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Hyperfractionated Accelerated Radiation Therapy (HART) of 70.6 Gy With Concurrent 5-FU/Mitomycin C Is Superior to HART of 77.6 Gy Alone in Locally Advanced Head and Neck Cancer: Long-term Results of the ARO 95-06 Randomized Phase III Trial

Purpose: To report the long-term results of the ARO 95-06 randomized trial comparing hyperfractionated accelerated chemoradiation with mitomycin C/5-fluorouracil (C-HART) with hyperfractionated accelerated radiation therapy (HART) alone in locally advanced head and neck cancer. Patients and Methods: The primary endpoint was locoregional control (LRC). Three hundred eighty-four patients with stage III (6%) and IV (94%) oropharyngeal (59.4%), hypopharyngeal (32.3%), and oral cavity (8.3%) cancer were randomly assigned to 30 Gy/2 Gy daily followed by twice-daily 1.4 Gy to a total of 70.6 Gy concurrently with mitomycin C/5-FU (C-HART) or 16 Gy/2 Gy daily followed by twice-daily 1.4 Gy to a total dose of 77.6 Gy alone (HART). Statistical analyses were done with the log-rank test and univariate and multivariate Cox regression analyses. Results: The median follow-up time was 8.7 years (95% confidence interval [CI]: 7.8-9.7 years). At 10 years, the LRC rates were 38.0% (C-HART) versus 26.0% (HART, P=.002). The cancer-specific survival and overall survival rates were 39% and 10% (C-HART) versus 30.0% and 9% (HART, P=.042 and P=.049), respectively. According to multivariate Cox regression analysis, the combined treatment was associated with improved LRC (hazard ratio [HR]: 0.6 [95% CI: 0.5-0.8; P=.002]). The association between combined treatment arm and increased LRC appeared to be limited to oropharyngeal cancer (P=.003) as compared with hypopharyngeal or oral cavity cancer (P=.264). Conclusions: C-HART remains superior to HART in terms of LRC. However, this effect may be limited to oropharyngeal cancer patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Time- and concentration-dependent genomic responses of the rat airway to inhaled nickel subsulfide

Objective: To provide insights into the mode of action for Ni{sub 3}S{sub 2} lung carcinogenicity by examining gene expression changes in target cells after inhalation exposure. Methods: Gene expression changes were determined in micro-dissected lung broncho-alveolar cells from Fischer 344 rats following inhalation of Ni{sub 3}S{sub 2} at 0.0, 0.04, 0.08, 0.15, and 0.60 mg/m{sup 3} (0.03, 0.06, 0.11, and 0.44 mg Ni/m{sup 3}) for one and four weeks (6 h/day, 5 days/week). Results: Broncho-alveolar lavage fluid evaluation and lung histopathology provided evidence of inflammation only at the two highest concentrations, which were similar to those tested in the 2-year bioassay. The number of statistically significant up- and down-regulated genes decreased markedly from one to four weeks of exposure, suggesting adaptation. Cell signal pathway enrichment at both time-points primarily reflected responses to toxicity, including inflammatory and proliferative signaling. While proliferative signaling was up-regulated at both time points, some inflammatory signaling reversed from down-regulation at 1 week to up-regulation at 4 weeks. Conclusions: These results support a mode of action for Ni{sub 3}S{sub 2} carcinogenicity driven by chronic toxicity, inflammation and proliferation, leading to mis-replication, rather than by direct genotoxicity. Benchmark dose (BMD) analysis identified the lowest pathway transcriptional BMD exposure concentration as 0.026 mg Ni/m{sup 3}, for apoptosis/survival signaling. When conducted on the basis of lung Ni concentration the lowest pathway BMD was 0.64 μg Ni/g lung, for immune/inflammatory signaling. Implications: These highly conservative BMDs could be used to derive a point of departure in a nonlinear risk assessment for Ni{sub 3}S{sub 2} toxicity and carcinogenicity. - Highlights: • The mode of action for lung carcinogenicity of inhaled Ni{sub 3}S{sub 2} was investigated in rats. • Gene expression changes were determined in micro-dissected lung tissue at 1–4 weeks. • A non-genotoxic mode of action (toxicity, inflammation, proliferation) was supported. • Analyses of lung lavage fluid and histopathology provided complementary results. • Transcriptional benchmark doses could inform point of departure for risk assessment.

60 APPLIED LIFE SCIENCES↗

A Frequency Domain Methodology for Quantitative Evaluation of Diffuse Wavefield With Applications to Seismic Imaging

Abstract Ambient Noise Imaging (ANI) of subsurface structures relies on seismic interferometry of diffuse seismic wavefields. However, the lack of effective methods to quantify and identify highly diffuse waves hampers applications of ANI, particularly in evaluating seismic attenuation and monitoring structural changes with high temporal resolution. Conventional ANI approaches require data normalization, which effectively suppresses the non‐diffuse component with large amplitude but also results in significant loss of amplitude and phase information in the continuous seismic records. In this study, we propose a frequency domain method to quantitatively evaluate the degree of diffuseness of seismic wavefields by analyzing their statistical characteristics of modal amplitudes for stationarity and randomness. Tests on synthetic waveform and field nodal records show that the proposed method can effectively distinguish between diffuse and non‐diffuse waveforms for either single‐ or three‐component data. As an application, we identify a 60‐s‐long diffuse coda of a local M 2.2 earthquake recorded by a dense nodal array on the San Jacinto Fault Zone, and successfully extract high‐quality dispersion curve andQ‐value without performing data normalization. These results are consistent with those obtained by conventional methods that assess the correlation between coherency and the Green's function, and by modeling ballistic waves generated by road traffic. Our proposed method can advance the imaging of subsurface velocity and attenuation structures as well as monitoring temporal changes for scientific studies and engineering applications.

Geochemistry & Geophysics↗

Deep neural network improves the estimation of polygenic risk scores for breast cancer

Polygenic risk scores (PRS) estimate the genetic risk of an individual for a complex disease based on many genetic variants across the whole genome. Here, we compared a series of computational models for estimation of breast cancer PRS. A deep neural network (DNN) was found to outperform alternative machine learning techniques and established statistical algorithms, including BLUP, BayesA, and LDpred. In the test cohort with 50% prevalence, the Area Under the receiver operating characteristic Curve (AUC) were 67.4% for DNN, 64.2% for BLUP, 64.5% for BayesA, and 62.4% for LDpred. BLUP, BayesA, and LPpred all generated PRS that followed a normal distribution in the case population. However, the PRS generated by DNN in the case population followed a bimodal distribution composed of two normal distributions with distinctly different means. This suggests that DNN was able to separate the case population into a high-genetic-risk case subpopulation with an average PRS significantly higher than the control population and a normal-genetic-risk case subpopulation with an average PRS similar to the control population. This allowed DNN to achieve 18.8% recall at 90% precision in the test cohort with 50% prevalence, which can be extrapolated to 65.4% recall at 20% precision in a general population with 12% prevalence. Interpretation of the DNN model identified salient variants that were assigned insignificant p values by association studies, but were important for DNN prediction. These variants may be associated with the phenotype through nonlinear relationships.

59 BASIC BIOLOGICAL SCIENCES↗

Bayesian stability and force modeling for uncertain machining processes

Accurately simulating machining operations requires knowledge of the cutting force model and system frequency response. However, this data is collected using specialized instruments in an ex-situ manner. Bayesian statistical methods instead learn the system parameters using cutting test data, but to date, these approaches have only considered milling stability. This paper presents a physics-based Bayesian framework which incorporates both spindle power and milling stability. Initial probabilistic descriptions of the system parameters are propagated through a set of physics functions to form probabilistic predictions about the milling process. The system parameters are then updated using automatically selected cutting tests to reduce parameter uncertainty and identify more productive cutting conditions, where spindle power measurements are used to learn the cutting force model. The framework is demonstrated through both numerical and experimental case studies. Results show that the approach accurately identifies both the system natural frequency and cutting force model.

42 ENGINEERING↗

Generalized framework for likelihood-based field-level inference of growth rate from velocity and density fields

Measuring the growth rate of large-scale structures ( f ) as a function of redshift has the potential to break degeneracies between modified gravity and dark energy models, when combined with expansion-rate probes. Direct estimates of peculiar velocities of galaxies have attracted interest as a means of estimating fσ 8 . In particular, field-level methods can be used to fit the field nuisance parameter along with cosmological parameters simultaneously. This article aims to provide the community with a unified framework for the theoretical modeling of the likelihood-based field-level inference by performing fast field covariance calculations for velocity and density fields. Our purpose is to lay the foundations for a nonlinear extension of the likelihood-based method at the field level. We have developed a generalized framework, implemented in the dedicated software flip to perform a likelihood-based inference of fσ 8 . We derived a new field covariance model, which includes wide-angle corrections. We also included the models previously described in the literature inside our framework. We compared their performance against ours, and we validated our model by comparing it with the two-point statistics of a recent N-body simulation. The tests we performed have allowed us to validate our software and determine the appropriate wavenumber range to integrate our covariance model and its validity in terms of separation. Our framework allows for a wider wavenumber coverage to be used in our calculations than in previous works, which is particularly interesting for nonlinear model extensions. Finally, our generalized framework allows us to efficiently perform a survey geometry-dependent Fisher forecast of the fσ 8 parameter. We show that the Fisher forecast method we developed gives an error bar that is 30% closer to a full likelihood-based estimation than a standard volume Fisher forecast.

Ravoux, Corentin↗

Survival analysis of colorectal cancer patients with tumor recurrence using global score test methodology

Colorectal cancer is the third and the second most common cancer worldwide in men and women respectively, and the second in Malaysia for both genders. Surgery, chemotherapy and radiotherapy are among the options available for treatment of patients with colorectal cancer. In clinical trials, the main purpose is often to compare efficacy between experimental and control treatments. Treatment comparisons often involve several responses or endpoints, and this situation complicates the analysis. In the case of colorectal cancer, sets of responses concerned with survival times include: times from tumor removal until the first, the second and the third tumor recurrences, and time to death. For a patient, the time to recurrence is correlated to the overall survival. In this study, global score test methodology is used in combining the univariate score statistics for comparing treatments with respect to each survival endpoint into a single statistic. The data of tumor recurrence and overall survival of colorectal cancer patients are taken from a Malaysian hospital. The results are found to be similar to those computed using the established Wei, Lin and Weissfeld method. Key factors such as ethnic, gender, age and stage at diagnose are also reported.

60 APPLIED LIFE SCIENCES↗

Instrument for precision long-term β-decay rate measurements

We describe an experimental setup for making precision measurements of relative β-decay rates of {sup 22}Na, {sup 36}Cl, {sup 54}Mn, {sup 60}Co, {sup 90}Sr, {sup 133}Ba, {sup 137}Cs, {sup 152}Eu, and {sup 154}Eu. The radioactive samples are mounted in two automated sample changers that sequentially position the samples with high spatial precision in front of sets of detectors. The set of detectors for one sample changer consists of four Geiger-Müller (GM) tubes and the other set of detectors consists of two NaI scintillators. The statistical uncertainty in the count rate is few times 0.01% per day for the GM detectors and about 0.01% per hour on the NaI detectors. The sample changers, detectors, and associated electronics are housed in a sealed chamber held at constant absolute pressure, humidity, and temperature to isolate the experiment from environmental variations. The apparatus is designed to accumulate statistics over many years in a regulated environment to test recent claims of small annual variations in the decay rates. We demonstrate that absent this environmental regulation, uncontrolled natural atmospheric pressure variations at our location would imprint an annual signal of 0.1% on the Geiger-Müller count rate. However, neither natural pressure variations nor plausible indoor room temperature variations cause a discernible influence on our NaI scintillator detector count rate.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Equation of state and transport properties of warm dense helium via quantum molecular dynamics simulations

The equation of state, self-diffusion, and viscosity coefficients of helium have been investigated by quantum molecular dynamics (QMD) simulations in the warm dense matter regime. Our simulations are validated through the comparison with the reliable experimental data. The calculated principal and reshock Hugoniots of liquid helium are in good agreement with the gas-gun data. On this basis, we revisit the issue for helium, i.e., the possibility of the instabilities predicted by chemical models at around 2000 GPa and 10 g/cm{sup 3} along the pressure isotherms of 6309, 15 849, and 31 623 K. Our calculations show no indications of instability in this pressure-temperature region, which reconfirm the predictions of previous QMD simulations. The self-diffusion and viscosity coefficients of warm dense helium have been systematically investigated by the QMD simulations. We carefully test the finite-size effects and convergences of statistics, and obtain numerically converged self-diffusion and viscosity coefficients by using the Kubo-Green formulas. The present results have been used to evaluate the existing one component plasma models. Finally, the validation of the Stokes-Einstein relationship for helium in the warm dense regime is discussed.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

A hybrid approach to excited-state-specific variational Monte Carlo and doubly excited states

We extend our hybrid linear-method/accelerated-descent variational Monte Carlo optimization approach to excited states and investigate its efficacy in double excitations. In addition to showing a superior statistical efficiency when compared to the linear method, our tests on small molecules show good energetic agreement with benchmark methods. We also demonstrate the ability to treat double excitations in systems that are too large for a full treatment by using selected configuration interaction methods via an application to 4-aminobenzonitrile. Finally, we investigate the stability of state-specific variance optimization against collapse to other states’ variance minima and find that symmetry, Ansatz quality, and sample size all have roles to play in achieving stability.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

ARE HIGH VELOCITY PEAKS IN THE MILKY WAY BULGE DUE TO THE BAR?

Recently the commissioning APOGEE observations of the Galactic bulge reported that a significant fraction of stars (∼10%) are in a cold (σ{sub V} ≈ 30 km s{sup –1}) high velocity peak (Galactocentric radial velocity ≈200 km s{sup –1}). These stars are speculated to reflect the stellar orbits in the Galactic bar. In this study, we use two N-body models of a Milky Way-like disk galaxy with different bar strengths to critically examine this possibility. The general trends of the Galactocentric radial velocity distribution in observations and simulations are similar, but neither our models nor the BRAVA data reveal a statistically significant cold high velocity peak. A Monte Carlo test further suggests that it is possible for a spurious high velocity peak to appear if there are only a limited number of stars observed. Thus, the reported cold high velocity peak, even if it is real, is unlikely due to stars on the bar-supporting orbits. Our models do predict an excess of stars with high radial velocity, but not in a distinct peak. In the distance-velocity diagram, the high velocity particles in different fields exist at a similar distance ∼8.5 ± 1 kpc away from the Sun. This result may be explained by geometric intersections between the line-of-sight and the particle orbits; high velocity stars naturally exist approximately at the tangent point, without constituting a distinct peak. We further demonstrate that even without the presence of a bar structure, particle motions in an axisymmetric disk can also exhibit an excess of high velocity stars.

79 ASTRONOMY AND ASTROPHYSICS↗

QUIJOTE scientific results – IV. A northern sky survey in intensity and polarization at 10–20 GHz with the multifrequency instrument

ABSTRACT We present QUIJOTE intensity and polarization maps in four frequency bands centred around 11, 13, 17, and 19 GHz, and covering approximately 29 000 deg2, including most of the northern sky region. These maps result from 9000 h of observations taken between May 2013 and June 2018 with the first QUIJOTE multifrequency instrument (MFI), and have angular resolutions of around 1°, and sensitivities in polarization within the range 35–40 µK per 1° beam, being a factor ∼2–4 worse in intensity. We discuss the data processing pipeline employed, and the basic characteristics of the maps in terms of real space statistics and angular power spectra. A number of validation tests have been applied to characterize the accuracy of the calibration and the residual level of systematic effects, finding a conservative overall calibration uncertainty of 5 per cent. We also discuss flux densities for four bright celestial sources (Tau A, Cas A, Cyg A, and 3C274), which are often used as calibrators at microwave frequencies. The polarization signal in our maps is dominated by synchrotron emission. The distribution of spectral index values between the 11 GHz and WMAP 23 GHz map peaks at β = −3.09 with a standard deviation of 0.14. The measured BB/EE ratio at scales of ℓ = 80 is 0.26 ± 0.07 for a Galactic cut |b| > 10°. We find a positive TE correlation for 11 GHz at large angular scales (ℓ ≲ 50), while the EB and TB signals are consistent with zero in the multipole range 30 ≲ ℓ ≲ 150. The maps discussed in this paper are publicly available.

Astronomy & Astrophysics↗

A unified catalogue-level reanalysis of stage-III cosmic shear surveys

ABSTRACT Cosmological parameter constraints from recent galaxy imaging surveys are reaching percent-level accuracy on the effective amplitude of the lensing signal, S8. The upcoming Legacy Survey of Space and Time (LSST) of the Vera C. Rubin Observatory will produce subpercent level measurements of cosmological parameters, providing a milestone test of the ΛCDM model. To supply guidance to the upcoming LSST analysis, it is important to understand thoroughly the results from different recent galaxy imaging surveys and assess their consistencies. In this work, we perform a unified catalogue-level reanalysis of three cosmic shear data sets: the first year data from the Dark Energy Survey (DES-Y1), the 1000 deg2 data set from the Kilo-Degree Survey (KiDS-1000), and the first year data from the Hyper Suprime-Cam Subaru Strategic Program (HSC-Y1). We utilize a pipeline developed and rigorously tested by the LSST Dark Energy Science Collaboration to perform the reanalysis and assess the robustness of the results to analysis choices. We find the S8 constraint to be robust to two different small-scale modelling approaches, and varying choices of cosmological priors. Our unified analysis allows the consistency of the surveys to be rigorously tested, and we find the three surveys to be statistically consistent. Due to the partially overlapping footprint, we model the cross-covariance between KiDS-1000 and HSC-Y1 approximately when combining all three data sets, resulting in a 1.6–1.9 per cent constraint on S8 given different assumptions on the cross-covariance.

79 ASTRONOMY AND ASTROPHYSICS↗

Impacts of floating-point non-associativity on reproducibility for HPC and deep learning applications

Run to run variability in parallel programs caused by floating-point non-associativity has been known to significantly affect reproducibility in iterative algorithms, due to accumulating errors. Non-reproducibility can critically affect the efficiency and effectiveness of correctness testing for stochastic programs. Recently, the sensitivity of deep learning training and inference pipelines to floating-point non-associativity has been found to sometimes be extreme. It can prevent certification for commercial applications, accurate assessment of robustness and sensitivity, and bug detection. New approaches in scientific computing applications have coupled deep learning models with high-performance computing, leading to an aggravation of debugging and testing challenges. Here we perform an investigation of the statistical properties of floating-point non-associativity within modern parallel programming models, and analyze performance and productivity impacts of replacing atomic operations with deterministic alternatives on GPUs. We examine the recently-added deterministic options in PyTorch within the context of GPU deployment for deep learning, uncovering and quantifying the impacts of input parameters triggering run to run variability and reporting on the reliability and completeness of the documentation. Finally, we evaluate the strategy of exploiting automatic determinism that could be provided by deterministic hardware, using the Groq LPUTM accelerator for inference portions of the deep learning pipeline. We demonstrate the benefits that a hardware-based strategy can provide within reproducibility and correctness efforts.

Shanmugavelu, Sanjif↗

A dosimetric comparison of proton and photon therapy in unresectable cancers of the head of pancreas

Purpose: Uncontrolled local growth is the cause of death in ∼30% of patients with unresectable pancreatic cancers. The addition of standard-dose radiotherapy to gemcitabine has been shown to confer a modest survival benefit in this population. Radiation dose escalation with three-dimensional planning is not feasible, but high-dose intensity-modulated radiation therapy (IMRT) has been shown to improve local control. Still, dose-escalation remains limited by gastrointestinal toxicity. In this study, the authors investigate the potential use of double scattering (DS) and pencil beam scanning (PBS) proton therapy in limiting dose to critical organs at risk. Methods: The authors compared DS, PBS, and IMRT plans in 13 patients with unresectable cancer of the pancreatic head, paying particular attention to duodenum, small intestine, stomach, liver, kidney, and cord constraints in addition to target volume coverage. All plans were calculated to 5500 cGy in 25 fractions with equivalent constraints and normalized to prescription dose. All statistics were by two-tailed paired t-test. Results: Both DS and PBS decreased stomach, duodenum, and small bowel dose in low-dose regions compared to IMRT (p < 0.01). However, protons yielded increased doses in the mid to high dose regions (e.g., 23.6–53.8 and 34.9–52.4 Gy for duodenum using DS and PBS, respectively; p < 0.05). Protons also increased generalized equivalent uniform dose to duodenum and stomach, however these differences were small (<5% and 10%, respectively; p < 0.01). Doses to other organs-at-risk were within institutional constraints and placed no obvious limitations on treatment planning. Conclusions: Proton therapy does not appear to reduce OAR volumes receiving high dose. Protons are able to reduce the treated volume receiving low-intermediate doses, however the clinical significance of this remains to be determined in future investigations.

60 APPLIED LIFE SCIENCES↗

SU-E-T-581: A Comparative Study of Standard IMRT and VMAT Planning Techniques for Unilateral and Bilateral Head and Neck Irradiation

Purpose: To compare dosimetric properties and monitor units (MU) of IMRT plans with several VMAT head and neck (H and N) plans. Methods: Seventeen unilateral H and N (UHN) and five bilateral H and N (BHN) patients initially treated with IMRT were replanned with VMAT. Several arc arrangements were studied for each patient: 1)for UHN, two 360° arcs, two 260° arcs, two 210° arcs, two 360° arcs with contralateral avoidance sectors, and 2)for BHN, two 360° arcs, two 360° arcs with bilateral avoidance sectors, two 360° arcs with bilateral avoidance sectors and a third arc limited to the upper neck. Optimization constraints were adjusted for each patient and plan. All plans were normalized to achieve the same highest-dose PTV coverage. Percent differences (IMRT-VMAT)/VMAT in MU, dose homogeneity (HI=maximum point dose/prescription dose), and organ-at-risk (OAR) metrics are reported and statistical significance evaluated (p<0.05; paired Student t-test). Results: Average reduction in MU with VMAT was 28% for UHN (p<0.0001) and 63% for BHN (p<0.0001). Average HI for UHN IMRT and 360° arc VMAT plans was 1.08 and for plans with arcs <360° average HI=1.10. Average HI for BHN IMRT was 1.07, for three-arc VMAT 1.08, and for two-arc VMAT 1.11. For UHN, two 210° arcs achieved lower contralateral parotid max (−2.6 Gy, p<0.02) and mean (−1.2 Gy, p=0.06) dose. For BHN two-arc plans, contralateral parotid mean dose increased (3.3 Gy, p<0.04) and larynx max dose increased (2.9 Gy, p<0.02) with no change in larynx mean dose. Conclusion: For UHN, 360degree arc VMAT consistently produced plans dosimetrically comparable to IMRT with the benefit of lower MU. VMAT with arcs <360degrees produced plans inferior to IMRT in dose homogeneity and without significantly improved OAR sparing. For BHN, three-arc plans were dosimetrically comparable to IMRT with lower MU, while two-arc plans were inferior to IMRT in HI and OAR dose. Research supported in part by a Kaye Family Award.

60 APPLIED LIFE SCIENCES↗

TU-C-12A-01: Measurement of Skeletal Muscle Lipids in Type 2 Diabetes Using in Vivo Proton MR Spectroscopy

Purpose: To quantify and compare the intramyocellular (IMCL), extramyocellular (EMCL) lipids and total fat fraction in human vastus lateralis (VL) muscle between lean controls and type 2 diabetic (T2DM) subjects using long echo time in vivo proton MR spectroscopy ({sup 1}H-MRS) Methods: {sup 1}H-MRS single voxel (15 × 15 × 15 mm{sup 3}) stimulated acquisition mode (STEAM) was performed in right vastus lateralis m. on 10 lean controls (age: 28.3±3.94 yrs, BMI: 24.25±3.20 kg/m{sup 2}) and 7 type 2 diabetic (age: 54.28±6.42 yrs, BMI: 31.34±3.13 kg/m{sup 2}) subjects with Siemens 3T MRI and four-channel flex coil. Unsuppressed water spectra (NSA = 16) with TR/TE = 3000/30 msec, TM = 10 msec, BW = 2000 Hz, and water-suppressed spectra (NSA = 128) with TR/TE = 3000/270 msec, TM = 10 msec, and fixed water suppression BW = 50 Hz were acquired. Spectral intensity ratios of IMCL-CH{sub 2}, EMCL-CH{sub 2} and total lipid (IMCL {sub +} EMCL) with unsuppressed water signal (W) were converted into absolute concentrations expressed in mmol/kg. Fat fraction (100 × F/(W+F)) was calculated, where F includes the signal intensities of IMCL and EMCL methylene (CH{sub 2})n, peaks only. Results: Comparison of IMCL (controls: 11.70 ± 6.7, T2DM: 21.74 ± 10.2, p ≤ 0.01), EMCL (controls: 22.89 ± 18.42, T2DM: 77.21 ± 33.4, p ≤ 0.001) and total lipid (64.35 mmol/kg less in controls, p ≤ 0.001) showed statistical significance using two-tailed student t-test. Fat fraction (%) exhibited considerable inter-individual variability for controls (3.14 ± 2.09; range: 1.34 - 7.04) and T2DM (9.34 ± 2.88; range: 4.15 - 13.67) and deemed significant (p ≤ 0.05 Conclusion: Single voxel STEAM {sup 1}H-MRS at long TE provides a robust non-invasive method for characterizing lipids within localized muscle regions, with well-resolved IMCL/EMCL peak separation. Regional lipid estimate and fat fraction in VL m. was significantly different in T2DM compared to lean controls. American Heart Association Southwest Affiliate Pre-doctoral Fellowship.

60 APPLIED LIFE SCIENCES↗

SU-E-P-56: Dosimetric Comparison of Three Post Modified Radical Mastectomy Radiotherapy Techniques for Locally Advanced Left-Sided Breast Cancer and Beyond

Purpose: To compare the dosimetry of post modified radical mastectomy radiotherapy (PMRMRT) for left-sided breast cancer using 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). Methods: We created ten sets of PMRMRT plans for ten consecutive patients and utilized two tangential and one or two supraclavicular beams in 3DCRT, a total of 5 beams in IMRT and two optimized partial arcs in VMAT. The difference in results between any two of the three new plans, between new and previous 3DCRT plans were compared and analyzed by ANOVA (α =0.05) and paired-sample t-test respectively. P values less than 0.05 were considered statistically significant. Results: Both IMRT and VMAT plans had similar PTV coverage, hotspot area and conformity (all p>0.05), and significantly higher PTV coverage compared with new 3DCRT (both p<0.001). IMRT plans had significantly less heart and left lung radiation exposure compared with VMAT (all p<0.05). The 3DCRT plans with larger estimated CTV displacement had better target coverage but worse OARs sparing compared to those with smaller one. Conclusion: IMRT has dosimetrical advantages over the other two techniques in PMRMRT for left-sided breast cancer. Individually quantifying and minimizing CTV displacement can significantly improve dosage distribution. This work was supported by the Medical Scientific Research Foundation of Guangdong Procvince (A2014455 to Changchun Ma)

60 APPLIED LIFE SCIENCES↗