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At least 127 records · Page 7

Computational Design of a Novel Medium-Carbon, Low-Alloy Steel Microalloyed with Niobium

The design of a new steel with specific properties is always challenging owing to the complex interactions of many variables. In this work, this challenge is dealt with by combining metallurgical principles with computational thermodynamics and kinetics to design a novel steel composition suitable for thermomechanical processing and induction heat treatment to achieve a hardness level in excess of 600 HV with the potential for good fracture toughness. CALPHAD-based packages for the thermodynamics and kinetics of phase transformations and diffusion, namely Thermo-Calc{sup ®} and JMatPro{sup ®}, have been combined with an interdendritic segregation tool (IDS) to optimize the contents of chromium, molybdenum and niobium in a proposed medium-carbon low-manganese steel composition. Important factors taken into account in the modeling and optimization were hardenability and as-quenched hardness, grain refinement and alloying cost. For further investigations and verification, the designed composition, i.e., in wt.% 0.40C, 0.20Si, 0.25Mn, 0.90Cr, 0.50Mo, was cast with two nominal levels of Nb: 0 and 0.012 wt.%. The results showed that an addition of Nb decreases the austenite grain size during casting and after slab reheating prior to hot rolling. Validation experiments showed that the predicted properties, i.e., hardness, hardenability and level of segregation, for the designed composition were realistic. It is also demonstrated that the applied procedure could be useful in reducing the number of experiments required for developing compositions for other new steels.

36 MATERIALS SCIENCE↗

An approach to contouring the dorsal vagal complex for radiotherapy planning

Multiple studies suggest that radiation dose to the area of the brainstem called the “dorsal vagal complex (DVC)” influences the frequency of nausea and vomiting during radiotherapy. The purpose of this didactic article is to describe the step-by-step process that we use to contour the general area of the DVC on axial computed tomography (CT) images as would be done for radiotherapy planning. The contouring procedure that we describe for contouring the area of the DVC is useful to medical dosimetrists and radiation oncologists.

61 RADIATION PROTECTION AND DOSIMETRY↗

Mammograms restoration by using Wiener filter

Restoration of digital mammograms, as a pre-processing tool, using deconvolution procedures, is analysed. It implies, knowing Modulation Transfer Function (MTF) of the mammography device and the estimation of the mammogram’s noise. Wiener filter is used, as the most objective in mammograms restoration by deconvolution. Using MATLAB program the deconvolution procedures are conducted in two ways with different level of approximation. The first method approximates the noise/signal power ratio by a constant and the second method uses autocorrelation functions of the noise and signals. Abilities and limitations of the methods are analysed and checked by using the raw images of the bar-pattern due to better visualisation of the obtained results. The raw images are obtained at a Computed Radiography (CR) mammography device in Clinical Centre in Podgorica. It is found that quality of the restored image highly depends of knowledge of type and magnitude of noise. In the both methods spatial resolution of the restored images are improved, but much better in a case where autocorrelation functions of the noise and signal are used. This procedure is proposed as an objective pre-processing tool to put back imperfectness of mammography devices.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

One-point remapping of Lagrangian perturbation theory in the mildly non-linear regime of cosmic structure formation

On the smallest scales, three-dimensional large-scale structure surveys contain a wealth of cosmological information which cannot be trivially extracted due to the non-linear dynamical evolution of the density field. Lagrangian perturbation theory (LPT) is widely applied to the generation of mock halo catalogs and data analysis. In this work, we compare topological features of the cosmic web such as voids, sheets, filaments and clusters, in the density fields predicted by LPT and full numerical simulation of gravitational large-scale structure formation. We propose a method designed to improve the correspondence between these density fields, in the mildly non-linear regime. We develop a computationally fast and flexible tool for a variety of cosmological applications. Our method is based on a remapping of the approximately-evolved density field, using information extracted from N-body simulations. The remapping procedure consists of replacing the one-point distribution of the density contrast by one which better accounts for the full gravitational dynamics. As a result, we obtain a physically more pertinent density field on a point-by-point basis, while also improving higher-order statistics predicted by LPT. We quantify the approximation error in the power spectrum and in the bispectrum as a function of scale and redshift. Our remapping procedure improves one-, two- and three-point statistics at scales down to 8 Mpc/h.

79 ASTRONOMY AND ASTROPHYSICS↗

Test Plan for the Boiling Water Reactor Dry Cask Simulator

The thermal performance of commercial nuclear spent fuel dry storage casks are evaluated through detailed numerical analysis . These modeling efforts are completed by the vendor to demonstrate performance and regulatory compliance. The calculations are then independently verified by the Nuclear Regulatory Commission (NRC). Carefully measured data sets generated from testing of full sized casks or smaller cask analogs are widely recognized as vital for validating these models. Recent advances in dry storage cask designs have significantly increased the maximum thermal load allowed in a cask in part by increasing the efficiency of internal conduction pathways and by increasing the internal convection through greater canister helium pressure. These same vertical, canistered cask systems rely on ventilation between the canister and the overpack to convect heat away from the canister to the environment for both above and below-ground configurations. While several testing programs have been previously conducted, these earlier validation attempts did not capture the effects of elevated helium pressures or accurately portray the external convection of above-ground and below-ground canistered dry cask systems. The purpose of the investigation described in this report is to produce a data set that can be used to test the validity of the assumptions associated with the calculations presently used to determine steady-state cladding temperatures in modern vertical, canistered dry cask systems. The BWR cask simulator (BCS) has been designed in detail for both the above-ground and below-ground venting configurations. The pressure vessel representing the canister has been designed, fabricated, and pressure tested for a maximum allowable pressure (MAWP) rating of 24 bar at 400 deg C. An existing electrically heated but otherwise prototypic BWR Incoloy-clad test assembly is being deployed inside of a representative storage basket and cylindrical pressure vessel that represents the canister. The symmetric single assembly geometry with well-controlled boundary conditions simplifies interpretation of results. Various configurations of outer concentric ducting will be used to mimic conditions for above and below-ground storage configurations of vertical, dry cask systems with canisters. Radial and axial temperature profiles will be measured for a wide range of decay power and helium cask pressures. Of particular interest is the evaluation of the effect of increased helium pressure on allowable heat load and the effect of simulated wind on a simplified below ground vent configuration. While incorporating the best available information, this test plan is subject to changes due to improved understanding from modeling or from as-built deviations to designs. As-built conditions and actual procedures will be documented in the final test report.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Determination of a Generic Human Error Probability Distribution, Part 1: A Dynamic Formulation of SPAR-H

In almost all major nuclear power plants (NPP) events include a significant human error component. As an example, in Fukushima Daiichi (2011) nuclear meltdown, the human actions related to the high-pressure injection cooling strongly affected accident evolution. Furthermore, in the Three Mile Island accident (1979) (which was initiated by a stuck open valve and thus was triggered a loss of coolant accident) the unit operators made decisions based upon false assumptions that contributed negatively to the accident. Given these premises, the ability to accurately model human interactions with plant evolution and, in particular, dynamically calculate human error probability (HEP) plays a major role in a probabilistic risk analysis (PRA). Human reliability analysis (HRA) identifies and models the causes of human errors, and quantifies HEP by applying different methodologies. HRA methods identify errors and reflect on the understanding of error-prone people and systems. There are a number of HRA methods available that assist in identifying the vulnerabilities in the system and provide guidance in determining the HEP. HEP is the probability of a human failure event (HFE), and quantification of HEPs under various situations is utilized in PRA of large complex systems. One of the more prominent HRA methods is the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) method that was developed to estimate HEPs for the use in the Standardized Plant Analysis Risk (SPAR) PRA models employed in U.S. NPPs. SPAR-H is implemented in U.S. NPPs by regulators at the U.S. Nuclear Regulatory Commission (NRC) to determine the HEP based on expert estimation through the use of calculation worksheets. In SPAR-H, the nominal HEPs (NHEPs) are multiplied by performance shaping factors (PSF) multiplier values to obtain the overall error probability. PSFs encompass the human components, individual characteristics, their environment, and aspects of the task. With PSFs, the goal is to capture all factors that can affect human performance. In SPAR-H there are eight PSFs used, each having respective levels corresponding to multipliers: Available Time, Stress/Stressors, Complexity, Experience/Training, Procedures, Ergonomics/Human Machine Interface, Fitness for Duty, and Work Processes. The PSF multipliers indicate enhanced, nominal, or degraded human performance. The SPAR-H method estimates the HEP through multiplying a NHEP with PSFs. Hence, SPAR-H is a traditional HRA method that assesses human performance at a fixed, or static, point in time. In a dynamic HRA framework, human performance is assessed on a continuous time basis. SPAR-H can be used within a dynamic PRA framework through the use of simulation and stochastic models. The goal of dynamic HRA is to build a more realistic model of the human-system interaction to enhance calculation of reliability, risk and safety analysis. The progression of events in dynamic SPAR-H considers that some PSFs may experience gradual change, while other change can be sudden due to individualistic differences or rapid plant status changes. The PSF changes are caused by contextual changes in the scenario. For example, as more time passes, the realization that a task should be completed sooner may cause the operator more stress. In another example, a sudden relay of information about sickness of a family member may alter the operator's general stress level and fitness for duty. Each PSF has a different dynamic nature; PSFs like stress and complexity change more quickly over the course of a task than experience and training. While the experience of an operator changes over the course of attaining the objective, the amount that this added experience changes the HEP is very minimal. In contrast, the stress, complexity, and procedures PSFs may change quite a bit over the course of task completion.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Deformable Image Registration for Adaptive Radiation Therapy of Head and Neck Cancer: Accuracy and Precision in the Presence of Tumor Changes

Purpose: To compare deformable image registration (DIR) accuracy and precision for normal and tumor tissues in head and neck cancer patients during the course of radiation therapy (RT). Methods and Materials: Thirteen patients with oropharyngeal tumors, who underwent submucosal implantation of small gold markers (average 6, range 4-10) around the tumor and were treated with RT were retrospectively selected. Two observers identified 15 anatomical features (landmarks) representative of normal tissues in the planning computed tomography (pCT) scan and in weekly cone beam CTs (CBCTs). Gold markers were digitally removed after semiautomatic identification in pCTs and CBCTs. Subsequently, landmarks and gold markers on pCT were propagated to CBCTs, using a b-spline-based DIR and, for comparison, rigid registration (RR). To account for observer variability, the pair-wise difference analysis of variance method was applied. DIR accuracy (systematic error) and precision (random error) for landmarks and gold markers were quantified. Time trend of the precisions for RR and DIR over the weekly CBCTs were evaluated. Results: DIR accuracies were submillimeter and similar for normal and tumor tissue. DIR precision (1 SD) on the other hand was significantly different (P<.01), with 2.2 mm vector length in normal tissue versus 3.3 mm in tumor tissue. No significant time trend in DIR precision was found for normal tissue, whereas in tumor, DIR precision was significantly (P<.009) degraded during the course of treatment by 0.21 mm/week. Conclusions: DIR for tumor registration proved to be less precise than that for normal tissues due to limited contrast and complex non-elastic tumor response. Caution should therefore be exercised when applying DIR for tumor changes in adaptive procedures.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Breast tumor segmentation in high resolution x-ray phase contrast analyzer based computed tomography

Purpose: Phase contrast computed tomography has emerged as an imaging method, which is able to outperform present day clinical mammography in breast tumor visualization while maintaining an equivalent average dose. To this day, no segmentation technique takes into account the specificity of the phase contrast signal. In this study, the authors propose a new mathematical framework for human-guided breast tumor segmentation. This method has been applied to high-resolution images of excised human organs, each of several gigabytes. Methods: The authors present a segmentation procedure based on the viscous watershed transform and demonstrate the efficacy of this method on analyzer based phase contrast images. The segmentation of tumors inside two full human breasts is then shown as an example of this procedure’s possible applications. Results: A correct and precise identification of the tumor boundaries was obtained and confirmed by manual contouring performed independently by four experienced radiologists. Conclusions: The authors demonstrate that applying the watershed viscous transform allows them to perform the segmentation of tumors in high-resolution x-ray analyzer based phase contrast breast computed tomography images. Combining the additional information provided by the segmentation procedure with the already high definition of morphological details and tissue boundaries offered by phase contrast imaging techniques, will represent a valuable multistep procedure to be used in future medical diagnostic applications.

60 APPLIED LIFE SCIENCES↗

A model-based scatter artifacts correction for cone beam CT

Purpose: Due to the increased axial coverage of multislice computed tomography (CT) and the introduction of flat detectors, the size of x-ray illumination fields has grown dramatically, causing an increase in scatter radiation. For CT imaging, scatter is a significant issue that introduces shading artifact, streaks, as well as reduced contrast and Hounsfield Units (HU) accuracy. The purpose of this work is to provide a fast and accurate scatter artifacts correction algorithm for cone beam CT (CBCT) imaging. Methods: The method starts with an estimation of coarse scatter profiles for a set of CBCT data in either image domain or projection domain. A denoising algorithm designed specifically for Poisson signals is then applied to derive the final scatter distribution. Qualitative and quantitative evaluations using thorax and abdomen phantoms with Monte Carlo (MC) simulations, experimental Catphan phantom data, and in vivo human data acquired for a clinical image guided radiation therapy were performed. Scatter correction in both projection domain and image domain was conducted and the influences of segmentation method, mismatched attenuation coefficients, and spectrum model as well as parameter selection were also investigated. Results: Results show that the proposed algorithm can significantly reduce scatter artifacts and recover the correct HU in either projection domain or image domain. For the MC thorax phantom study, four-components segmentation yields the best results, while the results of three-components segmentation are still acceptable. The parameters (iteration number K and weight β) affect the accuracy of the scatter correction and the results get improved as K and β increase. It was found that variations in attenuation coefficient accuracies only slightly impact the performance of the proposed processing. For the Catphan phantom data, the mean value over all pixels in the residual image is reduced from −21.8 to −0.2 HU and 0.7 HU for projection domain and image domain, respectively. The contrast of the in vivo human images is greatly improved after correction. Conclusions: The software-based technique has a number of advantages, such as high computational efficiency and accuracy, and the capability of performing scatter correction without modifying the clinical workflow (i.e., no extra scan/measurement data are needed) or modifying the imaging hardware. When implemented practically, this should improve the accuracy of CBCT image quantitation and significantly impact CBCT-based interventional procedures and adaptive radiation therapy.

60 APPLIED LIFE SCIENCES↗

Simultaneous Implementation of NiSWAP and NSWAP Gates Using N + 1 Qubits in a Cavity or Coupled to a Circuit

We propose an effective method to realize NiSWAP and NSWAP gates in a cavity or coupled to a circuit driven by a strong microwave field. The scheme is insensitive to the initial state of the resonator mode, and the operation time is independent of the number of qubits involved in the gates operations. These logic gates can be realized in a time much shorter than the radiative time and the lifetime of the cavity photon, and can be realized in a time (nanosecond-scale) much smaller than the decoherence time and the dephasing time (microsecond-scale) in circuit QED. Numerical simulation under the influence of the gates operations shows that the scheme can be implemented with high fidelity. We also propose a detailed procedure and experimentally analyze its feasibility. Moreover, the scheme might be experimentally achieved efficiently within current state-of-the-art technology.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Life Extension of Nuclear Plant Facilities through Monitoring and Detailed Analysis - 16175

The UK has accumulated a substantial legacy of radioactive waste from various civil nuclear and defence programmes. Presently, however most of the UK radioactive waste is generated from nine power stations which generate approximately one sixth of the of the country's electricity. Irradiated fuel is removed from these reactors and safe management of the radioactive solid and liquid effluents is required. The safe management of these effluents is essential. Sellafield, in West Cumbria UK, contains two reprocessing plants, one designed to process nuclear fuel from Magnox reactors (CO{sub 2} cooled with Uranium bar fuel) and the other to process nuclear fuel from Advanced Gas cooled Reactors and Pressurized Water Reactors. The reprocessing stage enables extraction of fissile material for recycling. This leaves a volume of dilute but high-level waste. The high-level radioactive liquid waste is concentrated to reduce its volume and then incorporated into borosilicate glass, using a process called vitrification. The glass is then poured into stainless steel containers and placed in long term storage. This required concentration of HLW liquor is achieved using a suite of aging evaporators. All evaporators are of similar design constructed from corrosion resistant stainless steel having dimensions height ∼11 m, internal diameter 3.05 m and capable of holding 13.7 m{sup 3} of liquor. The basic principle of operation is to heat the dilute liquor under partial vacuum, at constant volume, until the target concentration is achieved. Heating of the liquor is achieved using steam heated coils within the evaporator, and steam in the jacket which surrounds the lower half of the evaporator vessel. The evaporator is then brought to atmospheric pressure and the concentrated liquor is ejected whilst hot. The evaporator is then cooled with water cooled coils and a water filled jacket. New dilute liquor is then added for a new batch. The process is then repeated. As the evaporators reach the end of their original design life accurate prediction of the current condition of nuclear plant facilities is essential to safely justify continued plant operation by ensuring structural integrity. This poses a significant challenge as many aging UK nuclear facilities were not inherently built with inspection in mind. The potential life limiting components of the HA evaporators at Sellafield are the surfaces that contact the product liquor at elevated temperatures i.e. the steam heated surfaces of the coils within the evaporator vessel and the vessel base and wall surrounded by the steam jacket. Each heating component is critical to the operational life of the evaporator - the removal from service of a coil heating component significantly reduces the operational flexibility and remnant life of this plant. Over the last decade a variety of cutting-edge expertise and methodologies have been utilised to accurately measure and then predict the current condition of the plant and also to predict its remnant life. This paper provides an overview of the development of several techniques deployed, namely non-destructive testing/inspection, in-house software development and finite element modelling. These methods have been validated by lab-scale or full-scale experiments along with historical plant data. These techniques have been evolved and refined for over a decade, providing vital insights into the physical behaviour of this complex reprocessing system. This enables not only accurate assessment of the current condition of the plant equipment but also allows scientifically underpinned predictions to be made of how it will behave into the future. This is critical for Sellafield as this knowledge feeds into their safety case to the Office of Nuclear Regulation to justify continued operation. It is concluded that this integrated approach provides a robust analysis tool which has driven change and optimisation of plant procedures ensuring continued safe operation whilst extending the life of the facility. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

CT-Guided Interventions Using a Free-Hand, Optical Tracking System: Initial Clinical Experience

PurposeThe present study was designed to evaluate the geometrical accuracy and clinical applicability of a new, free-hand, CT-guided, optical navigation system.MethodsFifteen procedures in 14 consecutive patients were retrospectively analyzed. The navigation system was applied for interventional procedures on small target lesions, in cases with long needle paths, narrow access windows, or when an out-of-plane access was expected. Mean lesion volume was 27.9 ml, and mean distance to target measured was 107.5 mm. Eleven of 15 needle trajectories were planned as out-of-plane approaches regarding the axial CT plane.ResultsNinety-one percent of the biopsies were diagnostic. All therapeutic interventions were technically successful. Targeting precision was high with a mean distance of the needle tip from planned target of 1.98 mm. Mean intervention time was 1:12 h. A statistically significant correlation between angular needle deviation and intervention time (p = 0.007), respiratory movement of the target (p = 0.008), and body mass index (p = 0.02) was detected. None of the evaluated parameters correlated significantly with the distance from the needle tip to the planned target.ConclusionsThe application of a navigation system for complex CT-guided procedures provided safe and effective targeting within a reasonable intervention time in our series.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

The Usefulness of Virtual Fluoroscopic Preprocedural Planning During Percutaneous Transhepatic Biliary Drainage

Purpose To retrospectively evaluate the usefulness of virtual fluoroscopic preprocedural planning (VFPP) in the percutaneous transhepatic biliary drainage (PTBD) procedure.Materials and MethodsTwenty-two patients who were treated by PTBD were included in this study. Twelve patients were treated using PTBD intraoperative referencing coronal computed tomography (CT) images (i.e., coronal CT group), and ten patients were treated using PTBD intraoperative referencing VFPP images (i.e., VFPP group). To analyze the effect of the intraoperative referencing VFPP image, the VFPP group was retrospectively compared with the coronal CT group.ResultsThe characteristics of both patient groups were not statistically significantly different. There were no significant differences in the targeted bile duct, diameter and depth of the target bile, breath-holding ability, number of targeted bile duct puncture attempts, change in the targeted bile duct, and exchange of the drainage catheter. However, the X-ray fluoroscopy time and the procedure time were significantly shorter in the VFPP group than in the coronal CT group (196 vs. 334 s, P < 0.05; and 16.0 vs. 27.2 min, P < 0.05).ConclusionIntraoperative referencing using the VFPP imaging in PTBD intuitively can be a useful tool for better localization of the guidewire in the bile duct and thereby shorten the X-ray fluoroscopy time and procedure time while minimizing radiation exposure and complications.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Validation and bias quantification of criticality safety codes for SRNS operations

The validation and bias quantification methods employed by the Criticality Safety Engineering group at Savannah River Nuclear Solutions (SRNS) are discussed. Both SCALE and MCNP are validated against benchmark experiments, where these benchmark models have been divided into subgroups representative of the types of fissile material operations at SRNS. A quantification of the bias is made for each subgroup for each code and the three methods employed for quantification are discussed. The bias information is employed directly in the establishment of the Upper Safety Limit (USL) value of the neutron multiplication factor when using standardized documented SRNS methods. A simple example of validation and bias quantification is given and the procedure for setting the USL using the derived bias information is also presented. (authors)

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

Tuning and Verification of an Internal Flooding Model for Dynamic PRA

In probabilistic risk assessment (PRA), the likelihoods and consequences of basic events are combined to determine possible system level outcomes and the likelihood of each outcome given an initial event. Both the consequences and likelihoods of basic events may be informed by the use of mathematical models or experimental data regarding the phenomena of interest. In either case, the impact of uncertainties on the results need to be evaluated. If a model is used to predict the evolution of an initiating event, uncertainty quantification can be computationally challenging for complex phenomena with many epistemic (e.g., model) uncertainties. In this work, a reduced order model is introduced for the flooding analysis of a multi-room building at a nuclear power plant under uncertainties which can require long run times using high fidelity computer models. The reduced order model focuses on macro-level transfer of water between rooms and tracks the water level within each room. In order to verify the model's fidelity, its results for the phenomena involved in a scenario of interest are compared to those of a computational fluid dynamics (CFD) code, which are taken to represent reality. This work does not focus on the overall fidelity of the flooding model, as the goal of the project for which it was developed is to develop a methodology rather than to analyze a particular case. The focus instead is on the tunability and verifiability of the reduced order model for relevant physical measures. In analyzing a particular case, the model may be required to incorporate more realistic description of phenomena; however, the procedure described in this work may be used to verify its performance as well. (authors)

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Retrospective review of thoracic neural damage during lung ablation - what the interventional radiologist needs to know about neural thoracic anatomy

Background and Purpose: Radiofrequency ablation (RFA) is associated with low neural morbidity compared with surgery, which commonly causes debilitating long-term pain. The purpose was to review the thoracic neural anatomy relevant to percutaneous RFA and to retrospectively review symptomatic nerve injury after lung RFA at our institution. Materials and Methods: We retrospectively examined all symptomatic nerve injuries occurring after computed tomography (CT)-guided RFA treatment of lung tumors for 462 patients/509 procedures/708 lesions treated at our large tertiary referral centre during 10 years. Results: Eight patients experienced neurological complications after heating during the RFA procedure. These complications occurred in the phrenic (n = 1), brachial (n = 3), left recurrent (n = 1), and intercostal nerves (n = 2) and the stellate ganglion (n = 1). Three were grade 2, four grade 3 and one grade 4 injuries (CTCAE v3). Conclusion: Although rare, neurological complications can occur after RFA, and they can occasionally be severe. To prevent these complications, it is important for the interventional radiologist to be aware of the anatomy of nervous structures and to attempt to identify nerves on CT scans during the RFA procedure. Creating a pneumothorax can be useful to avoid nerve damage and related clinical complications.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Delayed-Phase Cone-Beam CT Improves Detectability of Intrahepatic Cholangiocarcinoma During Conventional Transarterial Chemoembolization

PurposeTo evaluate the detectability of intrahepatic cholangiocarcinoma (ICC) on dual-phase cone-beam CT (DPCBCT) during conventional transarterial chemoembolization (cTACE) compared to that of digital subtraction angiography (DSA) with respect to pre-procedure contrast-enhanced magnetic resonance imaging (CE-MRI) of the liver.MethodsThis retrospective study included 17 consecutive patients (10 male, mean age 64) with ICC who underwent pre-procedure CE-MRI of the liver, and DSA and DPCBCT (early-arterial phase (EAP) and delayed-arterial phase (DAP)) just before cTACE. The visibility of each ICC lesion was graded by two radiologists on a three-rank scale (complete, partial, and none) on DPCBCT and DSA images, and then compared to pre-procedure CE-MRI.ResultsOf 61 ICC lesions, only 45.9 % were depicted by DSA, whereas EAP- and DAP-CBCT yielded a significantly higher detectability rate of 73.8 % and 93.4 %, respectively (p < 0.01). Out of the 33 lesions missed on DSA, 18 (54.5 %) and 30 (90.9 %) were revealed on EAP- and DAP-CBCT images, respectively. DSA depicted only one lesion that was missed by DPCBCT due to streak artifacts caused by a prosthetic mitral valve. DAP-CBCT identified significantly more lesions than EAP-CBCT (p < 0.01). Conversely, EAP-CBCT did not detect lesions missed by DAP-CBCT. For complete lesion visibility, DAP-CBCT yielded significantly higher detectability (78.7 %) compared to EAP (31.1 %) and DSA (21.3 %) (p < 0.01).ConclusionDPCBCT, and especially the DAP-CBCT, significantly improved the detectability of ICC lesions during cTACE compared to DSA. We recommend the routine use of DAP-CBCT in patients with ICC for per-procedure detectability and treatment planning in the setting of TACE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Digestive Tract Complications of Renal Cryoablation

We report a case each of duodenorenal and colorenal fistula that arose after computed tomography-guided percutaneous cryoablation (PCA) for renal cell carcinoma and use imaging and endoscopic findings to analyze their causes and mechanisms. Both complications occurred though the edge of the iceball did not touch the intestinal wall, and patients’ symptoms and fistula formation occurred several days after the PCA procedure. Based on imaging and endoscopy findings, we suspected the colorenal fistula resulted from bowel injury caused by ischemia from the occlusion of small vessels at the procedure’s low temperature. Both cases were resolved conservatively without surgical intervention.

62 RADIOLOGY AND NUCLEAR MEDICINE↗