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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 OSTI2011

Assessment of transboundary environmental effects in the Pearl River Delta Region: Is there a role for strategic environmental assessment?

China's EIA Law does not require transboundary proposals to be assessed, despite recognition of this globally, for example in the Espoo Convention and Kiev Protocol, and in the European EIA and SEA Directives. In a transboundary context assessment within a state is unusual, as regulating these effects is primarily about the relationship between states. However where a state has more than one legal system such as in the Pearl River Delta (PRD) Region of southern China, transboundary effects should also be addressed. Yet despite the geographical connections between Guangdong Province in mainland China (where the EIA Law applies) and the Hong Kong and Macau Special Administrative Regions (which have their own provisions, neither of which requires transboundary assessments), EIA and SEA are carried out separately. Coordinated or joint approaches to transboundary assessment are generally absent, with the legal autonomy of Hong Kong and Macau a major constraint. As a result institutional responses at the policy level have developed. The article considers global experiences with regulating transboundary EIA and SEA, and analyses potential application to land use, transport and air and water planning in the PRD Region. If applied, benefits may include prevention or mitigation of cumulative effects, broader public participation, and improvements to environmental governance. The PRD Region experience may encourage China to conduct and coordinate EIA and SEA processes with neighbouring states, which has been non-existent or extremely limited to date.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2016

With Whom Does LANL Publish? – A look at LANL collaborations from 1990 -2015 using the Web of Science

Collaborations are critical to the science, technology, and engineering achievements at Los Alamos National Laboratory (LANL). This report analyzed the collaborations as measured through peer-reviewed publications from the Web of Science (WoS) database for LANL for the 1990 – 2015 period. Both a cumulative analysis over the entire time period and annual analyses were performed. The results found that the Department of Energy national laboratories, University of California campuses, and other academic institutions collaborate with LANL on regular basis. Results provide insights into trends in peer-reviewed papers collaborations for LANL.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2023

Probabilistic Multi-Hazard Performance Assessment of Concrete Structures in Nuclear Installations

Concrete structures in nuclear installations are subject to time-dependent degradation mechanisms that can deteriorate their physical and mechanical properties, potentially exacerbating the risk of structural failure under external forces such as a seismic event. Previous research has extensively investigated the seismic response of nuclear concrete structures and the associated risk, as well as their effect on structural components safety margins. However, substantial work is still necessary to incorporate concrete aging effects into such evaluations. In fact, most models in the literature assume pristine concrete conditions and do not account for the impact of aging on the structural components’ fragility curves. This work identifies relevant time-dependent degradation mechanisms and provides simplified models to predict the the evolution of key material properties based on data from the literature. Namely, this work focuses on the aging effects of corrosion, alkali–silica reaction (ASR), and irradiation on reinforced concrete within US Department of Energy (DOE) nuclear facilities and nuclear power plants (NPP) structures. Furthermore, degradation models based on literature data are presented that define the relationship between probabilistic material properties and the concrete’s age. In this work, sampled material properties served as input for a simplified finite element model (FEM) of a critical nuclear structural system, with the output of the FEM being the seismic response for a given ground motion. The results of the FEM were then used within a probabilistic performance assessment with a statistically significant number of samples. The research presented herein addresses the detrimental effects of hazards caused by natural phenomena on deteriorated concrete elements of nuclear installations. This work directly benefits the safety analysis performed on US DOE/ National Nuclear Security Administration (NNSA) nuclear facilities located in areas prone to seismic activity. The results presented herein could aid in the improvement of DOE-STD-1020, the DOE Standard that addresses seismic risk analysis and capacity evaluation in DOE facilities. DOE-STD-1020 refers to the requirements in American Society of Civil Engineers (ASCE) 4-98, now superseded by ASCE 4-16, that shall be met in performing dynamic response analyses and generating in-structure response spectra, provided that such requirements are consistent with the requirements of ASCE/Structural Engineering Institute (SEI) 43-05. Moreover, the results presented herein could also aid in the updating of section C3.1.1. of ASCE 4-16 to account for the effects of aging on the stiffness of reinforced elements and American Concrete Institute (ACI) 349.3R-18, “Report on Evaluation and Repair of Existing Nuclear Safety-Related Concrete Structures.” Ultimately, this work can assist the risk assessment of potential lifetime extension of the existing US commercial nuclear fleet (light water reactors) and the safety analysis of the emerging advanced nuclear reactors. The proposed proof-of-concept methodology employs open-source DOE computational tools and is transferable to commercial software commonly used by engineering firms.

42 ENGINEERING↗
NASA NTRS2012

Alterations of Cellular Immune Reactions in Crew Members Overwintering in the Antarctic Research Station Concordia

Background: Concordia Station is located inside Antarctica about 1000km from the coast at an altitude of 3200m (Dome C). Hence, individuals living in this harsh environment are exposed to two major conditions: 1.) hypobaric hypoxia and 2.) confinement and extreme isolation. Both hypoxia and confinement can affect human immunity and health, and are likely to be present during exploration class space missions. This study focused on immune alterations measured by a new global immunity test assay, similar to the phased out delayed type hypersensitivity (DTH) skin test. Methods: After informed written consent 14 healthy male subjects were included to the CHOICE-study (Consequences-of-longterm-Confinement-and-Hypobaric-HypOxia-on-Immunity-in-the Antarctic-Concordia-Environment). Data collection occurred during two winter-over periods lasting each one year. During the first campaign 6 healthy male were enrolled followed by a second campaign with 8 healthy males. Blood was drawn monthly and incubated for 48h with various bacterial, viral and fungal antigens followed by an analysis of plasma cytokine levels (TNF-alpha, IL2, IFN-gamma, IL10). As a control, blood was incubated without stimulation ("resting condition"). Goals: The scope of this study was to assess the consequences of hypoxia and confinement on cellular immunity as assessed by a new in vitro DTH-like test. Results: Initial results indicate that under resting conditions the in vitro DTH-like test showed low cytokine levels which remained almost unchanged during the entire observation period. However, cytokine responses to viral, bacterial and fungal antigens were remarkably reduced at the first month after arrival at Concordia when compared to levels measured in Europe prior to departure for Antarctica. With incrementing months of confinement this depressed DTH-like response tended to reverse, and in fact to show an "overshooting" immune reaction after stimulation. Conclusion: The reduced in vitro DTH-like test response in the early phase of Antarctic wintering over con rms distinct immune suppressive effects seen after (sub-)acute hypobaric hypoxia. The reversal and overshooting reaction of cellular immune responses upon stimulation, but not the resting state, indicate either a) priming of immune answers and/or b) an uncoupled or disregulated control of cellular immune answers by auto-, para- and endocrine pathways. Further analyses and correlations are warranted. Acknowledgement: Supported by the European Space Agency (ESA), the French (IPEV) and Italian (PNRA) polar institutes, the German National Space Program (DLR, 50WB0719/WB0919), by BELSPO/PROEDEX/ESA (C90-380/-391), NASA and by the Concordia crews who have participated with great enthusiasm.

Crucian, Brian↗
DOE OSTI2022

LCA Tools Available at NETL

This presentation was given at the virtual kickoff meeting for funding opportunity announcements 2596 and 2598 - University Training and Research for Fossil Energy and Carbon Management - UCR and Minority Serving Institutions (MSIs). The presentation covered available and in progress tools that can help carbon capture projects perform environmental life cycle analyses (LCAs). The presentation also briefly covers working being performed by the NETL LCA team.

Jamieson, Matthew↗
DOE OSTI2019

In-House Alternative for Chemical Analyses of Rhenium and Sulfur in Glass

Accurate measurements of rhenium (Re) and sulfur (S) concentrations in solid samples are of critical importance for the key research activities at the Pacific Northwest National Laboratory (PNNL) Waste Form Development Laboratory (WFDL) related to Re behavior during waste glass melting process and solubility of S in glass. Southwest Research Institute (SwRI) has provided reliable services for chemical analysis needs at WFDL; however, its long turnaround time, occasionally up to 5 months, has caused some difficulties. An in-house method was developed for dissolving and fusing glass and feed samples in preparation for analyses by inductively coupled plasma-optical emission spectrometry and -mass spectrometry at a PNNL facility. Using a previously developed sodium hydroxide fusion method as a basis, four groups of samples from Hanford waste glass research were digested and fused at WFDL. The samples included 1) Enhanced low-activity waste glass correlation phase 2/3 melter glasses from the Vitreous State Laboratory at the Catholic University of America, 2) AN-102 dried feeds and glasses, 3) SS-AN-102 dried feeds and glasses, and 4) Integrated Research Project S solubility study glasses. We evaluated three different sets of solution preparation and analysis combinations, which included 1) a WFDL-prepared solution analyzed at SwRI, 2) a PNNLprepared solution analyzed at a laboratory in the Building-331at PNNL, and 3) an SwRIprepared solution analyzed at SwRI. We concluded that the PNNL in-house Re results can be used in parallel with the SwRI data based on the relative standard deviation values less than 6% from three different sets of solution preparation and analysis for all three groups of rhenium-containing samples tested. However, it was proposed that the in-house S data be used for the barium oxide-free glasses only because of the issue of barium sulfate precipitation in digestion/fusion solutions prepared from glasses containing barium oxide. In addition, higher analytical biases between the PNNL and SwRI S results are expected compared to the Re results, based on the relative standard deviation values of less than 10% from three different sets of solution preparation and analysis for two groups of S-containing samples.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2020

The role of nuclear in China’s energy future: insights from integrated assessment

China, the world’s largest electricity consumer, has strong motivations to deploy nuclear power due to increasing electricity demand and environmental concerns. However, there are social, institutional, and technical barriers to future nuclear expansion. This paper provides an updated assessment of nuclear energy potential in China with analyses at both national and provincial levels and compares results with studies previously conducted. Using an integrated assessment model, this paper considers the interactions among different socioeconomic development pathways, technology options, climate policies, and social/political concerns on inland siting. Among all factors explored, climate policies have the most significant impact on accelerating the deployment of nuclear technologies. Inland siting of nuclear power plants increases total capacity, but the impact is limited without climate policy. The amount of annual nuclear generation across scenarios and studies is unlikely to rise above 11% by 2030 and 30% by 2050 of total Chinese electricity generation. A dramatic increase in total Chinese nuclear energy generating capacity – around 3900 TWh of nuclear generation by 2050 – is only possible in scenarios where China sees electricity demand increase substantially, sticks to and tightens its current Paris Accord commitments, achieves low costs of nuclear technologies, and allows inland siting of nuclear power plants.

China, integrated assesment, Nuclear Power Plants↗
DOE OSTI2025

Final design of outer poloidal field coils for COMPASS Upgrade

The paper aims to provide an overview of the final design of the outer poloidal field coils system for COMPASS Upgrade. Due to a relatively unique combination of design features of the new device (placement in high toroidal magnetic field, copper coils sub-cooled to liquid nitrogen temperature, hot vacuum vessel operation), the poloidal field coils design faced several interesting engineering challenges. Most notably high electromagnetic stress in the coil conductor, compatibility of the insulation to thermal and mechanical stress and design of coil supports with given spatial constraints while able to accommodate coil movements and withstand considerable mechanical stress. In conclusion, the paper describes solution to these challenges together with underlying analyses and mechanical tests.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗
DOE OSTI2013

Influence of spatial beam inhomogeneities on the parameters of a petawatt laser system based on multi-stage parametric amplification

We have developed a technique for investigating the evolution of spatial inhomogeneities in high-power laser systems based on multi-stage parametric amplification. A linearised model of the inhomogeneity development is first devised for parametric amplification with the small-scale self-focusing taken into account. It is shown that the application of this model gives the results consistent (with high accuracy and in a wide range of inhomogeneity parameters) with the calculation without approximations. Using the linearised model, we have analysed the development of spatial inhomogeneities in a petawatt laser system based on multi-stage parametric amplification, developed at the Institute of Laser Physics, Siberian Branch of the Russian Academy of Sciences (ILP SB RAS). (control of laser radiation parameters)

43 PARTICLE ACCELERATORS↗
DOE OSTI2024

Mechanisms of regulation of the rhizosphere, roots and shoots of naive poplars

Trees are associated with a broad range of microorganisms colonising the diverse tissues of their host. However, the early dynamics of the microbiota assembly microbiota from the root to shoot axis and how it is linked to root exudates and metabolite contents of tissues remain unclear. Here, we characterised how fungal and bacterial communities are altering root exudates as well as root and shoot metabolomes in parallel with their establishment in poplar cuttings (Populus tremula x tremuloides clone T89) over 30 days of growth. Sterile poplar cuttings were planted in natural or gamma irradiated soils. Bulk and rhizospheric soils, root and shoot tissues were collected from day 1 to day 30 to track the dynamic changes of fungal and bacterial communities in the different habitats by DNA metabarcoding. Root exudates and root and shoot metabolites were analysed in parallel by gas chromatography-mass spectrometry.

09 BIOMASS FUELS↗
NASA NTRS1974

Short-range forecasts with the GISS model of the global atmosphere

A nine-layer, primitive equation (PE) model of the global atmosphere developed at the Goddard Institute for Space Studies (GISS) has been used to generate six 48-hr forecasts during December 1972 and January 1973. Operational analyses north of 18 N and experimental global analyses made available by the National Meteorological Center (NMC), NOAA, were used as the initial conditions; the operational analyses were used to verify the forecasts at 12-hr intervals over the Northern Hemisphere north of 22 N. The combined analyses were used to verify the forecasts in the global domain. RMS errors of the sea-level pressure, 1000-mb heights, and vector geostrophic winds, and 500-mb heights and vector geostrophic winds indicate that the GISS forecasts have skill comparable to those made by operational PE models.

Druyan, L. M.↗
DOE OSTI2014

Prevalence and Predictors of Neoadjuvant Therapy for Stage IIIA Non-Small Cell Lung Cancer in the National Cancer Database: Importance of Socioeconomic Status and Treating Institution

Purpose: The optimal locoregional therapy for stage IIIA non-small cell lung cancer (NSCLC) is controversial, with definitive chemoradiation therapy (CRT) and neoadjuvant therapy followed by surgery (NT-S) serving as competing strategies. In this study, we used the National Cancer Database to determine the prevalence and predictors of NT in a large, modern cohort of patients. Methods and Materials: Patients with stage IIIA NSCLC treated with CRT or NT-S between 2003 and 2010 at programs accredited by the Commission on Cancer were included. Predictors were categorized as clinical, time/geographic, socioeconomic, and institutional. In accord with the National Cancer Database, institutions were classified as academic/research program and as comprehensive and noncomprehensive community cancer centers. Logistic regression and random effects multilevel logistic regression were performed for univariable and multivariable analyses, respectively. Results: The cohort consisted of 18,581 patients, 3,087 (16.6%) of whom underwent NT-S (10.6% induction CRT, 6% induction chemotherapy). The prevalence of NT-S was constant over time, but there were significant relative 31% and 30% decreases in pneumonectomy and right-sided pneumonectomy, respectively, over time (P trend <.02). In addition to younger age, lower T stage, and favorable comorbidity score, indicators of higher socioeconomic status were strong independent predictors of NT-S, including white race, higher income, and private/managed insurance. The type of institution (academic/research program vs comprehensive or noncomprehensive community cancer centers, odds ratio 1.54 and 2.08, respectively) strongly predicted NT-S, but treatment volume did not. Conclusions: Neoadjuvant therapy followed by surgery was an uncommon treatment approach in Commission on Cancer programs, and the prevalence of postinduction pneumonectomy decreased over time. Higher socioeconomic status and treatment at academic institutions were significant predictors of NT-S. Further research should be performed to enable a better understanding of these disparities.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2025

Strategies for community-sourced biocuration in bioinformatics: a case study on MIBiG 4.0

Biocuration is essential to transform molecular sequence data into standardized, machine-readable resources. Such curated datasets enable comparative analysis, predictive modeling, and data integration across bioinformatics platforms. While professional biocuration is resource-intensive and usually limited to institutional settings, community-driven approaches can mobilize large-scale annotation of specialized datasets and are more resilient to disruptions in scientific funding. Here, we present a model for community-powered curation applied to the Minimum Information about a Biosynthetic Gene Cluster (MIBiG) repository. Through a framework of workflows for metadata capture, annotation validation, and contributor coordination, the MIBiG 4.0 initiative recruited 267 scientists across 178 institutions from 33 countries, volunteering an estimated 4000 h of work. These efforts expanded the MIBiG repository by 22% and enhanced its usability in downstream molecular data analyses in comparative genomic analyses, natural product discovery, and machine learning applications. We provide strategies and actionable lessons for adopting this model, supporting the sustainability of curated bioinformatics resources central to nucleic acid research and related fields.

biocuration↗
NASA NTRS2002

Risk-Based Probabilistic Approach to Aeropropulsion System Assessment

In an era of shrinking development budgets and resources, where there is also an emphasis on reducing the product development cycle, the role of system assessment, performed in the early stages of an engine development program, becomes very critical to the successful development of new aeropropulsion systems. A reliable system assessment not only helps to identify the best propulsion system concept among several candidates, it can also identify which technologies are worth pursuing. This is particularly important for advanced aeropropulsion technology development programs, which require an enormous amount of resources. In the current practice of deterministic, or point-design, approaches, the uncertainties of design variables are either unaccounted for or accounted for by safety factors. This could often result in an assessment with unknown and unquantifiable reliability. Consequently, it would fail to provide additional insight into the risks associated with the new technologies, which are often needed by decision makers to determine the feasibility and return-on-investment of a new aircraft engine. In this work, an alternative approach based on the probabilistic method was described for a comprehensive assessment of an aeropropulsion system. The statistical approach quantifies the design uncertainties inherent in a new aeropropulsion system and their influences on engine performance. Because of this, it enhances the reliability of a system assessment. A technical assessment of a wave-rotor-enhanced gas turbine engine was performed to demonstrate the methodology. The assessment used probability distributions to account for the uncertainties that occur in component efficiencies and flows and in mechanical design variables. The approach taken in this effort was to integrate the thermodynamic cycle analysis embedded in the computer code NEPP (NASA Engine Performance Program) and the engine weight analysis embedded in the computer code WATE (Weight Analysis of Turbine Engines) with the fast probability integration technique (FPI). FPI was developed by Southwest Research Institute under contract with the NASA Glenn Research Center. The results were plotted in the form of cumulative distribution functions and sensitivity analyses and were compared with results from the traditional deterministic approach. The comparison showed that the probabilistic approach provides a more realistic and systematic way to assess an aeropropulsion system. The current work addressed the application of the probabilistic approach to assess specific fuel consumption, engine thrust, and weight. Similarly, the approach can be used to assess other aspects of aeropropulsion system performance, such as cost, acoustic noise, and emissions. Additional information is included in the original extended abstract.

Tong, Michael T.↗
NASA NTRS1999

Economic Analysis on the Space Transportation Architecture Study (STAS) NASA Team

The National Aeronautics and Space Administration (NASA) performed the Space Transportation Architecture Study (STAS) to provide information to support end-of-the-decade decisions on possible near-term US Government (USG) investments in space transportation. To gain a clearer understanding of the costs and benefits of the broadest range of possible space transportation options, six teams, five from aerospace industry companies and one internal to NASA, were tasked to answer three primary questions: a) If the Space Shuttle system should be replaced; b) If so, when the replacement should take place and how the transition should be implemented; and c) If not, what is the upgrade strategy to continue safe and affordable flight of the Space Shuttle beyond 2010. The overall goal of the Study was "to develop investment options to be considered by the Administration for the President's FY2001 budget to meet NASA's future human space flight requirements with significant reductions in costs." This emphasis on government investment, coupled with the participation by commercial f'trms, required an unprecedented level of economic analysis of costs and benefits from both industry and government viewpoints. This paper will discuss the economic and market models developed by the in-house NASA Team to analyze space transportation architectures, the results of those analyses, and how those results were reflected in the conclusions and recommendations of the STAS NASA Team. Copyright 1999 by the American Institute of Aeronautics and Astronautics, Inc. No copyright is asserted in the United States under Title 17, U.$. Code. The U.S. Government has a royalty-free license to exercise all rights under the copyright claimed herein for Governmental purposes. All other rights are reserved by the copyright owner.

Shaw, Eric J.↗
NASA NTRS2018

Portable Electron Microscopy for ISS and Beyond

Advances in space exploration have evolved in lockstep with key technology advances in diverse fields such as materials science, biological science, and engineering risk management. Research in these areas, where structure and physical processes come together, can proceed rapidly in part due to sophisticated ground-based analytical tools that help re-searchers develop technologies and engineering processes that push frontiers of human space exploration. Electron microscopes (EM) are an example of such a workhorse tool, lending a unique blend of strong optical scattering, high native resolution, large depth of focus, and spectroscopy via characteristic X-ray emission, providing exquisite high-magnification structural imaging and chemical analysis. Ground-based EM’s have been essential in NASA research for many years. In particular, in mineralogy and petrology, EM is used to understand the origin and evolution of the solar system, particularly rocky bodies. In microbiology, EM has helped visualize the architecture of tissues and cells. In engineering/materials science, EM has been used to characterize particulate debris in air and water samples, determine pore sizes in ceramics/catalysts, understand the nature of fibers, determine composition and morphology of new and existing materials, and characterize micro-textures of vapor deposited films. EM is highly effective at investigating a wide variety of nanoscale materials/biomaterials at the core of many of NASA’s inquiries. Despite exquisite optical performance and versatility, EM’s are traditionally large, heavy, and have high power consumption. They are also expensive so they tend to be housed at universities and large research institutions, or at major industrial laboratory sites with support staff, supplies, and skilled operators. Since most organizations cannot support their own EM, samples are often sent to these large institutions and service centers to be imaged, at great expense and of-ten with delay of weeks to months for complex analyses. Complexity, high cost, and maintenance associated with collecting EM image data has until now severely limited fields in which EM is used. Making EM accessible outside constrained terrestrial laboratory environments will bring EM’s performance and versatility to a much broader range of scientific and engineering endeavors, including in space.

Own, C. S.↗
DOE OSTI2017

Multi-actor involvement for integrating ecosystem services in strategic environmental assessment of spatial plans

Integrating an ecosystem services (ES) approach into Strategic Environmental Assessment (SEA) of spatial plans potentially enhances the consideration of the value of nature in decision making and policy processes. However, there is increasing concern about the institutional context and a lack of a common understanding of SEA and ecosystem services for adopting them as an integrated framework. This paper addresses this concern by analysing the current understanding and network relations in a multi-actor arrangement as a first step towards a successful integration of ES in SEA and spatial planning. Our analysis focuses on a case study in Chile, where we administered a questionnaire survey to some of the main actors involved in the spatial planning process. The questionnaire focused on issues such as network relations among actors and on conceptual understanding, perceptions and challenges for integrating ES in SEA and spatial planning, knowledge on methodological approaches, and the connections and gaps in the science-policy interface. Our findings suggest that a common understanding of SEA and especially of ES in a context of multiple actors is still at an initial stage in Chile. Additionally, the lack of institutional guidelines and methodological support is considered the main challenge for integration. We conclude that preconditions exist in Chile for integrating ES in SEA for spatial planning, but they strongly depend on appropriate governance schemes that promote a close science-policy interaction, as well as collaborative work and learning. - Highlights: • Linking ecosystem services in SEA is an effective framework for sustainability. • Multi-actor understanding and networks in ecosystem services and SEA were analyzed. • Understanding of SEA and especially of ES is still in an initial stage in Chile. • A lack of institutional guidelines is one of the key challenges for this link.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2014

Economic Analyses in Squamous Cell Carcinoma of the Head and Neck: A Review of the Literature From a Clinical Perspective

The purpose of this review was to describe cost-effectiveness and cost analysis studies across treatment modalities for squamous cell carcinoma of the head and neck (SCCHN), while placing their results in context of the current clinical practice. We performed a literature search in PubMed for English-language studies addressing economic analyses of treatment modalities for SCCHN published from January 2000 to March 2013. We also performed an additional search for related studies published by the National Institute for Health and Clinical Excellence in the United Kingdom. Identified articles were classified into 3 clinical approaches (organ preservation, radiation therapy modalities, and chemotherapy regimens) and into 2 types of economic studies (cost analysis and cost-effectiveness/cost-utility studies). All cost estimates were normalized to US dollars, year 2013 values. Our search yielded 23 articles: 13 related to organ preservation approaches, 5 to radiation therapy modalities, and 5 to chemotherapy regimens. In general, studies analyzed different questions and modalities, making it difficult to reach a conclusion. Even when restricted to comparisons of modalities within the same clinical approach, studies often yielded conflicting findings. The heterogeneity across economic studies of SCCHN should be carefully understood in light of the modeling assumptions and limitations of each study and placed in context with relevant settings of clinical practices and study perspectives. Furthermore, the scarcity of comparative effectiveness and quality-of-life data poses unique challenges for conducting economic analyses for a resource-intensive disease, such as SCCHN, that requires a multimodal care. Future research is needed to better understand how to compare the costs and cost-effectiveness of different modalities for SCCHN.

62 RADIOLOGY AND NUCLEAR MEDICINE↗