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At least 19 records

Risks of secondary malignancies with heterotopic bone radiation therapy for patients younger than 40 years

Heterotopic ossification (HO) of the bone is defined as a benign condition in which abnormal bone formation occurs in soft tissue. One of the most common prophylactic treatments for HO is radiation therapy (RT). This study retrospectively reviewed 20 patients younger than the age of 40 who received radiation to prevent HO in a single fraction of 7 Gray. The purpose of this study is to assess the risk of a second malignancy in these patients by recreating their treatment fields and contouring organs at risk to estimate the radiation dose absorbed by normal tissues outside the radiation treatment field. Diagnostic computed tomography (CT) scans for each patient were used to recreate treatment fields and to calculate dose to structures of interest. The distance from the field edge to each structure and its depth was recorded. Dose measurements in a water phantom were performed for the range of depths, distances, and field sizes used in the actual treatment plans. Computer-generated doses were compared to estimates based on measurement. The structure dose recorded was the higher dose generated between the 2 methods. Scatter dose was recorded to the rectum, bladder, sigmoid colon, small bowel, ovaries and utero-cervix in female patients, and prostate and gonads in male patients. In some patients, there is considerable dose received by certain organs from scatter because of their proximity to the radiation field. The average dose to the ovarian region was 4.125 Gy with a range of 1.085 to 6.228 Gy. The risk estimate for these patients ranged from 0.16% to 0.93%. The average total lifetime risk estimate for the bladder in all patients is 0.22% and the average total lifetime risk estimate for the remainder organs in all patients is 1.25%. In conclusions, proper shielding created from multileaf collimators (MLCs), blocks, and shields should always be used when possible.

61 RADIATION PROTECTION AND DOSIMETRY↗

Validating a Local Failure Risk Stratification for Use in Prospective Studies of Adjuvant Radiation Therapy for Bladder Cancer

Purpose: To inform prospective trials of adjuvant radiation therapy (adj-RT) for bladder cancer after radical cystectomy, a locoregional failure (LF) risk stratification was proposed. This stratification was developed and validated using surgical databases that may not reflect the outcomes expected in prospective trials. Our purpose was to assess sources of bias that may affect the stratification model's validity or alter the LF risk estimates for each subgroup: time bias due to evolving surgical techniques; trial accrual bias due to inclusion of patients who would be ineligible for adj-RT trials because of early disease progression, death, or loss to follow-up shortly after cystectomy; bias due to different statistical methods to estimate LF; and subgrouping bias due to different definitions of the LF subgroups. Methods and Materials: The LF risk stratification was developed using a single-institution cohort (n=442, 1990-2008) and the multi-institutional SWOG 8710 cohort (n=264, 1987-1998) treated with radical cystectomy with or without chemotherapy. We evaluated the sensitivity of the stratification to sources of bias using Fine-Gray regression and Kaplan-Meier analyses. Results: Year of radical cystectomy was not associated with LF risk on univariate or multivariate analysis after controlling for risk group. By use of more stringent inclusion criteria, 26 SWOG patients (10%) and 60 patients from the single-institution cohort (14%) were excluded. Analysis of the remaining patients confirmed 3 subgroups with significantly different LF risks with 3-year rates of 7%, 17%, and 36%, respectively (P<.01), nearly identical to the rates without correcting for trial accrual bias. Kaplan-Meier techniques estimated higher subgroup LF rates than competing risk analysis. The subgroup definitions used in the NRG-GU001 adj-RT trial were validated. Conclusions: These sources of bias did not invalidate the LF risk stratification or substantially change the model's LF estimates.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Training course for radiation safety technicians

Course of instruction includes sections on basic information, natural radioactivity, properties of alpha, beta, gamma, X rays, and neutrons, concepts of radiation units and dose determinations, shielding, biological effects, background radiation, radiation protection standards, and internal dose calculation.

Lasuk, S. R.↗

The Radiation Unit is Difficult for the General Public to Understand - An Easier Alternative Unit is Required - 17223

One of the difficult things to explain about nuclear power and/or radiation to the public is the 'radiation unit'. Especially after the Fukushima accident, many people are concerned about radiation, but over 70% of public who responded to the survey do not understand what the Bq (Becquerel) refers to. Changing the SI unit (International System of Units) is not easy, and instead, auxiliary units can be used. We considered several auxiliary units: one using an index number (like that for earthquakes), one that makes a comparison to general drug risk, one that makes a comparison to an amount of foodstuff (like BED), an introducing index comparing annual dose limit, using number compared to the background, and colorizing (i.e, red, green, blue). KHNP-CRI surveyed the public about radiation and radiation unit indexes to determine which was easiest to understand. For the question 'Do you know what the radiation unit Becquerel (Bq) is?', over 70% answered 'No'. When asked,'Do you think radioactivity is contagious and can be transmitted through a person's respiratory system or via skin contact?', over 47% answered 'It is definitely or possibly contagious'. When asked, 'Which would you prefer as an easier to understand radiation auxiliary unit, if it were to be changed?', over 70% preferred 'colorizing or figure'. It is interesting that men prefer figures whereas women prefer colorizing. The sample population of the survey was 500 adult men and women in Korea. The sampling error was based on random sampling, a confidence interval of 95%, and a standard maximum allowable sampling error of ± 4.4% point. The survey method was 'Computer Aided Telephone Interview' (CATI). (authors)

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗

MO-DE-204-00: International Symposium: Patient Dose Reduction in Diagnostic Radiology

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented. Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.

60 APPLIED LIFE SCIENCES↗

MO-DE-204-03: Radiology Dose Optimisation - An Australian Perspective

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented. Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.

60 APPLIED LIFE SCIENCES↗

MO-DE-204-04: Dose Optimization in CT: Trends and Motivation in the US

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented. Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.

60 APPLIED LIFE SCIENCES↗

MO-DE-204-02: Optimization of the Patient CT Dose in Europe

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented. Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.

60 APPLIED LIFE SCIENCES↗

MO-DE-204-01: Radiation Doses in Over 50 Developing Countries of Asia, Africa, Eastern European and Latin America

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented. Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.

60 APPLIED LIFE SCIENCES↗

Recent Progress on the Stochastic Objective Decision Aide (SODA) Application

Idaho State University, in collaboration with Idaho National Laboratory, is engaged in development of a simple to use software application that utilizes stochastic techniques for the calculation of radiation doses associated with hypothetical radioactive material releases. This work is being performed through a grant from the U.S. Department of Energy (DOE) Nuclear Safety Research and Development (NSR and D) Program. Initial progress on the application was reported previously. Recent additions to the application are reported here. The Stochastic Objective Decision Aide (SODA) provides an easy to use software application to help decision makers support their judgment about the need or lack of need for safety structures, systems, and components. SODA is not intended to replace traditional design basis accident dose calculation methodology, nor is it intended to replace existing software used to perform formal dose consequence calculations. Rather, SODA is intended to supplement information obtained from existing codes to give a decision maker more information about an accident scenario. SODA also provides a simple method to perform parametric or sensitivity studies on individual input parameters. Non-reactor nuclear facilities operated under the approval authority of the US DOE use unmitigated hazard evaluations to determine if potential radiological doses associated with design basis events challenge dose evaluation guidelines. Unmitigated events that sufficiently challenge dose evaluation guidelines merit the selection of safety structures, systems, or components (SSCs) to prevent or mitigate the hazard. Dose consequence calculations traditionally involve use of the 'five-factor' formula: ST = MAR.DR.ARF.RF.LPF where ST is the source term (Bq), MAR is the total available material-at-risk (Bq), DR is the damage ratio (no units), ARF is the airborne release fraction (no units), RF is the respirable fraction (no units), and LPF is the leak path factor (no units). Potential radiation doses are then calculated using: CED = χ/Q.BR.ST.DCF (2) where CED is the committed effective dose (Sv), χ/Q is the plume dispersion (s/m{sup 3}), BR is the breathing rate (m{sup 3}/s), ST is the source term (Bq), and DCF is the dose conversion factor (Sv/Bq). Conservative single value input parameters are typically used to represent ARF, RF, LPF and BR. The traditional methodology, while conservative, can lead to skewed conclusions in the balance between cost and risk reduction resulting in over engineered systems with greater design, construction and operating costs. Rather than using a bounding single point value for each parameter in the dose consequence calculation, SODA uses distributions for some or all of the parameters. Each input parameter distribution is stochastically sampled and the resulting dose consequence calculation is repeated many times to develop a dose consequence distribution. The resulting distribution provides more information for the decision maker to rely upon when determining the need for safety SSCs. The SODA application was developed using MATLAB and it incorporates the use of Monte Carlo techniques as well as a graphical user interface (GUI). The application includes user selection of the governing distribution for parameters such as the MAR, DR, ARF, RF, LPF,χ/Q, BR, and DCF. While MATLAB was used for the development work, the application is distributed as a self-contained executable program. Features of the application include pull down menus with available distributions for the various parameters. The user has the option to plot the input parameter distribution that results from the random sampling process. The resulting dose consequence distribution is automatically analyzed to determine its similarity to well know distributions. This was done using the Bayesian Information Criterion method. If the resulting distribution is sufficiently similar to a well-known distribution, the application provides information about the distributions such as the mean value and other parameters. (authors)

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

TU-D-201-07: Severity Indication in High Dose Rate Brachytherapy Emergency Response Procedure

Purpose: Understanding the corresponding dose to different staff during the High Dose Rate (HDR) Brachytherapy emergency response procedure could help to develop a strategy in efficiency and effective action. In this study, the variation and risk analysis methodology was developed to simulation the HDR emergency response procedure based on severity indicator. Methods: A GammaMedplus iX HDR unit from Varian Medical System was used for this simulation. The emergency response procedure was decomposed based on risk management methods. Severity indexes were used to identify the impact of a risk occurrence on the step including dose to patient and dose to operation staff by varying the time, HDR source activity, distance from the source to patient and staff and the actions. These actions in 7 steps were to press the interrupt button, press emergency shutoff switch, press emergency button on the afterloader keypad, turn emergency hand-crank, remove applicator from the patient, disconnect transfer tube and move afterloader from the patient, and execute emergency surgical recovery. Results: Given the accumulated time in second at the assumed 7 steps were 15, 5, 30, 15, 180, 120, 1800, and the dose rate of HDR source is 10 Ci, the accumulated dose in cGy to patient at 1cm distance were 188, 250, 625, 813, 3063, 4563 and 27063, and the accumulated exposure in rem to operator at outside the vault, 1m and 10cm distance were 0.0, 0.0, 0.1, 0.1, 22.6, 37.6 and 262.6. The variation was determined by the operators in action at different time and distance from the HDR source. Conclusion: The time and dose were estimated for a HDR unit emergency response procedure. It provided information in making optimal decision during the emergency procedure. Further investigation would be to optimize and standardize the responses for other emergency procedure by time-spatial-dose severity function.

60 APPLIED LIFE SCIENCES↗

SU-G-PinS Room/Hall E-00: HAZMAT Training for the Medical Physicist - Part II

Medical Physicists are frequently involved in shipping radioactive materials or supervising those who do. Current U.S. Department of Transportation Hazardous Material Regulations, 49 CFR Parts 171 - 185, require hazmat employees to have documented training specified in 49 CFR 172 Subpart H. A hazmat employee is defined as an individual who: (1) loads, unloads or handles hazardous material; (2) manufactures, tests, reconditions, repairs, modifies, marks or otherwise represents containers, drums or packagings as qualified for use in the transportation of hazardous materials; (3) prepares hazardous materials for transportation; (4) is responsible for safety of transporting hazardous materials; or (5) operates a vehicle used to transport hazardous materials. Recurrent training is required at least once every three years. (The IATA two year training interval is not applicable and is generally misunderstood.) FAA has escalated inspection and enforcement. Facilities who ship radiopharmaceuticals to other laboratories, return radiopharmaceuticals or radioactive sources to suppliers, or otherwise ship radioactive materials have been cited for failure to provide and document the required training. The interrelationship of transportation regulations, 49 CFR, IATA, ICAO and other transportation regulations, which are frequently misunderstood, will be explained. The course will cover typical shipments by air and highway which are encountered in a medical institution. Items such as fissile materials, highway route controlled quantities, rail shipments, vessel shipments and such will be omitted; although specific questions may be addressed. A major objective of the course is to present the process of shipping radioactive material in a sequential and logical fashion. How radioactive materials for transportation purposes are defined by activity concentrations for exempt materials and activity limits for exempt consignments will be explained. Radioactive material shipments of excepted packages and Type A packages will be emphasized. The program is designed to meet the function specific DOT training requirements for shippers of medical radioactive materials. General awareness training and security awareness training can be obtained from two free DOT training CDs. Safety training and security awareness training is generally satisfied by the training required under the institution’s radioactive material license. For shippers of radioactive Yellow III labeled packages an in-depth written security plan and training are no longer required as of April 8, 2010. In general almost all shippers of medical radioactive material are now not required to have an in-depth security plan. Contents of general awareness training, security awareness training and in-depth security plans will be briefly outlined. It is the hazmat employer’s responsibility to ensure that each hazmat employee is properly trained. No third party can fulfill that requirement. It is the hazmat employer’s responsibility to determine the degree to which this course meets the employer’s requirements, including contents of the course and the examination. Participants will gain sufficient knowledge to prepare hazmat training programs for others in their institutions. A handout will be posted which should be printed out and brought to the course for reference during the presentation. The handout will also satisfy part of the training documentation required by DOT. A feature handout section is a composite table which provides A1, A2, RQ, Exempt Concentration, and Exempt Consignment values in a single table in both Becquerel and Curie units. Course attendance will be certified through the AAPM CEU documentation system. Learning Objectives: Understand the regulatory requirements for shipping radioactive materials. Understand the regulatory requirements for training of hazmat employees. Comprehend how to classify, package, mark, label, document, placard, and transport radioactive materials.

60 APPLIED LIFE SCIENCES↗

SU-G-PinS Room/Hall E-01

Medical Physicists are frequently involved in shipping radioactive materials or supervising those who do. Current U.S. Department of Transportation Hazardous Material Regulations, 49 CFR Parts 171 - 185, require hazmat employees to have documented training specified in 49 CFR 172 Subpart H. A hazmat employee is defined as an individual who: (1) loads, unloads or handles hazardous material; (2) manufactures, tests, reconditions, repairs, modifies, marks or otherwise represents containers, drums or packagings as qualified for use in the transportation of hazardous materials; (3) prepares hazardous materials for transportation; (4) is responsible for safety of transporting hazardous materials; or (5) operates a vehicle used to transport hazardous materials. Recurrent training is required at least once every three years. (The IATA two year training interval is not applicable and is generally misunderstood.) FAA has escalated inspection and enforcement. Facilities who ship radiopharmaceuticals to other laboratories, return radiopharmaceuticals or radioactive sources to suppliers, or otherwise ship radioactive materials have been cited for failure to provide and document the required training. The interrelationship of transportation regulations, 49 CFR, IATA, ICAO and other transportation regulations, which are frequently misunderstood, will be explained. The course will cover typical shipments by air and highway which are encountered in a medical institution. Items such as fissile materials, highway route controlled quantities, rail shipments, vessel shipments and such will be omitted; although specific questions may be addressed. A major objective of the course is to present the process of shipping radioactive material in a sequential and logical fashion. How radioactive materials for transportation purposes are defined by activity concentrations for exempt materials and activity limits for exempt consignments will be explained. Radioactive material shipments of excepted packages and Type A packages will be emphasized. The program is designed to meet the function specific DOT training requirements for shippers of medical radioactive materials. General awareness training and security awareness training can be obtained from two free DOT training CDs. Safety training and security awareness training is generally satisfied by the training required under the institution’s radioactive material license. For shippers of radioactive Yellow III labeled packages an in-depth written security plan and training are no longer required as of April 8, 2010. In general almost all shippers of medical radioactive material are now not required to have an in-depth security plan. Contents of general awareness training, security awareness training and in-depth security plans will be briefly outlined. It is the hazmat employer’s responsibility to ensure that each hazmat employee is properly trained. No third party can fulfill that requirement. It is the hazmat employer’s responsibility to determine the degree to which this course meets the employer’s requirements, including contents of the course and the examination. Participants will gain sufficient knowledge to prepare hazmat training programs for others in their institutions. A handout will be posted which should be printed out and brought to the course for reference during the presentation. The handout will also satisfy part of the training documentation required by DOT. A feature handout section is a composite table which provides A1, A2, RQ, Exempt Concentration, and Exempt Consignment values in a single table in both Becquerel and Curie units. Course attendance will be certified through the AAPM CEU documentation system. Learning Objectives: Understand the regulatory requirements for shipping radioactive materials. Understand the regulatory requirements for training of hazmat employees. Comprehend how to classify, package, mark, label, document, placard, and transport radioactive materials.

60 APPLIED LIFE SCIENCES↗

Technical Note: Development of a 3D printed subresolution sandwich phantom for validation of brain SPECT analysis

Purpose: To make an adaptable, head shaped radionuclide phantom to simulate molecular imaging of the brain using clinical acquisition and reconstruction protocols. This will allow the characterization and correction of scanner characteristics, and improve the accuracy of clinical image analysis, including the application of databases of normal subjects. Methods: A fused deposition modeling 3D printer was used to create a head shaped phantom made up of transaxial slabs, derived from a simulated MRI dataset. The attenuation of the printed polylactide (PLA), measured by means of the Hounsfield unit on CT scanning, was set to match that of the brain by adjusting the proportion of plastic filament and air (fill ratio). Transmission measurements were made to verify the attenuation of the printed slabs. The radionuclide distribution within the phantom was created by adding {sup 99m}Tc pertechnetate to the ink cartridge of a paper printer and printing images of gray and white matter anatomy, segmented from the same MRI data. The complete subresolution sandwich phantom was assembled from alternate 3D printed slabs and radioactive paper sheets, and then imaged on a dual headed gamma camera to simulate an HMPAO SPECT scan. Results: Reconstructions of phantom scans successfully used automated ellipse fitting to apply attenuation correction. This removed the variability inherent in manual application of attenuation correction and registration inherent in existing cylindrical phantom designs. The resulting images were assessed visually and by count profiles and found to be similar to those from an existing elliptical PMMA phantom. Conclusions: The authors have demonstrated the ability to create physically realistic HMPAO SPECT simulations using a novel head-shaped 3D printed subresolution sandwich method phantom. The phantom can be used to validate all neurological SPECT imaging applications. A simple modification of the phantom design to use thinner slabs would make it suitable for use in PET.

60 APPLIED LIFE SCIENCES↗

Prediction of liver remnant regeneration after living donor liver transplantation using preoperative CT texture analysis

Purpose: To predict the rate of liver regeneration after living donor liver transplantation (LDLT) using pre-operative computed tomography (CT) texture analysis. Materials and methods: 112 living donors who performed right hepatectomy for LDLT were included retrospectively. We measured the volume of future remnant liver (FLR) on pre-operative CT and the volume of remnant liver (LR) on follow-up CT, taken at a median of 123 days after transplantation. The regeneration index (RI) was calculated using the following equation: [(V{sub LR}−V{sub FLR})/V{sub FLR}] × 100. Computerized texture analysis of the semi-automatically segmented FLR was performed. We used a stepwise, multivariable linear regression to assess associations of clinical features and texture parameters in relation to RI and to make the best-fit predictive model. Results: The mean RI was 110.7 ± 37.8%, highly variable ranging from 22.4% to 247.0%. Among texture parameters, volume of FLR, standard deviation, variance, and gray level co-occurrence matrices (GLCM) contrast were found to have significant correlations between RI. In multivariable analysis, smaller volume of FLR (ß − 0.17, 95% CI − 0.22 to − 0.13) and lower GLCM contrast (ß − 1.87, 95% CI − 3.64 to − 0.10) were associated with higher RI. The regression equation predicting RI was following: RI = 203.82 + 10.42 × pre-operative serum total bilirubin (mg/dL) − 0.17 × V{sub FLR} (cm{sup 3}) − 1.87 × GLCM contrast (× 100). Conclusion: Volume of FLR and GLCM contrast were independent predictors of RI, showing significant negative correlations. Pre-operative CT with texture analysis can be useful for predicting the rate of liver regeneration in living donor of liver transplantation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Can Laws Be a Potential PET Image Texture Analysis Approach for Evaluation of Tumor Heterogeneity and Histopathological Characteristics in NSCLC?

We investigated the association between the textural features obtained from {sup 18}F-FDG images, metabolic parameters (SUVmax{sub ,} SUVmean, MTV, TLG), and tumor histopathological characteristics (stage and Ki-67 proliferation index) in non-small cell lung cancer (NSCLC). The FDG-PET images of 67 patients with NSCLC were evaluated. MATLAB technical computing language was employed in the extraction of 137 features by using first order statistics (FOS), gray-level co-occurrence matrix (GLCM), gray-level run length matrix (GLRLM), and Laws’ texture filters. Textural features and metabolic parameters were statistically analyzed in terms of good discrimination power between tumor stages, and selected features/parameters were used in the automatic classification by k-nearest neighbors (k-NN) and support vector machines (SVM). We showed that one textural feature (gray-level nonuniformity, GLN) obtained using GLRLM approach and nine textural features using Laws’ approach were successful in discriminating all tumor stages, unlike metabolic parameters. There were significant correlations between Ki-67 index and some of the textural features computed using Laws’ method (r = 0.6, p = 0.013). In terms of automatic classification of tumor stage, the accuracy was approximately 84% with k-NN classifier (k = 3) and SVM, using selected five features. Texture analysis of FDG-PET images has a potential to be an objective tool to assess tumor histopathological characteristics. The textural features obtained using Laws’ approach could be useful in the discrimination of tumor stage.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Determination of Gray Cast Iron Age Strengthening by Nondestructive Methods: Effect of Alloying Elements

Gray cast iron age strengthening is a phenomenon known as a modification of the alloy’s structure by iron-nitride precipitation during few days after casting. It generates an evolution of cast iron mechanical properties as a gain of hardness and Young’s modulus. In a first time, this article presents the possibility to monitor the aging time and the intensity of age strengthening using two nondestructive methods: nonstandard Rockwell hardness and inert frequencies measurement. In a second time, the study shows the influence of the alloying elements on this phenomenon and particularly the influence of free nitrogen amount, which is a first-order parameter to control aging. Finally, a prediction model of the time and the intensity of age strengthening has been elaborated using the results of the two different monitoring described.

36 MATERIALS SCIENCE↗

Optimization of Interlayer/CrWN Bilayer Films Fabricated and Monitored under Shewhart Control

Chromium tungsten nitride (CrWN) films were deposited onto SUS 304 stainless steel, cutter inserts and glass substrates using direct current reactive magnetron sputtering, with pure W and Cr metal targets. The deposition parameters for the interlayer (W and WN) with multiple qualities were optimized using the gray Taguchi method. The microstructure of these coatings was determined using x-ray diffraction, scanning electron microscopy, energy dispersive spectroscopy and transmission electron microscopy. The results showed that the mechanical properties of bilayer samples with an interlayer of WN nitride film are superior to those with a W metal interlayer. Moreover, increasing the N{sub 2}/(N{sub 2} + Ar) flow ratio and working pressure enhanced the microhardness and the elastic recovery for coatings with an interlayer/CrWN bilayer. Dry milling tests also showed that bilayer film coatings have better mechanical performance. This increase in multiple performance characteristics is attributed to a bilayer that is manufactured using the gray Taguchi method. Control charts, which are powerful tools and widely used, were employed to monitor and ensure high-quality fabrication of the interlayer/CrWN bilayer and to show the coating processes to be stable and well regulated.

36 MATERIALS SCIENCE↗