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At least 1,099 records · Page 61

Application of Analytical Hierarchy Process for Narrowing Down Nep Candidate Reactor Designs

Nuclear electric propulsion (NEP)-powered vehicles have been contemplated for human Mars missions. The nuclear power system contemplates using a high temperature light-weight nuclear reactor for the production of electrical power in the range of 2-5 MWe with a 3-10 year service life. A myriad of technology options exist for achieving these mission objectives. The analytic hierarchy process (AHP), a multi-attribute decision method, is being used to narrow down the candidate designs. The AHP is a structured decision process that fuses model-supplied quantitative data with subjective assessments to facilitate decisions that involve multiple competing criteria. Proven end-to-end nuclear design and systems analysis tools will be used to provide quantitative performance data such as end-to-end system reliability, system robustness to recover from off-normal conditions, system specific weight (α in kg/kWe), and the ability to meet the service life-time and power level requirements. Three high assay low enriched uranium (HALEU) reactor concepts, namely, gas-, heat pipe- and pumped liquid-cooled nuclear cores coupled to a He/Xe gas or supercritical CO2- Brayton power conversion system are being modeled using the AHP to understand the trade-offs associated with these design combinations. In addition to the reactor and power conversion options, there are a myriad of additional components and subsystems – e.g., radiators, heat exchangers, and recuperators – that also figure into the evaluation process. The choice of the right overall system is a multidimensional problem that has to include not only quantitative data, but also the so called “external factors”, examples of which include the component and subsystem Technology Readiness Levels (TRLs), the associated Advancement Degrees of Difficulty (AD2), the cost and schedule required to achieve a technical maturity consistent with mission infusion, alignment with the priorities of NASA’s Space Nuclear Propulsion program, and alignment with other ongoing government and commercial investments in micro reactors. Focused expert elicitations form the basis for qualitative data set. As a final step, decision-makers individually express their opinions regarding the relative importance of the criteria and preferences among the alternatives through pairwise comparisons. The paper will describe the AHP approach, progress to-date applying it to the NEP human Mars mission problem, and preliminary results. Use of AHP provides sufficient flexibility for incorporating industry input at different stages as the technologies evolve through additional research and development. It is expected that the decision process will be ongoing and expanded to examine additional options and technology choices, culminating in a defensible set of candidate reactor concepts that will form the basis for developing a multi-year NEP technology maturation strategy. .

Dasari V Rao↗

A Point Kinetics Model for Estimating Neutron Multiplication of Bare Uranium Metal in Tagged Neutron Measurements

An extension of the point kinetics model is developed in this paper to describe the neutron multiplicity response of a bare uranium object under interrogation by an associated particle imaging deuterium-tritium (D-T) measurement system. This extended model is used to estimate the total neutron multiplication of the uranium. Both MCNPX-PoliMi simulations and data from active interrogation measurements of highly enriched and depleted uranium geometries are used to evaluate the potential of this method and to identify the sources of systematic error. The detection efficiency correction for measured coincidence response is identified as a large source of systematic error. If the detection process is not considered, results suggest that the method can estimate total multiplication to within 13% of the simulated value. Values for multiplicity constants in the point kinetics equations are sensitive to enrichment due to (n, xn) interactions by D-T neutrons and can introduce another significant source of systematic bias. This can theoretically be corrected if isotopic composition is known a priori. Finally, the spatial dependence of multiplication is also suspected of introducing further systematic bias for high multiplication uranium objects.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

Grating-based x-ray differential phase contrast imaging with twin peaks in phase-stepping curves—phase retrieval and dewrapping

Purpose: X-ray differential phase contrast CT implemented with Talbot interferometry employs phase-stepping to extract information of x-ray attenuation, phase shift, and small-angle scattering. Since inaccuracy may exist in the absorption grating G{sub 2} due to an imperfect fabrication, the effective period of G{sub 2} can be as large as twice the nominal period, leading to a phenomenon of twin peaks that differ remarkably in their heights. In this work, the authors investigate how to retrieve and dewrap the phase signal from the phase-stepping curve (PSC) with the feature of twin peaks for x-ray phase contrast imaging. Methods: Based on the paraxial Fresnel–Kirchhoff theory, the analytical formulae to characterize the phenomenon of twin peaks in the PSC are derived. Then an approach to dewrap the retrieved phase signal by jointly using the phases of the first- and second-order Fourier components is proposed. Through an experimental investigation using a prototype x-ray phase contrast imaging system implemented with Talbot interferometry, the authors evaluate and verify the derived analytic formulae and the proposed approach for phase retrieval and dewrapping. Results: According to theoretical analysis, the twin-peak phenomenon in PSC is a consequence of combined effects, including the inaccuracy in absorption grating G{sub 2}, mismatch between phase grating and x-ray source spectrum, and finite size of x-ray tube’s focal spot. The proposed approach is experimentally evaluated by scanning a phantom consisting of organic materials and a lab mouse. The preliminary data show that compared to scanning G{sub 2} over only one single nominal period and correcting the measured phase signal with an intuitive phase dewrapping method that is being used in the field, stepping G{sub 2} over twice its nominal period and dewrapping the measured phase signal with the proposed approach can significantly improve the quality of x-ray differential phase contrast imaging in both radiograph and CT. Conclusions: Using the phase retrieval and dewrapping methods proposed to deal with the phenomenon of twin peaks in PSCs and phase wrapping, the performance of grating-based x-ray differential phase contrast radiography and CT can be significantly improved.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Challenges of Using Indistinguishable from Background as a Release Criterion at FUSRAP Projects - 18157

The US Army Corps of Engineers (USACE) utilizes the Multi-Agency Radiation Survey and Site Investigation Manual (MARSSIM) approach to site release on Formerly Utilized Sites Remedial Action Program (FUSRAP) projects. Use of Indistinguishable from Background (IFB) as a release criterion is discussed in MARSSIM as Scenario B; however, the discussion is arguably limited and refers the user to other documents. USACE has utilized the IFB approach at select FUSRAP projects. USACE experience is that use of IFB as a release criterion has been difficult to implement at best. There are many challenges in using the IFB approach. These include: release criterion is required per MARSSIM; multiple reference areas need to be established; and data presentation. Potential methods to overcome these challenges are discussed. USACE has utilized alternative statistical approaches as well as the IFB approach discussed in MARSSIM for specific purposes at FUSRAP sites. Alternatives to the IFB approach discussed in this paper include other statistical tests such as the Tukey Kramer test. These alternatives may be better suited to release an area of a property prior to the development of release criteria. USACE has found using the IFB criterion useful in certain specific circumstances. These include post MARSSIM Scenario A final status survey data evaluations and for review of historical data. The challenges, alternatives, and circumstances to use the IFB approach are discussed. Other environmental remediation projects attempting to utilize IFB as a criterion may benefit from the USACE experiences as discussed herein. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Clinical Validation of 4-Dimensional Computed Tomography Ventilation With Pulmonary Function Test Data

Purpose: A new form of functional imaging has been proposed in the form of 4-dimensional computed tomography (4DCT) ventilation. Because 4DCTs are acquired as part of routine care for lung cancer patients, calculating ventilation maps from 4DCTs provides spatial lung function information without added dosimetric or monetary cost to the patient. Before 4DCT-ventilation is implemented it needs to be clinically validated. Pulmonary function tests (PFTs) provide a clinically established way of evaluating lung function. The purpose of our work was to perform a clinical validation by comparing 4DCT-ventilation metrics with PFT data. Methods and Materials: Ninety-eight lung cancer patients with pretreatment 4DCT and PFT data were included in the study. Pulmonary function test metrics used to diagnose obstructive lung disease were recorded: forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity. Four-dimensional CT data sets and spatial registration were used to compute 4DCT-ventilation images using a density change–based and a Jacobian-based model. The ventilation maps were reduced to single metrics intended to reflect the degree of ventilation obstruction. Specifically, we computed the coefficient of variation (SD/mean), ventilation V20 (volume of lung ≤20% ventilation), and correlated the ventilation metrics with PFT data. Regression analysis was used to determine whether 4DCT ventilation data could predict for normal versus abnormal lung function using PFT thresholds. Results: Correlation coefficients comparing 4DCT-ventilation with PFT data ranged from 0.63 to 0.72, with the best agreement between FEV1 and coefficient of variation. Four-dimensional CT ventilation metrics were able to significantly delineate between clinically normal versus abnormal PFT results. Conclusions: Validation of 4DCT ventilation with clinically relevant metrics is essential. We demonstrate good global agreement between PFTs and 4DCT-ventilation, indicating that 4DCT-ventilation provides a reliable assessment of lung function. Four-dimensional CT ventilation enables exciting opportunities to assess lung function and create functional avoidance radiation therapy plans. The present work provides supporting evidence for the integration of 4DCT-ventilation into clinical trials.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Performing Numerical Analysis of Cybersecurity Options Using Dynamic Risk Analysis Tool EMRALD

Cyberattacks can have many different attack paths, durations, and goals. There are also many different mitigation options involving hardware, software, and/or humans. Considering a cyber threat should involve defense-in-depth methods and a quantitative or numerical evaluation of overall effectiveness against dynamic, time-dependent attacks to make cost and risk-informed decisions. Typical cyberattack modeling methods only provide a qualitative evaluation. The main areas of cybersecurity are confidentiality, integrity, and availability. For companies with cyber-physical systems such as advanced nuclear reactors, cyber-related safety is a requirement set by North American Electric Reliability and the U.S. Nuclear Regulatory Commission. They are also concerned about availability or reliability as a business case. As cyber threats are evolving to a business-for-hire structure, more attacks may focus on disrupting business success and reliability, causing financial and economic stability risk. Companies want to know business reliability and recovery from those threats, and that requires modeling physical behavior of the targets. Dynamic-state-based and Markov-based modeling provides a method for better cyber scenario modeling with different tools having issues such as state-base explosion. Dynamic modeling enables time and conditional features not found in other numerical evaluation methods. EMRALD (Event Modeling Risk Assessment using Lined Diagrams) is a dynamic risk analysis modeling and simulation tool and has features that reduce modeling issues. It has been used to model different time-dependent events including plant behavior and operator procedures. As a general modeling tool, EMRALD can also be used to model cyberattack scenarios with varying mitigation options and quantify effectiveness, producing numerical data for risk-informed decisions. This paper uses EMRALD to demonstrate that dynamic numerical risk analysis can be used for cyber threat modeling to provide insights for design decision-making and optimize defense strategies. Keywords: cyber modeling; cyber-physical systems; numerical cyber modeling

97 - MATHEMATICS AND COMPUTING↗

The Expanded Capabilities Of The Cementitious Barriers Partnership Software Toolbox Version 2.0 - 14331

The Cementitious Barriers Partnership (CBP) Project is a multi-disciplinary, multi-institutional collaboration supported by the U.S. Department of Energy (US DOE) Office of Tank Waste Management. The CBP program has developed a set of integrated tools (based on state-of-the-art models and leaching test methods) that help improve understanding and predictions of the long-term structural, hydraulic and chemical performance of cementitious barriers used in nuclear applications. The CBP Software Toolbox – “Version 1.0” was released early in FY2013 and was used to support DOE-EM performance assessments in evaluating various degradation mechanisms that included sulfate attack, carbonation and constituent leaching. The sulfate attack analysis predicted the extent and damage that sulfate ingress will have on concrete vaults over extended time (i.e., > 1000 years) and the carbonation analysis provided concrete degradation predictions from rebar corrosion. The new release “Version 2.0” includes upgraded carbonation software and a new software module to evaluate degradation due to chloride attack. Also included in the newer version are a dual regime module allowing evaluation of contaminant release in two regimes – both fractured and un-fractured. The integrated software package has also been upgraded with new plotting capabilities and many other features that increase the “user-friendliness” of the package. Experimental work has been generated to provide data to calibrate the models to improve the credibility of the analysis and reduce the uncertainty. Tools selected for and developed under this program have been used to evaluate and predict the behavior of cementitious barriers used in near-surface engineered waste disposal systems for periods of performance up to or longer than 100 years for operating facilities and longer than 1000 years for waste disposal. The CBP Software Toolbox is and will continue to produce tangible benefits to the working DOE Performance Assessment (PA) community.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Application of quantitative methods for reliability testing of a nuclear power plant digital rod position indication diagnostic system - 391

Obsolescence, aging, reliability, and performance issues are driving nuclear facilities to replace conventional analog Instrumentation and Control (I and C) systems with digital technologies. In addition, the designs of the next generation of nuclear reactors, including Small Modular Reactors (SMRs), will incorporate digital I and C for most, if not all, of their safety and non-safety related functions. As part of an on-going research and development (R and D) effort under the auspices of the U.S. Department of Energy (DOE), Analysis and Measurement Services Corporation (AMS) is developing a platform to provide automated testing of digital I and C systems and create a standard method of evaluation for reliability assessments. This hands-on R and D effort has produced a Software Reliability Tester (SRT), which is a set of software and hardware tools designed to automate the testing of digital I and C systems to measure and quantify how well the systems perform under normal operating conditions and in the presence of faults. Furthermore, the SRT provides the foundation for a practical tool to automate verification and validation (V and V) activities and reduce the amount of testing time of digital I and C systems. When combined with its capabilities of integrating both reliability and fault tolerance quantification, the SRT can be used to ensure that digital I and C implementations are both safe and cost-effective for the nuclear industry. This paper describes the application of the SRT to perform V and V of a new Digital Rod Position Indication (DRPI) diagnostic system. The DRPI diagnostic system is a digital system that monitors the rod address and rod position data bus voltages of typical DRPI systems in nuclear power plants to detect and diagnose faults. For this application, the SRT was configured to exercise the inputs of the DRPI diagnostic system, and test cases were generated for common system faults such as address and data bit errors, bus voltage, and timing problems. These test cases were applied by the SRT hardware as voltage inputs to the DRPI diagnostic system and the outputs were compared to expected values generated by a model of the DRPI diagnostic system. Included in the paper is a description of the overall design of the SRT including the hardware and software architectures. Methodologies for automating test cases are also described. V and V using the SRT demonstrates the benefits of automated testing and qualification to provide a quantitative assessment of reliability and cost effective implementation of digital I and C in existing and next generation nuclear power plants. (authors)

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Generation of Enrichment-Dependent Thermal Neutron Scattering Data

This work details the generation of enrichment-dependent thermal neutron scattering cross sections for several crucial uranium fuel compounds. The evaluations of the thermal scattering law (TSL) and associated cross sections for uranium dioxide (UO 2 ), uranium carbide (UC), and uranium nitride (UN) were performed using standard ab initio lattice dynamics (AILD) methods. The data for uranium metal was produced using a novel hybrid approach of molecular dynamics combined with lattice dynamics methods. 235 U enrichments of 5%, 10% (LEU+), 19.75% (HALEU), 93% (HEU), and 100% were considered, in addition to natural uranium. The enrichment-dependent masses and free atom cross sections were used in the generation of elastic and inelastic thermal neutron scattering cross sections, while the calculation of the phonon density of states (DOS) and resulting TSL considered only the natural isotopic composition of uranium. The use of an identical DOS for all enrichments is expected to have minimal impact on the final data, as the small change in uranium mass should not significantly affect lattice vibrations. The cross sections are shown to exhibit significant dependence on 235 U enrichment. The submission of this data to the National Nuclear Data Center (NNDC) for release in the ENDF/B-VIII.1 database should support the design of advanced reactor concepts.

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

MOOSE ProbML: Parallelizable Probabilistic Machine Learning and Uncertainty Quantification Capabilities

The Multiphysics Object Oriented Simulation Environment (MOOSE) is a widely used open- source finite element software for performing multiphysics multiscale simulations in a massively parallel fashion. Recently, the computational team at Idaho National Laboratory (INL) has implemented Probabilistic Machine Learning (ProbML) capabilities in MOOSE—in a parallelized fashion—and enable active learning with large-scale computational models for tasks such as surrogate model development, scale bridging, forward/inverse uncertainty quantification (UQ), Bayesian optimization, etc. This presentation summarizes these developments in MOOSE along with demonstrations on several real applications relevant to nuclear energy. At the fundamental level, samplers like Monte Carlo/Latin Hypercube, variance reduction, parallelized Markov Chain Monte Carlo (MCMC) support uncertainty propagation in both forward and inverse settings. These samplers can be integrated with the Gaussian processes (GP) suite in MOOSE, which offer several variants like scalar GPs, multi-output GPs, and deep GPs, to enable active learning. These GPs can be tuned using gradient-based optimization methods like Adam and its variants or gradient-free methods like the elliptical slice sampler (a variant of MCMC adept under Gaussian settings) for more complex covariance kernels or likelihoods whose gradient computations can be cumbersome. A variety of batch acquisition functions permit parallelized evaluation of the computational model and support different learning objectives with high efficiency like Bayesian inference, global surrogate development, optimization, etc. Furthermore, libtorch integration supports training, evaluation, and re-training of neural networks and other complex machine learning models in active learning settings. The impacts of these developments are shown on several real applications: (1) nuclear fuel inverse UQ and model inadequacy assessment using the Kennedy O’Hagan framework; (2) uncertainty aware surrogate modeling for additive manufacturing to predict field quantities; (3) nuclear reactor rare events analysis; and (4) complex fluid flow prediction using a global surrogate with quantified prediction uncertainty. Finally, the outlook of MOOSE ProbML is discussed for both outer-loop and inner-loop computations in the broad view to accelerate fuels and materials qualification, address gaps in knowledge and data, and assess new reactor/fuel systems.

11 - NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

SU-E-T-595: Output Factor Calculation for a Uniform Scanning Proton Therapy System

Purpose: To develop an analytical model that predicts dose output factors for patient treatment fields in a uniform scanning proton therapy system. Methods: A model to predict output factors for patient specific treatment fields was produced based on the methods developed by Kooy et al. (2003). The Kooy model predicts the output factor based on the ratio of the entrance dose under calibration conditions to that for a given range and modulation corrected for the inverse square effect. Field specific output factors were plotted as a function of a single parameter r, where r = (Range-Modulation)/Modulation. The model targeted user range 1 sub-span 3 through user range 2 sup-span 2 of the IBA uniform scanning proton therapy system. The data set included points measured using the 10 cm and 18 cm snout sizes to eliminate stem effects on the monitor unit chambers. The data was fit using equation 15 from Kooy et al. (2003), and the resulting model was tested against measurements that were not included in the original data set. Results: For the range and sub span investigated, 120 data points were tested against the model prediction. The model predicted the output factor within 2% for 96% of the points tested and within 2.5% for 99% of the points tested. All points were within 3% of the predicted values. Conclusion: Monitor units for patient treatment fields with proton ranges that fall within the tested interval can be predicted using a model based on the methods developed at MGH. With further evaluation, it will be possible to model all user ranges and sub-spans of the IBA system. Further testing is also needed to predict output factors using a 25 cm snout which introduces variable scanning pattern sizes and stem effects on the monitor unit chambers.

61 RADIATION PROTECTION AND DOSIMETRY↗

Alternative Method for Performing As-Built, As-Irradiated Neutronics Analyses

Neutronics analyses have been used to assist in the design, development, and qualification of miniature fuel (MiniFuel) experiments irradiated in the High Flux Isotope Reactor (HFIR) at Oak Ridge National Laboratory (ORNL) since their conception almost a decade ago. In recent years, upon completion of a MiniFuel target’s irradiation, neutronics analyses that reflect the as-built, as-irradiated conditions of an experiment have also been performed to validate postirradiation examination (PIE) efforts. Several radiation transport and depletion/activation software wrapper programs have been developed to increase the fidelity of these calculations; at ORNL, a program called HFIRCON is the primary software method employed. However, the utilization of these wrapper programs comes at a cost. To produce accurate results, the radiation transport portion of these analyses requires significant time and resources to execute. Therefore, this report discusses an alternative methodology for calculating some of the desired output for PIE validation—specifically, the output used in evaluating the experiment’s fuel burnup—without complete reliance on ORNL’s wrapper program. The alternative method is not a new software but rather a procedure for utilizing the depletion/activation software, SCALE, in conjunction with limited input data and reasonable assumptions to bypass most of the radiation transport calculations and thereby reduce the time required for the completion of a standard analysis.

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

Coregistered positron emission particle tracking (PEPT) and X-ray computed tomography (CT) for engineering flow measurements

Increasingly, fully 3D experimental measurements of flow in complex engineering geometries are required to validate computational fluid dynamics models that support and inform reactor design and licensing. One barrier to such measurements is the complexity of typical reactor components and subsequent lack of optical access in these systems. To overcome this, the deployment of coregistered positron emission particle tracking (PEPT) and X-ray computed tomography (CT) is explored for flow measurement in reactor thermal hydraulic components and model (scaled) systems. Through this methodology, fully 3D flow information (via PEPT) and detailed internal geometry (via CT) are captured in opaque systems such as pipes, rod bundles, packed beds, etc. The reconstructed flow field and geometry can then be overlain to reveal detailed flow features around internal structures within a given test section. This is enabled through the use of a combined preclinical PET/CT scanner with overlapping PET and CT fields of view. Such measurements are useful for characterizing flow inside such intricate nuclear thermal hydraulic components as core geometries and heat exchangers, among others, and providing valuable 3D validation data for CFD models. In this work, basic tests of this 3D flow/geometry mapping are presented, and the implications of such measurements are discussed. Further, preliminary measurements are made with both point sources and flow in a simple pipe flow geometry to evaluate the capabilities of this technique. PEPT and CT features are coregistered with up to 0.1 mm precision, and pipe flow mean velocity and Reynolds stresses are reconstructed with similar accuracy to previous PEPT demonstrations. The utility of PEPT/CT is shown herein, and suggestions for future measurements are made.

3D flow measurement↗

First hydrogen operation of NIO1: Characterization of the source plasma by means of an optical emission spectroscopy diagnostic

NIO1 (Negative Ion Optimization 1) is a compact and flexible radio frequency H{sup −} ion source, developed by Consorzio RFX and INFN-LNL. The aim of the experimentation on NIO1 is the optimization of both the production of negative ions and their extraction and beam optics. In the initial phase of its commissioning, NIO1 was operated with nitrogen, but now the source is regularly operated also with hydrogen. To evaluate the source performances, an optical emission spectroscopy diagnostic was installed. The system includes a low resolution spectrometer in the spectral range of 300-850 nm and a high resolution (50 pm) one, to study, respectively, the atomic and the molecular emissions in the visible range. The spectroscopic data have been interpreted also by means of a collisional-radiative model developed at IPP Garching. Besides the diagnostic hardware and the data analysis methods, the paper presents the first plasma measurements across a transition to the full H mode, in a hydrogen discharge. The characteristic signatures of this transition in the plasma parameters are described, in particular, the sudden increase of the light emitted from the plasma above a certain power threshold.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Remaining Useful Strength (RUS) Prediction of SiCf-SiCm Composite Materials Using Deep Learning and Acoustic Emission

Prognosis techniques for prediction of remaining useful life (RUL) are of crucial importance to the management of complex systems for they can lead to appropriate maintenance interventions and improvements in reliability. While various data-driven methods have been introduced to predict the remaining useful life (RUL) of machinery systems or batteries, no research has been reported on the remaining useful strength (RUS) prediction of silicon carbide fiber reinforced silicon carbide matrix (SiCf-SiCm) materials with pivotal role in its potential usage as a structural material in nuclear reactors and turbine engines. Knowledge of its degradation process is of the utmost importance to the manufacturers. For this purpose, two approaches based on the machine-learning techniques of random-forest (RF) and convolutional neural network (CNN) are proposed to predict the RUS of SiCf-SiCm using only acoustic emission (AE) signals generated during the material’s stress applying process. Experimental results show that the CNN models achieved better predictive performance than the RF models but the latter with expert-engineered features achieves better prediction for AE signals in the early stage of degradation. Additionally, our results demonstrate that both models can correctly predict the SiCf-SiCm RUS as evaluated by our robust testing method from which the best average root mean square error (RMSE) and Pearson correlation coefficient of 3.55 ksi units and 0.85 were obtained.

36 MATERIALS SCIENCE↗

Neurohumoral indicators of efficacy radiofrequency cardiac denervation

In this study, we compared pre- and postoperative parameters of the cardiac sympathetic innervation. The aim of the study was to examine the approaches to evaluating the quality of radiofrequency (RF)-induced cardiac denervation by using non-invasive and laboratory methods. The study included 32 people with long-lasting persistent atrial fibrillation (AF). The patients were divided into 2 groups according to the objectives of the study: group 1 (main) - 21 patients with mitral valve diseases, which simultaneously with radiofrequency ablation (RFA) AF carried out on the effects of the paraganglionic nervous plexuses by C. Pappone (2004) and N. Doll (2008) schemes. The second group (control) contained 11 patients with heart diseases in sinus rhythm (the RF denervation not been performed). All patients, who underwent surgical treatment, were received examination of cardiac sympathetic tone by using {sup 123}I-MIBG. All of them made blood analysis from ascending aorta and coronary sinus to determine the level of norepinephrine and its metabolites before and after cardiac denervation. Data of radionuclide examination are correlating with laboratory data.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Are We Appropriately Selecting Therapy For Patients With Cervical Cancer? Longitudinal Patterns-of-Care Analysis for Stage IB-IIB Cervical Cancer

Purpose: We performed a patterns-of-care analysis evaluating the effects of newer technology and recent research findings on treatment decisions over 26 years to determine whether patients with cervical cancer are being appropriately selected for treatment to optimize the therapeutic ratio. Methods and Materials: A retrospective analysis was conducted using the Surveillance, Epidemiology and End Results (SEER) program from 1983 to 2009. We identified 10,933 women with stage IB-IIB cervical carcinoma. Results: Of the 10,933 subjects identified, 40.1% received surgery, 26.8% received radiation (RT), and 33.1% received surgery plus RT. RT use increased after 2000 compared to prior to 2000, with a corresponding decrease in surgery and surgery plus RT. Among patients with risk factors including tumor size >4 cm, positive parametria, and positive lymph nodes, declining use of surgery plus RT was observed. However, 23% of patients with tumors >4 cm, 20% of patients with positive parametria, and 55% of node-positive patients continued to receive surgery plus RT as of 2009. Factors associated with increased use of surgery plus RT included patient age <50 and node-positive status. Conclusions: In this largest patterns-of-care analysis to date for patients with locally advanced cervical cancer, we found a substantial proportion of patients continue to undergo surgery followed by radiation, despite randomized data supporting the use of definitive radiation therapy, with lower morbidity than surgery and radiation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Doses to Carotid Arteries After Modern Radiation Therapy for Hodgkin Lymphoma: Is Stroke Still a Late Effect of Treatment?

Purpose: Hodgkin lymphoma (HL) survivors are at an increased risk of stroke because of carotid artery irradiation. However, for early-stage HL involved node radiation therapy (INRT) reduces the volume of normal tissue exposed to high doses. Here, we evaluate 3-dimensional conformal radiation therapy (3D-CRT), volumetric-modulated arc therapy (VMAT), and proton therapy (PT) delivered as INRT along with the extensive mantle field (MF) by comparing doses to the carotid arteries and corresponding risk estimates. Methods and Materials: We included a cohort of 46 supradiaphragmatic stage I-II classical HL patients. All patients were initially treated with chemotherapy and INRT delivered as 3D-CRT (30 Gy). For each patient, we simulated MF (36 Gy) and INRT plans using VMAT and PT (30 Gy). Linear dose-response curves for the 20-, 25-, and 30-year risk of stroke were derived from published HL data. Risks of stroke with each technique were calculated for all patients. Statistical analyses were performed with repeated measures analysis of variance. Results: The mean doses to the right and left common carotid artery were significantly lower with modern treatment compared with MF, with substantial patient variability. The estimated excess risk of stroke after 20, 25, and 30 years was 0.6%, 0.86%, and 1.3% for 3D-CRT; 0.67%, 0.96%, and 1.47% for VMAT; 0.61%, 0.96%, and 1.33% for PT; and 1.3%, 1.72%, and 2.61% for MF. Conclusions: INRT reduces the dose delivered to the carotid arteries and corresponding estimated risk of stroke for HL survivors. Even for the subset of patients with lymphoma close to the carotid arteries, the estimated risk is low.

62 RADIOLOGY AND NUCLEAR MEDICINE↗