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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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All sourcesNASA NTRSDOE OSTI
DOE OSTI2026

UV–Vis–NIR Reflectance Spectroscopy and Chemometrics for Monitoring Pu Directly on an Ion Exchange Column

Here, we present a fiber-optic UV–vis–NIR reflectance spectroscopy method for direct, noninvasive monitoring of Pu(IV) in a glass ion exchange column during dynamic loading and elution in a glovebox. A movable probe enables spatially resolved spectral acquisition along the column axis, capturing distinct features associated with Pu(IV) nitrate complexes during loading and free ions during elution. Principal component analysis was applied to extract the dominant spectral variance and resolve relative concentration profiles without requiring precise knowledge of optical penetration depth or species identity. This in situ approach reveals spatial gradients and speciation dynamics in real time, which provides actionable insight into Pu(IV) ion migration, resin saturation, and breakthrough behavior under evolving flow conditions. The method offers a practical, fiber-compatible strategy to monitor glass column–based separations for Pu and other lanthanides or actinides and to characterize metal–resin interactions in flow-through systems.

actinide↗
DOE OSTI2019

Visibility of Hypovascularized Liver Tumors during Intra-Arterial Therapy Using Split-Bolus Single-Phase Cone Beam CT

Purpose: To validate a split-bolus contrast injection protocol for single-phase CBCT in terms of detectability of hypovascular liver tumors compared to digital subtraction angiography (DSA). Materials and Methods: In this retrospective, single-center study, 20 consecutive patients with in total 77 hypovascularized tumors referred for intra-arterial therapy received a split-bolus single-phase CBCT. Two readers rated the visibility of the target tumors scheduled for embolization in CBCT and DSA compared to the pre-interventional multiphasic CT or MRI used as reference on a 3-point scoring system (1 = optimal, 3 = not visible) and catheter-associated artifacts (1 = none, 3 = extended). SNR, CNR and contrast values were derived from 37 target tumors in CBCT and MRI. Statistical analysis included the kappa test to determine interrater reliability, the Friedman’s test for the inter-modality comparison evaluating tumor visibility in DSA and CBCT as well as for quantitative assessment. Post hoc analysis included the Wilcoxon signed-rank test. p values < 0.05 were considered significant. Results: Ninety percentage of target tumors were rated as visible in CBCT and 37.5% in DSA (p < 0.001). 70.1% of pre-interventionally detected hypovascularized tumors were depicted with CBCT and 31.2% by DSA (p < 0.001). 7.8% of known tumors were outside the FOV. Quantitative assessment showed higher image contrasts in CBCT (1.91 ± 7.01) compared to hepatobiliary-phase MRI (0.29 ± 0.14, p = 0.003) and to portal-venous (p.v.) MRI (0.31 ± 0.13, p < 0.001), but higher CNR for MRI (1.18 ± 0.80; 13.92 ± 15.82; 13.79 ± 6.65). Conclusion: In conclusion, the split-bolus single-phase CBCT detects significantly more hypovascularized liver tumors compared to DSA performed through the proper hepatic artery with high image contrasts. Level of Evidence: Level III, diagnostic study.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

THE BOSS EMISSION-LINE LENS SURVEY. II. INVESTIGATING MASS-DENSITY PROFILE EVOLUTION IN THE SLACS+BELLS STRONG GRAVITATIONAL LENS SAMPLE

We present an analysis of the evolution of the central mass-density profile of massive elliptical galaxies from the SLACS and BELLS strong gravitational lens samples over the redshift interval z Almost-Equal-To 0.1-0.6, based on the combination of strong-lensing aperture mass and stellar velocity-dispersion constraints. We find a significant trend toward steeper mass profiles (parameterized by the power-law density model with {rho}{proportional_to}r {sup -{gamma}}) at later cosmic times, with magnitude d < {gamma} > /dz = -0.60 {+-} 0.15. We show that the combined lens-galaxy sample is consistent with a non-evolving distribution of stellar velocity dispersions. Considering possible additional dependence of <{gamma} > on lens-galaxy stellar mass, effective radius, and Sersic index, we find marginal evidence for shallower mass profiles at higher masses and larger sizes, but with a significance that is subdominant to the redshift dependence. Using the results of published Monte Carlo simulations of spectroscopic lens surveys, we verify that our mass-profile evolution result cannot be explained by lensing selection biases as a function of redshift. Interpreted as a true evolutionary signal, our result suggests that major dry mergers involving off-axis trajectories play a significant role in the evolution of the average mass-density structure of massive early-type galaxies over the past 6 Gyr. We also consider an alternative non-evolutionary hypothesis based on variations in the strong-lensing measurement aperture with redshift, which would imply the detection of an 'inflection zone' marking the transition between the baryon-dominated and dark-matter halo-dominated regions of the lens galaxies. Further observations of the combined SLACS+BELLS sample can constrain this picture more precisely, and enable a more detailed investigation of the multivariate dependences of galaxy mass structure across cosmic time.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2019

Comparative Analysis of Intra-arterial Cone-Beam Versus Conventional Computed Tomography During Hepatic Arteriography for Transarterial Chemoembolization Planning

Purpose: To compare the imaging characteristics of intra-arterial cone-beam computed tomography during hepatic arteriography (CBCTHA) versus intra-arterial computed tomography during hepatic arteriography (CTHA) for intraprocedural transarterial chemoembolization (TACE) planning. Materials and Methods: This single-institution retrospective study included 144 patients (96 men, mean age 67.9 years; 48 women, mean age 62.3 years) who underwent 181 TACE sessions between January 2015 and July 2017. Intraprocedural CBCTHA (111 procedures) or CTHA (70 procedures) was performed for TACE planning. Reformatted maximum intensity projection CBCTHA and CTHA images were reviewed by two radiologists and classified using an ordinal scoring system (for tumor identification, tumor feeder vessel identification, and streaking artifact) and a binary scoring system (for the presence of breathing motion artifact and field of view encompassing the entire liver). Data were analyzed using an F test and a z-score test. Results: There were no significant differences in demographic and tumor characteristics between the CBCTHA and CTHA patient cohorts. CTHA was superior to CBCTHA for tumor identification (P < .0001), tumor feeder vessel identification (P < .05), streaking artifact (P < .0001), and field of view encompassing the entire liver (P < .0001). There was a trend toward a lower frequency of breathing motion artifact with CTHA than with CBCTHA (1.4% vs. 10%; P = .057). Conclusion: CTHA provides improved clinical relevant imaging information compared to CBCTHA for intraprocedural TACE planning. Level of Evidence: Level III, retrospective comparative study.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Impact of Patient and Lesion Characteristics on Drug-Coated Balloon Angioplasty in the Femoropopliteal Artery: A Pooled Analysis of Four Randomized Controlled Multicenter Trials

Objectives: The principal objective of this pooled analysis was to investigate various patient and lesion characteristics on late lumen loss (LLL) after drug-coated balloon (DCB) angioplasty. Background: Four randomized controlled trials (THUNDER, FEMPAC, PACIFIER, CONSEQUENT) were pooled to investigate the influence of various patient and lesion characteristics on DCB angioplasty and on plain old balloon angioplasty (POBA) in patients with femoropopliteal artery disease. Methods: Angiographic data from 355 patients were pooled to assess the impact of patient (demographics, cardiovascular risk factors, cardiovascular co-morbidities, Rutherford stages) and lesion-/procedure-related (location, occlusion, length, restenosis, calcification, subintimal crossing, post-dilatation, dissection, stenting) characteristics on LLL. Linear regression models were utilized with LLL as the dependent variable to determine the predictive value of cardiovascular and lesion-/procedure-related factors. Results: Observational statistics revealed that LLL was lower in the DCB group as compared to POBA independent of all tested patient variables. LLL after DCB was also independent of most lesion and procedural characteristics except for lesion length and bailout stenting. LLL increased with lesion length in both treatment groups. Bailout stenting did not improve LLL in the DCB group but did so in the POBA group (0.74 ± 1.07 mm vs. 1.22 ± 1.36 mm, p = 0.043). Conclusions: DCB was superior to POBA for all tested patient subgroups and lesion subgroups. Our results suggest that all patients and lesions benefit to a similar degree from the use of DCB. DCB-PTA should therefore be preferred to POBA in all patients with steno-occlusive femoropopliteal lesions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Frequency, pressure and strain dependence of nonlinear elasticity in Berea Sandstone

Acoustoelasticity measurements in a sample of room dry Berea sandstone are conducted at various loading frequencies to explore the transition between the quasi-static ( f → 0) and dynamic (few kilohertz) nonlinear elastic response. We carry out these measurements at multiple confining pressures and perform a multivariate regression analysis to quantify the dependence of the harmonic content on strain amplitude, frequency, and pressure. The modulus softening (equivalent to the harmonic at 0f) increases by a factor 2–3 over 3 orders of magnitude increase in frequency. Harmonics at 2f, 4f, and 6f exhibit similar behaviors. In contrast, the harmonic at 1f appears frequency independent. This result corroborates previous studies showing that the nonlinear elasticity of rocks can be described with a minimum of two physical mechanisms. This study provides quantitative data that describes the rate dependency of nonlinear elasticity. Furthermore, these findings can be used to improve theories relating the macroscopic elastic response to microstructural features.

58 GEOSCIENCES↗
DOE OSTI2017

Direct Imaging of the Relaxation of Individual Ferroelectric Interfaces in a Tensile-Strained Film

Understanding the dynamic behavior of interfaces in ferroic materials is an important field of research with widespread practical implications, as the motion of domain walls and phase boundaries are associated with substantial increases in dielectric and piezoelectric effects. Although commonly studied in the macroscopic regime, the local dynamics of interfaces have received less attention, with most studies limited to domain growth and/or reversal by piezoresponse force microscopy (PFM). Here, spatial mapping of local domain wall-related relaxation in a tensile-strained PbTiO 3 thin film using time-resolved band-excitation PFM is demonstrated, which allows exploring of the field-induced strain (piezoresponse) as a function of applied voltage and time. Through multivariate statistical analysis on the resultant 4-dimensional dataset (x,y,V,t) with functional fitting, it is determined that the relaxation is strongly correleated with the distance to the domain walls, and varies based on the type of domain wall present in the probed volume. Phase-field modeling shows the relaxation behavior near and away from the interfaces, and confirms the modulation of the z-component of polarization by wall motion, yielding the observed piezoresponse relaxation. Lastly, these studies shed light on the local dynamics of interfaces in ferroelectric thin films, and are therefore important for the design of ferroelectric-based components in microelectromechanical systems.

36 MATERIALS SCIENCE↗
DOE OSTI2018

The Electrochemical Sodiation of FeSb 2 : New Insights from Operando 57 Fe Synchrotron Mössbauer and X-Ray Absorption Spectroscopy

Operando Sb K–edge X–ray absorption spectroscopy and 57 Fe Synchrotron Mössbauer Spectroscopy, used for the first time in the field of operando energy storage materials, assisted by operando magnetic measurements, were combined to clarify the role of iron and antimony in the electrochemical reaction mechanism of FeSb 2 as negative electrode material for sodium–ion batteries (SIB). Both datasets were analyzed using an innovative chemometric approach involving principal component analysis (PCA) and multivariate curve resolution – alternating least square analysis (MCR–ALS) yielding new insights on the sodiation reaction. Our findings show that the reaction of Na with FeSb 2 during discharge leads to the formation of Na 3 Sb along with superparamagnetic Fe amorphous nanoparticles which contain small amounts of Sb dissolved in their lattice. During the following desodiation, the pristine material FeSb 2 is not recovered while iron nanoparticles grow in size, and continue growing also along the following discharge. Here, even though such iron nanoparticles remain electrochemically inactive, they play a key role in the reduction and stabilization of the polarization as well as in the reversibility of the electrochemical sodiation of antimony.

25 ENERGY STORAGE↗
DOE OSTI2020

Validation of Stage N3 of the Eighth Edition AJCC Staging System for Nasopharyngeal Carcinoma

Objectives To validate stage nodal (N)3 of the 8th edition American Joint Committee on Cancer (AJCC) staging system for nasopharyngeal carcinoma (NPC). Methods This retrospective cohort study extracted NPC patients from the Surveillance, Epidemiology, and End Results database between 2004 and 2016. Pathologically confirmed patients with complete data of level IV, N3a, and N3b lymph node metastasis were investigated. The included patients were divided into level IV, N3a, and N3b groups. Five‐year overall survival (OS) and cancer‐specific survival (CSS) were compared among the three groups. Results A total of 693 patients were included: 285 (41.13%) patients in the level IV group, 124 (17.89%) patients in the N3a group, and 284 (40.98%) patients in the N3b group. The 5‐year OS (57.1%, 55.0%, and 55.2%) and CSS (64.4%, 63.5%, and 64.4%) were not different among the level IV, N3a, and N3b groups. Multivariate regression analysis revealed that N stage was not an independent prognostic factor for OS (hazard ratio [HR] = 1.03, 95% confidence interval [CI]: 0.91–1.17; P = .65) or CSS (HR = 1.03, 95% CI: 0.89–1.19; P = .70). Conclusion Stage N3 of the 8th edition AJCC staging system for NPC is reasonable. Level of Evidence III Laryngoscope , 131:535–540, 2021

Pan, Xin‐Bin↗
DOE OSTI2012

Spectral Signatures for the Classification of Microbial Species using Raman Spectra

In general, classification-based methods based on Confocal Raman microscopy are focused on targeted studies under which the spectral libraries are collected under controlled instrument parameters, which facilitate analyses via standard multivariate data analysis methods and cross-validation. We develop and compare approaches to combine spectra collected at different times and varying levels of spectral resolution into a single spectral library. We demonstrate these approaches on a relevant test case; the identification of microbial species from a natural environment.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2016

Discrete Time McKean–Vlasov Control Problem: A Dynamic Programming Approach

We consider the stochastic optimal control problem of nonlinear mean-field systems in discrete time. We reformulate the problem into a deterministic control problem with marginal distribution as controlled state variable, and prove that dynamic programming principle holds in its general form. We apply our method for solving explicitly the mean-variance portfolio selection and the multivariate linear-quadratic McKean–Vlasov control problem.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2019

Corpus luteum with ovarian stromal edema is associated with pelvic pain and confusion for ovarian torsion

Purpose: To distinguish the corpus luteum with adjacent ovarian stromal edema as an entity associated with pelvic pain, with confounding ultrasound features that may lead to false-positive diagnosis of ovarian torsion. Methods: This is a blinded, retrospective study of 243 corpora lutea on transvaginal ultrasound. Imaging parameters included ovarian and corpus luteum volumes, central cystic space within the corpus luteum, vascularity around the corpus luteum, peripherally displaced follicles, and complex free fluid. Residual volume (ovarian volume minus corpus luteum volume) was used as a surrogate for ovarian stromal edema. Clinical parameters included age, pregnancy, and location/acuity of pain if present. Concern for ovarian torsion in radiology reports was documented. Results: 51.0% (124/243) of patients presented with pain. Multivariate regression analysis of factors significantly associated with pain (including age, p = 0.001; larger corpus luteum volume, p = 0.002; larger residual volume, p < 0.001; complex free fluid, p = 0.002; and peripherally displaced follicles, p < 0.001) left only increased residual volume as significantly associated with pain [OR 1.02–1.16; p = 0.01]. False-positive concern for ovarian torsion on ultrasound was present in 12.9% (16/124) of patients with pain, associated with enlarged ovaries (p < 0.001) and peripherally displaced follicles (p < 0.001). High correlation between location of pain and side of the corpus luteum was demonstrated in patients with pain < 14 days duration (p < 0.001). Conclusion: Corpus luteum with ovarian stromal edema is associated with pelvic pain and can mimic ovarian torsion on ultrasound. Further research should explore diagnostically useful differences between cases of ovarian torsion and cases of ovarian edema related to corpora lutea.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Rapid kVp switching dual-energy CT in the assessment of urolithiasis in patients with large body habitus: preliminary observations on image quality and stone characterization

Purpose: The purpose of this study was to investigate the image quality (IQ) considerations of rapid kVp switching dual-energy CT (rsDECT) in the assessment of urolithiasis in patients with large body habitus and to evaluate whether it allows stone characterization. Materials and methods: In this IRB-approved, HIPAA compliant retrospective study, 93 consecutive patients (M/F = 72/21, mean age 56.9 years, range 23–83 years) with large body habitus (> 90 kg/198 lbs) who underwent dual-energy (DE) stone protocol CT on a rapid kVp switching DECT scanner between January 2013 and December 2016 were included. Scan acquisition protocol included an initial unenhanced single-energy CT (SECT) scan of KUB followed by targeted DECT in the region of stones. Two readers evaluated both CT data sets (axial 5 mm 120 kVp/140 kVp QC/70 keV monoenergetic, material density water/iodine images and coronal/sagittal 3 mm images) for the assessment of image quality (Scores: 1–4) and characterization of stone composition (reference standard: crystallography). Results: One hundred and five CT examinations were performed in 93 patients (mean body weight 105.12 ± 13.53 kg, range 91–154 kg), and a total of 321 urinary tract calculi (mean size-4.8 ± 3.2 mm, range 1.2–22 mm) were detected. Both SECT and targeted monoenergetic images were of acceptable image quality (mean IQ: 3.77 and 3.83, kappa 0.79 and 0.87 respectively). Material density water and iodine images had lower IQ scores (mean IQ: 2.97 and 3.09 respectively) with image quality deterioration due to severe photon starvation/streak artifacts in 20% (21/105) and 17% (18/105) scans, respectively. Characterization of stone composition into uric acid/non-uric acid stones was achieved in 93.14% (299/321) of calculi (mean size: 4.99 ± 3.3 mm, range 1.2–22 mm), while 7% (22/321) stones could not be characterized (mean size 3.03 ± 1.16 mm, range 1.6–6.4 mm) (p < 0.001). Most common reason for non-characterization was image quality deterioration of the material density iodine images due to severe photon starvation artifacts. On multivariate regression, stone size and patient weight were predictors of stone composition determination on DECT (p < 0.05). The transverse diameter had a weak negative correlation with stone composition determination, but it was not statistically significant. Stone characterization into uric acid vs. non-uric acid stones was accurate in 95% (n = 38/40) of stones in comparison with crystallography. Conclusion: In patients with large body habitus, rsDECT allowed characterization of most calculi (93%) despite image quality deterioration due to photon starvation/streak artifacts in up to 20% of material density images. Stone size and patient weight were predictors of stone composition determination on DECT, and small calculi in very large patients may not be characterized.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Deep learning and radiomics: the utility of Google TensorFlow™ Inception in classifying clear cell renal cell carcinoma and oncocytoma on multiphasic CT

Purpose: Currently, all solid enhancing renal masses without microscopic fat are considered malignant until proven otherwise and there is substantial overlap in the imaging findings of benign and malignant renal masses, particularly between clear cell RCC (ccRCC) and benign oncocytoma (ONC). Radiomics has attracted increased attention for its utility in pre-operative work-up on routine clinical images. Radiomics based approaches have converted medical images into mineable data and identified prognostic imaging signatures that machine learning algorithms can use to construct predictive models by learning the decision boundaries of the underlying data distribution. The TensorFlow™ framework from Google is a state-of-the-art open-source software library that can be used for training deep learning neural networks for performing machine learning tasks. The purpose of this study was to investigate the diagnostic value and feasibility of a deep learning-based renal lesion classifier using open-source Google TensorFlow™ Inception in differentiating ccRCC from ONC on routine four-phase MDCT in patients with pathologically confirmed renal masses. Methods: With institutional review board approval for this 1996 Health Insurance Portability and Accountability Act compliant retrospective study and a waiver of informed consent, we queried our institution’s pathology, clinical, and radiology databases for histologically proven cases of ccRCC and ONC obtained between January 2000 and January 2016 scanned with a an intravenous contrast-enhanced four-phase renal mass protocol (unenhanced (UN), corticomedullary (CM), nephrographic (NP), and excretory (EX) phases). To extract features to be used for the machine learning model, the entire renal mass was contoured in the axial plane in each of the four phases, resulting in a 3D volume of interest (VOI) representative of the entire renal mass. We investigated thirteen different approaches to convert the acquired VOI data into a set of images that adequately represented each tumor which was used to train the final layer of the neural network model. Training was performed over 4000 iterations. In each iteration, 90% of the data were designated as training data and the remaining 10% served as validation data and a leave-one-out cross-validation scheme was implemented. Accuracy, sensitivity, specificity, positive (PPV) and negative predictive (NPV) values, and CIs were calculated for the classification of the thirteen processing modes. Results: We analyzed 179 consecutive patients with 179 lesions (128 ccRCC and 51 ONC). The ccRCC cohort had a mean size of 3.8 cm (range 0.8–14.6 cm) and the ONC cohort had a mean lesion size of 3.9 cm (range 1.0–13.1 cm). The highest specificity and PPV (52.9% and 80.3%, respectively) were achieved in the EX phase when we analyzed the single mid-slice of the tumor in the axial, coronal and sagittal plane, and when we increased the number of mid-slices of the tumor to three, with an accuracy of 75.4%, which also increased the sensitivity to 88.3% and the PPV to 79.6%. Using the entire tumor volume also showed that classification performance was best in the EX phase with an accuracy of 74.4%, a sensitivity of 85.8% and a PPV of 80.1%. When the entire tumor volume, plus mid-slices from all phases and all planes presented as tiled images, were submitted to the final layer of the neural network we achieved a PPV of 82.5%. Conclusions: The best classification result was obtained in the EX phase among the thirteen classification methods tested. Our proof of concept study is the first step towards understanding the utility of machine learning in the differentiation of ccRCC from ONC on routine CT images. We hope this could lead to future investigation into the development of a multivariate machine learning model which may augment our ability to accurately predict renal lesion histology on imaging.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

The yield and patient factors associated with CT colonography C-RADS results in a non-screening patient population

Objectives: To determine the proportion of diagnostic computed tomography colonography (CTC) Reporting and Data System (C-RADS) categories in a non-screening population, and which patient factors are associated with a positive CTC (C2–4), a non-diagnostic CTC (C0), and potentially relevant extracolonic findings (ECF, E3–4). Methods: Diagnostic CTCs performed at a single academic center from 2017 to 2018 were retrospectively reviewed. For each examination, the indications, age, sex, admission status, and C-RADS categories were recorded. Multivariate logistic regression was performed of patient demographic factors and clinical indications, with adjusted odds ratios (OR) and 95% confidence intervals. Results: 1373 CTCs were included. The mean age was 66.4 ± 13 years (range 24–97). There were 782 women and 75 inpatients. The number of CTCs reported as C0–C4 were 194/1373 (14.1%), 970/1373 (70.6%), 77/1373 (5.6%), 86/1373 (6.3%), and 46/1373 (3.4%), respectively, and 134/1373 (9.8%), 960/1373 (69.9%), 173/1373 (12.6%), and 106/1373 (7.7%) CTCs were reported as E1–4, respectively. Factors that demonstrated the strongest associations were as follows: with C2–4, age groups 50–79 (OR 2.8, 95% confidence interval 1.4–6.1), 80–89 (6.2, 2.9–14.5) and ≥ 90 (7.6, 2.0–29.1), and inpatients (3.4, 1.8–6.4); with C0, age groups 50–79 (5.9, 2.2–24.4), 80–89 (9.8, 3.4–41.8), and ≥ 90 (22.5, 5.8–113.0), incomplete colonoscopy (3.2, 2.0–5.1) and melena or gastrointestinal bleeding (4.1, 1.8–9.4); and with E3–4, age groups 50–79 (1.6, 1.0–2.9), 80–89 (2.0, 1.1–3.9), and ≥ 90 (3.2, 1.2–8.8), and inpatients (2.3, 1.3–3.9). Conclusion: Older age is increasingly associated with a positive test, a non-diagnostic test and potentially relevant ECF. Inpatients are also associated with positive tests and E3–4 findings. Symptoms are not strongly associated with a positive CTC.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Early Stage Hepatocellular Carcinomas Not Feasible for Ultrasound-Guided Radiofrequency Ablation: Comparison of Transarterial Chemoembolization Alone and Combined Therapy with Transarterial Chemoembolization and Radiofrequency Ablation

PurposeTo report the results of combined therapy with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for early stage hepatocellular carcinoma (HCC) considered infeasible for ultrasound (US)-guided RFA in comparison with those of TACE monotherapy.MethodsFrom January 2007 through December 2010, 91 patients with early or very early stage HCC infeasible for US-guided RFA received either TACE alone (TACE group; n = 54) or TACE immediately followed by RFA (TACE–RFA group; n = 37) as a first-line treatment. 1-month tumor response, time to progression (TTP), and overall survival (OS) rates were calculated. Univariate and multivariate analyses were performed to identify prognostic factors.ResultsTACE–RFA group showed a better 1-month tumor response than TACE group (P < .001). The mean TTP was 29.7 ± 3.4 months (95 % confidence intervals [CIs] 23.0–36.5) in TACE group and 34.9 ± 2.8 months (95 % CIs 29.4–40.4) in TACE–RFA group. TACE–RFA group had a significantly longer TTP (P = .014). Cumulative 1-, 2-, and 3-year OS rates in the TACE and TACE–RFA groups were 91, 79, and 71 % and 100, 97, and 93 %, respectively (P = .008). Initial treatment of TACE was found to be the only significant risk factor for tumor progression and OS in multivariate analysis.ConclusionTACE–RFA combination therapy appears superior to TACE monotherapy in terms of 1-month tumor response, TTP, and OS when performed for early stage HCC infeasible for US-guided RFA.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Treatment Outcome Following Transarterial Chemoembolization in Advanced Bone and Soft Tissue Sarcomas

PurposeTransarterial chemoembolization (TACE) is used to treat unresectable bone and soft tissue sarcoma (STS) and as a pre-surgical adjuvant treatment. However, its efficiency for advanced STS is undetermined. This study evaluated TACE’s efficiency in treating advanced STS and prognostic factors for patient survival.Materials and MethodsWe enrolled 39 patients with unresectable STS who underwent TACE as an alternative treatment during 2010–2014, with overall survival (OS) as the primary end point. Cancer pain was evaluated by visual analogue scores (VAS) before and after TACE procedures. Factors that affect survival were evaluated by multivariate analyses (Cox proportional hazard model).ResultsMean OS after TACE was 23.7 ± 2.1 months, with 1-year OS 71.5 %, 2-year OS 45.8 %, and 3-year OS 32.5 %. Lesion number and tumor stage were key predictors of survival. TACE was found to decrease cancer pain VAS and increase relapse interval. Size of polyvinyl alcohol (PVA) particle diameter (P = 0.03) and imaging response (P = 0.044) were also found to affect relapse interval.ConclusionTACE was an effective treatment for advanced STS, with a 32.5 % 3-year OS rate, and led to lower cancer pain VAS and longer relapse intervals than chemoinfusion only. Smaller PVA particles are preferable during the TACE procedure.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Haemorrhagic Complications and Symptomatic Venous Thromboembolism in Interventional Tumour Ablations: The Impact of Peri-interventional Thrombosis Prophylaxis

AimThe aim of this study was to assess the rates of haemorrhagic and thrombotic complications in patients undergoing interventional tumour ablation with and without peri-interventional low-molecular-weight heparin (LMWH) thrombosis prophylaxis.MethodsPatients presented with primary and secondary neoplastic lesions in the liver, lung, kidney, lymph nodes and other locations. A total of 781 tumour ablations (radiofrequency ablation, n = 112; interstitial brachytherapy, n = 669) were performed in 446 patients over 22 months; 260 were conducted under peri-interventional thrombosis prophylaxis with LMWH (H-group;) and 521 without this (NH-group, in 143 of these, LMWH was given post-interventionally).ResultsSixty-three bleeding events occurred. There were significantly more bleedings in the H-group than in the NH-group (all interventions, 11.66 and 6.26 %, p = 0.0127; liver ablations, 12.73 and 7.1 %, p = 0.0416). The rate of bleeding events Grade ≥ III in all procedures was greater by a factor of >2.6 in the H-group than in the NH-group (4.64 and 1.73 %, p = 0.0243). In liver tumour ablations, the corresponding factor was about 3.3 (5.23 and 1.54 %, p = 0.028). In uni- and multivariate analyses including covariates, the only factor constantly and significantly associated with the rate of haemorrhage events was peri-interventional LMWH prophylaxis. Only one symptomatic lung embolism occurred in the entire cohort (NH-group). The 30- and 90-day mortalities were significantly greater in the H-group than in the NH-group.ConclusionsPeri-interventional LMWH thrombosis prophylaxis should be considered with caution. The rate of clinically relevant thrombotic events was extremely low.

62 RADIOLOGY AND NUCLEAR MEDICINE↗