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DOE OSTI2024

Enabling the broader adoption of fusion simulation on complex geometry

This project addressed a key barrier to advanced fusion and nuclear simulation: the difficulty of performing high-fidelity Monte Carlo neutronics directly on complex, real-world CAD geometry. Traditional workflows require engineers to rebuild CAD models as simplified constructive solid geometry, a time-consuming and error-prone process that limits design iteration and broader adoption of simulation tools. The goal of this Phase I SBIR was to make CAD-based neutronics practical, accessible, and robust for industrial and research users. During the project, Coreform significantly enhanced the Direct Accelerated Geometry Monte Carlo (DAGMC) workflow and fully integrated it into Coreform Cubit as a first-class capability. Major achievements include optimized material assignment and surface meshing workflows, substantial performance improvements to geometry imprinting and preparation, native export of DAGMC models, and new visualization tools to support OpenMC source definition and lost-particle debugging. Coreform also expanded Cubit’s capabilities as a full OpenMC preprocessor, including the ability to convert OpenMC constructive solid geometry models back into CAD for visualization, multiphysics coupling, and debugging. In collaboration with Argonne National Laboratory, the project delivered comprehensive new DAGMC documentation and training materials, transforming DAGMC from a research-oriented tool into a production-ready workflow. Results were disseminated through tutorials, conference training, and multiple well-attended webinars demonstrating integrated CAD-based neutronics and multiphysics workflows. Overall, this project demonstrated that high-fidelity Monte Carlo simulations can be performed directly on complex CAD geometry, reducing setup time, improving usability, and enabling faster, more informed design decisions for fusion and nuclear energy systems.

42 ENGINEERING↗

DOE OSTI2019

Comparison of two software systems for quantification of myocardial blood flow in patients with hypertrophic cardiomyopathy

Backgorund: Quantification of myocardial blood flow (MBF) by positron emission tomography (PET) is important for investigation of angina in hypertrophic cardiomyopathy (HCM). Several software programs exist for MBF quantification, but they have been mostly evaluated in patients (with normal cardiac geometry), referred for evaluation of coronary artery disease (CAD). Software performance has not been evaluated in HCM patients who frequently have hyperdynamic LV function, LV outflow tract (LVOT) obstruction, small LV cavity size, and variation in the degree/location of LV hypertrophy. Aim: We compared results of MBF obtained using PMod, which permits manual segmentation, to those obtained by FDA-approved QPET software which has an automated segmentation algorithm. Methods: {sup 13}N-ammonia PET perfusion data were acquired in list mode at rest and during pharmacologic vasodilation, in 76 HCM patients and 10 non-HCM patients referred for evaluation of CAD (CAD group.) Data were resampled to create static, ECG-gated and 36-frame-dynamic images. Myocardial flow reserve (MFR) and MBF (in ml/min/g) were calculated using QPET and PMod softwares. Results: All HCM patients had asymmetric septal hypertrophy, and 50% had evidence of LVOT obstruction, whereas non-HCM patients (CAD group) had normal wall thickness and ejection fraction. PMod yielded significantly higher values for global and regional stress-MBF and MFR than for QPET in HCM. Reasonably fair correlation was observed for global rest-MBF, stress-MBF, and MFR using these two softwares (rest-MBF: r = 0.78; stress-MBF: r = 0.66.; MFR: r = 0.7) in HCM patients. Agreement between global MBF and MFR values improved when HCM patients with high spillover fractions (> 0.65) were excluded from the analysis (rest-MBF: r = 0.84; stress-MBF: r = 0.72; MFR: r = 0.8.) Regionally, the highest agreement between PMod and QPET was observed in the LAD territory (rest-MBF: r = 0.82, Stress-MBF: r = 0.68) where spillover fraction was the lowest. Unlike HCM patients, the non-HCM patients (CAD group) demonstrated excellent agreement in MBF/MFR values, obtained by the two softwares, when patients with high spillover fractions were excluded (rest-MBF: r = 0.95; stress-MBF: r = 0.92; MFR: r = 0.95). Conclusions: Anatomic characteristics specific to HCM hearts contribute to lower correlations between MBF/MFR values obtained by PMod and QPET, compared with non-HCM patients. These differences indicate that PMod and QPET cannot be used interchangeably for MBF/MFR analyses in HCM patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2017

MiR-362-3p inhibits the proliferation and migration of vascular smooth muscle cells in atherosclerosis by targeting ADAMTS1

Atherosclerosis is a progressive condition of the large arteries that can cause coronary artery disease (CAD). Growing amounts of evidence have indicated that microRNAs (miRNAs, miRs) can be used as diagnostic biomarkers in many cellular processes associated with CAD. MiR-362-3p has been implicated in many biological cellular functions. However, little is known about the role of miR-362-3p during atherosclerosis. In the present study, significant downregulation of miR-362-3p was observed in 110 atherosclerotic CAD patients and not in the 84 controls. The upregulation of miR-362-3p was demonstrated to inhibit vascular smooth muscle cell (VSMC) proliferation and migration, and impede the G1/S cell cycle transition. Bioinformatics analysis indicated that a disintegrin and metalloproteinase with thrombospondin motifs 1 (ADAMTS1) was a direct target of miR-362-3p. Subsequent experiments demonstrated that miR-362-3p binds to the 3′-untranslated region (UTR) of ADAMTS1 and decreases its levels of mRNA and protein expression. Overexpression of ADAMTS1 partially restored the miR-362-3p-mediated inhibition of VSMC proliferation, cell cycle, and migration. Upregulation of ADAMTS1 in plasma samples was detected in atherosclerotic CAD patients. Taken together, our findings suggested that miR-362-3p inhibits the proliferation and migration of VSMCs by directly targeting ADAMTS1, which might provide novel insight into the molecular mechanisms underlying the action of miR-362-3p in atherosclerosis. - Highlights: • MiR-362-3p expression is downregulated in the plasma samples of atherosclerotic CAD patients. • MiR-362-3p overexpression inhibits VSMC proliferation, cell cycle progression, and migration. • ADAMTS1 is a direct target of miR-362-3p. • Dysfunction of miR-362-3p may contribute to the pathophysiology of atherosclerosis.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2024

Development of a Method for Shape Optimization for a Gas Turbine Fuel Injector Design Using Metal-Additive Manufacturing

Adjoint shape optimization has enabled physics-based optimal designs for aerodynamic surfaces. Additive manufacturing (AM) makes it possible to manufacture complex shapes. However, there has been a gap between optimal and manufacturable surfaces due to the inherent limitations of commercial computational fluid dynamics (CFD) codes to implement geometric constraints during adjoint computation. In such cases, the design sensitivities are exported and used to perform constrained shape modifications using parametric information stored in computer aided design (CAD) files to satisfy manufacturability constraints. However, modifying the design using adjoint methods in CFD solvers and performing constrained shape modification in CAD can lead to inconsistencies due to different shape parameterization schemes. This paper describes a method to enable the simultaneous optimization of the fluid domain and impose AM manufacturability constraints, resolving one of the key issues of geometry definition for isogeometric analysis. Similar to a grid convergence study, the proposed method verifies the consistencies between shape parameterization techniques present within commercial CAD and CFD software during mesh movement as a part of the adjoint shape optimization routine. By identifying the appropriate parameters essential to a shape optimization study, the error metric between the different parameterization techniques converges to demonstrate sufficient consistencies for justifiable exchange of data between CAD and CFD. For the identified shape optimization parameters, the error metric to measure the deviation between the two parameterization schemes lies within the AM laser-powder bed fusion (L-PBF) process tolerance. Additionally, comparison for subsequent objective function calculations between iterations of the optimization loop showed acceptable differences within 1% variation between the modified geometries obtained using the two parameterization schemes. This method provides justification for the use of multiphysics guided adjoint design sensitivities computed in CFD software to perform shape modifications in CAD to incorporate AM manufacturability constraints during the shape optimization loop such that optimal designs are also additively manufacturable.

33 ADVANCED PROPULSION SYSTEMS↗

NASA NTRS1990

A3I visibility modeling project

The Army-NASA Aircrew Aircraft Integration program is supporting a joint project to build a visibility computer-aided design (CAD) tool. CAD has become an essential tool in modern engineering applications. CAD tools are used to create engineering drawings and to evaluate potential designs before they are physically realized. The visibility CAD tool will provide the design engineer with a tool to aid in the location and specification of windows, displays, and control in crewstations. In an aircraft cockpit the location of instruments and the emissive and reflective characteristics of the surfaces must be determined to assure adequate aircrew performance. The visibility CAD tool will allow the designer to ask and answer many of these questions in the context of a three-dimensional graphical representation of the cockpit. The graphic representation of the cockpit is a geometrically valid model of the cockpit design. A graphic model of a pilot, called the pilot manikin, can be placed naturalistically in the cockpit model. The visibility tool has the capability of mapping the cockpit surfaces and other objects modeled in this graphic design space onto the simulated pilot's retinas for a given visual fixation.

Larimer, James↗

NASA NTRS1999

Airplane Mesh Development with Grid Density Studies

Automatic Grid Generation Wish List Geometry handling, including CAD clean up and mesh generation, remains a major bottleneck in the application of CFD methods. There is a pressing need for greater automation in several aspects of the geometry preparation in order to reduce set up time and eliminate user intervention as much as possible. Starting from the CAD representation of a configuration, there may be holes or overlapping surfaces which require an intensive effort to establish cleanly abutting surface patches, and collections of many patches may need to be combined for more efficient use of the geometrical representation. Obtaining an accurate and suitable body conforming grid with an adequate distribution of points throughout the flow-field, for the flow conditions of interest, is often the most time consuming task for complex CFD applications. There is a need for a clean unambiguous definition of the CAD geometry. Ideally this would be carried out automatically by smart CAD clean up software. One could also define a standard piece-wise smooth surface representation suitable for use by computational methods and then create software to translate between the various CAD descriptions and the standard representation. Surface meshing remains a time consuming, user intensive procedure. There is a need for automated surface meshing, requiring only minimal user intervention to define the overall density of mesh points. The surface mesher should produce well shaped elements (triangles or quadrilaterals) whose size is determined initially according to the surface curvature with a minimum size for flat pieces, and later refined by the user in other regions if necessary. Present techniques for volume meshing all require some degree of user intervention. There is a need for fully automated and reliable volume mesh generation. In addition, it should be possible to create both surface and volume meshes that meet guaranteed measures of mesh quality (e.g. minimum and maximum angle, stretching ratios, etc.).

Cliff, Susan E.↗

NASA NTRS2004

Turbofan Engine Simulated in a Graphical Simulation Environment

Recently, there has been an increase in the development of intelligent engine technology with advanced active component control. The computer engine models used in these control studies are component-level models (CLM), models that link individual component models of state space and nonlinear algebraic equations, written in a computer language such as Fortran. The difficulty faced in performing control studies on Fortran-based models is that Fortran is not supported with control design and analysis tools, so there is no means for implementing real-time control. It is desirable to have a simulation environment that is straightforward, has modular graphical components, and allows easy access to health, control, and engine parameters through a graphical user interface. Such a tool should also provide the ability to convert a control design into real-time code, helping to make it an extremely powerful tool in control and diagnostic system development. Simulation time management is shown: Mach number versus time, power level angle versus time, altitude versus time, ambient temperature change versus time, afterburner fuel flow versus time, controller and actuator dynamics, collect initial conditions, CAD output, and component-level model: CLM sensor, CAD input, and model output. The Controls and Dynamics Technologies Branch at the NASA Glenn Research Center has developed and demonstrated a flexible, generic turbofan engine simulation platform that can meet these objectives, known as the Modular Aero-Propulsion System Simulation (MAPSS). MAPSS is a Simulink-based implementation of a Fortran-based, modern high pressure ratio, dual-spool, low-bypass, military-type variable-cycle engine with a digital controller. Simulink (The Mathworks, Natick, MA) is a computer-aided control design and simulation package allows the graphical representation of dynamic systems in a block diagram form. MAPSS is a nonlinear, non-real-time system composed of controller and actuator dynamics (CAD) and component-level model (CLM) modules. The controller in the CAD module emulates the functionality of a digital controller, which has a typical update rate of 50 Hz. The CLM module simulates the dynamics of the engine components and uses an update rate of 2500 Hz, which is needed to iterate to balance mass and energy among system components. The actuators in the CAD module use the same sampling rate as those in the CLM. Two graphs of normalized spool speed versus time in seconds and one graph of normalized average metal temperature versus time in seconds is shown. MAPSS was validated via open-loop and closed-loop comparisons with the Fortran simulation. The preceding plots show the normalized results of a closed-loop comparison looking at three states of the model: low-pressure spool speed, high-pressure spool speed, and the average metal temperature measured from the combustor to the high-pressure turbine. In steady state, the error between the simulations is less than 1 percent. During a transient, the difference between the simulations is due to a correction in MAPSS that prevents the gas flow in the bypass duct inlet from flowing forward instead of toward the aft end, which occurs in the Fortran simulation. A comparison between MAPSS and the Fortran model of the bypass duct inlet flow for power lever angles greater than 35 degrees is shown.

Parker, Khary I.↗

NASA NTRS2007

Usefulness of Derived Frank Lead Parameters in Screening for Coronary Artery Disease and Cardiomyopathy

We investigated the accuracy of several known as well as newly-introduced derived Frank-lead ECG parameters in differentiating healthy individuals from patients with obstructive coronary artery disease (CAD) and cardiomyopathy (CM). Advanced high-fidelity 12-lead ECG tests (approx. 5-min supine) were first performed on a "training set" of 99 individuals: 33 with ischemic or dilated CM and low ejection fraction (EF less than 40%); 33 with catheterization-proven obstructive CAD but normal EF; and 33 age-/gender-matched healthy controls. The following derived Frank lead parameters were studied for their accuracy in detecting CAD and CM: the spatial ventricular gradient (VG), including its beat-to-beat coefficient of variability (VG CV); the spatial mean QRS (SM-QRS) and T-waves (SM-T) and their beat-to-beat coefficients of variability; the spatial ventricular activation time (VAT); the mean and maximum spatial QRS-T angles; and standard late potentials parameters (RMS40, fQRSD and LAS). Several of these parameters were accurate in discriminating between the control group and both diseased groups at p less than 0.0001. For example the fQRSD, VG CV, mean spatial QRS-T angle and VG minus SM-QRS (which is similar to the SM-T) had retrospective areas under the ROC curve of 0.78, 0.78, 0.80, and 0.84 (CAD vs. controls) and 0.93, 0.88, 0.98 and 0.99 (CM vs. controls), respectively. The single most effective parameter in discriminating between the CAD and CM groups was the spatial VAT (44 plus or minus 5.8 vs. 53 plus or minus 9.9 ms, p less than 0.0001), with an area under the ROC curve of 0.80. Since subsequent prospective analyses using new groups of patients and healthy subjects have yielded only slightly less accurate results, we conclude that derived Frank-lead parameters show great promise for potentially contributing to the development of a rapid and inexpensive resting ECG-based screening test for heart disease.

DePalma, J. L.↗

NASA NTRS2007

Construction and Use of Resting 12-Lead High Fidelity ECG "SuperScores" in Screening for Heart Disease

We investigated the accuracy of several conventional and advanced resting ECG parameters for identifying obstructive coronary artery disease (CAD) and cardiomyopathy (CM). Advanced high-fidelity 12-lead ECG tests (approx. 5-min supine) were first performed on a "training set" of 99 individuals: 33 with ischemic or dilated CM and low ejection fraction (EF less than 40%); 33 with catheterization-proven obstructive CAD but normal EF; and 33 age-/gender-matched healthy controls. Multiple conventional and advanced ECG parameters were studied for their individual and combined retrospective accuracies in detecting underlying disease, the advanced parameters falling within the following categories: 1) Signal averaged ECG, including 12-lead high frequency QRS (150-250 Hz) plus multiple filtered and unfiltered parameters from the derived Frank leads; 2) 12-lead P, QRS and T-wave morphology via singular value decomposition (SVD) plus signal averaging; 3) Multichannel (12-lead, derived Frank lead, SVD lead) beat-to-beat QT interval variability; 4) Spatial ventricular gradient (and gradient component) variability; and 5) Heart rate variability. Several multiparameter ECG SuperScores were derivable, using stepwise and then generalized additive logistic modeling, that each had 100% retrospective accuracy in detecting underlying CM or CAD. The performance of these same SuperScores was then prospectively evaluated using a test set of another 120 individuals (40 new individuals in each of the CM, CAD and control groups, respectively). All 12-lead ECG SuperScores retrospectively generated for CM continued to perform well in prospectively identifying CM (i.e., areas under the ROC curve greater than 0.95), with one such score (containing just 4 components) maintaining 100% prospective accuracy. SuperScores retrospectively generated for CAD performed somewhat less accurately, with prospective areas under the ROC curve typically in the 0.90-0.95 range. We conclude that resting 12-lead high-fidelity ECG employing and combining the results of several advanced ECG software techniques shows great promise as a rapid and inexpensive tool for screening of heart disease.

Schlegel, T. T.↗

NASA NTRS2017

A Dose of Reality: Radiation Analysis for Realistic Human Spacecraft

INTRODUCTION As with most computational analyses, a tradeoff exists between problem complexity, resource availability and response accuracy when modeling radiation transport from the source to a detector. The largest amount of analyst time for setting up an analysis is often spent ensuring that any simplifications made have minimal impact on the results. The vehicle shield geometry of interest is typically simplified from the original CAD design in order to reduce computation time, but this simplification requires the analyst to "re-draw" the geometry with a limited set of volumes in order to accommodate a specific radiation transport software package. The resulting low-fidelity geometry model cannot be shared with or compared to other radiation transport software packages, and the process can be error prone with increased model complexity. The work presented here demonstrates the use of the DAGMC (Direct Accelerated Geometry for Monte Carlo) Toolkit from the University of Wisconsin, to model the impacts of several space radiation sources on a CAD drawing of the US Lab module. METHODS The DAGMC toolkit workflow begins with the export of an existing CAD geometry from the native CAD to the ACIS format. The ACIS format file is then cleaned using SpaceClaim to remove small holes and component overlaps. Metadata is then assigned to the cleaned geometry file using CUBIT/Trelis from csimsoft (Registered Trademark). The DAGMC plugin script removes duplicate shared surfaces, facets the geometry to a specified tolerance, and ensures that the faceted geometry is water tight. This step also writes the material and scoring information to a standard input file format that the analyst can alter as desired prior to running the radiation transport program. The scoring results can be transformed, via python script, into a 3D format that is viewable in a standard graphics program. RESULTS The CAD model of the US Lab module of the International Space Station, inclusive of all the racks and components, was simplified to remove holes and volume overlaps. Problematic features within the drawing were also removed or repaired to prevent runtime issues. The cleaned drawing was then run through the DAGMC workflow to prepare for analysis. Pilot tests modeling transport of 1GeV proton and 800MeV/A oxygen sources show that reasonable results are converged upon in an acceptable amount of overall computation time from drawing preparation to data analysis. The FLUKA radiation transport code will next be used to model both a GCR and a trapped radiation source. These results will then be compared with measurements that have been made by the radiation instrumentation deployed inside the US Lab module. DISCUSSION Early analyses have indicated that the DAGMC workflow is a promising toolkit for running vehicle geometries of interest to NASA through multiple radiation transport codes. In addition, recent work has shown that a realistic human phantom, provided via a subcontract with the University of Florida, can be placed inside any vehicle geometry for a combinatorial analysis. This added functionality gives the user the ability to score various parameters at the organ level, and the results can then be used as input for cancer risk models.

Barzilla, J. E.↗

DOE OSTI2014

Methodological Aspects of Shielding and Activation Analyses for ITER Diagnostics Systems - Paper 125

It is expected that the diagnostics systems of the ITER tokamak will provide valuable measurement data about the first in its kind D-T fusion plasma with emission of 14 MeV neutrons. These systems must withstand the neutron and secondary photon radiation along the ITER operation. Under the neutron irradiation the ITER materials are getting radioactive and therefore an adequate shielding must be provided along all the time of ITER operation and shut-down for the reliable machine operation and for the safe personnel access to its components, such as the diagnostics ports. These are the prerequisites for the shielding and activation analysis of the ITER diagnostics systems discussed in this paper. This paper provides insight into the current tasks of neutronics support for the development of ITER diagnostics systems. The tasks themselves range from relatively straightforward ones such as Monte Carlo radiation transport calculations for shielding analyses of the diagnostics systems, to more advanced tasks of Shut-Down Dose Rate (SDDR) analyses for which the dedicated Rigorous 2-Step mesh-based (R2Smesh) and Direct 1-Step (D1S) methodologies were applied. The accuracy and precision of the ITER neutronics analysis is dependent on the methodological approaches and the implying modeling assumptions. In addition to the SDDR challenges, another distinguishing feature of fusion neutronics is a wide use of CAD-based neutronics modeling to design components of fusion devices such as ITER and DEMO. Basically, there are two possibilities of CAD geometry settings in Monte Carlo (MC) radiation transport models, either by the geometry format conversion of CAD models into the format of MC models by means of the interface programs such as McCad and MCAM or by the direct use of CAD geometry engine in MC calculations such as it was realized in the DAGMC code approach. Several conversion interfaces and the DAGMC software library have been tested on the 3D ITER model developed for the CAD-MCNP benchmark. It was concluded that the considered approaches have reached the maturity level to allow their application to real ITER design analyses.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2022

Layered CAD/CSG geometry for spatially complex radiation transport scenarios

Many spatially complex fission, fusion, and national security Monte Carlo (MC) radiation transport scenarios involve combining computer-aided design (CAD) models with constructive solid geometry (CSG) models. A layered geometry method has been implemented in the Shift MC code to address this need. With layered geometry, multiple CAD and/or CSG models can be clipped, translated, rotated, and placed in overlapping layers to form transport-ready geometries. Here, the utility of this method is demonstrated with two problems: (1) a fixed-source simulation with a layered geometry consisting of a LiDAR-generated CAD model of the Combined Arms Collective Training Facility urban environment overlaid with CSG models of a mock hotel and a detector apparatus, and (2) a k-eigenvalue calculation using a layered geometry model of the Transformational Challenge Reactor consisting of CAD fuel elements placed in a CSG core. Tallied particle flux distributions match expectations, but tracking robustness must be improved prior to general-purpose use.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

DOE OSTI2019

Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET

Purpose of Review: Radionuclide myocardial perfusion imaging (MPI) continues to be the most reliable modality for diagnosis of hemodynamically significant coronary artery disease (CAD). The application of radionuclide MPI using single photon emission computed tomography (SEPCT) and positron emission tomography (PET) for CAD is reviewed, with emphasis on diagnosis and risk stratification. Recent Findings: Contemporary studies have reported the diagnostic and prognostic value of novel imaging protocols, employing stress-first or stress-only approach. In addition, the superior diagnostic value of PET has been established with a role of assessment of myocardial blood flow to improve risk stratification. The utility of MPI in special populations, such as the elderly, women, and diabetic patients has also been recently evaluated. Furthermore, multicenter studies have reported a similar diagnostic and prognostic value of radionuclide MPI compared with other functional and anatomical techniques for CAD. Summary: Radionuclide MPI with SPECT and PET are efficacious for diagnosis and prognosis of CAD. Its universal application in varied patient populations highlights its excellent clinical effectiveness.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2017

Avoiding full corrections in dynamic SPECT images impacts the performance of SPECT myocardial blood flow quantitation

Introduction: This study investigated the performance of SPECT myocardial blood flow (MBF) quantitation lacking full physical corrections (All Corr) in dynamic SPECT (DySPECT) images. Methods: Eleven healthy normal volunteers (HVT) and twenty-four patients with angiography-documented CAD were assessed. All Corr in {sup 99m}Tc-sestamibi DySPECT encompassed noise reduction (NR), resolution recovery (RR), and corrections for scatter (SC) and attenuation (AC), otherwise no correction (NC) or only partial corrections. The performance was evaluated by quality index (R{sup 2}) and blood-pool spillover index (FBV) in kinetic modeling, and by rest flow (RMBF) and stress flow (SMBF) compared with those of All Corr. Results: In HVT group, NC diminished 2-fold flow uniformity with the most degraded quality (15%-18% reduced R{sup 2}) and elevated spillover effect (45%-50% increased FBV). Consistently higher RMBF and SMBF were discovered in both groups (HVT 1.54/2.31 higher; CAD 1.60/1.72; all P < .0001). Bland-Altman analysis revealed positive flow bias (HVT 0.9-2.6 mL/min/g; CAD 0.7-1.3) with wide ranges of 95% CI of agreement (HVT NC −1.9-7.1; NR −0.4-4.4; NR + SC −1.1-4.3; NR + SC + RR −0.7-2.5) (CAD NC −1.2-3.8; NR −1.0-2.8; NR + SC −1.0-2.5; NR + SC + RR −1.1-2.6). Conclusions: Uncorrected physical interference in DySPECT images can extensively impact the performance of MBF quantitation. Full physical corrections should be considered to warrant this tool for clinical utilization.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2018

Validation of a clinical pathway to assess asymptomatic renal transplant candidates using myocardial perfusion imaging

Abstracts: Background: An AHA/ACCF scientific statement proposed 8 risk factors to assess the need for noninvasive coronary artery disease (CAD) surveillance in asymptomatic patients undergoing evaluation for kidney transplantation. The clinical application of these risk factors and the role of noninvasive testing in this context have not been defined. Methods and Results: We retrospectively followed a cohort of 581 consecutive kidney transplant recipients of whom 401 had pre-transplant radionuclide myocardial perfusion imaging (MPI) and 90 had pre-transplant coronary angiography. The sum of pre-transplant AHA/ACCF risk factors (age >60 years, hypertension, diabetes, cardiovascular disease, dyslipidemia, smoking, dialysis >1 year, left ventricular hypertrophy) was calculated. MPI scans were analyzed by a “blinded” reader. Patients were followed for a mean of 3.7 ± 2.3 years post-transplant for major adverse cardiac events (MACE), defined as cardiac death or non-fatal myocardial infarction. The sum of risk factors was associated with modest discriminatory capacity for obstructive angiographic CAD (area under the curve [AUC], 0.70; P = 0.004), 30-day post-operative MACE (AUC, 0.60; P = 0.036), and long-term MACE (AUC, 0.63; P < 0.001). A threshold of ≥3 risk factors was optimal for identifying patients at risk. MPI provided incremental predictive value for obstructive CAD (P = 0.02) and long-term MACE (P = 0.04) but not post-operative MACE (P = 0.56). MPI was best predictive of long-term MACE in intermediate risk (3-4 risk factors) patients. Conclusions: Asymptomatic kidney transplant candidates with ≥3 AHA/ACCF risk factors are at increased cardiac risk, and should be considered for noninvasive CAD surveillance. Intermediate risk patients (3-4 factors) benefit the most from pre-transplant MPI to define long-term MACE risk.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2019

Improved diagnosis of the number of stenosed coronary artery vessels by segmentation with scatter and photo-peak window data for attenuation correction in myocardial perfusion SPECT

Background: Attenuation correction using segmentation of scatter and photo-peak window data (SSPAC) enables an evaluation of the attenuation map in a patient-specific manner without additional radiation exposure. We compared the accuracy of SSPAC and non-corrected myocardial perfusion scintigraphy methods for diagnosing the number of stenosed coronary artery vessels. Methods and Results: We retrospectively reviewed the data from 183 consecutive patients who underwent {sup 99m}Tc-tetrofosmin stress/rest SPECT examination and a coronary angiography within 3 months. The MPS images were reconstructed with and without SSPAC attenuation correction. We examined the accuracy of the quantitative interpretation using summed differential score in the detection of coronary artery disease (CAD). The attenuation maps were successfully determined in 179 of 183 patients (98%). In terms of the vessel-based diagnostic ability, sensitivity, specificity, positive predictive and negative predictive values of the SSPAC and non-correction methods for diagnosing CAD in individual coronary territories were 77%*, 89%, 74%*, and 90%* vs 51%, 87%, 62%, and 82%, respectively (*P < .05). In 35 patients with multi-vessel CAD, those values were 78%*, 81%, 93%, and 55%* vs 49%, 81%, 89%, and 34%, respectively (*P < .05; AUC: 0.82 vs 0.62, P < .05). Conclusion: SSPAC-corrected SPECT myocardial perfusion images exhibit improved accuracy in the detection of the number of stenosed coronary artery vessels, even in patients with multi-vessel CAD.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2019

Coronary vascular age: An alternate means for predicting stress-induced myocardial ischemia in patients with suspected coronary artery disease

Background: Coronary artery calcium (CAC) can be used to estimate vascular age in adults, providing a convenient transformation of CAC from Agatston units into a year’s scale. We investigated the role of coronary vascular age in predicting stress-induced myocardial ischemia in subjects with suspected coronary artery disease (CAD). Methods: A total of 717 subjects referred to CAC scoring and {sup 82}Rb PET/CT stress-rest myocardial perfusion imaging for suspected CAD were studied. CAC score was measured according to the Agatston method and coronary vascular age by equating estimated CAD risk for chronological age and CAC using the formula 39.1 + 7.25 × ln(CAC + 1). Results: Stress-induced ischemia was present in 105 (15%) patients. Mean chronological age, CAC score, and coronary vascular age were higher (all P < .001) in patients with ischemia compared to those without. At incremental analysis, the global Chi square increased from 41.26 to 68.77 (P < .001) when chronological age was added to clinical variables. Including vascular age in the model, the global Chi square further increased from 68.77 to 106.38 (P < .001). Adding chronological age to clinical data, continuous net reclassification improvement (cNRI) was 0.57, while adding vascular age to clinical data and chronological age cNRI was 0.62. At decision curve analysis, the model including vascular age was associated with the highest net benefit compared to the model including only clinical data, to the model including chronological age and clinical data, and to a strategy considering that all patients had ischemia. The model including vascular age also showed the largest reduction in false-positive rate without missing any ischemic patients. Conclusions: In subjects with suspected CAD, coronary vascular age is strongly associated with stress-induced ischemia. The communication of a given vascular age would have a superior emotive impact improving observance of therapies and healthier lifestyles.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2016

Versatile function of the circadian protein CIPC as a regulator of Erk activation

The CLOCK-interacting protein, Circadian (CIPC), has been identified as an additional negative-feedback regulator of the circadian clock. However, recent study on CIPC knockout mice has shown that CIPC is not critically required for basic circadian clock function, suggesting other unknown biological roles for CIPC. In this study, we focused on the cell cycle dependent nuclear-cytoplasmic shuttling function of CIPC and on identifying its binding proteins. Lys186 and 187 were identified as the essential amino acid residues within the nuclear localization signal (NLS) of CIPC. We identified CIPC-binding proteins such as the multifunctional enzyme CAD protein (carbamoyl-phosphate synthetase 2, aspartate transcarbamoylase, and dihydroorotase), which is a key enzyme for de novo pyrimidine synthesis. Compared to control cells, HEK293 cells overexpressing wild-type CIPC showed suppressed cell proliferation and retardation of cell cycle. We also found that PMA-induced Erk activation was inhibited with expression of wild-type CIPC. In contrast, the NLS mutant of CIPC, which reduced the ability of CIPC to translocate into the nucleus, did not exhibit these biological effects. Since CAD and Erk have significant roles in cell proliferation and cell cycle, CIPC may work as a cell cycle regulator by interacting with these binding proteins. - Highlights: • CIPC is a cell cycle dependent nuclear-cytoplasmic shuttling protein. • K186 and 187are the essential amino acid residues within the NLS of CIPC. • CAD was identified as a novel CIPC-binding protein. • CIPC might regulate the activity and translocation of CAD in the cells.

60 APPLIED LIFE SCIENCES↗