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At least 307 records · Page 17

The Association of Age-Related and Off-Target Retention with Longitudinal Quantification of [ 18 F]MK6240 Tau PET in Target Regions

6-(fluoro- 18 F)-3-(1H-pyrrolo[2,3-c]pyridin-1-yl)isoquinolin-5-amine ([ 18 F]MK6240) tau PET tracer quantifies the brain tau neurofibrillary tangle load in Alzheimer disease. The aims of our study were to test the stability of common reference region estimates in the cerebellum over time and across diagnoses and evaluate the effects of age-related and off-target retention on the longitudinal quantification of [ 18 F]MK6240 in target regions. Methods: We assessed reference, target, age-related, and off-target regions in 125 individuals across the aging and Alzheimer disease spectrum with longitudinal [ 18 F]MK6240 SUVs and SUV ratios (SUVRs) (mean ± SD, 2.25 ± 0.40 y of follow-up). We obtained SUVR from meninges, exhibiting frequent off-target retention with [ 18 F]MK6240. Additionally, we compared tracer uptake between 37 cognitively unimpaired young (CUY) (mean age, 23.41 ± 3.33 y) and 27 cognitively unimpaired older (CU) adults (amyloid-β–negative and tau-negative, 58.50 ± 9.01 y) to identify possible nonvisually apparent, age-related signal. Two-tailed t testing and Pearson correlation testing were used to determine the difference between groups and associations between changes in region uptake, respectively. Results: Inferior cerebellar gray matter SUV did not differ on the basis of diagnosis and amyloid-β status, cross-sectionally and over time. [ 18 F]MK6240 uptake significantly differed between CUY and CU adults in the putamen or pallidum (affecting ~75% of the region) and in the Braak II region (affecting ~35%). Changes in meningeal and putamen or pallidum SUVRs did not significantly differ from zero, nor did they vary across diagnostic groups. We did not observe significant correlations between longitudinal changes in age-related or meningeal off-target retention and changes in target regions, whereas changes in all target regions were strongly correlated. Conclusion: Inferior cerebellar gray matter was similar across diagnostic groups cross-sectionally and stable over time and thus was deemed a suitable reference region for quantification. Despite not being visually perceptible, [ 18 F]MK6240 has age-related retention in subcortical regions, at a much lower magnitude but topographically colocalized with significant off-target signal of the first-generation tau tracers. The lack of correlation between changes in age-related or meningeal and target retention suggests little influence of possible off-target signals on longitudinal tracer quantification. Nevertheless, the age-related retention in the Braak II region needs to be further investigated. Future postmortem studies should elucidate the source of the newly reported age-related [ 18 F]MK6240 signal, and in vivo studies should further explore its impact on tracer quantification.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Low-Jitter Clock Receivers for Fast Timing Applications

Precision timing is a key requirement for emerging 4D particle tracking, Positron Emission Tomography (PET), beam and fusion plasma diagnostics, and other systems. Time-to-Digital Converters (TDCs) are commonly used to provide digital estimates of the relative timing between events, but the jitter performance of a TDC can be no better than the performance of the circuits that acquire the pulses and deliver them to the TDC. Several clock receiver and distribution circuits were evaluated, and a differential amplifier with resistive loads driving a pseudo-differential clock distribution network, developed using design guidelines for radiation tolerance and cryogenic compatibility, was fabricated as part of three prototypes: an analog front-end testbed chip for high-precision timing pixel readout, a dedicated TDC evaluation chip, and a Low-Gain Avalanche Detector (LGAD) readout circuit. Based on TDC measurements of the prototypes, we infer that the jitter added by the clock receiver and distribution circuits is less than 2.25 ps-rms. This performance meets the requirements of many future precision timing systems. The clock receiver and on-chip pseudo-differential driver were fabricated in commercial 28-nm CMOS technology and occupy 2288 µm 2 .

47 OTHER INSTRUMENTATION↗

Evaluation Challenges for the Application of Extended Reality Devices in Medicine

Augmented and virtual reality devices are being actively investigated and implemented for a wide range of medical uses. However, significant gaps in the evaluation of these medical devices and applications hinder their regulatory evaluation. Addressing these gaps is critical to demonstrating the devices’ safety and effectiveness. We outline the key technical and clinical evaluation challenges discussed during the US Food and Drug Administration’s public workshop, “Medical Extended Reality: Toward Best Evaluation Practices for Virtual and Augmented Reality in Medicine” and future directions for evaluation method development. Evaluation challenges were categorized into several key technical and clinical areas. Finally, we highlight current efforts in the standards communities and illustrate connections between the evaluation challenges and the intended uses of the medical extended reality (MXR) devices. Participants concluded that additional research is needed to assess the safety and effectiveness of MXR devices across the use cases.

60 APPLIED LIFE SCIENCES↗

Applying queueing theory to evaluate wait-time-savings of triage algorithms

Abstract In the past decade, artificial intelligence (AI) algorithms have made promising impacts in many areas of healthcare. One application is AI-enabled prioritization software known as computer-aided triage and notification (CADt). This type of software as a medical device is intended to prioritize reviews of radiological images with time-sensitive findings, thus shortening the waiting time for patients with these findings. While many CADt devices have been deployed into clinical workflows and have been shown to improve patient treatment and clinical outcomes, quantitative methods to evaluate the wait-time-savings from their deployment are not yet available. In this paper, we apply queueing theory methods to evaluate the wait-time-savings of a CADt by calculating the average waiting time per patient image without and with a CADt device being deployed. We study two workflow models with one or multiple radiologists (servers) for a range of AI diagnostic performances, radiologist’s reading rates, and patient image (customer) arrival rates. To evaluate the time-saving performance of a CADt, we use the difference in the mean waiting time between the diseased patient images in the with-CADt scenario and that in the without-CADt scenario as our performance metric. As part of this effort, we have developed and also share a software tool to simulate the radiology workflow around medical image interpretation, to verify theoretical results, and to provide confidence intervals for the performance metric we defined. We show quantitatively that a CADt triage device is more effective in a busy, short-staffed reading setting, which is consistent with our clinical intuition and simulation results. Although this work is motivated by the need for evaluating CADt devices, the evaluation methodology presented in this paper can be applied to assess the time-saving performance of other types of algorithms that prioritize a subset of customers based on binary outputs.

Thompson, Yee Lam Elim (ORCID:0000000196537707)↗

X-Ray Phase Contrast Imaging for Dynamic Material Mix Experiments, LAO-003-17, Year 3 of 3

X-ray phase contrast imaging with transmission gratings for density profile measurements has been developed and tested for dynamic experimental applications. Talbot-Lau x-ray deflectometry is a new method of measuring x-ray refraction in addition to attenuation and ultrasmall-angle scattering that has recently been developed for static imaging, primarily for medical and industrial applications. To obtain density profiles from fast-evolving systems, we must use a flash x-ray source with a spot size much larger than the continuous microfocus sources of static imaging systems, and we can obtain only a single exposure. The challenges to measuring electron density profiles of two mixed elements from a single-image, low spatial resolution system are addressed, and initial results from the first dynamic experiments with one such system, conducted on a gas launcher at the end of FY 2018 and beginning of FY 2019, are presented. In FY 2019, we designed and built a new deflectometer designed for detonator experiments to test new techniques to improve the sensitivity and reliability of the diagnostic.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Evaluation of Deep Learning Model Architectures for Point-of-Care Ultrasound Diagnostics

Point-of-care ultrasound imaging is a critical tool for patient triage during trauma for diagnosing injuries and prioritizing limited medical evacuation resources. Specifically, an eFAST exam evaluates if there are free fluids in the chest or abdomen but this is only possible if ultrasound scans can be accurately interpreted, a challenge in the pre-hospital setting. In this effort, we evaluated the use of artificial intelligent eFAST image interpretation models. Widely used deep learning model architectures were evaluated as well as Bayesian models optimized for six different diagnostic models: pneumothorax (i) B- or (ii) M-mode, hemothorax (iii) B- or (iv) M-mode, (v) pelvic or bladder abdominal hemorrhage and (vi) right upper quadrant abdominal hemorrhage. Models were trained using images captured in 27 swine. Using a leave-one-subject-out training approach, the MobileNetV2 and DarkNet53 models surpassed 85% accuracy for each M-mode scan site. The different B-mode models performed worse with accuracies between 68% and 74% except for the pelvic hemorrhage model, which only reached 62% accuracy for all model architectures. These results highlight which eFAST scan sites can be easily automated with image interpretation models, while other scan sites, such as the bladder hemorrhage model, will require more robust model development or data augmentation to improve performance. With these additional improvements, the skill threshold for ultrasound-based triage can be reduced, thus expanding its utility in the pre-hospital setting.

47 OTHER INSTRUMENTATION↗

DICOMs, Missiles, and Metadata: The U.S. Nuclear Weapons Program Leverages a Medical Standard

Digital Imagine and Communications in Medicine (DICOM) images, although most commonly used in medical settings, have been widely adopted by the United States Department of Energy (DOE) for capturing images of the internal components in a nuclear weapon. DICOMs, a lesser-known file format that combine nested metadata structures with complex image data-including multiple planes, frames, and high resolution-require the creation of access copies to support usability within the DOE. Used primarily for ensuring the safety, security, and reliability of the U.S. nuclear stockpile, the Los Alamos National Laboratory (LANL)’s DICOM images and corresponding image metadata must be accessible to scientists and researchers via our institutional centralized databases. This paper describes the author's creation of a Python script that converts DICOM images into accessible, archive-friendly TIFF files while preserving key image data and metadata.

96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗

Gradient-based surface nuclear magnetic resonance for groundwater investigation

In medical magnetic resonance imaging, spatial localization (imaging) is based upon the application of controlled magnetic field gradients on top of the main magnetic field to spatially modulate the frequency and/or phase of the nuclear magnetic resonance (NMR) signal across the volume of investigation. In this work, we have applied similar physical principles to produce controlled magnetic field gradients during surface NMR-based groundwater investigations. In this approach, a gradient pulse of variable amplitude or duration is applied immediately after the excitation pulse to cause predictable phase encoding of the NMR signal as a function of depth. This approach is also applicable to emerging surface NMR detection methods that use a prepolarization field with fast nonadiabatic turn-off to generate detectable NMR signals from the shallow subsurface. In this case, the gradient pulse is applied after terminating the prepolarization field and provides a heretofore unavailable means of localizing the NMR response as a function of depth. The application of gradients can also be combined with tip-angle-based modulation to yield higher imaging resolution than can be achieved through either gradient- or tip-angle-based imaging alone. We implemented this new gradient-based capability into a surface NMR gradient generation accessory that is compatible with the GMR-Flex instrument and developed surface NMR-specific forward modeling and linear inverse models. We validated the accuracy of this novel gradient-based sNMR technology using computer simulations, experiments using a small pool filled with a discrete layer of bulk water, and field experiments at well-characterized groundwater test sites along Ebey Island, WA, and Larned, KS. The gradient-based sNMR imaging observations were compared with high-resolution direct push NMR results observed at these sites. The results of computer simulations and field experiments indicate improvements in both the detection (signal-to-noise ratio) and spatial resolution of shallow subsurface water content using gradient-based surface NMR, compared with traditional surface NMR imaging methods.

Geochemistry & Geophysics↗

Fabrication of a Point-Like Transmission Target for Reducing Computed Tomography Imaging Artifacts

In this study, we address the challenge of enhancing image quality and spatial resolution in computed tomography (CT) imaging by introducing simulation and fabrication of high aspect ratio, point-like transmission targets. Utilizing advanced electroplating techniques, traditionally employed in the fabrication of Through Substrate Via (TSV) interconnects for CMOS circuitry, we successfully embed copper targets within silicon substrates. This method allows us to create high-aspect-ratio features specifically designed for X-ray transmission targets, resulting in micro targets that exhibit a volume increase compared to conventional evaporated surface targets. Furthermore, we present simulation results of the X-ray spectrum generated by these targets, demonstrating their potential to significantly improve both image quality and spatial resolution in CT applications. Our findings suggest that leveraging advanced fabrication techniques can open new avenues for the development of enhanced imaging technologies in medical diagnostics and beyond.

47 OTHER INSTRUMENTATION↗

Apparatus, system, and method for radiation hardened plastic and flexible elastomer scintillator

A scintillating material that is a radiation hardened plastic and flexible elastomer is disclosed. The material is useful in a wide range of high energy particle environments and can be used to create detectors. Such detectors can be used in physics experiments or in medical treatment or imaging. The scintillator can be radiation hardened so as to allow for an extended lifetime over other materials.

Akgun, Ugur↗

Multi-Scale Lithofacies and Chemostratigraphic Analysis of Two Middle Devonian Marcellus Shale Wells in Northern West Virginia, USA

The Marcellus Shale Energy and Environmental Laboratory (MSEEL) consists of two project areas within the dry gas producing region of the Marcellus shale play in Monongalia County, West Virginia. MSEEL is a collaborative field project led by West Virginia University, with Northeast Natural Energy LLC, several industrial partners, and sponsored by the US Department of Energy National Energy Technology Laboratory. The study areas are drilled approximately 8.5 miles apart to better understand the vertical and lateral changes in stratigraphy over a short distance. Two vertical pilot wells, MIP-3H and Boggess 17H were drilled in the fall of 2015 and spring of 2019, respectively. Core was recovered from the MIP-3H (API: 47-061-01707-00-00) 112 feet (34m) between depths of 7445 to 7557 feet, and from the Boggess 17H (API: 47-061-01812-00-00) 139 feet (42m) between depths of 7908 and 8012 ft. A full suite of triple combo (gamma ray, neutron, density logs), image logs, and advanced logging tools were run in both wells and calibrated to core analysis. Core analysis includes medical computed tomography (CT) scans, mineralogy and chemostratigraphy determined from handheld X-Ray fluorescence (hhXRF) and X-Ray powder diffraction (XRD) measurements, and determination of total organic content (TOC). Lithofacies were determined at core-scale using traditional core description techniques and medical CT-scan images. Log-scale facies are based on mineralogy and TOC data and developed using petrophysical logging data calibrated to core data (XRD and pyrolysis data). Chemostratigraphic analysis utilized hhXRF data to determine the major and trace element trends in the cores. In the two wells six shale lithofacies were recognized at the core and log scale. Both wells show organic-rich facies (TOC > 6.5%) primarily in the middle and lower Marcellus, with a slight decrease in thickness of this interval in the Boggess 17H. This interval is interpreted as an increase in paleo-productivity (increased Ni, Zn, and V), decreased sedimentation (decreased detrital proxies), and anoxic to euxinic conditions (increased Mo and chalcophile elements). Paleo-redox conditions in both wells are dynamic throughout deposition transitioning between euxinic/anoxic to dysoxic/oxic. This trend is seen through elemental proxies and calcite/pyrite concretion distributions.

03 NATURAL GAS↗

Mo-99 Concentration and processing by Solvent Extraction and Ion Exchange

Normally derived from its transient-equilibrium parent molybdenum-99 ( 99 Mo) (t½ = 66 h), the short-lived isotope technetium-99m ( 99m Tc) (t ½ = 6.0 h) is the most widely used medical isotope in diagnostic imaging today. The National Nuclear Security Administration’s (NNSA’s) Material Management and Minimization (M3) program—established under the auspices of the American Medical Isotope Production Act—has been tasked with facilitating the work of domestic 99 Mo suppliers that do not use highly enriched uranium (HEU). Superconducting electron linear accelerators that employ high-Z converter targets can generate bremsstrahlung photons and neutron fluxes that can induce photonuclear reactions and uranium (U) fission. Argonne, in collaboration with industrial partners, has been developing the process chemistry for superconducting linear accelerator (LINAC)-irradiated triuranium octoxide (U 3 O 8 ) targets to produce 99 Mo. In short, the process involves dissolving the irradiated targets in nitric acid, which simultaneously releases valuable fission products (xenon and iodine). After adjusting the acid concentration, producers process the feed using tri-n-butyl phosphate (TBP), then mix the raffinate derived from this extraction cycle with a phosphinic acid such as Cyanex 272 or di(2-ethylhexyl) phosphoric acid (HDEHP), which is selective for Mo (molybdenum liquid liquid extraction [MoLLE]). In the next step, a concentration column comprising an anion exchange platform is used to decontaminate the remaining fission products, generating a pure 99 Mo stream in sodium hydroxide (NaOH)/sodium chloride (NaCl).

38 RADIATION CHEMISTRY, RADIOCHEMISTRY, AND NUCLEA↗

A Comprehensive Survey of Readout Strategies for SiPMs Used in Nuclear Imaging Systems

Silicon photomultipliers (SiPMs) offer advantages such as lower relative cost, smaller size, and lower operating voltages compared to photomultiplier tubes. A SiPM’s readout circuit topology can significantly affect the characteristics of an imaging array. In nuclear imaging and detection, energy, timing, and position are the primary characteristics of interest. Nuclear imaging has applications in the medical, astronomy, and high energy physics fields, making SiPMs an active research area. This work is focused on the circuit topologies required for nuclear imaging. We surveyed the readout strategies including the front end preamplification topology choices of transimpedance amplifier, charge amplifier, and voltage amplifier. In addition, a review of circuit topologies suitable for energy, timing, and position information extraction was performed along with a summary of performance limitations and current challenges.

42 ENGINEERING↗

Evolution of radiation protection for medical workers

Within a few months of discovery, X-rays were being used worldwide for diagnosis and within a year or two for therapy. It quickly became clear that while there were significant benefits, there were significant associated hazards, not only for the patients, but also for the operators of the equipment. Simple radiation protection measures were implemented within a decade or two and radiation protection for physicians and other operators has continued to evolve over the last century driven by cycles of widening uses, new technologies, realization of previously unidentified effects, development of recommendations and regulations, along with the rise of related societies and professional organizations. Today, the continue acceleration of medical radiation uses in diagnostic imaging and in therapeutic modalities not imagined at the turn of this century, such as positron emission tomography, calls for constant vigilance and flexibility to provide adequate protection for the growing numbers of medical radiation workers.

61 RADIATION PROTECTION AND DOSIMETRY↗

High average-flux laser-driven neutron source

Laser-driven neutron generation is an attractive alternative to more established methods for compact, short-pulse-duration neutron sources with applications in medical science, material science and imaging. Despite extensive investigation of various techniques, achieving performance comparable to nuclear reactors or conventional accelerators remains challenging. In this work, we generate a stable, high-repetition-rate laser-driven neutron source reaching a record average flux of 7.8 × 10 7 n/sr/s, improving on other existing laser-based sources by more than one order of magnitude. Our approach is based on a two-step process where electrons are accelerated to relativistic energies via laser wakefield acceleration (LWFA), and subsequently generate neutrons through Bremsstrahlung emission followed by photonuclear reactions in a tungsten converter. Experimental results, supported by Monte Carlo simulations, show a neutron flux of 3.0 × 10 7 n/cm 2 /s near the target, on par with some compact accelerator-based neutron sources. Additionally, a direct comparison with the target-normal sheath acceleration (TNSA) pitcher-catcher scheme, performed on the same laser system, reveals a significantly higher total neutron yield of 3.9 × 10 8 neutrons per shot, outperforming the TNSA scheme by several orders of magnitude. These findings represent a significant advancement towards the development of practical laser-driven neutron sources and highlight the advantages of LWFA-based neutron generation for future applications.

Vallières, Simon [Institut National de la Recherch↗

Differences in Outcomes between Patellar Dislocations Managed in Emergent versus Non-Emergent Care Settings

Abstract Patellar dislocations occur at a much higher rate in military than civilian populations. Past population-level studies have shown that surgical management is as good as or superior to conservative care and may reduce future reoccurrences. Although in acute cases and in civilian clinics, patellar dislocations are usually managed first in an emergent care setting, previous work suggests this can lead to increased costs. This study compared differences in downstream care type and intensity of services based on whether initial care occurred in emergent or non-emergent care settings. In our sample of 1,523 Military Health System (MHS) beneficiaries with patellar dislocation and 2-year follow-up, we found non-significant differences in costs, intensity of services, and rates of surgical repair regardless of whether the patient was initially seen in an emergent versus non-emergent care setting. Although we found significant increases in the use of imaging, patellar dislocation-related medical visits, and frequency of closed treatment approaches in emergent care settings, these values were very small and likely not clinically significant. These findings, which included all the patellar dislocations reported across the entire MHS in a 24-month period, suggest that neither emergent nor non-emergent care settings are likely to influence the long-term care received by the individual.

Orthopedics↗

Sparse measurement medical CT reconstruction using multi-fused block matching denoising priors

A major challenge for medical X-ray CT imaging is reducing the number of X-ray projections to lower radiation dosage and reduce scan times without compromising image quality. However these under-determined inverse imaging problems rely on the formulation of an expressive prior model to constrain the solution space while remaining computationally tractable. Traditional analytical reconstruction methods like Filtered Back Projection (FBP) often fail with sparse measurements, producing artifacts due to their reliance on the Shannon-Nyquist Sampling Theorem. Consensus Equilibrium, which is a generalization of Plug and Play, is a recent advancement in Model-Based Iterative Reconstruction (MBIR), has facilitated the use of multiple denoisers are prior models in an optimization free framework to capture complex, non-linear prior information. However, 3D prior modelling in a Plug and Play approach for volumetric image reconstruction requires long processing time due to high computing requirement. Instead of directly using a 3D prior, this work proposes a BM3D Multi Slice Fusion (BM3D-MSF) prior that uses multiple 2D image denoisers fused to act as a fully 3D prior model in Plug and Play reconstruction approach. Our approach does not require training and are thus able to circumvent ethical issues related with patient training data and are readily deployable in varying noise and measurement sparsity levels. In addition, reconstruction with the BM3D-MSF prior achieves similar reconstruction image quality as fully 3D image priors, but with significantly reduced computational complexity. We test our method on clinical CT data and demonstrate that our approach improves reconstructed image quality.

Hossain, Maliha [ORNL]↗