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• Aim of the study is to compare TD and TH plans in HF PMRT setting for selected pts. • TD plans were re-planned on TH with same prescription dose and constraints. • TD compared to TH reached a good target coverage, with an optimal sparing of OARs. Postmastectomy radiotherapy (PMRT) with TomoHelical™ (TH) or TomoDirect™ (TD) allows a uniform target coverage. In this study, we compare treatment plans using TD and TH in the setting of hypofractionated PMRT and immediate breast reconstruction. The TD-treatment plans of breast cancer patients treated between May 2016 and August 2019 were retrospectively selected. All the TD plans were re-planned on TH with the same prescription dose (40.05 Gy/15 fractions) and according to our dose/volume constraints. Data about the 2 treatment plans were compared with a focus on PTV coverage and all the organs at risk (OARs) constraints. Fifty patients for a total number of 100 treatment plans (50 with TD and 50 re-planned with TH) were analyzed. All the median value in the TD PTV CHEST WALL plans fulfilled the predefined planning objectives, even though TH emerged as best for target coverage with statistically significant difference for V90%. TD provided the lowest V95% for the PTV SVC, but the median value was near to the recommended value of 90% (89.8 % vs 98.6% for TD and TH, respectively). Overall, TD reached the best OARs sparing. The main statistically significant differences with TH were for contralateral breast, ipsilateral and contralateral lung. All the other dose values for TH were higher than TD, but they fulfilled the recommended/acceptable predefined planning objectives. In the setting of PMRT, TD compared to TH reached an acceptable target volume coverage, with an optimal sparing of OARs. [ABSTRACT FROM AUTHOR]

To evaluate if a computer-aided diagnosis (CAD) system on ultrasound (US) can improve the diagnostic performance of inexperienced radiologists. We collected ultrasound images of 256 breast lesions taken between March and May 2020. We asked two experienced and two inexperienced radiologists to retrospectively review the US features of each breast lesion according to the Breast Imaging Reporting and Data System (BI-RADS) categories. A CAD examination with S-Detect™ software (Samsung Healthcare, Seoul, South Korea) was conducted retrospectively by another uninvolved radiologist blinded to the BIRADS values previously attributed to the lesions. Diagnostic performances of experienced and inexperienced radiologists and CAD were compared and the inter-observer agreement among radiologists was calculated. The diagnostic performance of the experienced group in terms of sensitivity was significantly higher than CAD (p < 0.001). Conversely, the diagnostic performance of inexperienced group in terms of both sensitivity and specificity was significantly lower than CAD (p < 0.001). We obtained an excellent agreement in the evaluation of the lesions among the two expert radiologists (Kappa coefficient: 88.7%), and among the two non-expert radiologists (Kappa coefficient: 84.9%). The US CAD system is a useful additional tool to improve the diagnostic performance of the inexperienced radiologists, eventually reducing the number of unnecessary biopsies. Moreover, it is a valid second opinion in case of experienced radiologists. • Breast ultrasound (US) is an essential imaging tool for breast cancer detection in women with dense breast. • New generation ultrasound machines try to include software that can automatically evaluate the risk of malignancy. • Computer-aided diagnosis system on ultrasound can improve the diagnostic performance of inexperienced radiologists. [ABSTRACT FROM AUTHOR]