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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 OSTI2013

Geomechanical effects on CO 2 leakage through fault zones during large-scale underground injection

The importance of geomechanics—including the potential for faults to reactivate during large-scale geologic carbon sequestration operations—has recently become more widely recognized. However, notwithstanding the potential for triggering notable (felt) seismic events, the potential for buoyancy-driven CO 2 to reach potable groundwater and the ground surface is actually more important from public safety and storage-efficiency perspectives. In this context, this paper extends the previous studies on the geomechanical modeling of fault responses during underground carbon dioxide injection, focusing on the short-term integrity of the sealing caprock, and hence on the potential for leakage of either brine or CO 2 to reach the shallow groundwater aquifers during active injection. We consider stress/strain-dependent permeability and study the leakage through the fault zone as its permeability changes during a reactivation, also causing seismicity. We analyze several scenarios related to the volume of CO 2 injected (and hence as a function of the overpressure), involving both minor and major faults, and analyze the profile risks of leakage for different stress/strain-permeability coupling functions. We conclude that whereas it is very difficult to predict how much fault permeability could change upon reactivation, this process can have a significant impact on the leakage rate. Moreover, our analysis shows that induced seismicity associated with fault reactivation may not necessarily open up a new flow path for leakage. Results show a poor correlation between magnitude and amount of fluid leakage, meaning that a single event is generally not enough to substantially change the permeability along the entire fault length. Finally, and consequently, even if some changes in permeability occur, this does not mean that the CO 2 will migrate up along the entire fault, breaking through the caprock to enter the overlying aquifer.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2019

Testing the efficacy of active pressure management as a tool to mitigate induced seismicity

Manipulation of subsurface stresses through fluid injection/extraction may induce seismicity through modulation of overpressure along faults. Globally, most industrial operations do not induce significant earthquakes. However, the possibility of inducing moderate to large earthquakes is recognized as a significant risk for basin-scale carbon dioxide (CO 2 ) storage operations (Niass et al., 2017). One possible method to reduce the occurrence of induced seismicity is to maintain only small (or zero) fluid overpressure changes in the subsurface through extraction of formation brine. For active pressure management (APM), operators may employ different procedures including extraction of various brine volumes and different configurations of injection/extraction well locations. However, the impact each these operational procedures on induced seismicity must be understood in order to develop management strategies. Here, we describe a numerical modeling workflow to evaluate the efficacy of APM techniques, that when applied to a specific site may be used to inform operational management strategies. We couple the multiphase reservoir model, NUFT, with the earthquake simulator, RSQSim and simulate seismicity induced by CO 2 injection into a hypothetical brine saturated reservoir. Reservoir overpressure is modified by co-extraction of brine at various fractions of the injected CO 2 volume from five potential wells. Our goal is to understand how the well-pair configuration and the extracted brine volume impact the total number and the maximum event magnitude. Additionally, the performance of each scenario is also evaluated in terms of the volume of CO 2 that can be stored before an earthquake above a tolerance threshold is induced.

58 GEOSCIENCES↗
DOE OSTI2021

Hydrogen carriers: Production, transmission, decomposition, and storage

Recognizing the potential role of liquid hydrogen carriers in overcoming the inherent limitations in transporting and storing gaseous and liquid hydrogen, a complete production and use scenario is postulated and analyzed for perspective one-way and two-way carriers. The carriers, methanol, ammonia and toluene/MCH (methylcyclohexane), are produced at commercially viable scales in a central location, transmitted by rail or pipelines for 2000 miles, and decomposed near city gates to generate fuel-cell quality hydrogen for distribution to refueling stations. In terms of the levelized cost of H 2 distributed to the stations, methanol is less expensive to produce (1.22 dollars per kg-H 2 ) than MCH (1.35 dollars per kg-H 2 ) or ammonia (2.20 dollars per kg-H 2 ). Levelized train transmission cost is smaller for methanol (0.63 dollars per kg-H 2 ) than ammonia (1.29 dollars per kg-H 2 ) or toluene/MCH system (2.07 dollars per kg-H 2 ). Levelized decomposition cost is smaller for ammonia (0.30-1.06 dollars per kg-H 2 ) than MCH (0.54-1.22 dollars per kg-H 2 ) or methanol (0.43-1.12 dollars per kg-H 2 ). Over the complete range of demand investigated, 10-350 tpd-H 2 , the levelized cost of H2 distributed to stations is aligned as methanol « ammonia ~ MCH. With pipelines at much larger scale, 6000 tpd-H 2 , the levelized cost decreases by ~1 dollar per kg-H 2 for ammonia and MCH and much less for methanol. Methanol is a particularly attractive low-risk carrier in the transition phase with lower than 50-tpd H 2 demand.

08 HYDROGEN↗
DOE OSTI2022

Performance and cost of fuel cells for off-road heavy-duty vehicles

Hydrogen fuel cell-powered off-road vehicles can replace hydrocarbon-powered off-road vehicles to reduce carbon dioxide and criteria pollutant emissions in the agriculture, construction, and mining industries. Vehicle manufacturers and customers recognize health and environmental benefits of emissions reductions but are ultimately compelled by the total cost of ownership of their vehicles. In this study, we conduct a technoeconomic evaluation for three hallmark off-road vehicles, tractors, wheel loaders, and excavators, comparing vehicles with hydrogen fuel cell + battery hybrid powertrains to traditional diesel powertrains. Stakeholder-valued performance metrics include fuel cell engine power, engine durability, hydrogen consumption rate, hydrogen storage system volume, and energy-regenerative drivetrain efficiency. The total cost of ownership includes capital, operating and maintenance, fuel, and fuel storage costs. State-of-the-art fuel cell powered wheel loaders and excavators are currently cost competitive with diesel platforms. If targeted improvements to cost, performance, and durability improvements of fuel cell stacks and storage systems are achieved, fuel cell systems would be cost competitive for tractors and significantly lower total cost of ownership options for wheel loaders and excavators.

33 ADVANCED PROPULSION SYSTEMS↗
DOE OSTI2025

Machine-learning and first-principles investigation of lightweight medium-entropy alloys for hydrogen-storage applications

The transition to a low-carbon economy demands efficient and sustainable energy-storage solutions, with hydrogen emerging as a promising clean-energy carrier and with metal hydrides recognized for their hydrogen-storage capacity. Here, we leverage machine learning (ML) to predict hydrogen-to-metal (H/M) ratios and solution energy by incorporating thermodynamic parameters and local lattice distortion (LLD) as key features. Our best-performing ML model provides improvements to H/M ratios and solution energies over a broad class of medium-entripy alloys (easily extendable to multi-principal-element alloys), such as Ti–Nb-X (X = Mo, Cr, Hf, Ta, V, Zr) and Co–Ni-X (X = Al, Mg, V). Ti–Nb–Mo alloys reveal compositional effects in H-storage behavior, in particular Ti, Nb, and V enhance H-storage capacity, while Mo reduces H/M and hydrogen weight percent by 40–50 %. We attributed results in molybdenum-rich alloys to slow hydrogen kinetics, as validated by our pressure-composition-temperature (PCT) isotherm experiments on pure Ti and Ti 5 Mo 95 alloys. Density functional theory (DFT) and molecular dynamics (MD) simulations also confirm that Ti and Nb promote H diffusion, whereas Mo hinders it, highlighting the interplay between electronic structure, lattice distortions, and hydrogen uptake. Notably, our Gradient Boosting Regression model identifies LLD as a critical factor in H/M predictions. Here, to aid material selection, we present two periodic tables illustrating elemental effects on (a) H 2 wt% and (b) solution energy, derived from ML, and provide a reference for identifying alloying elements that enhance hydrogen solubility and storage.

08 HYDROGEN↗
DOE OSTI2018

Anisotropic finite hyper-elastoplasticity of geomaterials with Drucker-Prager/Cap type constitutive model formulation

The formulation of large strain anisotropic hyper-elastoplasticity of geomaterials is examined. Attention is given to the role of structure tensors (also called fabric tensors), especially in context of the Eshelby-Mandel stress and large inelastic volume changes attributable to porosity. Both (hyper-)elastic and inelastic orthotropic symmetry, reducing to the particular case of transverse isotropy, are considered. Specific material assumptions and constitutive choices are identified for the development of a novel Anisotropic Drucker-Prager/Cap (ADPC) model formulated within the intermediate configuration consistent with multiplicative split of the deformation gradient. The model is calibrated to existing experimental measurements, including high pressure large strain triaxial compression of lithographic (Solnhofen) limestone and triaxial compression measurements on Tournemire shale assessing elastoplastic anisotropy. Manifest implications of constitutive theory are investigated, including consequences of recognizing (or not) the Eshelby-Mandel stress as energy conjugate to the plastic velocity gradient and including (or not) contribution from the skew-symmetric parts of the Mandel stress to the plastic anisotropy. Numerical simple shear experiments and large deformation simulated indentation experiments are provided in order to investigate model predictions and demonstrate the overall robustness in finite element modeling.

42 ENGINEERING↗
DOE OSTI2023

A verification study of fatigue-based methods in API RP 1183 for estimating fatigue life of pipeline dents

Pipeline dents are mechanical damage caused by a third party in buried pipelines during construction or maintenance repair. Dents are recognized as a leading cause of pipeline failures for both liquid and gas transmission lines, and their assessment and management are critical to pipeline integrity. To meet the industry need, American Institute of Petroleum (API) in 2020 published a recommended practice (RP) 1183 – Assessment and Management of Pipeline Dents. This API code provides the pipeline industry “standard methods” for evaluating severity and fatigue life of pipeline dents with a single peak. This paper performed an initial verification study of fatigue-based methods prescribed in API RP 1183 for estimating fatigue life of pipeline dents. A brief review was first given to the dent fatigue-based methods, including three dent screening methods for estimating dent fatigue life in Sections 7.4.1, 7.4.2, and 7.4.3 of API 1183 and one dent assessment method for predicting fatigue life in Section 8.3.4. In order to verify these fatigue life prediction methods, a set of “standard examples” of dents provided in Annexes A.1 to A.5 of API RP 1183 were utilized in this study to calculate fatigue life, to determine restraint condition, and to evaluate both screening and assessment methods for single-peak dents. Through detailed calculations and comparisons, this study confirmed some specifications of API RP 1183, but also found some self-inconsistences and errors existing in this new API code. Furthermore, this includes the self-inconsistences between three screening methods and the self-inconsistence between the screening and assessment methods. On this basis, recommendations were made on how the operators should use API RP 1183, and what actions API should take to improve this code.

42 ENGINEERING↗
DOE OSTI2019

Characterization and numerical simulation of liquid refrigerant R-134a flow emerging from a flooded evaporator tube bundle

The distribution of liquid droplets emerging from an evaporator tube bundle is characterized for refrigerant R-134a with a triangular tube arrangement with a pitch of 1.167. The purpose of this research was to improve understanding of the droplet ejection process to aid in design of evaporators typically used in larger chiller systems. A laser and camera system captured images of the evaporator headspace at varying conditions. Conventional shadowgraphy techniques were applied to recognize and match droplets for velocity calculations. The evaporator conditions varied with bundle mass fluxes of 20.3 and 40.7 kg s -1 m -2 , top-rows heat fluxes of 15.8 and 31.5 kWm -2 , and outlet saturation temperatures of 4.4 and 12.8 °C. Conditions ranged from flooded to dryout of the top rows. Droplet number, size distribution, velocity, and liquid volume fraction are presented in the headspace above the bundle. A method to numerically duplicate the droplet loading in the headspace using CFD with a Lagrangian discrete-phase model is also presented and verified, providing a powerful design tool. Liquid distribution in the headspace is found to be a strong function of all varied properties, particularly mass flux, liquid level, and saturation temperature

42 ENGINEERING↗
DOE OSTI2013

Management of Pediatric Spinal Cord Astrocytomas: Outcomes With Adjuvant Radiation

Purpose: Pediatric intramedullary spinal cord tumors are exceedingly rare; in the United States, 100 to 200 cases are recognized annually, of these, most are astrocytomas. The purpose of this study is to report the outcomes in pediatric patients with spinal cord astrocytomas treated at a tertiary care center. Methods and Materials: An institutional review board-approved retrospective single-institution study was performed for pediatric patients with spinal cord astrocytomas treated at our hospital from 1990 to 2010. The patients were evaluated on the extent of resection, progression-free survival (PFS), and development of radiation-related toxicities. Kaplan-Meier curves and multivariate regression model methods were used for analysis. Results: Twenty-nine patients were included in the study, 24 with grade 1 or 2 (low-grade) tumors and 5 with grade 3 or 4 (high-grade) tumors. The median follow-up time was 55 months (range, 1-215 months) for patients with low-grade tumors and 17 months (range, 10-52 months) for those with high-grade tumors. Thirteen patients in the cohort received chemotherapy. All patients underwent at least 1 surgical resection. Twelve patients received radiation therapy to a median radiation dose of 47.5 Gy (range, 28.6-54.0 Gy). Fifteen patients with low-grade tumors and 1 patient with a high-grade tumor exhibited stable disease at the last follow-up visit. Acute toxicities of radiation therapy were low grade, whereas long-term sequelae were infrequent and manageable when they arose. All patients with low-grade tumors were alive at the last follow-up visit, compared with 1 patient with a high-grade tumor. Conclusion: Primary pediatric spinal cord astrocytomas vary widely in presentation and clinical course. Histopathologic grade remains a major prognostic factor. Patients with low-grade tumors tend to have excellent disease control and long-term survival compared to those with high-grade tumors. This experience suggests that radiation therapy may enhance tumor control with an acceptably low risk of long-term sequelae in this sensitive patient population.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Volumetric Spectroscopic Imaging of Glioblastoma Multiforme Radiation Treatment Volumes

Purpose: Magnetic resonance (MR) imaging and computed tomography (CT) are used almost exclusively in radiation therapy planning of glioblastoma multiforme (GBM), despite their well-recognized limitations. MR spectroscopic imaging (MRSI) can identify biochemical patterns associated with normal brain and tumor, predominantly by observation of choline (Cho) and N-acetylaspartate (NAA) distributions. In this study, volumetric 3-dimensional MRSI was used to map these compounds over a wide region of the brain and to evaluate metabolite-defined treatment targets (metabolic tumor volumes [MTV]). Methods and Materials: Volumetric MRSI with effective voxel size of ∼1.0 mL and standard clinical MR images were obtained from 19 GBM patients. Gross tumor volumes and edema were manually outlined, and clinical target volumes (CTVs) receiving 46 and 60 Gy were defined (CTV{sub 46} and CTV{sub 60}, respectively). MTV{sub Cho} and MTV{sub NAA} were constructed based on volumes with high Cho and low NAA relative to values estimated from normal-appearing tissue. Results: The MRSI coverage of the brain was between 70% and 76%. The MTV{sub NAA} were almost entirely contained within the edema, and the correlation between the 2 volumes was significant (r=0.68, P=.001). In contrast, a considerable fraction of MTV{sub Cho} was outside of the edema (median, 33%) and for some patients it was also outside of the CTV{sub 46} and CTV{sub 60}. These untreated volumes were greater than 10% for 7 patients (37%) in the study, and on average more than one-third (34.3%) of the MTV{sub Cho} for these patients were outside of CTV{sub 60}. Conclusions: This study demonstrates the potential usefulness of whole-brain MRSI for radiation therapy planning of GBM and revealed that areas of metabolically active tumor are not covered by standard RT volumes. The described integration of MTV into the RT system will pave the way to future clinical trials investigating outcomes in patients treated based on metabolic information.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Radiation Therapy Overcomes Adverse Prognostic Role of Cyclooxygenase-2 Expression on Reed-Sternberg Cells in Early Hodgkin Lymphoma

Purpose: To analyze the role of radiation therapy (RT) on the adverse prognostic influence of cyclooxygenase-2 (COX-2) expression on Reed-Sternberg (RS) cells, in the setting of early Hodgkin lymphoma (HL) treated with ABVD (adriamycin, vinblastine, bleomycin, dacarbazine). Methods and Materials: In the present study we retrospectively investigated the prognostic value of COX-2 expression in a large (n=143), uniformly treated early HL population from the Spanish Network of HL using tissue microarrays. Univariate and multivariate analyses were done, including the most recognized clinical variables and the potential role of administration of adjuvant RT. Results: Median age was 31 years; the expression of COX-2 defined a subgroup with significantly worse prognosis. Considering COX-2{sup +} patients, those who received RT had significantly better 5-year progression-free survival (PFS) (80% vs 54% if no RT; P=.008). In contrast, COX-2{sup −} patients only had a modest, nonsignificant benefit from RT in terms of 5-year PFS (90% vs 79%; P=.13). When we compared the outcome of patients receiving RT considering the expression of COX-2 on RS cells, we found a nonsignificant 10% difference in terms of PFS between COX-2{sup +} and COX-2{sup −} patients (P=.09), whereas the difference between the 2 groups was important (25%) in patients not receiving RT (P=.04). Conclusions: Cyclooxygenase-2 RS cell expression is an adverse independent prognostic factor in early HL. Radiation therapy overcomes the worse prognosis associated with COX-2 expression on RS cells, acting in a chemotherapy-independent way. Cyclooxygenase-2 RS cell expression may be useful for determining patient candidates with early HL to receive consolidation with RT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Dosimetric Predictors of Radiation-Induced Vaginal Stenosis After Pelvic Radiation Therapy for Rectal and Anal Cancer

Purpose: Although vaginal stenosis (VS) is a recognized toxicity in women who receive pelvic radiation therapy (RT), the relationship between RT dose and the volume and extent of toxicity has not been analyzed. We modeled this relationship to identify predictors of VS. Methods and Materials: We evaluated 54 women, aged 29 to 78 years, who underwent pelvic RT for rectal or anal cancer during 2008 to 2011 and were enrolled in a prospective study evaluating vaginal dilator use. Maximum dilator size was measured before RT (baseline) and 1 month and 12 months after RT. Dilator use was initiated at 1 month. The difference (D) in dilator size before and after RT was recorded. Those with D ≤−1 were classified as having VS (n=35); those with D ≥0 were classified as having no VS (n=19 at 1 month). Dose-volume parameters were extracted, and the generalized equivalent uniform dose (gEUD) was used to build a predictive model. Results: The mean vaginal doses were 50.0 Gy and 36.8 Gy for anal and rectal cancer patients, respectively. One month after RT, a gEUD model using a wide range of a values suggests that sparing of vaginal volume to a low dose may be important. When gEUD (a = −1) was <35 Gy and the mean vaginal dose was <43 Gy, severe VS was reduced (P=.02). A 1-year analysis suggests increasingly negative D values with increasing mean dose. However, patients with compliance <40% were more likely to have toxicity. Conclusions: Vaginal stenosis is influenced by multiple RT dose-volume characteristics. Mean dose and gEUD constraints together may reduce the risk of severe VS. Patients receiving higher mean vaginal doses should have greater compliance with dilator therapy to minimize risk of toxicity. Further validation with independent datasets is needed.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Medical Student–Reported Outcomes of a Radiation Oncologist–Led Preclinical Course in Oncology: A Five-Year Analysis

Purpose: There is a recognized need for more robust training in oncology for medical students. At our institution, we have offered a core dedicated oncology block, led by a radiation oncologist course director, during the second year of the medical school curriculum since the 2008-2009 academic year. Herein, we report the outcomes of the oncology block over the past 5 years through an analysis of student perceptions of the course, both immediately after completion of the block and in the third year. Methods and Materials: We analyzed 2 separate surveys. The first assessed student impressions of how well the course met each of the course's learning objectives through a survey that was administered to students immediately after the oncology block in 2012. The second was administered after students completed the oncology block during the required radiology clerkship in the third year. All questions used a 5-level Likert scale and were analyzed by use of a Wilcoxon signed-rank test. Results: Of the 169 students who took the oncology course in 2012, 127 (75.1%) completed the course feedback survey. Over 73% of students agreed or strongly agreed that the course met its 3 learning objectives. Of the 699 medical students who took the required radiology clerkship between 2010 and 2013, 538 participated in the second survey, for a total response rate of 77%. Of these students, 368 (68.4%) agreed or strongly agreed that the course was effective in contributing to their overall medical education. Conclusion: Student perceptions of the oncology block are favorable and have improved across multiple categories since the inception of the course. Students self-reported that a dedicated preclinical oncology block was effective in helping identify the basics of cancer therapy and laying the foundation for clinical electives in oncology, including radiation oncology.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Technology for Innovation in Radiation Oncology

Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology,” which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

A Comparative Evaluation of Normal Tissue Doses for Patients Receiving Radiation Therapy for Hodgkin Lymphoma on the Childhood Cancer Survivor Study and Recent Children's Oncology Group Trials

Purpose: Survivors of pediatric Hodgkin lymphoma (HL) are recognized to have an increased risk of delayed adverse health outcomes related to radiation therapy (RT). However, the necessary latency required to observe these late effects means that the estimated risks apply to outdated treatments. We sought to compare the normal tissue dose received by children treated for HL and enrolled in the Childhood Cancer Survivor Study (CCSS) (diagnosed 1970-1986) with that of patients treated in recent Children's Oncology Group (COG) trials (enrolled 2002-2012). Methods and Materials: RT planning data were obtained for 50 HL survivors randomly sampled from the CCSS cohort and applied to computed tomography planning data sets to reconstruct the normal tissue dosimetry. For comparison, the normal tissue dosimetry data were obtained for all 191 patients with full computed tomography–based volumetric RT planning on COG protocols AHOD0031 and AHOD0831. Results: For early-stage patients, the mean female breast dose in the COG patients was on average 83.5% lower than that for CCSS patients, with an absolute reduction of 15.5 Gy. For advanced-stage patients, the mean breast dose was decreased on average by 70% (11.6 Gy average absolute dose reduction). The mean heart dose decreased on average by 22.9 Gy (68.6%) and 17.6 Gy (56.8%) for early- and advanced-stage patients, respectively. All dose comparisons for breast, heart, lung, and thyroid were significantly lower for patients in the COG trials than for the CCSS participants. Reductions in the prescribed dose were a major contributor to these dose reductions. Conclusions: These are the first data quantifying the significant reduction in the normal tissue dose using actual, rather than hypothetical, treatment plans for children with HL. These findings provide useful information when counseling families regarding the risks of contemporary RT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Comparison of Planning Quality and Efficiency Between Conventional and Knowledge-based Algorithms in Nasopharyngeal Cancer Patients Using Intensity Modulated Radiation Therapy

Purpose: Intensity modulated radiation therapy (IMRT) is widely used to achieve a highly conformal dose and improve treatment outcome. However, plan quality and planning time are institute and planner dependent, and no standardized tool exists to recognize an optimal plan. RapidPlan, a knowledge-based algorithm, can generate constraints to assist optimization and produce high-quality IMRT plans. This report evaluated the quality and efficiency of using RapidPlan in nasopharyngeal carcinoma (NPC) IMRT planning. Methods and Materials: RapidPlan was configured using 79 radical IMRT plans for NPC; 20 consecutive NPC patients indicated for radical radiation therapy between October 2014 and May 2015 were then recruited to assess its performance. The ability of RapidPlan to produce acceptable plans was evaluated. For plans that could not achieve clinical acceptance, manual touch-up was performed. The IMRT plans produced without RapidPlan (manual plans) and with RapidPlan (RP-2 plans, including those with manual touch-up) were compared in terms of dosimetric quality and planning efficiency. Results: RapidPlan by itself could produce clinically acceptable plans for 9 of the 20 patients; manual touch-up increased the number of acceptable plans (RP-2 plans) to 19. The target dose coverage and conformity were very similar. No difference was found in the maximum dose to the brainstem and optic chiasm. RP-2 plans delivered a higher maximum dose to the spinal cord (46.4 Gy vs 43.9 Gy, P=.002) but a lower dose to the parotid (mean dose to right parotid, 37.3 Gy vs 45.4 Gy; left, 34.4 Gy vs 43.1 Gy; P<.001) and the right cochlea (mean dose, 48.6 Gy vs 52.6 Gy; P=.02). The total planning time for RP-2 plans was significantly less than that for manual plans (64 minutes vs 295 minutes, P<.001). Conclusions: This study shows that RapidPlan can significantly improve planning efficiency and produce quality IMRT plans for NPC patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

The Radiation Oncology Job Market: The Economics and Policy of Workforce Regulation

Examinations of the US radiation oncology workforce offer inconsistent conclusions, but recent data raise significant concerns about an oversupply of physicians. Despite these concerns, residency slots continue to expand at an unprecedented pace. Employed radiation oncologists and professional corporations with weak contracts or loose ties to hospital administrators would be expected to suffer the greatest harm from an oversupply. The reduced cost of labor, however, would be expected to increase profitability for equipment owners, technology vendors, and entrenched professional groups. Policymakers must recognize that the number of practicing radiation oncologists is a poor surrogate for clinical capacity. There is likely to be significant opportunity to augment capacity without increasing the number of radiation oncologists by improving clinic efficiency and offering targeted incentives for geographic redistribution. Payment policy changes significantly threaten radiation oncologists' income, which may encourage physicians to care for greater patient loads, thereby obviating more personnel. Furthermore, the implementation of alternative payment models such as Medicare's Oncology Care Model threatens to decrease both the utilization and price of radiation therapy by turning referring providers into cost-conscious consumers. Medicare funds the vast majority of graduate medical education, but the extent to which the expansion in radiation oncology residency slots has been externally funded is unclear. Excess physician capacity carries a significant risk of harm to society by suboptimally allocating intellectual resources and creating comparative shortages in other, more needed disciplines. There are practical concerns associated with a market-based solution in which medical students self-regulate according to job availability, but antitrust law would likely forbid collaborative self-regulation that purports to restrict supply. Because Congress is unlikely to create one central body to govern residency controls for all specialties, we recommend better reporting of program-specific employment metrics and careful, intellectually honest re-evaluation of existing Accreditation Council for Graduate Medical Education accreditation standards.

61 RADIATION PROTECTION AND DOSIMETRY↗