Results for “SAFETY DEVICE” — Page 27

DOE OSTI2014

Effect of the helicity injection rate and the Lundquist number on spheromak sustainment

The dynamics of the magnetic relaxation process during the sustainment of spheromak configurations at different helicity injection rates is studied. The three-dimensional activity is recovered using time-dependent resistive magnetohydrodynamic simulations. A cylindrical flux conserver with concentric electrodes is used to model configurations driven by a magnetized coaxial gun. Magnetic helicity is injected by tangential boundary flows. Different regimes of sustainment are identified and characterized in terms of the safety factor profile. The spatial and temporal behavior of fluctuations is described. The dynamo action is shown to be in close agreement with existing experimental data. These results are relevant to the design and operation of helicity injected devices, as well as to basic understanding of the plasma relaxation mechanism in quasi-steady state.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

DOE OSTI2016

Poster - 30: Use of a Hazard-Risk Analysis for development of a new eye immobilization tool for treatment of choroidal melanoma

Purpose: Our treatment for choroidal melanoma utilizes the GTC frame. The patient looks at a small LED to stabilize target position. The LED is attached to a metal arm attached to the GTC frame. A camera on the arm allows therapists to monitor patient compliance. To move to mask-based immobilization we need a new LED/camera attachment mechanism. We used a Hazard-Risk Analysis (HRA) to guide the design of the new tool. Method: A pre-clinical model was built with input from therapy and machine shop personnel. It consisted of an aluminum frame placed in aluminum guide posts attached to the couch top. Further development was guided by the Department of Defense Standard Practice - System Safety hazard risk analysis technique. Results: An Orfit mask was selected because it allowed access to indexes on the couch top which assist with setup reproducibility. The first HRA table was created considering mechanical failure modes of the device. Discussions with operators and manufacturers identified other failure modes and solutions. HRA directed the design towards a safe clinical device. Conclusion: A new immobilization tool has been designed using hazard-risk analysis which resulted in an easier-to-use and safer tool compared to the initial design. The remaining risks are all low probability events and not dissimilar from those currently faced with the GTC setup. Given the gains in ease of use for therapists and patients as well as the lower costs for the hospital, we will implement this new tool.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

WE-DE-207A-00: Advances in Image-Guided Neurointerventions-Clinical Pull and Technology Push

1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being pursued. For the highest spatial and temporal resolution, x-ray guidance with fluoroscopy and angiography although dominant are still being vastly improved. New detectors such as the Micro-Angiographic Fluoroscope (MAF) and x-ray source designs that enable higher outputs while maintaining small focal spots will be highlighted along with new methods for minimizing the radiation dose to patients. Additionally, new platforms for training and device testing that include patient-specific 3D printed vascular phantoms and new metrics such as generalized relative object detectability for objectively inter-comparing systems will be discussed. This will improve the opportunity for better evaluation of these technological advances which should contribute to the safety and efficacy of image guided minimally invasive neuro-endovascular procedures. Learning Objectives: To understand the operation of new x-ray imaging chain components such as detectors and sources To be informed about the latest testing methods, with 3D printed vascular phantoms, and new evaluation metrics for advanced imaging in x-ray image guided neurovascular interventions Advances in cone beam CT anatomical and functional imaging in angio-suite to enable one-stop-shop stroke imaging workflow Guang-Hong Chen - The introduction of flat-panel detector based cone-beam CT in clinical angiographic imaging systems enabled treating physicians to obtain three-dimensional anatomic roadmaps for bony structure, soft brain tissue, and vasculatures for treatment planning and efficacy checking after the procedures. However, much improvement is needed to reduce image artifacts, reduce radiation dose, and add potential functional imaging capability to provide four-dimensional dynamic information of vasculature and brain perfusion. In this presentation, some of the new techniques developed to address radiation dose issues, image artifact reduction and brain perfusion using C-arm cone-beam CT imaging system will be introduced for the audience. Learning Objectives: To understand the clinical need of one-stop-shop stroke imaging workflow To understand to technical challenges in cone beam CT perfusion To understand the potential technical solutions to enable one-stop-shop imaging workflow Recent advances in devices used in neuro--interventions Mattew Gounis - Over the past two decades, there has been explosive development of medical devices that have revolutionized the endovascular treatment of cerebrovascular diseases. There is now Level 1, Class A evidence that intra-arterial, mechanical thrombectomy in acute ischemic stroke is superior to medical management; and similarly that minimally invasive, endovascular repair of ruptured brain aneurysms is superior to surgical treatment. Stent-retrievers are now standard of care for emergent large vessel occlusions causing a stroke, with a number of patients need to treat for good clinical outcomes as low as 4. Recent technologies such as flow diverters and disrupters, intracranial self-expanding stents, flexible large bore catheters that can reach vessels beyond the circle of Willis, stent-retrievers, and super-compliant balloons are the result of successful miniaturization of design features and novel manufacturing technologies capable of building these devices. This is a rapidly evolving field, and the device technology enabling such advancements will be reviewed. Importantly, image-guidance technology has not kept pace in neurointervention and the ability to adequately characterize these devices in vivo remains a significant opportunity. Learning Objectives: A survey of devices used in neurointerventions, their materials and essential design characteristics Funding support received from NIH and DOD; Funding support received from GE Healthcare; Funding support received from Siemens AX; Patent royalties received from GE Healthcare; G. Chen, Funding received from NIH; funding received from DOD; funding received from GE Healthcare; funding received from Siemens AX.; M. Gounis, consultant for Codman Neurovascular and Stryker Neurovascular; Holds stock in InNeuroCo Inc, research grants: NIH, Medtronic Neurovascular, Microvention/Terumo, Cerevasc LLC, Gentuity, Codman Neurovascular, Philips Healthcare, Stryker Neurovascular, Tay Sachs Foundation, and InNeuroCo Inc.; S. Rudin, Supported in part by NIH Grant R01EB002873 and the Toshiba Medical System Corp.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

WE-DE-207A-01: Parallels in the Evolution of X-Ray Angiographic Systems and Devices Used for Minimally Invasive Endovascular Therapy

1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being pursued. For the highest spatial and temporal resolution, x-ray guidance with fluoroscopy and angiography although dominant are still being vastly improved. New detectors such as the Micro-Angiographic Fluoroscope (MAF) and x-ray source designs that enable higher outputs while maintaining small focal spots will be highlighted along with new methods for minimizing the radiation dose to patients. Additionally, new platforms for training and device testing that include patient-specific 3D printed vascular phantoms and new metrics such as generalized relative object detectability for objectively inter-comparing systems will be discussed. This will improve the opportunity for better evaluation of these technological advances which should contribute to the safety and efficacy of image guided minimally invasive neuro-endovascular procedures. Learning Objectives: To understand the operation of new x-ray imaging chain components such as detectors and sources To be informed about the latest testing methods, with 3D printed vascular phantoms, and new evaluation metrics for advanced imaging in x-ray image guided neurovascular interventions Advances in cone beam CT anatomical and functional imaging in angio-suite to enable one-stop-shop stroke imaging workflow Guang-Hong Chen - The introduction of flat-panel detector based cone-beam CT in clinical angiographic imaging systems enabled treating physicians to obtain three-dimensional anatomic roadmaps for bony structure, soft brain tissue, and vasculatures for treatment planning and efficacy checking after the procedures. However, much improvement is needed to reduce image artifacts, reduce radiation dose, and add potential functional imaging capability to provide four-dimensional dynamic information of vasculature and brain perfusion. In this presentation, some of the new techniques developed to address radiation dose issues, image artifact reduction and brain perfusion using C-arm cone-beam CT imaging system will be introduced for the audience. Learning Objectives: To understand the clinical need of one-stop-shop stroke imaging workflow To understand to technical challenges in cone beam CT perfusion To understand the potential technical solutions to enable one-stop-shop imaging workflow Recent advances in devices used in neuro--interventions Mattew Gounis - Over the past two decades, there has been explosive development of medical devices that have revolutionized the endovascular treatment of cerebrovascular diseases. There is now Level 1, Class A evidence that intra-arterial, mechanical thrombectomy in acute ischemic stroke is superior to medical management; and similarly that minimally invasive, endovascular repair of ruptured brain aneurysms is superior to surgical treatment. Stent-retrievers are now standard of care for emergent large vessel occlusions causing a stroke, with a number of patients need to treat for good clinical outcomes as low as 4. Recent technologies such as flow diverters and disrupters, intracranial self-expanding stents, flexible large bore catheters that can reach vessels beyond the circle of Willis, stent-retrievers, and super-compliant balloons are the result of successful miniaturization of design features and novel manufacturing technologies capable of building these devices. This is a rapidly evolving field, and the device technology enabling such advancements will be reviewed. Importantly, image-guidance technology has not kept pace in neurointervention and the ability to adequately characterize these devices in vivo remains a significant opportunity. Learning Objectives: A survey of devices used in neurointerventions, their materials and essential design characteristics Funding support received from NIH and DOD; Funding support received from GE Healthcare; Funding support received from Siemens AX; Patent royalties received from GE Healthcare; G. Chen, Funding received from NIH; funding received from DOD; funding received from GE Healthcare; funding received from Siemens AX.; M. Gounis, consultant for Codman Neurovascular and Stryker Neurovascular; Holds stock in InNeuroCo Inc, research grants: NIH, Medtronic Neurovascular, Microvention/Terumo, Cerevasc LLC, Gentuity, Codman Neurovascular, Philips Healthcare, Stryker Neurovascular, Tay Sachs Foundation, and InNeuroCo Inc.; S. Rudin, Supported in part by NIH Grant R01EB002873 and the Toshiba Medical System Corp.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

WE-DE-207A-02: Advances in Cone Beam CT Anatomical and Functional Imaging in Angio-Suite to Enable One-Stop-Shop Stroke Imaging Workflow

1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being pursued. For the highest spatial and temporal resolution, x-ray guidance with fluoroscopy and angiography although dominant are still being vastly improved. New detectors such as the Micro-Angiographic Fluoroscope (MAF) and x-ray source designs that enable higher outputs while maintaining small focal spots will be highlighted along with new methods for minimizing the radiation dose to patients. Additionally, new platforms for training and device testing that include patient-specific 3D printed vascular phantoms and new metrics such as generalized relative object detectability for objectively inter-comparing systems will be discussed. This will improve the opportunity for better evaluation of these technological advances which should contribute to the safety and efficacy of image guided minimally invasive neuro-endovascular procedures. Learning Objectives: To understand the operation of new x-ray imaging chain components such as detectors and sources To be informed about the latest testing methods, with 3D printed vascular phantoms, and new evaluation metrics for advanced imaging in x-ray image guided neurovascular interventions Advances in cone beam CT anatomical and functional imaging in angio-suite to enable one-stop-shop stroke imaging workflow Guang-Hong Chen - The introduction of flat-panel detector based cone-beam CT in clinical angiographic imaging systems enabled treating physicians to obtain three-dimensional anatomic roadmaps for bony structure, soft brain tissue, and vasculatures for treatment planning and efficacy checking after the procedures. However, much improvement is needed to reduce image artifacts, reduce radiation dose, and add potential functional imaging capability to provide four-dimensional dynamic information of vasculature and brain perfusion. In this presentation, some of the new techniques developed to address radiation dose issues, image artifact reduction and brain perfusion using C-arm cone-beam CT imaging system will be introduced for the audience. Learning Objectives: To understand the clinical need of one-stop-shop stroke imaging workflow To understand to technical challenges in cone beam CT perfusion To understand the potential technical solutions to enable one-stop-shop imaging workflow Recent advances in devices used in neuro--interventions Mattew Gounis - Over the past two decades, there has been explosive development of medical devices that have revolutionized the endovascular treatment of cerebrovascular diseases. There is now Level 1, Class A evidence that intra-arterial, mechanical thrombectomy in acute ischemic stroke is superior to medical management; and similarly that minimally invasive, endovascular repair of ruptured brain aneurysms is superior to surgical treatment. Stent-retrievers are now standard of care for emergent large vessel occlusions causing a stroke, with a number of patients need to treat for good clinical outcomes as low as 4. Recent technologies such as flow diverters and disrupters, intracranial self-expanding stents, flexible large bore catheters that can reach vessels beyond the circle of Willis, stent-retrievers, and super-compliant balloons are the result of successful miniaturization of design features and novel manufacturing technologies capable of building these devices. This is a rapidly evolving field, and the device technology enabling such advancements will be reviewed. Importantly, image-guidance technology has not kept pace in neurointervention and the ability to adequately characterize these devices in vivo remains a significant opportunity. Learning Objectives: A survey of devices used in neurointerventions, their materials and essential design characteristics Funding support received from NIH and DOD; Funding support received from GE Healthcare; Funding support received from Siemens AX; Patent royalties received from GE Healthcare; G. Chen, Funding received from NIH; funding received from DOD; funding received from GE Healthcare; funding received from Siemens AX.; M. Gounis, consultant for Codman Neurovascular and Stryker Neurovascular; Holds stock in InNeuroCo Inc, research grants: NIH, Medtronic Neurovascular, Microvention/Terumo, Cerevasc LLC, Gentuity, Codman Neurovascular, Philips Healthcare, Stryker Neurovascular, Tay Sachs Foundation, and InNeuroCo Inc.; S. Rudin, Supported in part by NIH Grant R01EB002873 and the Toshiba Medical System Corp.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

WE-DE-207A-03: Recent Advances in Devices Used in Neuro--Interventions

1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being pursued. For the highest spatial and temporal resolution, x-ray guidance with fluoroscopy and angiography although dominant are still being vastly improved. New detectors such as the Micro-Angiographic Fluoroscope (MAF) and x-ray source designs that enable higher outputs while maintaining small focal spots will be highlighted along with new methods for minimizing the radiation dose to patients. Additionally, new platforms for training and device testing that include patient-specific 3D printed vascular phantoms and new metrics such as generalized relative object detectability for objectively inter-comparing systems will be discussed. This will improve the opportunity for better evaluation of these technological advances which should contribute to the safety and efficacy of image guided minimally invasive neuro-endovascular procedures. Learning Objectives: To understand the operation of new x-ray imaging chain components such as detectors and sources To be informed about the latest testing methods, with 3D printed vascular phantoms, and new evaluation metrics for advanced imaging in x-ray image guided neurovascular interventions Advances in cone beam CT anatomical and functional imaging in angio-suite to enable one-stop-shop stroke imaging workflow Guang-Hong Chen - The introduction of flat-panel detector based cone-beam CT in clinical angiographic imaging systems enabled treating physicians to obtain three-dimensional anatomic roadmaps for bony structure, soft brain tissue, and vasculatures for treatment planning and efficacy checking after the procedures. However, much improvement is needed to reduce image artifacts, reduce radiation dose, and add potential functional imaging capability to provide four-dimensional dynamic information of vasculature and brain perfusion. In this presentation, some of the new techniques developed to address radiation dose issues, image artifact reduction and brain perfusion using C-arm cone-beam CT imaging system will be introduced for the audience. Learning Objectives: To understand the clinical need of one-stop-shop stroke imaging workflow To understand to technical challenges in cone beam CT perfusion To understand the potential technical solutions to enable one-stop-shop imaging workflow Recent advances in devices used in neuro--interventions Mattew Gounis - Over the past two decades, there has been explosive development of medical devices that have revolutionized the endovascular treatment of cerebrovascular diseases. There is now Level 1, Class A evidence that intra-arterial, mechanical thrombectomy in acute ischemic stroke is superior to medical management; and similarly that minimally invasive, endovascular repair of ruptured brain aneurysms is superior to surgical treatment. Stent-retrievers are now standard of care for emergent large vessel occlusions causing a stroke, with a number of patients need to treat for good clinical outcomes as low as 4. Recent technologies such as flow diverters and disrupters, intracranial self-expanding stents, flexible large bore catheters that can reach vessels beyond the circle of Willis, stent-retrievers, and super-compliant balloons are the result of successful miniaturization of design features and novel manufacturing technologies capable of building these devices. This is a rapidly evolving field, and the device technology enabling such advancements will be reviewed. Importantly, image-guidance technology has not kept pace in neurointervention and the ability to adequately characterize these devices in vivo remains a significant opportunity. Learning Objectives: A survey of devices used in neurointerventions, their materials and essential design characteristics Funding support received from NIH and DOD; Funding support received from GE Healthcare; Funding support received from Siemens AX; Patent royalties received from GE Healthcare; G. Chen, Funding received from NIH; funding received from DOD; funding received from GE Healthcare; funding received from Siemens AX.; M. Gounis, consultant for Codman Neurovascular and Stryker Neurovascular; Holds stock in InNeuroCo Inc, research grants: NIH, Medtronic Neurovascular, Microvention/Terumo, Cerevasc LLC, Gentuity, Codman Neurovascular, Philips Healthcare, Stryker Neurovascular, Tay Sachs Foundation, and InNeuroCo Inc.; S. Rudin, Supported in part by NIH Grant R01EB002873 and the Toshiba Medical System Corp.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

WE-DE-207A-04: Advances in Radiological Neuro-Endovascular Interventional Imaging

1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being pursued. For the highest spatial and temporal resolution, x-ray guidance with fluoroscopy and angiography although dominant are still being vastly improved. New detectors such as the Micro-Angiographic Fluoroscope (MAF) and x-ray source designs that enable higher outputs while maintaining small focal spots will be highlighted along with new methods for minimizing the radiation dose to patients. Additionally, new platforms for training and device testing that include patient-specific 3D printed vascular phantoms and new metrics such as generalized relative object detectability for objectively inter-comparing systems will be discussed. This will improve the opportunity for better evaluation of these technological advances which should contribute to the safety and efficacy of image guided minimally invasive neuro-endovascular procedures. Learning Objectives: To understand the operation of new x-ray imaging chain components such as detectors and sources To be informed about the latest testing methods, with 3D printed vascular phantoms, and new evaluation metrics for advanced imaging in x-ray image guided neurovascular interventions Advances in cone beam CT anatomical and functional imaging in angio-suite to enable one-stop-shop stroke imaging workflow Guang-Hong Chen - The introduction of flat-panel detector based cone-beam CT in clinical angiographic imaging systems enabled treating physicians to obtain three-dimensional anatomic roadmaps for bony structure, soft brain tissue, and vasculatures for treatment planning and efficacy checking after the procedures. However, much improvement is needed to reduce image artifacts, reduce radiation dose, and add potential functional imaging capability to provide four-dimensional dynamic information of vasculature and brain perfusion. In this presentation, some of the new techniques developed to address radiation dose issues, image artifact reduction and brain perfusion using C-arm cone-beam CT imaging system will be introduced for the audience. Learning Objectives: To understand the clinical need of one-stop-shop stroke imaging workflow To understand to technical challenges in cone beam CT perfusion To understand the potential technical solutions to enable one-stop-shop imaging workflow Recent advances in devices used in neuro--interventions Mattew Gounis - Over the past two decades, there has been explosive development of medical devices that have revolutionized the endovascular treatment of cerebrovascular diseases. There is now Level 1, Class A evidence that intra-arterial, mechanical thrombectomy in acute ischemic stroke is superior to medical management; and similarly that minimally invasive, endovascular repair of ruptured brain aneurysms is superior to surgical treatment. Stent-retrievers are now standard of care for emergent large vessel occlusions causing a stroke, with a number of patients need to treat for good clinical outcomes as low as 4. Recent technologies such as flow diverters and disrupters, intracranial self-expanding stents, flexible large bore catheters that can reach vessels beyond the circle of Willis, stent-retrievers, and super-compliant balloons are the result of successful miniaturization of design features and novel manufacturing technologies capable of building these devices. This is a rapidly evolving field, and the device technology enabling such advancements will be reviewed. Importantly, image-guidance technology has not kept pace in neurointervention and the ability to adequately characterize these devices in vivo remains a significant opportunity. Learning Objectives: A survey of devices used in neurointerventions, their materials and essential design characteristics Funding support received from NIH and DOD; Funding support received from GE Healthcare; Funding support received from Siemens AX; Patent royalties received from GE Healthcare; G. Chen, Funding received from NIH; funding received from DOD; funding received from GE Healthcare; funding received from Siemens AX.; M. Gounis, consultant for Codman Neurovascular and Stryker Neurovascular; Holds stock in InNeuroCo Inc, research grants: NIH, Medtronic Neurovascular, Microvention/Terumo, Cerevasc LLC, Gentuity, Codman Neurovascular, Philips Healthcare, Stryker Neurovascular, Tay Sachs Foundation, and InNeuroCo Inc.; S. Rudin, Supported in part by NIH Grant R01EB002873 and the Toshiba Medical System Corp.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management

The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process. A systematic understanding of the likelihood and clinical impact of possible failures throughout a course of radiotherapy is needed to direct limit QM resources efficiently to produce maximum safety and quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and has developed a framework for designing QM activities, based on estimates of the probability of identified failures and their clinical outcome through the RT planning and delivery process. The Task Group has chosen a specific radiotherapy process required for “intensity modulated radiation therapy (IMRT)” as a case study. The goal of this work is to apply modern risk-based analysis techniques to this complex RT process in order to demonstrate to the RT community that such techniques may help identify more effective and efficient ways to enhance the safety and quality of our treatment processes. The task group generated by consensus an example quality management program strategy for the IMRT process performed at the institution of one of the authors. This report describes the methodology and nomenclature developed, presents the process maps, FMEAs, fault trees, and QM programs developed, and makes suggestions on how this information could be used in the clinic. The development and implementation of risk-assessment techniques will make radiation therapy safer and more efficient.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Evaluation of the first version of the new RFPI system dedicated to PIP-II project accelerator

The Low-Level Radio Frequency (LLRF) control system is one of the most critical superconducting linac infrastructures responsible for the parameters of the beam acceleration. The LLRF system mainly focuses on the electromagnetic field parameters inside the cavity. While it incorporates fast feedback algorithms to optimize energy transfer to the passing particle beam it does not follow other cryomodule or cavity parameter changes. The Radio Frequency Protection Interlock (RFPI) system closely monitors various factors (like cryomodule vacuum, beamline vacuum, field emission probe current level, temperature, RF signal leakage, etc). Its simple but reliable logic has to provide an instant decision about the LLRF system or high-power amplifier output signal blocking in case of safety region excitation. This contribution presents a new version of the RFPI system which logic is implemented in the FPGA chip. The initial work on the prototype of the new system design resulted in the PoC (Proof of Concept) device. The PoC offers the possibility of various protection logic configurations, input signals parameters evaluation, and modularity aspects verification. The structure and test results from the device evaluation are summarized and discussed in this contribution.

43 PARTICLE ACCELERATORS↗

DOE OSTI2017

Consider the Consequences: A Powerful Approach for Reducing ICS Cyber Risk

Here, by identifying and analyzing threats, vulnerabilities, and impacts, asset owners can develop a risk profile for their industrial control systems (ICSs). This information is essential in developing, prioritizing, and implementing mitigations to reduce ICS cyber risk. To help bridge the gap between the cyber and physical domains, and gain a better understanding of cascading cyber/physical impacts, this paper will discuss the safety perspective of physical impacts, describe the ICS cyber kill chain model, explain the cyber/physical interface, review the “layers of protection analysis model” from a security perspective, discuss protection layers, and suggest a reference architecture for securing digital control devices.

99 GENERAL AND MISCELLANEOUS↗

DOE OSTI2015

The quiescent H-mode regime for high performance edge localized mode-stable operation in future burning plasmas

For the first time, DIII-D experiments have achieved stationary quiescent H-mode (QH-mode) operation for many energy confinement times at simultaneous ITER-relevant values of beta, confinement, and safety factor, in an ITER-like shape. QH-mode provides excellent energy confinement, even at very low plasma rotation, while operating without edge localized modes (ELMs) and with strong impurity transport via the benign edge harmonic oscillation (EHO). By tailoring the plasma shape to improve the edge stability, the QH-mode operating space has also been extended to densities exceeding 80% of the Greenwald limit, overcoming the long-standing low-density limit of QH-mode operation. In the theory, the density range over which the plasma encounters the kink-peeling boundary widens as the plasma cross-section shaping is increased, thus increasing the QH-mode density threshold. The DIII-D results are in excellent agreement with these predictions, and nonlinear magnetohydrodynamic analysis of reconstructed QH-mode equilibria shows unstable low n kink-peeling modes growing to a saturated level, consistent with the theoretical picture of the EHO. Furthermore, high density operation in the QH-mode regime has opened a path to a new, previously predicted region of parameter space, named “Super H-mode” because it is characterized by very high pedestals that can be more than a factor of two above the peeling-ballooning stability limit for similar ELMing H-mode discharges at the same density.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

DOE OSTI2022

Realistic operation of two residential cordwood-fired outdoor hydronic heater appliances—Part 2: Particle number and size

The use of wood as a fuel for home heating is a concern from an environmental health and safety perspective as biomass combustion appliances emit high concentrations of particulate matter. Wood burning significantly contributes to wintertime particulate matter concentrations in many states in the northern United States. Of particular concern are outdoor wood-fired hydronic heaters. These devices are concerning as they tend to have very large combustion chambers and typical use patterns can result in long periods of low output, which result in an increased particulate matter emission rate relative to high heat output operating conditions. In this study, the performance of two hydronic heaters operating under different combustion conditions, including four different heat output categories approximately corresponding to categories I–IV denoted in Environmental Protection Agency Method 28 Outdoor Wood-fired Hydronic Heaters, and during start-up and reloading events were investigated. Measurements of flue gas particulate number concentration and size for particles with aerodynamic diameters between 0.006 and 10 µm were made using a dilution sampling system. The measured particle number concentration in the flue gas was between 0.71 and 420 million particles per cubic centimeter and was dependent on fuel loading and heat output. For each hydronic heater tested, the highest average particle concentration was found at the beginning of each test during the cold-start condition. Additionally, the majority of the particles had aerodynamic diameters less than 0.100 µm (particles of this size made up between 64% and 97% of all particles) and less than 1% of all particles had aerodynamic diameters greater than 1 µm for all phases. For particles in the accumulation mode, between 0.100 and 1 µm, the mean particle diameter was dependent on fuel loading and heat output.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

DOE OSTI2017

Battery Testing FY 2017 Annual Progress Report

Abuse tests are designed to determine the safe operating limits of HEV\PHEV energy storage devices. Testing is intended to achieve certain worst-case scenarios to yield quantitative data on cell\module\pack response, allowing for failure mode determination and guiding developers toward improved materials and designs. Standard abuse tests with defined start and end conditions are performed on all devices to provide comparison between technologies. New tests and protocols are developed and evaluated to more closely simulate real-world failure conditions. When scaling from cell to the battery level, a detailed understanding of cell interactions provides insight on safety performance. Single point failures from a cell or group of cells can be initiated by a number of triggers including internal short circuit, misuse or abuse, or component failure at the battery or system level. Propagation of a single failure event (regardless of the initiation trigger) through an entire battery, system, or vehicle is an unacceptable outcome with regards to EV battery safety. In this FY, our work has focused on evaluating the propagation of a single cell thermal runaway event through a battery using a variety of design considerations with an emphasis on passive thermal management impacts. This has been coupled with thermal modeling by NREL for these testing conditions. In addition, alternative failure initiation methods have been evaluated to provide direct comparisons of possible energy injection between modes. This data was compiled to better identify what propagation test method is appropriate given certain battery designs. Expanding the analysis of short circuit current during failure propagation has been done for EV relevant chemistries. Ongoing test development and validation to obtain these values has been achieved. While robust mechanical models for vehicles and vehicle components exist, there is a gap for mechanical modeling of EV batteries. The challenge with developing a mechanical model for a battery is the heterogeneous nature of the materials and components (polymers, metals, metal oxides, liquids). Our work will provide empirical data on the mechanical behavior of batteries under compressive load to understand how a battery may behave in a vehicle crash scenario. This work is performed in collaboration with the U.S. Council for Automotive Research (USCAR) and Computer Aided Engineering of Batteries (CAEBAT). These programs have supported the design and development of a drop tower testing apparatus to close the gap between cell/string level testing and full scale crash testing with true dynamic rate effects.

25 ENERGY STORAGE↗

DOE OSTI2023

Lithium-Ion UPS Battery Research and Commentary

Lithium-ion batteries are increasingly prevalent in a variety of devices both small and large. The high level of stored energy in UPS battery racks is closely scrutinized because sudden, uncontrolled release of chemical and electrical energy could be an ignition source. With this in mind, lithium-ion battery safety is the subject of several testing standards, including UL 1642, UL 1973, and UL 9540A.The motivation for this research and commentary is the potential installation of lithium-ion batteries in a Vertiv UPS assembly for one of the buildings on the ORNL campus. The battery modules Vertiv uses are compliant with abuse survival testing, demonstrating that cells and modules are rugged. The modules are further compliant with fire propagation requirements – in the event a failure does produce a fire, it doesn’t spread. Beyond these, the rack level assemblies Vertiv sources comply with UL requirements to contain a fire within the rack.This three-tiered approach to battery safety suggests Vertiv’s lithium-ion UPS battery racks can reasonably be considered for use in a facility with appropriate fire protection provisions and an informed emergency response team.

25 ENERGY STORAGE↗

DOE OSTI2025

Low-cost buffer storage for solar industrial steam applications

Motivation and importance: Many industrial process heat consumers operate throughout the day, and deep decarbonization with solar energy requires thermal energy storage. Thermal energy storage provides an additional operational benefit of firm delivery of steam – essential to reducing the risk of costly production interruptions. The group of process heat consumers that use steam for biofuels production for the California transportation fuels market is incentivized through the Low Carbon Fuel Standard (LCFS) to reduce their carbon intensity through the use of solar steam. Examples include ethanol and dimethyl ether production. The production of these and other fuels involves distillation driven by steam reboilers with steam pressures in the range 100-280 psig. These pressures can be delivered from the type of thermal energy storage that has been the focus of this project – a steam accumulator Sunvapor, Inc. (SVI) calls a “Bullet Steam Accumulator” or “BSA TM ”. Our project adds to the understanding of the design and integration of steam accumulators charged by solar thermal energy in a biofuels production facility, and similar facilities that consume process steam. The fuel application requires a demanding level of Process Safety Management not found in other steam applications. The type of steam accumulator SVI engineered and built integrates steam generation and storage in one vessel to reduce cost. Achieving a first of a kind permit to operate such a first device has also added to the understanding of the industrial application of such systems. Goals: The overall goal of the project has been to demonstrate the advantages that a “Bullet Steam Accumulator” (BSA™) can provide to solar steam integration with a manufacturing process. The industrial host has already been convinced of the potential of the available solar steam to lower than carbon intensity score. They have been interviewed for a number of publications such as that tout the advantages SVI’s system brings to their operations. Accomplishments: At the end of 2023 Sunvapor placed in service the country’s first industrial solar boiler with thermal energy storage. At the same time, this placement in service represents the first pilot commercial system to decarbonize biofuels production through the use of solar thermal energy. While the full technical effectiveness will be shown as soon as the customer’s plant is able to consume the available steam, the economic feasibility was indicated early in the project when the combination of costs and steam pricing required to meet investor expectations was determined. The project represents a reference pilot from which a full-scale commercial system may be expanded. This pilot is a necessary first step in providing the full potential benefits to the public, including decarbonization of transportation fuels. The decarbonization of the separation steps in fuels production may be the most cost-effective and nearest term solar fuel. Co-benefits include a reduction of air pollutants such as NOx and particulate matter, and job creation for the construction, operation and maintenance of industrial solar facilities.

14 SOLAR ENERGY↗

DOE OSTI2025

Exponential Backoff and Its Security Implications for Safety-Critical OT Protocols over TCP/IP Networks

The convergence of Operational Technology (OT) and Information Technology (IT) networks has become increasingly prevalent with the growth of Industrial Internet of Things (IIoT) applications. This shift, while enabling enhanced automation, remote monitoring, and data sharing, also introduces new challenges related to communication latency and cybersecurity. Oftentimes, legacy OT protocols were adapted to the TCP/IP stack without an extensive review of the ramifications to their robustness, performance, or safety objectives. To further accommodate the IT/OT convergence, protocol gateways were introduced to facilitate the migration from serial protocols to TCP/IP protocol stacks within modern IT/OT infrastructure. However, they often introduce additional vulnerabilities by exposing traditionally isolated protocols to external threats. This study investigates the security and reliability implications of migrating serial protocols to TCP/IP stacks and the impact of protocol gateways, utilizing two widely used OT protocols: Modbus TCP and DNP3. Our protocol analysis finds a significant safety-critical vulnerability resulting from this migration, and our subsequent tests clearly demonstrate its presence and impact. A multi-tiered testbed, consisting of both physical and emulated components, is used to evaluate protocol performance and the effects of device-specific implementation flaws. Through this analysis of specifications and behaviors during communication interruptions, we identify critical differences in fault handling and the impact on time-sensitive data delivery. The findings highlight how reliance on lower-level IT protocols can undermine OT system resilience, and they inform the development of mitigation strategies to enhance the robustness of industrial communication networks.

DNP3↗

DOE OSTI2020

Lawrence Livermore National Laboratory ABSL-3 Tissue Digester Run Data Report

Purpose: Provide data from a water run of the LLNL tissue digestor to confirm operational status for possible extension of Medical Waste permit, since the annual recertification maintenance and testing could not take place due to the shelter-in-place of the tissue digester vendor who is located outside of California. This is a unique medical waste device and the vendor who certifies our other medical waste equipment (permitted autoclaves), does not service the tissue digester.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2020

Lawrence Livermore National Laboratory ABSL-3 Tissue Digester 12 June 2020 Run Data Report, Report 2

Purpose: Provide data from a water run of the LLNL tissue digester to confirm operational status for possible extension of Medical Waste permit, since the annual recertification maintenance and testing could not take place due to the shelter-in-place of the tissue digester vendor who is located outside of California. This is a unique medical waste device and the vendor who certifies our other medical waste equipment (permitted autoclaves), does not service the tissue digester.

59 BASIC BIOLOGICAL SCIENCES↗