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At least 73 records · Page 4

Nuclear excitation functions for medical isotope production: Targeted radionuclide therapy via nat IR$(d, x)$ 193m Pt

193m Pt is an Auger emitting radionuclide which may have therapeutic potential, particularly when labeled to the chemotherapeutic drug cisplatin. One challenge to broader explorations of its clinical potential is the need for production routes with high specific activity. As part of a larger campaign to address gaps in reaction data for emerging medical radionuclides, this work seeks to characterize the nat Ir(d,x) reactions as a potential production pathway for 193m Pt. A stacked target irradiation, consisting of natural iridium, iron, nickel, and copper foils, was performed using a 33 MeV deuteron beam at the Lawrence Berkeley National Laboratory 88-Inch Cyclotron. This measurement, along with previous experimental data, suggests an energy window between 11 to 18 MeV to maximize the production and radiopurity of 193m Pt. This experiment has yielded cross sections for 43 channels of deuteron-induced reactions from threshold to 30 MeV, including the first experimental results of nat Ir(d,x) 188m1+g,190m1+g Ir (cumulative), nat Ni(d,x) 56,57,58 m,58g Co (independent), nat Cu(d,x) 61 Co (cumulative) and nat Fe(d,x) 53 Fe, 48 V (cumulative). The results were compared with literature data, the TENDL-2023 database, and default theoretical calculations from the TALYS-2.04, CoH-3.6.0, EMPIRE 3.2.3, and ALICE-2020 reaction modeling codes. Here, this work presents another example of the lack of predictive capabilities for this set of modern nuclear-reaction modeling codes, and highlights the unsatisfactory modeling of experimental cross sections. Experimental data are important to improve the codes in general, and new experimental results can be used to improve the models. Finally, this measurement has revealed the need for an updated evaluation of the nat Cu(d,x) 63 Zn deuteron monitor reaction.

193mPt↗

Generation of radioisotopes for medical applications using high-repetition, high-intensity lasers

We used the PW high-repetition laser facility VEGA-3 at Centro de Láseres Pulsados in Salamanca, with the goal of studying the generation of radioisotopes using laser-driven proton beams. Various types of targets have been irradiated, including in particular several targets containing boron to generate α-particles through the hydrogen–boron fusion reaction. We have successfully identified γ-ray lines from several radioisotopes created by irradiation using laser-generated α-particles or protons including 43 Sc, 44 Sc, 48 Sc, 7 Be, 11 C and 18 F. We show that radioisotope generation can be used as a diagnostic tool to evaluate α-particle generation in laser-driven proton–boron fusion experiments. We also show the production of 11 C radioisotopes, ≈ 6 × 10 6 , and of 44 Sc radioisotopes, ≈ 5 × 10 4 per laser shot. This result can open the way to develop laser-driven radiation sources of radioisotopes for medical applications.

gamma ray spectroscopy↗

Unified Medical Language System resources improve sieve-based generation and Bidirectional Encoder Representations from Transformers (BERT)–based ranking for concept normalization

Concept normalization, the task of linking phrases in text to concepts in an ontology, is useful for many downstream tasks including relation extraction, information retrieval, etc. We present a generate-and-rank concept normalization system based on our participation in the 2019 National NLP Clinical Challenges Shared Task Track 3 Concept Normalization. The shared task provided 13 609 concept mentions drawn from 100 discharge summaries. We first design a sieve-based system that uses Lucene indices over the training data, Unified Medical Language System (UMLS) preferred terms, and UMLS synonyms to generate a list of possible concepts for each mention. We then design a listwise classifier based on the BERT (Bidirectional Encoder Representations from Transformers) neural network to rank the candidate concepts, integrating UMLS semantic types through a regularizer. Our generate-and-rank system was third of 33 in the competition, outperforming the candidate generator alone (81.66% vs 79.44%) and the previous state of the art (76.35%). During postevaluation, the model’s accuracy was increased to 83.56% via improvements to how training data are generated from UMLS and incorporation of our UMLS semantic type regularizer. Analysis of the model shows that prioritizing UMLS preferred terms yields better performance, that the UMLS semantic type regularizer results in qualitatively better concept predictions, and that the model performs well even on concepts not seen during training. Our generate-and-rank framework for UMLS concept normalization integrates key UMLS features like preferred terms and semantic types with a neural network–based ranking model to accurately link phrases in text to UMLS concepts.

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗

Spatial inequities in access to medications for treatment of opioid use disorder highlight scarcity of methadone providers under counterfactual scenarios

Access to treatment and medication for opioid use disorder (MOUD) is essential in reducing opioid use and associated behavioral risks, such as syringe sharing among persons who inject drugs (PWID). Syringe sharing among PWID carries high risk of transmission of serious infections such as hepatitis C and HIV. MOUD resources, such as methadone provider clinics, however, are often unavailable to PWID due to barriers like long travel distance to the nearest methadone provider and the required frequency of clinic visits. The goal of this study is to examine the uncertainty in the effects of travel distance in initiating and continuing methadone treatment and how these interact with different spatial distributions of methadone providers to impact co-injection (syringe sharing) risks. A baseline scenario of spatial access was established using the existing locations of methadone providers in a geographical area of metropolitan Chicago, Illinois, USA. Next, different counterfactual scenarios redistributed the locations of methadone providers in this geographic area according to the densities of both the general adult population and according to the PWID population per zip code. We define different reasonable methadone access assumptions as the combinations of short, medium, and long travel distance preferences combined with three urban/suburban travel distance preference. Our modeling results show that when there is a low travel distance preference for accessing methadone providers, distributing providers near areas that have the greatest need (defined by density of PWID) is best at reducing syringe sharing behaviors. However, this strategy also decreases access across suburban locales, posing even greater difficulty in regions with fewer transit options and providers. As such, without an adequate number of providers to give equitable coverage across the region, spatial distribution cannot be optimized to provide equitable access to all PWID. Our study has important implications for increasing interest in methadone as a resurgent treatment for MOUD in the United States and for guiding policy toward improving access to MOUD among PWID.

59 BASIC BIOLOGICAL SCIENCES↗

Radiological Considerations Supporting the American Medical Isotope Producer Niowave

This report provides a summary of work performed by Savannah River National Laboratory (SRNL) during FY22 in support of Niowave, an American Medical Isotope Production (AMIP) facility. SRNL served in a technical support role, funded by NA-231, supporting Niowave in the beginning of non radiological functional testing of their airport facility in FY22. Through this agreement, SRNL provides Niowave access to subject matter experts (SMEs) for questions that may arise during the drafting of engineering plans, facility policies, and/or response procedures. This report summarizes discussions between SRNL and Niowave about guidance concerning issues with the floor of the hot cells, dispersible removable contamination (beta emitting fission product), hot cell operation specifically utilization of cameras or mirrors, and the process for removing contaminated waste from the hot cell. Lessons learned and other various resources provided to Niowave by SRNL during FY22 are referenced in this report. This work was funded through NNSA’s Office of Material Management and Minimization, Conversion Office (NA-231).

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Medical Imaging Equipment Energy Efficiency [Slides]

The slide deck is being prepared for healthcare sector stakeholders as a resource on the energy use of Medical Imaging Equipment (MIE) which will provide an overview of existing work, review existing literature on MIE energy use and identify energy efficiency opportunities.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

Lowering the computational barrier: Partially Bayesian neural networks for transparency in medical imaging AI

Deep Neural Networks (DNNs) can provide clinicians with fast and accurate predictions that are highly valuable for high-stakes medical decision-making, such as in brain tumor segmentation and treatment planning. However, these models largely lack transparency about the uncertainty in their predictions, potentially giving clinicians a false sense of reliability that may lead to grave consequences in patient care. Growing calls for Transparent and Responsible AI have promoted Uncertainty Quantification (UQ) to capture and communicate uncertainty in a systematic and principled manner. However, traditional Bayesian UQ methods remain prohibitively costly for large, million-dimensional tumor segmentation DNNs such as the U-Net. In this work, we discuss a computationally-efficient UQ approach via the partially Bayesian neural networks (pBNN). In pBNN, only a single layer, strategically selected based on gradient-based sensitivity analysis, is targeted for Bayesian inference. We illustrate the effectiveness of pBNN in capturing the full uncertainty for a 7.8-million parameter U-Net. We also demonstrate how practitioners and model developers can use the pBNN's predictions to better understand the model's capabilities and behavior.

97 MATHEMATICS AND COMPUTING↗

Medical Imaging Equipment Energy Efficiency

The fact sheet is being prepared for stakeholders of Better Building Alliance's (BBA) Healthcare sector as a resource on the energy use of medical imaging equipment. This is a concise version of earlier published slide deck - NREL/PR-5500-83743.

ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATION↗

Medical Imaging Equipment Energy Efficiency

The energy use of medical imaging equipment (MIE) in healthcare facilities is estimated to be about 5% of total site energy use. MIE energy use is only expected to increase as technology advances and more patients seek services from MIE, enabling more facilities to install additional MIE. Healthcare organizations need reliable information regarding comprehensive energy use or lifetime energy costs with which to make energy-efficient MIE procurement decisions, and there are currently no MIE energy or efficiency standards in the United States (U.S.). This fact sheet provides background on MIE energy consumption, key terms, and guidance on why and how to meter MIE, helping stakeholders make informed decisions to enhance their facility's performance.

ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATION↗

The United States Department of Energy and National Institutes of Health Collaboration: Medical Care Advances via Discovery in Physical Sciences

Over several months, representatives from the U.S. Department of Energy (DOE) Office of Science and National Institutes of Health (NIH) had a number of meetings that lead to the conclusion that innovations in the Nation's health care could be realized by more directed interactions between NIH and DOE. It became clear that the expertise amassed and instrumentation advances developed at the DOE physical science laboratories to enable cutting-edge research in particle physics could also feed innovation in medical healthcare. To meet their scientific mission, the DOE laboratories created advances in such technologies as particle beam generation, radioisotope production, high-energy particle detection and imaging, superconducting particle accelerators, superconducting magnets, cryogenics, high-speed electronics, artificial intelligence, and big data. To move forward, NIH and DOE initiated the process of convening a joint work- shop which occurred on July 12th and 13th, 2021. Here, this Special Report presents a summary of the findings of the collaborative workshop and introduces the goals of the next one.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

Endogeneity of pedestrian survival time and emergency medical service response time: Variations across disadvantaged and non-disadvantaged communities

The Vision Zero-Safe Systems Approach prioritizes fast access to Emergency Medical Services (EMS) to improve the survivability of road users in transportation crashes, especially concerning the recent increase in pedestrian-involved crashes. Pedestrian crashes resulting in immediate or early death are considerably more severe than those taking longer. The time gap between injury and fatality is known as survival time, and it heavily relies on EMS response time. The characteristics of the crash location may be associated with EMS response and survival time. A US Department of Transportation initiative identifies communities often facing challenges. Six disadvantaged community (DAC) indicators, including economy, environment, equity, health, resilience, and transportation access, enable an analysis of how survival and EMS response times vary across DACs and non-DACs. To this end, this study created a unique and comprehensive database by linking DACs data with 2017–2021 pedestrian-involved fatal crashes. This study utilizes two-stage residual inclusion models with segmentation for DACs and non-DACs accounting for the endogenous relationship between EMS response and pedestrian survival time. The results indicate that EMS response time is higher and pedestrian survival time is lower in DACs than in non-DACs. A delayed EMS response time is associated with a greater reduction in survival time in DACs compared to non-DACs. Factors, e.g., nighttime and interstate crashes, contribute to higher EMS response time, while pedestrian drugs, driver speeding, and hit-and-run behaviors are associated with a greater reduction in survival time in DACs than non-DACs. Finally, the implications of the findings are discussed in the paper.

60 APPLIED LIFE SCIENCES↗

Development of a SnO 2 -based 44 Ti/ 44 Sc generator for medical applications

Towards application of 44 Sc for diagnostic nuclear medicine, a 44 Ti/ 44 Sc generator based on an inorganic resin has been evaluated. Unlike other radionuclide generators used for medical applications, the long-term retention of the parent 44 Ti is vital due to its long half life. In this work, tin dioxide (SnO 2 ), a robust inorganic-based resin, has been synthesized and used as the stationary phase for a 44 Ti/ 44 Sc generator. The sorption behavior of 44 Ti/ 44 Sc was tested on SnO 2 with varying acids, concentrations, and times. Preliminary batch study results showed >88 % 44 Ti retention to the resin at lower acid concentrations (0.05 M HNO 3 and 0.05 M HCl). A pilot generator was evaluated for a year, demonstrating 85.3 ± 2.8 % 44 Sc elution yields and 0.71 ± 0.14 % 44 Ti breakthrough in 5 M HNO 3 . Based on capacity studies, a 7.4 MBq (200 µCi) upscaled generator system was constructed for further evaluation of the SnO 2 resin stability and the efficacy of the eluted 44 Sc for radiolabeling. 44 Sc could be regularly eluted from this generator in 5 M HNO 3 with an overall average radiochemical yield 84.7 ± 9.5 %. Post-elution processing of the 44 Sc with DGA-normal resin removed all 44 Ti present and allowed for high 44 Sc-DOTA labeling yields of 94.2 ± 0.5 %. Overall, SnO 2 has been shown to be a viable material for a 44 Ti/ 44 Sc generator.

07 ISOTOPE AND RADIATION SOURCES↗

Evaluation of Subetadex-α-methyl, a Polyanionic Cyclodextrin Scaffold, as a Medical Countermeasure against Fentanyl and Related Opioids

Subetadex-α-methyl (SBX-Me), a modified, polyanionic cyclodextrin scaffold, has been evaluated for its utilization as a medical countermeasure (MCM) to neutralize the effects of fentanyl and related opioids. Initial in vitro toxicity assays demonstrate that SBX-Me has a nontoxic profile, comparable to the FDA-approved cyclodextrin-based drug Sugammadex. Pharmacokinetic analysis showed rapid clearance of SBX-Me with an elimination half-life of ~7.4 h and little accumulation in major organs. SBX-Me was also evaluated for its ability to counteract the effects of fentanyl, carfentanil, and remifentanil in rats. Recovery times in rats exposed to sublethal fentanyl doses were found to be shorter when treated with SBX-Me after opioid exposure. The recovery times were reduced from ~35 to ~17 min for fentanyl, ~172 to ~59 min for carfentanil, and ~18 to ~12 min for remifentanil. SBX-Me increased the elimination half-life for fentanyl and remifentanil from 5.37 to 6.42 h and 8.24 to 9.74 h, respectively. These data support SBX-Me as a solid platform from which further research can be launched for the development of a MCM against the effects of fentanyl and its analogs. Furthermore, the data suggests that SBX-Me and other analogs are attractive candidates as broad spectrum opioids targeting MCMs.

Chemistry↗

A new generation of direct X-ray detectors for medical and synchrotron imaging applications

Abstract Large-area X-ray imaging is one of the most widely used imaging modalities that spans several scientific and technological fields. Currently, the direct X-ray conversion materials that are being commercially used for large-area (> 8 cm × 4 cm without tiling) flat panel applications, such as amorphous selenium (a-Se), have usable sensitivities of up to only 30 keV. Although there have been many promising candidates (such as polycrystalline HgI 2 and CdTe), none of the semiconductors were able to assuage the requirement for high energy (> 40 keV) large-area X-ray imaging applications due to inadequate cost, manufacturability, and long-term performance metrics. In this study, we successfully demonstrate the potential of the hybrid Methylammonium lead iodide (MAPbI 3 ) perovskite-based semiconductor detectors in satisfying all the requirements for its successful commercialization in synchrotron and medical imaging. This new generation of hybrid detectors demonstrates low dark current under electric fields needed for high sensitivity X-ray imaging applications. The detectors have a linear response to X-ray energy and applied bias, no polarization effects at a moderate bias, and signal stability over long usage durations. Also, these detectors have demonstrated a stable detection response under BNL’s National Synchrotron Light Source II (NSLS-II) 70 keV monochromatic synchrotron beamline.

47 OTHER INSTRUMENTATION↗

Sparse measurement medical CT reconstruction using multi-fused block matching denoising priors

A major challenge for medical X-ray CT imaging is reducing the number of X-ray projections to lower radiation dosage and reduce scan times without compromising image quality. However these under-determined inverse imaging problems rely on the formulation of an expressive prior model to constrain the solution space while remaining computationally tractable. Traditional analytical reconstruction methods like Filtered Back Projection (FBP) often fail with sparse measurements, producing artifacts due to their reliance on the Shannon-Nyquist Sampling Theorem. Consensus Equilibrium, which is a generalization of Plug and Play, is a recent advancement in Model-Based Iterative Reconstruction (MBIR), has facilitated the use of multiple denoisers are prior models in an optimization free framework to capture complex, non-linear prior information. However, 3D prior modelling in a Plug and Play approach for volumetric image reconstruction requires long processing time due to high computing requirement. Instead of directly using a 3D prior, this work proposes a BM3D Multi Slice Fusion (BM3D-MSF) prior that uses multiple 2D image denoisers fused to act as a fully 3D prior model in Plug and Play reconstruction approach. Our approach does not require training and are thus able to circumvent ethical issues related with patient training data and are readily deployable in varying noise and measurement sparsity levels. In addition, reconstruction with the BM3D-MSF prior achieves similar reconstruction image quality as fully 3D image priors, but with significantly reduced computational complexity. We test our method on clinical CT data and demonstrate that our approach improves reconstructed image quality.

Hossain, Maliha [ORNL]↗