Texture Alignment by Optimization Method.

Microstructure analysis via electron backscatter diffraction has become an indispensable tool in materials science and engineering. In order to interpret or predict the anisotropy in crystalline materials, the texture is assessed, e.g. via pole figure diagrams. To ensure a correct characterization, it is crucial to align the measured sample axes as closely as possible with the manufacturing process directions. However, deviations are inevitable due to sample preparation and manual measurement setup. Postprocessing is mostly done manually, which is tedious and operator-dependent. In this work, it is shown that the deviation can be calculated using the contour of the crystal orientations. This can also be utilized to define the axis symmetry of pole figure diagrams through an objective function, allowing for symmetric alignment by minimization. Experimental textures of extruded profiles and synthetically generated textures were used to demonstrate the general applicability of the method. It has proven to work excellently for deviations of up to 5∘, which are typical for careful manual sample preparation and mounting. While the performance of the algorithm is reduced with increasing misalignment, good results have also been obtained for deviations up to 15∘.

Internal lead shielding for clinical electron treatments.

Electron beams are often used to treat superficial lesions of the lip, cheek, nose, and ear. Lead is frequently used to block distal structures. It is customary to place an internal bolus of low atomic number in between the tissue and the lead to reduce electron backscatter from the lead. Space for the lead and the internal bolus is quite limited. A previous method for estimating the thickness of the lead plus internal bolus is not self-consistent and leads to a larger than necessary thickness. A new method is described here to provide a quick, accurate, and self-consistent estimate of the minimum necessary thickness of the internal bolus and the lead for incident electron beam energies of 4, 6, 8, 9, and 10 MeV as a function of the thickness of the overlying tissue. This method limits the dose enhancement at the tissue/bolus interface due to the underlying lead to 10%. Measurements made with gafchromic film validate this methodology.

Evaluation of Scatterer Parameters From Ultrasound Scattering Models Taking Into Account Scattering From Nuclei and Cells of Cell-Pellet Biophantoms and Ex Vivo Tumors.

The Quantitative Ultrasound backscatter coefficient provides the capability to evaluate tissue microstructure parameters. Tissue-based scatterer parameters are extracted using ultrasound scattering models. It is challenging to correlate ultrasound scatterer parameters of tissue structures from optical-measured histology, possibly because of inappropriate scattering models or the presence of multiple scatterers. The objective of this study is to pursue the quantification of pertinent scatterer parameters with scattering models that consider ultrasound scattering from nuclei and cells. The concentric sphere model (CSM) and the structure factor model adapted for two types of scatterers (SFM2) are evaluated for cell-pellet biophantoms and ex vivo tumors of four cell lines: 4T1, JC, LMTK, and MAT. The structure factor model (SFM) was used for comparison. CSM and SFM2 provided scatterer parameters closer to histology (lower relative errors) for nucleus and cell radii and volume fractions than SFM but were not always accompanied by lower dispersion of the scatterer distribution (lower coefficient of variation). CSM and SFM2 quantified cell and nucleus radius and volume fraction parameters with lower relative error compared to SFM. For tumors, CSM provided better results than SFM2.

Spectral-based Quantitative Ultrasound Imaging Processing Techniques: Comparisons of RF Versus IQ Approaches.

Quantitative ultrasound (QUS) is an imaging technique which includes spectral-based parameterization. Typical spectral-based parameters include the backscatter coefficient (BSC) and attenuation coefficient slope (ACS). Traditionally, spectral-based QUS relies on the radio frequency (RF) signal to calculate the spectral-based parameters. Many clinical and research scanners only provide the in-phase and quadrature (IQ) signal. To acquire the RF data, the common approach is to convert IQ signal back into RF signal via mixing with a carrier frequency. In this study, we hypothesize that the performance, that is, accuracy and precision, of spectral-based parameters calculated directly from IQ data is as good as or better than using converted RF data. To test this hypothesis, estimation of the BSC and ACS using RF and IQ data from software, physical phantoms and in vivo rabbit data were analyzed and compared. The results indicated that there were only small differences in estimates of the BSC between when using the original RF, the IQ derived from the original RF and the RF reconverted from the IQ, that is, root mean square errors (RMSEs) were less than 0.04. Furthermore, the structural similarity index measure (SSIM) was calculated for ACS maps with a value greater than 0.96 for maps created using the original RF, IQ data and reconverted RF. On the other hand, the processing time using the IQ data compared to RF data were substantially less, that is, reduced by more than a factor of two. Therefore, this study confirms two things: (1) there is no need to convert IQ data back to RF data for conducting spectral-based QUS analysis, because the conversion from IQ back into RF data can introduce artifacts. (2) For the implementation of real-time QUS, there is an advantage to convert the original RF data into IQ data to conduct spectral-based QUS analysis because IQ data-based QUS can improve processing speed.

High-frequency Quantitative Ultrasound Imaging of Human Rotator Cuff Muscles: Assessment of Repeatability and Reproducibility.

This study evaluated the repeatability and reproducibility of using high-frequency quantitative ultrasound (QUS) measurement of backscatter coefficient (BSC), grayscale analysis, and gray-level co-occurrence matrix (GLCM) textural analysis, to characterize human rotator cuff muscles. The effects of varying scanner settings across two different operators and two US systems were investigated in a healthy volunteer with normal rotator cuff muscles and a patient with chronic massive rotator cuff injury and substantial muscle degeneration. The results suggest that BSC is a promising method for assessing rotator cuff muscles in both control and pathological subjects, even when operators were free to adjust system settings (depth, level of focus, and time-gain compensation). Measurements were repeatable and reproducible across the different operators and ultrasound imaging platforms. In contrast, grayscale and GLCM analyses were found to be less reliable in this setting, with significant measurement variability. Overall, the repeatability and reproducibility measurements of BSC indicate its potential as a diagnostic tool for rotator cuff muscle evaluation.

Daily Living Activity Recognition with Frequency-Shift WiFi Backscatter Tags.

To provide diverse in-home services like elderly care, versatile activity recognition technology is essential. Radio-based methods, including WiFi CSI, RFID, and backscatter communication, are preferred due to their minimal privacy intrusion, reduced physical burden, and low maintenance costs. However, these methods face challenges, including environmental dependence, proximity limitations between the device and the user, and untested accuracy amidst various radio obstacles such as furniture, appliances, walls, and other radio waves. In this paper, we propose a frequency-shift backscatter tag-based in-home activity recognition method and test its feasibility in a near-real residential setting. Consisting of simple components such as antennas and switches, these tags facilitate ultra-low power consumption and demonstrate robustness against environmental noise because a context corresponding to a tag can be obtained by only observing frequency shifts. We implemented a sensing system consisting of SD-WiFi, a software-defined WiFi AP, and physical switches on backscatter tags tailored for detecting the movements of daily objects. Our experiments demonstrate that frequency shifts by tags can be detected within a 2 m range with 72% accuracy under the line of sight (LoS) conditions and achieve a 96.0% accuracy (F-score) in recognizing seven typical daily living activities with an appropriate receiver/transmitter layout. Furthermore, in an additional experiment, we confirmed that increasing the number of overlaying packets enables frequency shift-detection even without LoS at distances of 3-5 m.

Patterns of crystal organization and calcite twin formation in planktonic, rotaliid, foraminifera shells and spines.

The foraminiferal order Rotaliida represents one third of the extant genera of foraminifers. The shells of these organisms are extensively used to decipher characteristics of marine ecosystems and global climate events. It was shown that shell calcite of benthic Rotaliida is twinned. We extend our previous work on microstructure and texture characterization of benthic Rotaliida and investigate shell calcite organization for planktonic rotaliid species. Based on results gained from electron backscattered diffraction (EBSD) and field emission electron microscopy (FESEM) imaging of chemically etched/fixed shell surfaces we show for the planktonic species Globigerinoides sacculifer, Pulleniatina obliquiloculata, Orbulina universa (belonging to the two main planktonic, the globigerinid and globorotaliid, clades): very extensive 60°-{001}-twinning of the calcite and describe a new and specific microstructure for the twinned crystals. We address twin and crystal morphology development from nucleation within a biopolymer template (POS) to outermost shell surfaces. We demonstrate that the calcite of the investigated planktonic Rotaliida forms through competitive growth. We complement the structural knowledge gained on the clade 1 and clade 2 species with EBSD results of Globigerinita glutinata and Candeina nitida shells (clade 3 planktonic species). The latter are significantly less twinned and have a different shell calcite microstructure. We demonstrate that the calcite of all rotaliid species is twinned, however, to different degrees. We discuss for the species of the three planktonic clades characteristics of the twinned calcite and of other systematic misorientations. We address the strong functionalization of foraminiferal calcite and indicate how the twinning affects biocalcite material properties.

A new method for calculating interplanar spacing to distinguish between similar phases in EBSD.

Commercial electron backscatter diffraction (EBSD) systems generally use interplanar angle matching for pattern indexing, and thus, they are unable to distinguish between some similar phases with close interplanar angles, such as Al and Si. The interplanar spacing is more diagnostic but generally difficult to apply in pattern indexing because it lacks precision. In this study, we proposed an efficient approach for accurately measuring interplanar spacing by correcting the reciprocal-lattice vector (RLV). The phase discrimination of Al and Si was performed by interplanar spacing matching. The Kikuchi bands were identified automatically by the self-developed method using pattern rotation combined with grey gradient recognition without the help of human eyes. The reliable RLV relationship was extracted by accurately drawing reciprocal-lattice vectors. The lengths of RLVs were corrected, and then the RLVs were used for evaluating lattice spacing. The results of five Kikuchi patterns with different clarity showed that this new method reduced the average error of interplanar spacings by 50.611% and achieved an average accuracy of 1.644% for lattice spacing calculation. The method could distinguish structures with a difference in lattice spacing of at least 3.3%. This method was also effective for fuzzy patterns and partially missing Kikuchi bands and might be used as a new strategy for improving the calculation accuracy of lattice spacing for fuzzy patterns. The method did not have additional requirements concerning the number of detected Kikuchi bands and poles. The accuracy of lattice spacing could be effectively improved by correcting the RLVs based on routine pattern recognition. This method might be used as an auxiliary approach to differentiate between similar phases and is well-adapted to the existing commercial EBSD system.

The structure of the eggshell and eggshell membranes of Crocodylus niloticus.

The macro- and microstructure, elemental composition, and crystallographic characteristics of the eggshell and eggshell membranes of the Crocodylus niloticus egg was investigated using optical and electron microscopy, energy-dispersive X-ray spectroscopy (EDS), electron backscatter diffraction (EBSD) and computerised tomography. The translucent ellipsoid egg is composed of two basic layers, the outer calcified layer referred to as the shell and an inner organic fibre layer, referred to as the shell membrane. The outer inorganic calcite shell is further divided into an external, palisade and mammillary layers with pore channels traversing the shell. The external layer is a thin layer of amorphous calcium and phosphorus, the underlying palisade layer consist of irregular wedge-shaped crystals composed calcite with traces of magnesium, sodium, sulphur and phosphorus. The crystals are mostly elongated, orientated perpendicular to the shell surface ending in cone-shaped knobs, which forms the inner mammillary layer. The elemental composition of the mammillae is like that of the palisade layer, but the crystal structure is much smaller and orientated randomly. The highest number of mammillae and shell pores are found at the equator of the egg, becoming fewer towards the egg poles. The shell thickness follows the same pattern, with the thickest area located at the equator. The eggshell membrane located right beneath and embedded in the mammillary layer of the shell; it is made up of unorganised fibre sheets roughly orientated at right angles to one another. Individual fibres consist of numerous smaller fibrils forming open channels that run longitudinally through the fibre.

Facet type determination based on combined atomic force microscopy and electron backscatter diffraction.

The distribution of facet types affects the functionality of the surfaces of polycrystalline films. However, we are not aware of a previously published convenient method to determine their distribution. This work describes and demonstrates a process to determine and map the Miller indexes (hkl) of crystal facets exposed at the surfaces of polycrystalline films. To find facet types in non-trivial cases, one must know the orientation of the crystal and the direction in which the facet is facing. The method presented here combines the crystal orientations obtained with electron backscatter diffraction with the topography of the same sample area measured with atomic force microscopy. A challenging step is to transfer the data from the two instruments into a common coordinate system. The sequence of steps in the data processing is presented, with methods to verify the results. The process is illustrated with the analysis of an etched copper clad laminate (CCL) and an electroless Cu film deposited on the CCL. This example relates to facet selection in electroless and galvanic plating processes in printed circuit board production, where an uncontrolled transition from epitaxial to non-epitaxial growth can lead to surfaces with unacceptable roughness.

Relationship between tissue characteristics and mechanical properties of coronary plaques: a comparison between integrated backscatter intravascular ultrasound (IVUS) and speckle-tracking IVUS.

High-risk coronary plaques have certain morphological characteristics. Thus, comprehensive assessment is needed for the risk stratification of plaques in patients with coronary artery disease. Integrated backscatter intravascular ultrasound (IB-IVUS) has been used successfully used to evaluate the tissue characteristics of coronary plaques; however, the mechanical properties of plaques have been rarely assessed. Therefore, we developed Speckle-tracking IVUS (ST-IVUS) to evaluate the mechanical properties of coronary plaque. This study aimed to evaluate the relation between the tissue characteristics of coronary plaques using IB-IVUS and their mechanical properties using ST-IVUS. We evaluated 95 non-targeted plaques in 95 patients undergoing elective percutaneous coronary intervention to the left anterior descending artery. We set regions of interest (ROIs) in the cross-sectional images of coronary plaques where we divided 120 degree plaques into four quadrants (every 30 degrees), with the center at the area of maximum atheroma thickness. We measured relative calcification area (%CA, relative fibrous area (%FI) and relative lipid pool area (%LP) in a total of 380 ROIs. In ST-IVUS analysis, we measured strain in the circumferential direction of the lumen area (LA strain: %), the external elastic membrane area strain (EEM strain: %), and strain in the radial direction (radial strain: %). On global cross-sectional area IB-IVUS analysis, the %CA was 1.2 ± 1.2%; the %FI was 49.0 ± 15.9%, and the %LP was 49.7 ± 16.5%. In ST-IVUS analysis, the LA strain was 0.67 ± 0.43%; the EEM strain was 0.49 ± 0.33%, and the radial strain was 2.02 ± 1.66%. On regional analysis, the %LP was not associated with the LA strain (r = - 0.002 p = 0.97), the EEM strain (r = - 0.05 p = 0.35), or with the radial strain (r = - 0.04 p = 0.45). These trends were seen between the %FI and the LA strain (r = 0.02 p = 0.74), the %FI and the EEM strain (r = 0.05 p = 0.35), and the %FI and the radial strain (r = 0.04 p = 0.50). A significant correlation was only observed between the %CA and the LA strain (r = - 0.15 p = 0.0038). Our findings indicate that the associations between mechanical properties and tissue characteristics lacked statistical significance, more often than not, and that it is necessary to evaluate the mechanical properties as well as plaque characteristics for risk stratification of coronary plaques.

Is myocardial fibrosis appropriately assessed by calibrated and 2D strain derived integrated backscatter?

AIMS: Increased collagen content of the myocardium modifies tissue reflectivity and integrated backscatter (IBS) indexes are suggested as markers of myocardial fibrosis (MF). We sought to assess the correlation between calibrated (c) IBS and bidimensional (2D) strain derived IBS with left ventricular (LV) MF in patients with severe aortic stenosis (AS). METHODS AND RESULTS: We made a prospective observational cohort study including 157 patients with severe AS referred for surgical aortic valve replacement (AVR), with complete preoperative transthoracic echocardiography, cardiac magnetic resonance (CMR) and endomyocardial biopsy (EMB) obtained from the anterior basal septum at the time of surgery. Two groups of 30 patients were specifically evaluated, with and without late gadolinium enhancement (LGE) at CMR. IBS was obtained at QRS peak from both parasternal long axis (PLAX) and apical-three-chamber (AP3C) views and measured in decibels (dB). Whole-cardiac cycle IBS at basal anterior septum was obtained from 2D longitudinal strain. Correlation analysis of reflectivity indexes was performed with global and segmental (anterior basal septum) values of native T1 and extracellular volume (ECV), and EMB collagen volume fraction (CVF) (Masson´s Trichrome). IBS values were compared in both group of patients (LGE + vs. LGE -). 60 patients (74 [36-74] years, 45% male) with high gradient (mean gradient: 63 ± 20mmHg), normal flow (45 ± 10mL/m2) AS and preserved left ventricular ejection fraction (60 ± 9%) were included. Basal septum cIBS was - 17.45 (-31.2-10.95) and - 9.17 ± 9.45dB from PLAX and A3C views, respectively. No significant correlations were found between IBS and both non-invasive CMR tissue characterization and CVF: median MF of 9.7(2.1-79.9)%. Acoustic indexes were not significantly different according to the presence of pre-operative LGE. CONCLUSION: In this group of patients with classical severe AS, IBS reflectivity indexes are of no added value to discriminate the presence of MF.

Extracting Quantitative Ultrasonic Parameters from the Backscatter Coefficient.

The ultrasonic backscatter coefficient (BSC) is a fundamental quantitative ultrasound (QUS) parameter that contains rich information about the underlying tissue. Deriving parameters from the BSC is essential for fully utilizing the information contained in BSC for tissue characterization. In this chapter, we review two primary approaches for extracting parameters from the BSC versus frequency curve: the model-based approach and the model-free approach, focusing on the model-based approach, where a scattering model is fit to the observed BSC to yield model parameters. For this approach, we will attempt to unite commonly used models under a coherent theoretical framework. We will focus on the underlying assumptions and conditions for various BSC models. Computer code is provided to facilitate the use of some of the models. The strengths and weaknesses of various models are also discussed.

Quantitative Ultrasound: Scattering Theory.

The radio-frequency ultrasound backscattered data from tissue is rich in information and can provide important information about tissue state that is not obtained through traditional B-mode imaging. To parameterize the ultrasound backscattered data, the frequency spectrum, i.e., the backscatter coefficient, can be modeled using scattering theory. Models of tissue scattering are often represented by simple discrete geometric shapes, i.e., discrete scattering model. The discrete scattering model provides important insights into how the spatial arrangement of scatterers contributes to the signal spectrum. Another competing model is the continuum scattering model. In this model, the tissue is described as a continuous tissue construct with scatterers that have a continuous impedance change from the background. The continuous model provides a form factor description of the underlying tissue scatterers such as an effective scatterer diameter. In this chapter, we will compare and contrast the two underlying tissue scattering models and how they provide insights into ultrasonic scattering from soft tissues.

Phantoms for Quantitative Ultrasound.

Tissue-mimicking materials and phantoms have an important role in quantitative ultrasound. These materials allow for investigation of new techniques with the ability to design materials with properties that are stable over time and available for repeated measurements to refine techniques and analysis algorithms. This chapter presents an overview of the history of phantoms, methods of creation of materials with a variety of acoustic properties, and methods of measurement of those properties. It includes a section addressing the measurement of variance in those techniques using interlaboratory comparisons. There is a wide range of existing tissue-mimicking materials that exhibit properties similar to those of most soft tissues. Ongoing work is part of the expansion of QUS as materials are developed to better mimic specific tissues, geometries, or pathologies.

Inter- and Intra-Operator Variability of Regularized Backscatter Quantitative Ultrasound for the Characterization of Breast Masses.

OBJECTIVES: Here we report on the intra- and inter-operator variability of the backscatter coefficient (BSC) estimated with a new low-variance quantitative ultrasound (QUS) approach applied to breast lesions in vivo. METHODS: Radiofrequency (RF) echo signals were acquired from 29 BIRADS 4 and 5 breast lesions in 2 sequential cohorts following 2 imaging protocols: cohort 1) radial and antiradial views, and cohort 2) short- and long-axis views. Protocol 2 was implemented after retraining and discussion on how to improve reproducibility. Each patient was scanned by at least 2 of 3 radiologists; each performed 3 acquisitions with transducer and patient repositioning in between acquisitions. BSC was estimated using a low-variance QUS approach based on regularization. Intra- and inter-operator variability of the intra-lesion median BSC was evaluated with a multifactorial ANOVA test (P-values) and the intraclass correlation coefficient (ICC). RESULTS: Inter-operator variability was only significant in the first protocol (P < .007); ICCinter = .77 (95% CI .71-.82), indicating good inter-operator agreement. In the second protocol, the inter-operator variability was not significant (P > .05) and agreement was excellent (ICCinter = .92 [.89-.94]). In both protocols, the intra-operator variability was not significant. CONCLUSIONS: Our findings demonstrate the need for standardizing image acquisition protocols for backscatter-based QUS to reduce inter-operator variability and ensure its successful translation to the characterization of suspicious breast masses.