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All sourcesNASA NTRSDOE OSTI
NASA NTRS2005

Vortobots

The term vortobots denotes proposed swimming robots that would have dimensions as small as micrometers or even nanometers and that would move in swarms through fluids by generating and exploiting vortices in a cooperative manner. Vortobots were conceived as means of exploring confined or otherwise inaccessible fluid environments: they are expected to be especially attractive for biomedical uses like examining the interiors of blood vessels. The main advantage of the vortobot concept, relative to other concepts for swimming microscopic robots, is that the mechanisms for locomotion would be relatively simple and, therefore, could be miniaturized more easily. For example, only a simple spinning paddle would be required to generate a vortex around a vortobot (see Figure 1). The difficulty is that a smart swarming and cooperative control algorithm would be necessary for purposeful locomotion. This necessity arises because, as a consequence of basic principles of vortex dynamics, an isolated single vortex cannot move by itself because its induced flow at the center is zero; however, a vortex can move other vortices by the induced flow. By cleverly adjusting the strength and sign of each member in a group of vortices, the group can achieve net translational motion in the preferred direction through cooperation. Figure 2 presents two simple examples that serve to illustrate the principle of cooperative motion of vortobots. For the sake of simplicity, these examples are based on an idealized two-dimensional potential flow of an inviscid, incompressible liquid. The example of the upper part of the figure is of two vortices of equal magnitude and opposite sign. The centers of the vortices would move along parallel paths. The example of the lower part of the figure is of two vortices of the same magnitude and sign. In this case, both vortices would move in a circle in diametrically opposite positions. More complex motions can be obtained by introducing more vortices (or pairs of vortices) and choosing different vortex strengths and orientations.

Park, Han↗
NASA NTRS2004

Transplanting Retinal Cells using Bucky Paper for Support

A novel treatment for retinal degenerative disorders involving transplantation of cells into the eye is currently under development at NASA Ames Research Center and Stanford University School of Medicine. The technique uses bucky paper as a support material for retinal pigment epithelial (RPE) cells, iris pigment epithelial (IPE) cells, and/or stem cells. This technology is envisioned as a treatment for age-related macular degeneration, which is the leading cause of blindness in persons over age 65 in Western nations. Additionally, patients with other retinal degenerative disorders, such as retinitis pigmentosa, may be treated by this strategy. Bucky paper is a mesh of carbon nanotubes (CNTs), as shown in Figure 1, that can be made from any of the commercial sources of CNTs. Bucky paper is biocompatible and capable of supporting the growth of biological cells. Because bucky paper is highly porous, nutrients, oxygen, carbon dioxide, and waste can readily diffuse through it. The thickness, density, and porosity of bucky paper can be tailored in manufacturing. For transplantation of cells into the retina, bucky paper serves simultaneously as a substrate for cell growth and as a barrier for new blood vessel formation, which can be a problem in the exudative type of macular degeneration. Bucky paper is easily handled during surgical implantation into the eye. Through appropriate choice of manufacturing processes, bucky paper can be made relatively rigid yet able to conform to the retina when the bucky paper is implanted. Bucky paper offers a distinct advantage over other materials that have been investigated for retinal cell transplantation - lens capsule and Descemet's membrane - which are difficult to handle during surgery because they are flimsy and do not stay flat.

Loftus, David J.↗
NASA NTRS2004

Using an Ultrasonic Instrument to Size Extravascular Bubbles

In an ongoing development project, microscopic bubbles in extravascular tissue in a human body will be detected by use of an enhanced version of the apparatus described in Ultrasonic Bubble- Sizing Instrument (MSC-22980), NASA Tech Briefs, Vol. 24, No. 10 (October 2000), page 62. To recapitulate: The physical basis of the instrument is the use of ultrasound to excite and measure the resonant behavior (oscillatory expansion and contraction) of bubbles. The resonant behavior is a function of the bubble diameter; the instrument exploits the diameter dependence of the resonance frequency and the general nonlinearity of the ultrasonic response of bubbles to detect bubbles and potentially measure their diameters. In the cited prior article, the application given most prominent mention was the measurement of gaseous emboli (essentially, gas bubbles in blood vessels) that cause decompression sickness and complications associated with cardiopulmonary surgery. According to the present proposal, the instrument capabilities would be extended to measure extravascular bubbles with diameters in the approximate range of 1 to 30 m. The proposed use of the instrument could contribute further to the understanding and prevention of decompression sickness: There is evidence that suggests that prebreathing oxygen greatly reduces the risk of decompression sickness by reducing the number of microscopic extravascular bubbles. By using the ultrasonic bubble-sizing instrument to detect and/or measure the sizes of such bubbles, it might be possible to predict the risk of decompression sickness. The instrument also has potential as a tool to guide the oxygen-prebreathing schedules of astronauts; high-altitude aviators; individuals who undertake high-altitude, low-opening (HALO) parachute jumps; and others at risk of decompression sickness. For example, an individual at serious risk of decompression sickness because of high concentrations of extravascular microscopic bubbles could be given a warning to continue to prebreathe oxygen until it was safe to decompress.

Magari, Patrick J.↗
NASA NTRS2015

Analyses of Magnetic Resonance Imaging of Cerebrospinal Fluid Dynamics Pre and Post Short and Long-Duration Space Flights

Preliminary results are based on analyses of data from 17 crewmembers. The initial analysis compares pre to post-flight changes in total cerebral blood flow (CBF) and craniospinal CSF flow volume. Total CBF is obtained by summation of the mean flow rates through the 4 blood vessels supplying the brain (right and left internal carotid and vertebral arteries). Volumetric flow rates were obtained using an automated lumen segmentation technique shown to have 3-4-fold improved reproducibility and accuracy over manual lumen segmentation (6). Two cohorts, 5 short-duration and 8 long-duration crewmembers, who were scanned within 3 to 8 days post landing were included (4 short-duration crewmembers with MRI scans occurring beyond 10 days post flight were excluded). The VIIP Clinical Practice Guideline (CPG) classification is being used initially as a measure for VIIP syndrome severity. Median CPG scores of the short and long-duration cohorts were similar, 2. Mean preflight total CBF for the short and long-duration cohorts were similar, 863+/-144 and 747+/-119 mL/min, respectively. Percentage CBF changes for all short duration crewmembers were 11% or lower, within the range of normal physiological fluctuations in healthy individuals. In contrast, in 4 of the 8 long-duration crewmembers, the change in CBF exceeded the range of normal physiological fluctuation. In 3 of the 4 subjects an increase in CBF was measured. Large pre to post-flight changes in the craniospinal CSF flow volume were found in 6 of the 8 long-duration crewmembers. Box-Whisker plots of the CPG and the percent CBF and CSF flow changes for the two cohorts are shown in Figure 4. Examples of CSF flow waveforms for a short and two long-duration (CPG 0 and 3) are shown in Figure 5. Changes in CBF and CSF flow dynamics larger than normal physiological fluctuations were observed in the long-duration crewmembers. Changes in CSF flow were more pronounced than changes in CBF. Decreased CSF flow dynamics were observed in a subject with VIIP signs. Study limitations include a slightly longer landing-to-MRI scan period for the short-duration cohort and limited sensitivity of the subjective discrete ordinal CPG scale. This limitation can be overcome by using imaging based parametric measures of VIIP severity such as globe deformation measures.

Alperin, Noam↗
NASA NTRS2016

Association Between Increased Vascular Density and Loss of Protective RAS in Early-stage NPDR

Our hypothesis predicts that retinal blood vessels increase in density during early-stage progression to moderate nonproliferative diabetic retinopathy (NPDR). The renin-angiotensin system (RAS) is implicated in the pathogenesis of DR and in the function of circulating angiogenic cells (CACs), a critical bone marrow-derived population that is instrumental in vascular repair.

Fractal↗
NASA NTRS2016

Translational Cellular Research on the International Space Station

The emerging field of Translational Research aims to coalesce interdisciplinary findings from basic science for biomedical applications. To complement spaceflight research using human subjects, translational studies can be designed to address aspects of space-related human health risks and help develop countermeasures to prevent or mitigate them, with therapeutical benefits for analogous conditions experienced on Earth. Translational research with cells and model organisms is being conducted onboard the International Space Station (ISS) in connection with various human systems impacted by spaceflight, such as the cardiovascular, musculoskeletal, and immune systems. Examples of recent cell-based translational investigations on the ISS include the following. The JAXA investigation Cell Mechanosensing seeks to identify gravity sensors in skeletal muscle cells to develop muscle atrophy countermeasures by analyzing tension fluctuations in the plasma membrane, which changes the expression of key proteins and genes. Earth applications of this study include therapeutic approaches for some forms of muscular dystrophy, which appear to parallel aspects of muscle wasting in space. Spheroids is an ESA investigation examining the system of endothelial cells lining the inner surface of all blood vessels in terms of vessel formation, cellular proliferation, and programmed cell death, because injury to the endothelium has been implicated as underpinning various cardiovascular and musculoskeletal problems arising during spaceflight. Since endothelial cells are involved in the functional integrity of the vascular wall, this research has applications to Earth diseases such as atherosclerosis, diabetes, and hypertension. The goal of the T-Cell Activation in Aging NASA investigation is to understand human immune system depression in microgravity by identifying gene expression patterns of candidate molecular regulators, which will provide further insight into factors that may play a critical role in immune function loss during aging. In addition, Omics investigations with cells have synergistic applications ranging from the evaluation of pharmacological countermeasures to drug discovery. Thus, cell-based translational research onboard the ISS is bidirectionally bridging cutting-edge cellular and molecular approaches with space bioastronautics and human health methodologies on Earth.

Love, John↗
NASA NTRS2016

Association Between Increased Vascular Density and Loss of Protective RAS in Early-Stage NPDR

Our hypothesis predicts that retinal blood vessels increase in density during early-stage progression to moderate nonproliferative diabetic retinopathy (NPDR). The prevailing paradigm of NPDR progression is that vessels drop out prior to abnormal, vision-impairing regrowth at late-stage proliferative diabetic retinopathy (DR). However, surprising results for our previous preliminary study 1 with NASA's VESsel GENeration Analysis (VESGEN) software showed that vessels proliferated considerably during moderate NPDR compared to drop out at both mild and severe NPDR. Validation of our hypothesis will support development of successful early-stage regenerative therapies such as vascular repair by circulating angiogenic cells (CACs). The renin-angiotensin system (RAS)is implicated in the pathogenesis of DR and in the function of CACs, a critical bone marrow-derived population that is instrumental in vascular repair.

Fractal↗
NASA NTRS2018

Measuring Work of Adhesion of Polystyrene Microspheres

Particle adhesion is relevant in fields ranging from aerospace and energy to civil engineering and medicine. The functions of aerodynamic surfaces, heat exchangers, solar panels, ventilation systems, and blood vessels are affected by the buildup of particulates on their surfaces. Direct measurement of the adhesive force between a particle and a surface is key to understanding and mitigating particle fouling. Approaches such as the Johnson-Kendall-Roberts (JKR) and Derjaguin-Muller-Toporov (DMT) models offer a first approximation of the forces involved but do not account for non-idealities like roughness or plastic deformation. Experimental measurements of adhesive forces often deviate significantly from predictions. One approach to measure adhesion is the colloidal probe technique, which uses a particle attached to the tip of an atomic force microscope (AFM) cantilever. The particle is touched to a surface and then withdrawn and a pull-off force (FPO) determined by cantilever deflection. FPO can be used to estimate work of adhesion (Wa) and other properties from existing models. We describe a new method for producing colloidal probes using wax as an adhesive to attach micrometer-scale spheres to AFM tips. This method can be used with a range of particles and minimizes the potential for changes to the particle surface chemistry or geometry from exposure to heat, chemicals, radiation, or external forces. Particle attachment to AFM tips is robust and reversible, allowing old particles to be replaced with new ones in a few minutes. Pull-off measurements using polystyrene (PS) particles, pristine and modified with myristyltrimethylammonium bromide (14-TAB), were collected from various substrates to demonstrate the viability of this technique and investigate the impact of particle surface modification.

Schmitz, Russell C.↗
NASA NTRSDate not supplied

Retinal Image Quality Assessment for Spaceflight-Induced Visual Impairment Study

Medical reports have identified visual impairments as a risk associated with extended exposure to microgravity. Etiology of these ocular changes is currently unknown. Current hypotheses propose cephalad fluid shifts resulting from microgravity as the primary cause of ocular damage. One approach to studying ocular response to microgravity is by examining possible changes in retinal blood vessels using a NASA model of microgravity, the head-down tilt (HDT) of human subjects undergoing prolonged bed rest (BR). Retinal vessels in astronauts and BR subjects are monitored by Heidelberg Spectralis infrared (IR) imaging, in which retinal image quality is limited by insufficient resolution of small vessels. Yet small vessels respond and remodel most actively to physiological stress.For our NASA study of BR subjects, we identify retinal image quality as thecapability to capture vascular detail to acceptable resolution of small vessels. We therefore are analyzing Spectralis images acquired with fluorescein angiography(FA), where increased contrast significantly improves image resolution. The FA images are of normal subjects participating in a clinical study on diabeticretinopathy (US National Institutes of Health). We hypothesize that FA Spectralis images are of superior quality compared to non-FA Spectralis IR images.

Rodrigo Rene Rai Munoz Abujder↗
NASA NTRSDate not supplied

A Gene Expression and Histologic Approach to Study Production and Outflow of Cerebrospinal Fluid in Hindlimb Suspended Rats

INTRODUCTION: The Spaceflight Associated Neuro-ocular Syndrome (SANS) is thought to be associated with weightlessness-induced cephalad fluid shift, possibly associated with a chronic elevation of intracranial pressure (ICP) during long-duration ISS missions. Changes in cerebrospinal fluid (CSF) dynamics and cranial compliance might be involved in the ICP increase. It is not known whether CSF production and/or outflow are altered in microgravity, but changes at the molecular and cellular level in the structures that produce and regulate the transcellular and paracellular secretion and reabsorption of CSF may be relevant. In this study, we used the rat hindlimb suspension (HS) model to examine the relationship between intracranial pressure (ICP) and the cellular responses to the prolonged change in body posture elicited specifically in the choroid plexus (CP). This was evaluated by transcriptomics, histopathology and ultrastructure of the CP and arachnoid villi (AV). METHODS: ICP was measured by telemetry. The morphology, ultrastructure, and gene expression profile of the CP was examined using male 9-month-old Long Evans rats subjected to HS for 14 and 90 days. A subset of animals completing 90-day HS returned to normal posture for 14 and 90 additional days of recovery. All HS rats had age-matched cage controls maintained in normal posture. A group of animals was maintained in conditions of 1% CO2 throughout the entire protocol. The rat brains were carefully removed and preserved for various analyses, including transmission electron microscopy (TEM), immunohistochemical analysis of specific targets involved in CSF regulation, and RNA sequencing analysis of laser capture micro-dissected CP tissue from the lateral ventricles. SUMMARY OF RESULTS: The ICP record was limited, which impacted any conclusions derived from the results. However, the ICP of rats in the CO2-enriched atmosphere appeared increased compared to those in a normal air composition. HS of rats resulted in an altered transcriptomics profile in the choroid plexus compared to animals maintained at normal posture. This was observed during both the HS period and during normal posture recovery period following 90 days of suspension. The greatest number of differentially expressed genes was observed at 90 days HS. Elevated CO2 also led to a different transcriptomics profile in the CP. The histology and ultrastructure results should be considered preliminary due to the limited number of samples. Examination of the CP by TEM showed blood vessel congestion and microvilli swelling in the CP, as well as some subpial and periventricular gliosis, but no associations were observed with treatment. There was no evidence of a reduced clearance of b-amyloid in the periventricular, perivascular and subpial regions of the brain in HS animals versus those in normal posture. Immunohistochemical staining of aquaporin 4, showed the localization to the subpial region and ependyma with increased immunoreactivity in the brains of CO2 exposed rats. This work was supported by awards NNX15AW48G to S.Z. Animal tissue and live data was provided under a tissue/data sharing agreement with Dr. Charles Fuller, UC Davis.

S B Zanello↗
NASA NTRSDate not supplied

A Gene Expression and Histologic Approach to Study Production and Outflow of Cerebrospinal Fluid in Hindlimb Suspended RATS

INTRODUCTION: The Spaceflight Associated Neuro-ocular Syndrome (SANS) is thought to be associated with weightlessness-induced cephalad fluid shift, possibly associated with a chronic elevation of intracranial pressure (ICP) during long-duration ISS missions. Changes in cerebrospinal fluid (CSF) dynamics and cranial compliance might be involved in the ICP increase. It is not known whether CSF production and/or outflow are altered in microgravity, but changes at the molecular and cellular level in the structures that produce and regulate the transcellular and paracellular secretion and reabsorption of CSF may be relevant. In this study, we used the rat hindlimb suspension (HS) model to examine the relationship between intracranial pressure (ICP) and the cellular responses to the prolonged change in body posture elicited specifically in the choroid plexus (CP). This was evaluated by transcriptomics, histopathology and ultrastructure of the CP and arachnoid villi (AV). METHODS: ICP was measured by telemetry. The morphology, ultrastructure, and gene expression profile of the CP was examined using male 9-month-old Long Evans rats subjected to HS for 14 and 90 days. A subset of animals completing 90-day HS returned to normal posture for 14 and 90 additional days of recovery. All HS rats had age-matched cage controls maintained in normal posture. A group of animals was maintained in conditions of 1% CO2 throughout the entire protocol. The rat brains were carefully removed and preserved for various analyses, including transmission electron microscopy (TEM), immunohistochemical analysis of specific targets involved in CSF regulation, and RNA sequencing analysis of laser capture micro-dissected CP tissue from the lateral ventricles. SUMMARY OF RESULTS: The ICP record was limited, which impacted any conclusions derived from the results. However, the ICP of rats in the CO2-enriched atmosphere appeared increased compared to those in a normal air composition. HS of rats resulted in an altered transcriptomics profile in the choroid plexus compared to animals maintained at normal posture. This was observed during both the HS period and during normal posture recovery period following 90 days of suspension. The greatest number of differentially expressed genes was observed at 90 days HS. Elevated CO2 also led to a different transcriptomics profile in the CP. The histology and ultrastructure results should be considered preliminary due to the limited number of samples. Examination of the CP by TEM showed blood vessel congestion and microvilli swelling in the CP, as well as some subpial and periventricular gliosis, but no associations were observed with treatment. There was no evidence of a reduced clearance of b-amyloid in the periventricular, perivascular and subpial regions of the brain in HS animals versus those in normal posture. Immunohistochemical staining of aquaporin 4, showed the localization to the subpial region and ependyma with increased immunoreactivity in the brains of CO2 exposed rats. This work was supported by awards NNX15AW48G to S.Z. Animal tissue and live data was provided under a tissue/data sharing agreement with Dr. Charles Fuller, UC Davis.

S B Zanello↗
NASA NTRSDate not supplied

Evaluation of Human Spaceflight-Related Tissue Weight Relief Using Whole Body Finite Element Model Simulations

Tissue Weight Relief (TWR) is a physiological condition observed in human spaceflight. It not only impacts the injury biomechanics of soft tissue but also the physiological responses of the cardiovascular system both due to fluid redistribution and the effect of tissue-related transmural pressure on the large venous blood vessels. Understanding the effects of tissue weight relief is especially important because of the role it may play in understanding the cause of Space Associated Neuro-Ocular Syndrome (SANS). SANS can be characterized by a number of ocular changes which reduce visual acuity and SANS related symptoms occur in up to 51% of astronauts. A prevailing theory for the causation of SANS is that of headward (cephalad) fluid shift and a prolonged increase of Intracranial Pressure (ICP) similar to intracranial hypertension, which is not fully supported by the experimental data or astronaut symptom reporting. However, it is still believed that SANS is caused by a pressure change in the eye and the surrounding tissues. It has been proposed that TWR plays a substantial role in affecting internal pressures and fluid shifts in microgravity. In this effort, two whole-body Finite Element (FE) models – Elemance and THUMS – are used to ascertain the microgravity-associated TWR of the musculature surrounding the lower body veins. Elemance and THUMS are physics-based computational models that have been validated and verified for several automotive and domestic applications, and as such, can simulate the relief of soft tissue weight due to changes in the gravitation vector. Specifically, the current effort modeled the transition of the gravitational vector from 1G to 0G, applied across the whole-body model in a supine position. For each 1G to 0G transition simulation, the lower body vein’s transmural pressure-time profile was extracted and averaged around the anterior portion of the thigh muscle. The ascertained transmural pressure changes from 1G to 0G transition are given in Figure 1 for the Elemance and the THUMS FE models. The transmural pressure changes of 10 mmHg and 21 mmHg are in the same order of magnitude as Lu’s value of 44 mmHg. It is to be noted that Lu implemented a 0D to 1D lumped parameter model and the Elemance and THUMS are 3D higher order computational models. This proof-of-concept approach demonstrates that TWR pressure can be adequately estimated with in silico techniques however, further in silico investigations need to be conducted to address the unique contributions to the transmural pressure from each of the computational models.

Finite element modeling↗
NASA NTRS2024

Findings From 9 Years of Renal Stone Surveillance of U.S. Astronauts

INTRODUCTION: Renal stones are thought to be a risk for spaceflight due to urine chemistry changes, induced by microgravity. Asymptomatic stone can have significant medical and mission impact.For9 years astronauts travelling to the International Space Station (ISS) have received pre-and post-flight renal ultrasound, according to a specialized renal ultrasound protocol, to look for renal calcifications or mineralized renal material (MRM).A new ultrasound machine was put in service halfway through the screening program. METHODS: MRM screening data from pre-and post-flight were compared, to look for changes in MRM burden. Pre-and post-flight scans from 42 subjects were compared. Studies were further stratified by old versus new machine. Measures were modeled using the analysis of variance (ANOVA) as defined by the interaction between pre-to postflight, and machine-to-machine. RESULTS: There was no observed statistical change seen in MRM burden pre-to postflight using the new higher-resolution ultrasound machine. DISCUSSION: The new machine gives more precise measurements and allows us to differentiate MRMs from other bright objects seen on ultrasound, such as small blood vessels. These data imply that spaceflight does not increase the risk of renal stone formation, at least out to the length of ISS missions. This data will be used to update NASA’s Human System Risk Board’s risk tracking documents, in-flight Concept of Operations, and our Clinical Practice Guideline.

K Cortez↗
DOE OSTI2021

Shape-memory polymer foam device for treating aneurysms

A system for treating an aneurysm in a blood vessel or vein, wherein the aneurysm has a dome, an interior, and a neck. The system includes a shape memory polymer foam in the interior of the aneurysm between the dome and the neck. The shape memory polymer foam has pores that include a first multiplicity of pores having a first pore size and a second multiplicity of pores having a second pore size. The second pore size is larger than said first pore size. The first multiplicity of pores are located in the neck of the aneurysm. The second multiplicity of pores are located in the dome of the aneurysm.

Ortega, Jason M.↗
NASA NTRS1961

Methods for Determining Blood Flow Through Intact Vessels of Experimental Animals Under Conditions of Gravitational Stress and in Extraterrestrial Space Capsules

Work during the initial six months of this program has proceeded along three lines: (1) technical development of blood flowmeter instrumentation: (2) surgical considerations related to special problems of chronic implantation of flowmeter probes: (3) study of the relationship between levels of blood flow and organ activity. Principal engineering effort has been focused on the fundamental phenomena operative in the flowmeter probe and on probe design. Two probes have been constructed and a third is nearing completion. A previously unrecognized source of zero drift has been discovered and corrected. has been designed, assembled, tested and successfully employed in work on the several probes. A significant innovation which has been introduced is the use of a transformer coupled input for suppression of unwanted common mode signals. New low noise transistor amplifiers with characteristics suitable for space vehicle packaging are being developed. Linearity of the present apparatus has been found to extend at least into the near turbulent flow region. Attention has been directed to the two vascular beds of physiologic interest that present particular problems with regard to chronic implantation of flowmeter probes, the myocardium and the liver. Surgical techniques have been perfected that will permit myocardial and liver blood flow measurement. Two groups of animals have successfully undergone surgery and await the implantation of probes. Studies of the relationship between organ blood flow and levels of physiologic activity have been initiated. The first organ system studied was the heart, For the first time autoregulatory mechanisms have been demonstrated within the myocardial vascular bed which rapidly and precisely maintain coronary blood flow at a level i n keeping with the magnitude of cardiac work, Following a summary statement of the status of the program, the work performed is described, A financial review of expenditures incurred and a proposal for future funding are appended,

Shaw, R. F.↗
DOE OSTI2019

Society of abdominal radiology gastrointestinal bleeding disease-focused panel consensus recommendations for CTA technical parameters in the evaluation of acute overt gastrointestinal bleeding

Purpose: To formulate consensus recommendations for CT angiography technical parameters used to evaluate overt gastrointestinal (GI) bleeding. Methods: An electronic questionnaire consisting of 17 questions was sent to a panel of 16 radiologists with expertise on the imaging of GI bleeding from the Society of Abdominal Radiology GI Bleeding disease-focused panel to obtain consensus agreement on issues related to CTA technical parameters for imaging overt GI bleeding. A multi-round Delphi method of voting was performed to obtain consensus which was defined as ≥ 80% agreement. Results: Consensus agreement was reached in 15/17 (89%) of the questions including the technique for the administration of IV contrast, the number of phases, scan timing, and image reconstruction. Conclusions: A panel of experts on the imaging of GI bleeding from the Society of Abdominal Radiology was able to reach consensus on the majority of technical parameters used for CTA of overt GI bleeding. These recommendations should improve the quality of patient care by adopting these minimal technical requirements for optimal exam performance and lead to less variation in the performance of these exams which will facilitate collecting and comparing published data from different centers. These recommendations will need revisions as additional scientific data become available.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Chemosaturation Percutaneous Hepatic Perfusion (CS-PHP) with Melphalan: Evaluation of 2D-Perfusion Angiography (2D-PA) for Leakage Detection of the Venous Double-Balloon Catheter

Purpose: To evaluate the feasibility of 2D-perfusion angiography (2D-PA) for detecting leakage of the double-balloon catheter used for chemosaturation percutaneous hepatic perfusion (CS-PHP). Materials and Methods: Overall, 112 CS-PHP (09/2015-09/2018) in 52 patients were retrospectively screened for leakage alongside the double-balloon catheter on standard venograms. Finally, 18 procedures with visually detected leakage were included. Fifteen consecutive procedures without leakage served as control. To evaluate 2D-PA for leakage detection, the acquired digital subtraction venograms were post-processed. For each balloon, two different target ROIs were evaluated to assess a possible impact of localization and shape of the ROIs. Time to peak (TTP), peak density (PD), area under the curve (AUC), and ratios of target ROI/reference ROIs (PD{sub tROI}/PD{sub REF}; AUC{sub tROI}/AUC{sub REF}; and TTP{sub tROI}/TTP{sub REF}) were calculated. Results: Leakages were located as follows: 15/18 cranial and 3/18 caudal. At the cranial balloon both ROIs showed a significant decrease in PD{sub tROI}/PD{sub REF} and AUC{sub tROI}/AUC{sub REF} (ROI1: p < 0.0001; p < 0.0001; ROI2: p < 0.0001; p < 0.0001) and a significant increase in TTP{sub tROI}/TTP{sub REF} (ROI1: p = 0.0009; ROI2: p = 0.0003) after double-balloon correction. Following balloon adjustment, the 2D-PA ratios (PD and AUC) of the tested ROIs differed significantly (p < 0.05). The inter-individual comparison of the 2D-PA parameters of the group with leakage before balloon correction and the non-leakage group showed significantly different 2D-PA values for the cranial balloon in both ROIs (p < 0.05). No significant differences were found for the caudal balloon. Conclusion: 2D-PA provides a feasible tool for detecting leakages alongside the cranial portion of the double-balloon catheter used in CS-PHP. The shape and position of the ROIs used to assess perfusion and flow have an impact on the measurements.

62 RADIOLOGY AND NUCLEAR MEDICINE↗