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Breast hypoplasia and impaired lactation are poorly studied sequelae of chest radiation therapy (RT) in children. The Pediatric Normal Tissue Effects in the Clinic female breast task force aimed to quantitate the radiation dose-volume effects on these endpoints.
Low-dose-rate (LDR) brachytherapy and stereotactic body radiation therapy (SBRT) have both shown acceptable outcomes in the treatment of low- and intermediate-risk prostate cancer. Minimal data have been published directly comparing rates of biochemical control and toxicity with these 2 modalities. We hypothesize that LDR and SBRT will provide similar rates of biochemical control.
Radioactive waste containing predominantly soil and rubble from the clean-up of a former uranium and thorium minerals processing research facility is currently stored at the Woomera Test Range in South Australia awaiting final disposal. Prior to commencing any manipulation of the nearly 10,000 waste drums (205 L or 55 gallon each), radon concentration monitoring and radon daughter dosimetry has been undertaken to (i) gain understanding of the temporal and spatial variation of radon and its daughters within the storage facility, which could provide insights into the radiological source term and (ii) confirm that radiological risks to workers are below the guideline values. A time series of nearly 12 months of detailed observations shows low level radon concentrations with annual average values that are slightly above the average radon concentrations in Australian homes. Peak values in summer are about three times higher than the annual average based on the CRM measurements. Both radon concentrations and annual effective dose are well below the regulatory limits. (authors)
To characterize the early changes in echocardiographically derived measures of cardiac function with contemporary radiation therapy (RT) in breast cancer and to determine the associations with radiation dose-volume metrics, including mean heart dose (MHD).
To comprehensively characterize dosimetric differences between calculations with a commercial model-based dose calculation algorithm (MBDCA) and the TG-43 formalism in application to accelerated partial breast irradiation (APBI) with the strut-adjusted volume implant (SAVI) applicator.
Definitive, nonsurgical management of gynecologic malignancies involves external beam radiation therapy (EBRT) and/or brachytherapy (BT). Summation of the cumulative dose is critical to assess the total biologic effective dose to targets and organs at risk. Cumulative dose calculation from EBRT and BT can be performed with or without image registration (IR) and biologic dose summation. Among these dose summation strategies, linear addition of dose-volume histogram (DVH) parameters without IR is the global standard for composite dose reporting. This approach stems from an era without image guidance and simple external beam and brachytherapy treatment approaches. With technological advances, EBRT and high-dose-rate BT have evolved to allow for volume-based treatment planning and delivery. Modern conformal therapeutic radiation involves volumetric or intensity modulated EBRT, capable of simultaneously treating multiple targets at different specified dose levels. Therefore, given the complexity of modern radiation treatment, the linear addition of DVH parameters from EBRT and high-dose-rate BT is challenging to represent the combined dose distribution. Deformable image registration (DIR) between EBRT and image guided brachytherapy (IGBT) data sets may provide a more nuanced calculation of multimodal dose accumulation. However, DIR is still nascent in this regard, and needs further development for accuracy and efficiency for clinical use. Biologic dose summation can combine physical dose maps from EBRT and each IGBT fraction, thereby generating a composite DVH from the biologic effective dose. However, accurate radiobiologic parameters are tissue-dependent and not well characterized. A combination of voxel-based DIR and biologic weighted dose maps may be the best approximation of dose accumulation but remains invalidated. The purpose of this report is to review dose summation strategies for EBRT and BT, including conventional equivalent dose in 2-Gy fractions dose summation without image registration, physical dose summation using 3-dimensional rigid IR and DIR, and biologic dose summation. We also provide general clinical workflows for IGBT with a focus on cervical cancer.
This panel focused on various dose and risk assessment tools for assessments, Deactivation and Decommissioning, remediation, and closure of sites of chemical and radioactive wastes. Representatives from the US government agencies, non-US countries and their representative regulatory bodies or authorities, as well as performance/risk assessment practitioners compared and contrasted the various guidance from regulatory agencies and authorities on how tools such as the Preliminary Remediation Goals (PRG) calculator, the Dose Compliance Concentrations (DCC) calculator, and Residual Radioactivity (RESRAD) should be used in support of analyses and decisions for environmental cleanup activities. Panelists with presentations: Cumulative Impact Evaluation: Innovative Tools for Evaluation of Groundwater Protection (Alaa Aly); Superfund Evaluation Process for Alternative Risk and Dose Models (with Focus on EPA and DOE Tools) (Stuart Walker); NRC Staff Perspective on Risk-Informed Approach and Reasonable Safety Assurance in D and D and LLW (Rateb (Boby) Abu Eid)
The Western New York Nuclear Service Center (WNYNSC), located approximately 48 km south of Buffalo, New York, is the site of a former nuclear fuel reprocessing and radioactive waste disposal facility. Spent nuclear fuel was processed there from 1966 to 1972, leaving behind radioactive and chemical wastes in two disposal areas and a waste tank farm. Site operations also resulted in releases of radioactivity to site soils, groundwater, and to surface waters draining the site. The New York State Energy Research and Development Authority (NYSERDA) and the U.S. Department of Energy (DOE) are collaborating in a process of decision making for decommissioning those facilities remaining at the WNYNSC following the completion of Phase 1 decommissioning. Neptune and Company, Inc. (Neptune) was contracted to develop a probabilistic performance assessment (PPA) computer model to assist the agencies in this process. The PPA Model includes a contaminant transport component focusing on the movement of contaminants within and among environmental media including groundwater and surface water transport, contaminant translocation by plants and animals, diffusion, and erosion. The model also includes evaluation of potential exposure and health effects for a Resident Farmer exposure scenario, where the Resident Farmer represents a critical group, described as that group of individuals reasonably expected to receive the greatest exposure to residual radioactivity for any applicable set of circumstances. The West Valley Site is located in the glaciated Allegheny Plateau region of western New York State. The waste reprocessing and disposal areas were constructed on a relatively fat area of plateau dissected by drainages of Buttermilk Creek, including Erdman Brook, Franks Creek, and Quarry Creek. An important aspect of the contaminant transport component of the PPA model is consideration of erosive processes such as slumping of the stream slopes and the advance of gullies from these streams. These erosion processes remove material from the plateau, growing the size of the creek valleys and making them wider and deeper. Of particular interest for the impact of erosion is radioactive waste contained in the Nuclear Regulatory Commission (NRC)-Licensed Disposal Area (NDA), the New York State-Licensed Disposal Area (SDA), and residual radiological inventory in the underground storage tanks at the Waste Tank Farm (WTF). The PPA Model is organized around geographically-defined facilities which were constructed upon the plateau, including the NDA, SDA, and WTF. Ongoing stream erosion processes will potentially transfer radioactive waste and residual inventory from these facilities to the ground surface on adjacent hillslope areas where erosion has breached the facility. Hence, it is important to evaluate the consequences of potential exposures to a Resident Farmer on the hillslopes below a breached facility. Two interrelated aspects of the dose assessment model related to hillslope exposure are discussed: 1) representation of the physical processes related to transport of radionuclides from facilities onto the hillslopes, and from the hillslopes into adjoining creeks where contaminated material migrates downstream with surface water and sediment, and; 2) adaptation of the activities associated with the Resident Farmer scenario to assess potential exposures to contamination in the hillslope areas. This discussion will cover the conceptual basis of the hillslope exposure and transport models, and also implementation in the PPA computer model. (authors)
The goal of the project was to devise and implement a method of accurately qualifying any noble gas emitted during fuel drying operations (part of the dry fuel storage process) in order to provide the data needed to validate the off-site dose calculations. The imputes of the project was the NRC publishing Information Notice 18-01, 'Noble Fission Gas Releases During Spent Fuel Cask Loading Operations' in February 2018. The information notice describes some industry events that occurred during vacuum drying operations as part of a dry fuel campaign. The solution was devised by Fort Calhoun Station staff in partnership with Mirion Technologies technical staff. The monitoring was accomplished by directing all the effluent from the fuel storage cask vacuum drying machine through a sample chamber containing a compact ISOCS characterized CZT based gamma spectrometer connected to a Mirion Data Analyst. This resulted near real-time quantification of the radionuclides of concern. (authors)
Spinal cord tolerance data for stereotactic body radiation therapy (SBRT) were extracted from published reports, reviewed, and modelled. For de novo SBRT delivered in 1 to 5 fractions, the following spinal cord point maximum doses (D{sub max}) are estimated to be associated with a 1% to 5% risk of radiation myelopathy (RM): 12.4 to 14.0 Gy in 1 fraction, 17.0 Gy in 2 fractions, 20.3 Gy in 3 fractions, 23.0 Gy in 4 fractions, and 25.3 Gy in 5 fractions. For reirradiation SBRT delivered in 1 to 5 fractions, reported factors associated with a lower risk of RM include cumulative thecal sac equivalent dose in 2 Gy fractions with an alpha/beta of 2 (EQD2{sub 2}) D{sub max} ≤70 Gy; SBRT thecal sac EQD2{sub 2} D{sub max} ≤25 Gy, thecal sac SBRT EQD2{sub 2} D{sub max} to cumulative EQD2{sub 2} D{sub max} ratio ≤0.5, and a minimum time interval to reirradiation of ≥5 months. Larger studies containing complete institutional cohorts with dosimetric data of patients treated with spine SBRT, with and without RM, are required to refine RM risk estimates.
The general concept of radiation therapy used in conventional cancer treatment is to increase the therapeutic index by creating a physical dose differential between tumors and normal tissues through precision dose targeting, image guidance, and radiation beams that deliver a radiation dose with high conformality, e.g., protons and ions. However, the treatment and cure are still limited by normal tissue radiation toxicity, with the corresponding side effects. A fundamentally different paradigm for increasing the therapeutic index of radiation therapy has emerged recently, supported by preclinical research, and based on the FLASH radiation effect. FLASH radiation therapy (FLASH-RT) is an ultra-high-dose-rate delivery of a therapeutic radiation dose within a fraction of a second. Experimental studies have shown that normal tissues seem to be universally spared at these high dose rates, whereas tumors are not. While dose delivery conditions to achieve a FLASH effect are not yet fully characterized, it is currently estimated that doses delivered in less than 200 ms produce normal-tissue-sparing effects, yet effectively kill tumor cells. Despite a great opportunity, there are many technical challenges for the accelerator community to create the required dose rates with novel compact accelerators to ensure the safe delivery of FLASH radiation beams.
Conventional cancer therapies include surgery, radiation therapy, chemotherapy, and, more recently, immunotherapy. These modalities are often combined to improve the therapeutic index. The general concept of radiation therapy is to increase the therapeutic index by creating a physical dose differential between tumors and normal tissues through precision dose targeting, image guidance, and high radiation beams that deliver radiation dose with high conformality, e.g., protons and ions. However, treatment and cure are still limited by normal tissue radiation toxicity, with many patients experiencing acute and long-term side effects. Recently, however, a fundamentally different paradigm for increasing the therapeutic index of radiation therapy has emerged, supported by preclinical research, and based on the FLASH radiation effect. FLASH radiation therapy (FLASH-RT) is an ultra-high dose-rate delivery of a therapeutic radiation dose within a fraction of a second. Experimental studies have shown that normal tissues seem to be universally spared at these high dose rates, whereas tumors are not. The dose delivery conditions are not yet fully characterized. Still, it is currently estimated that large doses of 10 Gy or more delivered in 200 ms or less produce normal tissue sparing effects yet effectively kill tumor cells. There is a great opportunity, but also many technical challenges, for the accelerator community to create the required dose rates with novel and compact accelerators to ensure the safe delivery of FLASH radiation beams.
Radiation-induced cardiac toxicity is a potential lethal complication. The aim of this study was to assess whether there is a dose-dependent relationship between radiation dose and myocardial fibrosis in patients who received neoadjuvant chemoradiation (nCRT) for esophageal cancer (EC).
Ultra-high-dose-rate FLASH radiation therapy has been shown to minimize side effects of irradiation in various organs while keeping antitumor efficacy. This property, called the FLASH effect, has caused enthusiasm in the radiation oncology community because it opens opportunities for safe dose escalation and improved radiation therapy outcome. Here, we investigated the impact of ultra-high-dose-rate FLASH versus conventional-dose-rate (CONV) total body irradiation (TBI) on humanized models of T-cell acute lymphoblastic leukemia (T-ALL) and normal human hematopoiesis.
We investigated whether delivery of a high biologically effective dose (BED) to primary tumors affects systemic outcomes of cancer-specific death (CSD) and overall survival (OS) rates after stereotactic body radiation therapy (SBRT) in patients with early-stage non-small cell lung cancer (ES-NSCLC).
This is a poster intended to be presented alongside a paper under the same name (INL/CON-24-82555 Rev:001) which displays some discussion and results from the paper. In short, an investigation of various industrial-grade high-temperature insulation materials were simulated to have been irradiated under conditions representative of a high-temperature nuclear experiment in order to identify materials with low activation potential.
Among the diverse advanced nuclear reactor concepts being developed are designs that expect to operate at much higher temperatures than conventional light-water reactors, and therefore require alternative materials for components capable of withstanding these extreme temperatures. Insulation is one such component where alternative high-temperature industrial composites are being considered. Low-power experiments can provide an opportunity for advancing our understanding of material behavior under irradiation; however, these experiments are not without occupational hazards. The focus of this paper is the potential for activation of insulating composites when exposed to neutron fluence during reactor experiments, and to discuss the subsequent contamination of the testing area. This paper will also discuss practical measures for preventing the creation and inhalation of activated particulate matter (i.e., dust), such as engineering and administrative controls and personal protective equipment. This paper evaluates the suitability of several insulation materials for use in reactor experiments based on their activation from neutron irradiation. The materials considered are Pyrogel XTE by Aspen Aerogel, Cerablanket and Kaowool by Morgan Advanced Materials, Thermo-12 Gold by Johns Manville, and Maxsil CF6-2000 by McAllister Mills. Although these materials are not yet widely used in the nuclear industry, they are common in other industries due to their thermal insulating properties. These materials produce dust while handling that can pose health and safety hazards, which could be further exacerbated by activation. The analysis presented in this paper utilizes a deterministic method developed to predict the activation source term of the provided insulation materials. The method calculates the atomic density of each element within the composites and simulates their exposure to a specified neutron flux density representative of low power experimental conditions. During the irradiation phase and throughout the extensive cooling period, neutron absorptions and nuclear decays are tracked for relevant isotopes. The residual activity within each composite is then assessed to identify the material with the lowest potential radiological hazard to workers. Dust will be created during installation and removal of insulating materials and may also be generated during the experiment. Contamination of surrounding surfaces due to dispersion is highly likely unless preventative measures are taken. The results of this analysis are used to estimate an internal dose from inhalation of activated dust, which is significantly lower than the allowable whole-body dose. However, the risk of internal exposure may increase if the dust becomes a transport vector for nuclear material. The goals of this paper are to enhance the understanding of the potential activation and contamination hazards from the use of these insulating materials in low-power nuclear experiments and to foster safer work environments through informed decision-making and strategic planning. This work ultimately contributes to a broader understanding of how new non-nuclear materials for advanced reactors impact the radiological safety of co-located workers, helping to ensure the responsible management of radioactive materials during installation and decommissioning activities.
During World War II (WWII), the Manhattan Engineering District established a secret laboratory in the mountains of northern New Mexico. The mission was to design, construct and test the first atomic weapon, nicknamed ‘The Gadget’ that was detonated at the TRINITY site in Alamogordo, NM. After WWII, nuclear weapons research continued, and the laboratory became the Los Alamos National Laboratory (LANL). The mortality experience of 26,328 workers first employed between 1943 and 1980 at LANL was determined through 2017. Included were 6157 contract workers employed by the ZIA Company. Organ dose estimates for each worker considered all sources of exposure, notably photons, neutrons, tritium, 238Pu and 239Pu. Vital status determination included searches within the National Death Index, Social Security Administration and New Mexico State Mortality Files. Standardized Mortality Ratios (SMR) and Cox regression models were used in the analyses. Most workers (55%) were hired before 1960, 38% had a college degree, 25% were female, 81% white, 13% Hispanic and 60% had died. Vital status was complete, with only 0.1% lost to follow-up. The mean dose to the lung for the 17,053 workers monitored for radiation was 28.6 weighted-mGy (maximum 16.8 weighted-Gy) assuming a Dose Weighting Factor of 20 for alpha particle dose to lung. The Excess Relative Risk (ERR) at 100 weighted-mGy was 0.01 (95%CI -0.02, 0.03; n = 839) for lung cancer. The ERR at 100 mGy was -0.43 (95%CI -1.11, 0.24; n = 160) for leukemia other than chronic lymphocytic leukemia (CLL), -0.06 (95%CI -0.16, 0.04; n = 3043) for ischemic heart disease (IHD), and 0.29 (95%CI 0.02, 0.55; n = 106) for esophageal cancer. Among the 6499 workers with measurable intakes of plutonium, an increase in bone cancer (SMR 2.44; 95%CI 0.98, 5.03; n = 7) was related to dose. The SMR for berylliosis was significantly high, based on 4 deaths. SMRs for Hispanic workers were significantly high for cancers of the stomach and liver, cirrhosis of the liver, nonmalignant kidney disease and diabetes, but the excesses were not related to radiation dose. There was little evidence that radiation increased the risk of lung cancer or leukemia. Esophageal cancer was associated with radiation, and plutonium intakes were linked to an increase of bone cancer. IHD was not associated with radiation dose. More precise evaluations will await the pooled analysis of workers with similar exposures such as at Rocky Flats, Savannah River and Hanford.