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At least 595 records · Page 33

Developing Deep Learning Models for System Remaining Useful Life Predictions: Application to Aircraft Engines

Prognostics and health management (PHM) is an important part of ensuring reliable operations of complex safety- critical systems. System-level remaining useful life (RUL) estimation is a much more complex problem than making estimations at the component level, and system-level RUL methodologies remain sparse in the literature. Model-based approaches have traditionally worked in the past for components such as capacitors, MOSFETs, batteries, or hard-drives (to name a few examples), but developing high fidelity dynamics models of cyber physical systems that can be used to study the effects of multiple degrading components in the system remains a challenging task. Some initial work on model-based System RUL predictions was demonstrated in Khorasgani, et al [1], but, to generalize the system-level prognostics problem, we have to resort to pure data driven and hybrid approaches. In this work, we propose an end-to-end data- driven framework for developing deep learning models to predict remaining useful life of cyber physical systems operating under unknown faulty conditions. The raw data is organized with a data schema that improves the model development process and down stream data analysis tasks. Due to the unknown faulty conditions, the raw sensor data is transformed into signals that expose the underlying degradation processes, which are then used for model development. Bayesian Optimization is used to tune the model parameters prior to training and validation. We show that this approach results in accurate predictions within 3 cycles to end of life (EOL). We demonstrate the effectiveness of our approach by applying it to the N-CMAPSS turbofan engine dataset recently released by NASA, which includes high fidelity degradation modeling, real world operating conditions, and a large set of fault operating modes.

Prognostics↗

Systems Health Management and Decision Making

In order to tackle and solve the prediction problem, it is essential to have awareness of the current state and health of the system, especially since it is necessary to perform condition-based predictions. To be able to accurately predict the future state of any system, it is required to possess knowledge of its current and future operations. Given models of the current and future system behavior, the general approach of model-based prognostics can be employed as a solution to the prior stated prediction problem. In case of electric aircrafts, computing remaining flying time is safety-critical, since an aircraft that runs out of power (battery charge) while in the air will eventually lose control leading to catastrophe. In order to tackle and solve the prediction problem, it is essential to have awareness of the current state and health of the system, especially since it is necessary to perform condition-based predictions. To be able to predict the future state of the system, it is also required to possess knowledge of the current and future operations of the vehicle. Discuss research approach to develop a system level health monitoring safety indicator which runs estimation and prediction algorithms to estimate remaining useful life predictions at system as well as subsystem levels. Given models of the current and future system behavior, a general approach of model-based prognostics can be employed as a solution to the prediction problem and further for decision making. In addition a digital twin concept is being implemented in the framework to demonstrate verification and validation of developed algorithms. Note - This presentation is for the short workshop conducted at the same conference and contains all previously approved and published information.

Systems Health Managent↗

Proactive Degradation Management

Robust growth in the nuclear power industry is anticipated as surging global demand for electricity converges with the desire to minimize carbon emissions. There are currently 439 nuclear power plants (NPP) in the commercial global fleet and by some estimates another 222 projects are in various stages of development. For both existing and new plant designs there are increasing needs for the application of advanced online surveillance, diagnostic and prognostic techniques to continuously monitor and assess the health of NPP systems and components. The added effectiveness of such programs has the potential to enable holistic plant management, and minimize exposure to future and unknown risks. This article makes the case for the use of a prognostic approach.

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗

Online Monitoring of Plant Assets in the Nuclear Industry

Today’s online monitoring technologies provide opportunities to perform predictive and proactive health management of assets within many different industries, in particular the defense and aerospace industries. The nuclear industry can leverage these technologies to enhance safety, productivity, and reliability of the aging fleet of existing nuclear power plants. The U.S. Department of Energy’s Light Water Reactor Sustainability Program is collaborating with the Electric Power Research Institute’s (EPRI’s) Long-Term Operations program to implement online monitoring in existing nuclear power plants. Proactive online monitoring in the nuclear industry is being explored using EPRI’s Fleet-Wide Prognostic and Health Management (FW-PHM) Suite software, a set of web-based diagnostic and prognostic tools and databases that serves as an integrated health monitoring architecture. This paper focuses on development of asset fault signatures used to assess the health status of generator step-up transformers and emergency diesel generators in nuclear power plants. Asset fault signatures describe the distinctive features based on technical examinations that can be used to detect a specific fault type. Fault signatures are developed based on the results of detailed technical research and on the knowledge and experience of technical experts. The Diagnostic Advisor of the FW-PHM Suite software matches developed fault signatures with operational data to provide early identification of critical faults and troubleshooting advice that could be used to distinguish between faults with similar symptoms. This research is important as it will support the automation of predictive online monitoring techniques in nuclear power plants to diagnose incipient faults, perform proactive maintenance, and estimate the remaining useful life of assets.

20 FOSSIL-FUELED POWER PLANTS↗

Machine Learning for Gearbox Fault Prediction by Using Both Scada and Modeled Data

This presentation outlines the work in the paper titled "Prognostics of Wind Turbine Gearbox Bearing Failures Using SCADA and Modeled Data" published by the PHM Society and presented at its 2020 annual conference. It is accessible at https://papers.phmsociety.org/index.php/phmconf/article/download/1292/862. The technical work is on machine learning approaches for prognostics for gearbox faults. The methodology combines SCADA time series data and physics domain modeling data, derived from the models developed by the NREL team, as inputs to machine learning models to predict gearbox bearing failures with one month lead time. Based on SCADA data, modeled data, and bearing failure log data from an actual wind plant, the performances of different machine-learning models on unseen data are then evaluated using industry-standard metrics such as precision, recall, and F1 score, and AUC (area under receiver operating characteristic curve). Results show the overall system performance enhancement in predicting bearing failure when modeled data are included with SCADA data. The reduction in terms of false alarms is about 50%, and improvement in terms of precision, and F1 score, and AUC is about 33%, and 12%, and 6% respectively, based on the best modeling case in this study.

49 EE - Wind and Water Power Program - Wind (EE-4W↗

Tau Positron Emission Tomography for Predicting Dementia in Individuals With Mild Cognitive Impairment

An accurate prognosis is especially pertinent in mild cognitive impairment (MCI), when individuals experience considerable uncertainty about future progression. To evaluate the prognostic value of tau positron emission tomography (PET) to predict clinical progression from MCI to dementia. This was a multicenter cohort study with external validation and a mean (SD) follow-up of 2.0 (1.1) years. Data were collected from centers in South Korea, Sweden, the US, and Switzerland from June 2014 to January 2024. Participant data were retrospectively collected and inclusion criteria were a baseline clinical diagnosis of MCI; longitudinal clinical follow-up; a Mini-Mental State Examination (MMSE) score greater than 22; and available tau PET, amyloid-β (Aβ) PET, and magnetic resonance imaging (MRI) scan less than 1 year from diagnosis. A total of 448 eligible individuals with MCI were included (331 in the discovery cohort and 117 in the validation cohort). None of these participants were excluded over the course of the study. Exposures included Tau PET, Aβ PET, and MRI. Positive results on tau PET (temporal meta–region of interest), Aβ PET (global; expressed in the standardized metric Centiloids), and MRI (Alzheimer disease [AD] signature region) was assessed using quantitative thresholds and visual reads. Clinical progression from MCI to all-cause dementia (regardless of suspected etiology) or to AD dementia (AD as suspected etiology) served as the primary outcomes. The primary analyses were receiver operating characteristics. In the discovery cohort, the mean (SD) age was 70.9 (8.5) years, 191 (58%) were male, the mean (SD) MMSE score was 27.1 (1.9), and 110 individuals with MCI (33%) converted to dementia (71 to AD dementia). Only the model with tau PET predicted all-cause dementia (area under the receiver operating characteristic curve [AUC], 0.75; 95% CI, 0.70-0.80) better than a base model including age, sex, education, and MMSE score (AUC, 0.71; 95% CI, 0.65-0.77; P = .02), while the models assessing the other neuroimaging markers did not improve prediction. In the validation cohort, tau PET replicated in predicting all-cause dementia. Compared to the base model (AUC, 0.75; 95% CI, 0.69-0.82), prediction of AD dementia in the discovery cohort was significantly improved by including tau PET (AUC, 0.84; 95% CI, 0.79-0.89; P < .001), tau PET visual read (AUC, 0.83; 95% CI, 0.78-0.88; P = .001), and Aβ PET Centiloids (AUC, 0.83; 95% CI, 0.78-0.88; P = .03). In the validation cohort, only the tau PET and the tau PET visual reads replicated in predicting AD dementia. In this study, tau-PET showed the best performance as a stand-alone marker to predict progression to dementia among individuals with MCI. This suggests that, for prognostic purposes in MCI, a tau PET scan may be the best currently available neuroimaging marker.

59 BASIC BIOLOGICAL SCIENCES↗

Causes and Implications of Persistent Atmospheric Carbon Dioxide Biases in Earth System Models

The strength of feedbacks between a changing climate and future CO2 concentrations are uncertain and difficult to predict using Earth System Models (ESMs). We analyzed emission-driven simulations--in which atmospheric CO2 levels were computed prognostically--for historical (1850-2005) and future periods (RCP 8.5 for 2006-2100) produced by 15 ESMs for the Fifth Phase of the Coupled Model Intercomparison Project (CMIP5). Comparison of ESM prognostic atmospheric CO2 over the historical period with observations indicated that ESMs, on average, had a small positive bias in predictions of contemporary atmospheric CO2. Weak ocean carbon uptake in many ESMs contributed to this bias, based on comparisons with observations of ocean and atmospheric anthropogenic carbon inventories. We found a significant linear relationship between contemporary atmospheric CO2 biases and future CO2 levels for the multi-model ensemble. We used this relationship to create a contemporary CO2 tuned model (CCTM) estimate of the atmospheric CO2 trajectory for the 21st century. The CCTM yielded CO2 estimates of 600 {plus minus} 14 ppm at 2060 and 947 {plus minus} 35 ppm at 2100, which were 21 ppm and 32 ppm below the multi-model mean during these two time periods. Using this emergent constraint approach, the likely ranges of future atmospheric CO2, CO2-induced radiative forcing, and CO2-induced temperature increases for the RCP 8.5 scenario were considerably narrowed compared to estimates from the full ESM ensemble. Our analysis provided evidence that much of the model-to-model variation in projected CO2 during the 21st century was tied to biases that existed during the observational era, and that model differences in the representation of concentration-carbon feedbacks and other slowly changing carbon cycle processes appear to be the primary driver of this variability. By improving models to more closely match the long-term time series of CO2 from Mauna Loa, our analysis suggests uncertainties in future climate projections can be reduced.

Hoffman, Forrest M↗

Steady state estimation of soil organic carbon using satellite‐derived canopy leaf area index

Abstract Estimation of soil organic carbon (SOC) stock using models typically requires long term spin‐up of the carbon‐nitrogen (CN) models, which has become a bottleneck for global modeling. We report a new numerical approach to estimate global SOC stock that can alleviate long spin‐up. The approach uses satellite‐based canopy leaf area index (LAI) and takes advantage of a reaction‐based biogeochemical module—Next Generation BioGeoChemical Module (NGBGC) that was recently developed and incorporated in version 4 of the Community Land Model (CLM4). Although NGBGC uses the same CN mechanisms as in CLM4CN, it can be easily configured to run prognostic or steady state simulations. The new approach was applied at point and global scales and compared with SOC derived from spin‐up by running NGBGC in the prognostic mode, and SOC from the Harmonized World Soil Database (HWSD). The steady state solution is comparable to the spin‐up value when the satellite LAI is close to that from the spin‐up solution, and largely captured the global variability of the HWSD SOC across the different dominant plant functional types (PFTs). The correlation between the simulated and HWSD SOC was, however, weak at both point and global scales, suggesting the needs for improving the biogeochemical processes described in CLM4 and updating HWSD. Besides SOC, the steady state solution also includes all other state variables simulated by a spin‐up run, which makes the tested approach a promising tool to efficiently estimate global SOC distribution and evaluate and compare multiple aspects simulated by different CN mechanisms in the model.

54 ENVIRONMENTAL SCIENCES↗

Modifications to WRF's dynamical core to improve the treatment of moisture for large-eddy simulations: WRF DY-CORE MOISTURE TREATMENT

Yamaguchi and Feingold (2012) note that the cloud fields in their Weather Research and Forecasting (WRF) large-eddy simulations (LESs) of marine stratocumulus exhibit a strong sensitivity to time stepping choices. In this study, we reproduce and analyze this sensitivity issue using two stratocumulus cases, one marine and one continental. Results show that (1) the sensitivity is associated with spurious motions near the moisture jump between the boundary layer and the free atmosphere, and (2) these spurious motions appear to arise from neglecting small variations in water vapor mixing ratio (qv) in the pressure gradient calculation in the acoustic sub­stepping portion of the integration procedure. We show that this issue is remedied in the WRF dynamical core by replacing the prognostic equation for the potential temperature θ with one for the moist potential temperature θm=θ(1+1.61qv), which allows consistent treatment of moisture in the calculation of pressure during the acoustic sub­steps. With this modification, the spurious motions and the sensitivity to the time stepping settings (i.e., the dynamic time step length and number of acoustic sub­steps) are eliminated in both of the example stratocumulus cases. This modification improves the applicability of WRF for LES applications, and possibly other models using similar dynamical core formulations, and also permits the use of longer time steps than in the original code.

Xiao, Heng↗

A nomogram for prediction of stage III/IV gastric cancer outcome after surgery: A multicenter population‐based study

Abstract Most patients with gastric cancer (GC) are first diagnosed at stage III‐IV and surgery resection remains the primary therapeutic modality for these patients. However, clinical staging used for prediction of those patients provides limited information. We collected clinicopathological data and disease‐progression information from 508 patients with stage III‐IV GC at three Chinese hospitals and 1298 patients from the Surveillance, Epidemiology, and End Results database. Based on the stepwise multivariate regression model, we constructed a novel nomogram to predict overall survival (OS). The performance of discrimination for this model was measured using Harrell's concordance index (C‐index) and receiver‐operating characteristic curve (ROC), and was validated using calibration plots. Multivariate Cox regression analyses showed that tumor size, age at diagnosis, N stage, tumor grade, and distant metastases were outstanding independent prognostic factors of stage III‐IV GC. We developed a nomogram based on these five prognostic predictors. In the training set, the C‐index of the nomogram was 0.645 (95% CI: 0.611‐0.679), which was higher than that of the American Joint Committee on Cancer TNM system alone (sixth TNM: 0.544; seventh TNM: 0.575; eighth TNM: 0.568). Similar results were observed in validation cohort. Moreover, calibration blots demonstrated good consistency between the actual and predicted OS probabilities. According to the nomogram, GC individuals could be classified into three groups (low‐, middle‐, and high‐risk) ( P < .001). Our nomogram complements the current staging system for prediction of individual prognosis with stage III‐IV GC, and may be helpful for making individualized treatment decisions.

Gao, Zhiying↗

Molecular subtyping reveals immune alterations in IDH wild‐type lower‐grade diffuse glioma

Abstract Isocitrate dehydrogenase ( IDH ) wild‐type diffuse lower‐grade glioma (LGG) is usually associated with poor outcome, but there have been disputes over its clinical outcome and classification. We present here a robust gene expression‐based molecular classification of IDH wild‐type diffuse LGG into two subtypes with distinct biological and clinical features. A discovery cohort of 49 IDH wild‐type diffuse LGGs from the Chinese Glioma Genome Atlas (CGGA) was subjected to clustering and function analysis. Seventy‐three tumors from The Cancer Genome Atlas (TCGA) were used to validate our findings. Consensus clustering of transcriptional data uncovered concordant classification of two robust and prognostically significant subtypes of IDH wild‐type LGG. Subtype 1, associated with poorer outcomes, was characterized by significantly higher immune and cytolytic scores, M2 macrophages, and up‐regulation of immune exhaustion markers, while Subtype 2, which had elevated lymphocytes and plasma cells, showed relatively favorable survival. Somatic alteration analysis revealed that Subtype 1 showed more frequently deleted regions, such as the locus of CDKN2A / CDKN2B , DMRTA1 , C9orf53 , and MTAP . Furthermore, we developed and validated a five‐gene signature for better application of this acquired stratification. Our data demonstrate the biological and prognostic heterogeneity within IDH wild‐type diffuse LGGs and deepen our molecular understandi‐g of this tumor entity. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Wu, Fan↗

Sensitivity of Cloud-Radiative Effects to Cloud Fraction Parametrizations in Tropical, Mid-Latitude and Arctic Kilometre-Scale Simulations

The Regional Atmosphere (RA) configuration of the Met Office Unified Model currently requires different cloud fraction parametrizations (CFP) for tropical and midlatitude simulations. To explore the scope for unification of these two RA configurations, this paper presents a detailed evaluation of simulations over tropical, midlatitude and arctic domains, with two different diagnostic CFPs, a prognostic CFP, and no CFP at all. Furthermore, a novel, hybrid approach was used that treats liquid cloud diagnostically and ice cloud prognostically. Using observations from three U.S. Department of Energy Atmospheric Radiation Measurement supersites, it is shown that none of these CFPs stands out as superior over all domains. Over the frequently overcast Arctic, the all-or-nothing approach best captures the cloud radiative properties. Conversely, CFPs are of benefit in regions with frequent partial cloudiness, such as the midlatitudes and the tropics. However, their improved cloud radiative properties often hide an error compensation. All models underestimate overcast, low-base cloud with small water paths in convective environments. In addition, mid-latitude overcast, low-base, optically thick clouds in the morning, possibly associated with overnight convection, are frequently too broken. Diagnostic schemes compensate for these errors by producing spurious, scattered afternoon cloud, which could be due to a correct cloud response to too eager convective initiation. Winter clouds over the midlatitudes are improved when liquid cloud is represented diagnostically with a bimodal saturation-departure PDF, without error compensation. While it is difficult to unify the RA across the globe around a single CFP scheme, the newly proposed Hybrid scheme performs reasonably well for cloud cover across all regions. It also exhibits SW biases that are smaller than most other configurations and is less affected by excessive liquid water paths and compensating errors than fully diagnostic schemes. Surface precipitation is fairly insensitive to the CFP in the simulations shown here.

54 ENVIRONMENTAL SCIENCES↗

Radiogenomics in renal cell carcinoma

Radiogenomics, a field of radiology investigating the association between the imaging features of a disease and its gene expression pattern, has expanded considerably in the last few years. Recent advances in whole-genome sequencing of clear cell renal cell carcinoma (ccRCC) and the identification of mutations with prognostic significance have led to increased interest in the relationship between imaging and genomic data. ccRCC is particularly suitable for radiogenomic analysis as the relative paucity of mutated genes allows for more straightforward genomic-imaging associations. The ultimate aim of radiogenomics of ccRCC is to retrieve additional data for accurate diagnosis, prognostic stratification, and optimization of therapy. In this review article, we will present the state-of-the-art of radiogenomics of ccRCC, and after briefly reviewing updates in genomics, we will discuss imaging-genomic associations for diagnosis and staging, prognosis, and for assessment of optimal therapy in ccRCC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Lung Radiofrequency Ablation for the Treatment of Unresectable Recurrent Non-Small-Cell Lung Cancer After Surgical Intervention

Purpose: A retrospective evaluation was done of clinical utility of lung radiofrequency (RF) ablation in recurrent non-small-cell lung cancer (NSCLC) after surgical intervention. Methods: During May 2003 to October 2010, 44 consecutive patients (26 male and 18 female) received curative lung RF ablation for 51 recurrent NSCLC (mean diameter 1.7 {+-} 0.9 cm, range 0.6 to 4.0) after surgical intervention. Safety, tumor progression rate, overall survival, and recurrence-free survival were evaluated. Prognostic factors were evaluated in multivariate analysis. Results: A total of 55 lung RF sessions were performed. Pneumothorax requiring pluerosclerosis (n = 2) and surgical suture (n = 1) were the only grade 3 or 4 adverse events (5.5%, 3 of 55). During mean follow-up of 28.6 {+-} 20.3 months (range 1 to 98), local tumor progression was found in 5 patients (11.4%, 5 of 44). The 1-, 3-, and 5-year overall survival rates were 97.7, 72.9, and 55.7%, respectively. The 1- and 3-year recurrence-free survival rates were 76.7 and 41.1%, respectively. Tumor size and sex were independent significant prognostic factors in multivariate analysis. The 5-year survival rates were 73.3% in 18 women and 60.5% in 38 patients who had small tumors measuring {<=}3 cm. Conclusion: Our results suggest that lung RF ablation is a safe and useful therapeutic option for obtaining long-term survival in treated patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Percutaneous Thermal Ablation of Breast Cancer Metastases in Oligometastatic Patients

ObjectiveTo evaluate prognostic factors associated with local control and disease-free-survival (DFS) of oligometastatic breast cancer patients treated by percutaneous thermal ablation (PTA).Materials and MethodsSeventy-nine consecutive patients (54.5 ± 11.2 years old) with 114 breast cancer metastases (28.9 ± 16.1 mm in diameter), involving the lungs, the liver, and/or the bone, were treated using PTA with a curative intent. The goal was to achieve a complete remission in association with systemic chemotherapy and hormonal therapy. We retrospectively evaluated the prognostic factors associated with 1- and 2-year local control and the 1- and 2-year DFS rates.ResultsThe 1- and 2-year local control rates were 83.0 and 76.1 %, respectively. Tumor burden was associated with a poorer outcome for local control after PTA (HR 1.027 by additional millimeter, p = 0.026; >4 cm HR 3.90). The 1- and 2-year DFS rates were 54.2 and 30.4 %, respectively. In multivariate analysis, triple-negative histological subtype and increased size of treated metastases were associated with a poorer DFS (HR 2.22; 95 % CI [1.13–4.36]; p = 0.02 and HR 2.43; 95 % CI [1.22–4.82]; p = 0.011, respectively).ConclusionPTA is effective for local control of breast cancer oligometastases. Tumor burden >4 cm and triple-negative histological subtype are associated with a poorer outcome.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Lung Shunt Fraction prior to Yttrium-90 Radioembolization Predicts Survival in Patients with Neuroendocrine Liver Metastases: Single-Center Prospective Analysis

ObjectiveTo investigate survival outcomes following radioembolization with Yttrium-90 (Y90) for neuroendocrine tumor liver metastases (NETLMs). This study was designed to assess the efficacy of Y90 radioembolization and to evaluate lung shunt fraction (LSF) as a predictor for survival.MethodsA single-center, prospective study of 44 consecutive patients (median age: 58.5 years, 29.5 % male) diagnosed with pancreatic (52.3 %) or carcinoid (47.7 %) NETLMs from 2006 to 2012 who underwent Y90 radioembolization was performed. Patients’ baseline characteristics, including LSF and median overall survival (OS) from first Y90 radioembolization, were recorded and compared between patients with high (≥10 %) and low (<10 %) LSF. Baseline comparisons were performed using Fisher’s exact tests for categorical and Mann–Whitney U test for continuous variables. Survival was calculated using the Kaplan–Meier method. Univariate (Wilcoxon rank-sum test) and multivariate analyses (Cox Proportional Hazard Model) for risk factor analysis were performed.ResultsThere was no statistically significant difference in age, gender, race, tumor properties, or previous treatments between patients with high (n = 15) and low (n = 29) LSF. The median OS was 27.4 months (95 %CI 12.73–55.23), with 4.77 months (95 %CI 2.87–26.73) for high and 42.77 months (95 %CI 18.47–59.73) for low LSF (p = 0.003). Multivariate analysis identified high LSF (p = 0.001), total serum bilirubin >1.2 mg (p = 0.016), and lack of pretreatment with octreotide (p = 0.01) as independent prognostic factors for poorer survival. Tumor type and total radiation dose did not predict survival.ConclusionsLSF ≥10 %, elevated bilirubin levels, and lack of pretreatment with octreotide were found to be independent prognostic factors for poorer survival in patients with NETLMs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Endovascular Revascularization of Hemodialysis Thrombosed Grafts with the Hydrodynamic Thrombectomy Catheter. Our 7-Year Experience

PurposeTo evaluate the efficacy and safety of the hydrodynamic thrombectomy catheter (AngioJet DVX) in the salvage of thrombosed hemodialysis vascular grafts.Materials and MethodsA retrospective study was designed, including all patients with occluded arteriovenous grafts treated with the AngioJet system between 2007 and 2014 in our institution. Outcomes included technical success, clinical success, complications, and primary and secondary patencies. Procedural success was defined as angiographic confirmation of flow restoration, the presence of a pulsatile thrill along the graft, and successful resumption of at least one hemodialysis session. Primary and secondary patencies after first AVG thrombectomy were calculated with Kaplan–Meier curves. Cox regression was used to determine prognostic factors of primary patency after every thrombectomy episode.ResultsA total of 149 thrombectomies were performed in 68 grafts. After thrombectomy, endovascular treatment of one or more stenosis was performed in all cases. Technical success was 93% and clinical success was 86%. Complications occurred in 7 thrombectomies, most of them were minor except for one anastomosis rupture requiring surgery. Primary and secondary patencies were 52, 41, and 23 and 76, 68, and 57% at 3, 6 and 12 months, respectively. Independent prognostic factors of poor patency after every thrombectomy episode were the presence of residual thrombus (OR 1.831, P = 0.008) and time from last thrombosis (less than 1 month; and OR 7.116, P < 0.001).ConclusionPercutaneous mechanical thrombectomy with AngioJet is a safe technique with a high-clinical success rate. The presence of residual thrombus after thrombectomy and early re-occlusions are related to poorer results.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Cytokines and {sup 90}Y-Radioembolization: Relation to Liver Function and Overall Survival

BackgroundTo evaluate the course of pro- and anti-inflammatory cytokines after {sup 90}Y-radioembolization (RE) of liver malignancies and to identify prognosticators for liver-related adverse events and survival.MethodsIn 34 consecutive patients with secondary or primary liver tumors scheduled for RE, the following cytokines were measured prior to and 2 h, 3 days, and 6 weeks after RE: interleukin (IL) -1, IL-2, IL-4, IL-6, IL-8, tumor necrosis factor alpha (TNF-α), and interferon-γ. Liver function impairment was defined as an elevation of liver-related laboratory values as graded by CTCAE ≥ 2 and/or serum bilirubin ≥30 µmol/l and/or development of ascites at 6-week follow-up.ResultsSignificant changes over time were seen in IL-1 (increase from 0.4 pg/ml (±0.7) at baseline to 1.1 pg/ml (±1.4) 3 days after RE (p = 0.02)), and in IL-6 (increase from 16.8 pg/ml (±21.8) at baseline to 54.6 pg/ml (±78.2) 3 days after RE (p = 0.003)). Baseline values of IL-6 and IL-8 were independently associated with liver function impairment at follow-up as well as decreased survival with an optimal cutoff at 6.53 and 60.8 pg/ml, respectively.ConclusionExpected changes in pro- and anti-inflammatory cytokines after RE were shown. Furthermore, baseline values of IL-6 and IL-8 were associated with later liver dysfunction and survival. We hypothesize that these biomarkers are potential prognosticators and might help in patient selection for RE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗