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At least 613 records · Page 34

Endovascular Tubular Stent-Graft Placement for Isolated Iliac Artery Aneurysms

Purpose: To evaluate the safety, efficacy, and mid-term outcomes of endovascular tubular stent-graft placement for repair of isolated iliac artery aneurysms (IAAs). Materials and Methods: Between January 2002 and March 2010, 20 patients (7 women and 13 men; mean age 74 years) underwent endovascular repair of 22 isolated IAAs. Two patients underwent endovascular repair for bilateral aneurysms. Ten para-anastomotic aneurysms (45%) developed after open abdominal aortic aneurysm (AAA) repair with an aorto-iliac graft, and 12 were true aneurysms (55%). Eleven straight and 11 tapered stent-grafts were placed. Contrast-enhanced computed tomography (CT) was performed to detect complications and evaluate aneurysmal shrinkage at week 1, 3, 6, and 12 months and once every year thereafter. Non-contrast-enhanced CT was performed in seven patients with chronic kidney disease. Results: All procedures were successful, without serious complications, during the mean (range) follow-up period of 746 days (47-2651). Type II endoleak not requiring treatment was noted in one patient. The mean (SD) diameters of the true and para-anastomotic aneurysms significantly (p < 0.05) decreased from 42.0 (9.3) to 36.9 (13.6) mm and from 40.1 (13.0) to 33.6 (15.8) mm, respectively; the mean (SD) shrinkage rates were 15.1% (20.2%) and 18.9% (22.4%), respectively. The primary patency rate was 100%, and no secondary interventions were required. Four patients (21%) developed transient buttock claudication, and one patient (5%) developed colorectal ischaemia, which was treated conservatively. Conclusion: Endovascular tubular stent-graft placement for the repair of isolated IAAs is safe and efficacious. Tapered stent-grafts of various sizes are required for accurate placement.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

On a framework for generating PoD curves assisted by numerical simulations

The Probability of Detection (PoD) curve method has emerged as an important tool for the assessment of the performance of NDE techniques, a topic of particular interest to the nuclear industry where inspection qualification is very important. The conventional experimental means of generating PoD curves though, can be expensive, requiring large data sets (covering defects and test conditions), and equipment and operator time. Several methods of achieving faster estimates for PoD curves using physics-based modelling have been developed to address this problem. Numerical modelling techniques are also attractive, especially given the ever-increasing computational power available to scientists today. Here we develop procedures for obtaining PoD curves, assisted by numerical simulation and based on Bayesian statistics. Numerical simulations are performed using Finite Element analysis for factors that are assumed to be independent, random and normally distributed. PoD curves so generated are compared with experiments on austenitic stainless steel (SS) plates with artificially created notches. We examine issues affecting the PoD curve generation process including codes, standards, distribution of defect parameters and the choice of the noise threshold. We also study the assumption of normal distribution for signal response parameters and consider strategies for dealing with data that may be more complex or sparse to justify this. These topics are addressed and illustrated through the example case of generation of PoD curves for pulse-echo ultrasonic inspection of vertical surface-breaking cracks in SS plates.

36 MATERIALS SCIENCE↗

Radiation Protection and Dosimetry in Medicine - An Overview - Paper 82

In recent years, radiological protection, radiation safety and dosimetry issues have emerged concerning the medical applications of ionizing radiation. Amongst several other issues, the dissemination of the use of Computer Tomography (CT), including for paediatric exams and the growing number of interventional radiology and interventional cardiology procedures have contributed to raise the concerns about the need to more fully justify the medical practices using ionizing radiation and to optimize the protection, reducing the dose to the patients and to the medical staff in the medical applications of ionizing radiation. The importance of implementing the principle of justification in the medical exposures and to further progress in the implementation of the principle of optimization of the protection is of paramount importance for the establishment of a robust international system of radiological protection. The consideration of radiosensitivity issues became mandatory in order to address different issues such as the paediatric CT exposures and the risk of secondary cancer induction in patients years or decades after radiation treatments. Low-dose radiation research also gained a renewed interest in order to overcome longstanding unresolved issues concerning namely the relationship between the radiological risk versus dose in the low dose region characteristic of the medical radiodiagnostic procedures and to shed some light in the mechanisms associated to the biological effects induced by ionizing radiation. Last but not least, the safety of radiotherapy treatments has also driven considerable efforts from the international community of experts, with the aim of reducing the number of incidents and accidents leading to the overexposure of patients to ionizing radiation. In this paper, an overview of the aforementioned topics is provided, considering the international Basic Safety Standards, European Union Directives and national regulations. Views and policies from international organizations such as the IAEA, the WHO and studies and reports from institutions such as the UNSCEAR, ICRP and the NCRP will be conveyed. Recent or ongoing epidemiological studies will be mentioned. Radiological protection and dosimetry of the patient and the workers in the medical applications of ionizing radiation will be discussed. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗

An efficient computational approach to model statistical correlations in photon counting x-ray detectors

Purpose: To introduce and evaluate an increment matrix approach (IMA) describing the signal statistics of energy-selective photon counting detectors including spatial–spectral correlations between energy bins of neighboring detector pixels. The importance of the occurring correlations for image-based material decomposition is studied. Methods: An IMA describing the counter increase patterns in a photon counting detector is proposed. This IMA has the potential to decrease the number of required random numbers compared to Monte Carlo simulations by pursuing an approach based on convolutions. To validate and demonstrate the IMA, an approximate semirealistic detector model is provided, simulating a photon counting detector in a simplified manner, e.g., by neglecting count rate-dependent effects. In this way, the spatial–spectral correlations on the detector level are obtained and fed into the IMA. The importance of these correlations in reconstructed energy bin images and the corresponding detector performance in image-based material decomposition is evaluated using a statistically optimal decomposition algorithm. Results: The results of IMA together with the semirealistic detector model were compared to other models and measurements using the spectral response and the energy bin sensitivity, finding a good agreement. Correlations between the different reconstructed energy bin images could be observed, and turned out to be of weak nature. These correlations were found to be not relevant in image-based material decomposition. An even simpler simulation procedure based on the energy bin sensitivity was tested instead and yielded similar results for the image-based material decomposition task, as long as the fact that one incident photon can increase multiple counters across neighboring detector pixels is taken into account. Conclusions: The IMA is computationally efficient as it required about 10{sup 2} random numbers per ray incident on a detector pixel instead of an estimated 10{sup 8} random numbers per ray as Monte Carlo approaches would need. The spatial–spectral correlations as described by IMA are not important for the studied image-based material decomposition task. Respecting the absolute photon counts and thus the multiple counter increases by a single x-ray photon, the same material decomposition performance could be obtained with a simpler detector description using the energy bin sensitivity.

60 APPLIED LIFE SCIENCES↗

Computational Fluid Dynamics Modeling of Bubbling in a Viscous Fluid for Validation of Waste Glass Melter Modeling

At the Hanford site, radioactive waste stored in underground tanks is slated for vitrification for final disposal. A comprehensive knowledge of the glass batch melting process will be useful in optimizing the process, which could potentially reduce the cost and duration of this multi-billion dollar cleanup effort. We are developing a high-fidelity heat transfer model of a Joule-heated ceramic lined melter to improve the understanding of the complex, inter-related processes occurring with the melter. The glass conversion rates in the cold cap layer are dependent on promoting efficient heat transfer. In practice, heat transfer is augmented by inserting air bubblers into the molten glass. However, the computational simulations must be validated to provide confidence in the solutions. As part of a larger validation procedure, it is beneficial to split the physics of the melter into smaller systems to validate individually. The substitution of molten glass for a simulant liquid with similar density and viscosity at room temperature provides a way to study mixing through bubbling as an isolated effect without considering the heat transfer dynamics. The simulation results are compared to experimental data obtained by the Vitreous State Laboratory at the Catholic University of America using bubblers placed within a large acrylic tank that is similar in scale to a pilot glass waste melter. Comparisons are made for surface area of the rising air bubbles between experiments and CFD simulations for a variety of air flow rates and bubble injection depths. Also, computed bubble rise velocity is compared to a well-accepted expression for bubble terminal velocity (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Ghrelin Suppression and Fat Loss after Left Gastric Artery Embolization in Canine Model

Purpose: To evaluate the effects of left gastric artery embolization (LGAE) on plasma ghrelin levels, abdominal fat, and body weight in beagles. Methods: The institutional animal care and use committee approved this study. Fifteen healthy adult beagles (12 male and three female animals) were randomly divided into three experimental groups: LGAE was proceeded with mixed emulsion of bleomycin A{sub 5} hydrochloride and lipiodol (group A), and polyvinyl alcohol particles (group B). Transcatheter saline injections in the left gastric artery were performed as a control. Weight and fasting plasma ghrelin levels were obtained at baseline and at weekly intervals for 8 weeks after the procedure in all animals. All animals were scanned and measured by multidetector computed tomography at baseline and at week 8 for evaluation of abdominal fat. Results: In LGAE-treated animals, plasma ghrelin and body weight significantly decreased compared to control animals (group A: P = 0.007 and P = 0.000; group B: P = 0.004 and P = 0.000, respectively). Subcutaneous fat size was also significantly reduced (P = 0.011 and P = 0.027 for groups A and B, respectively). The decreasing percentage in ghrelin levels at week 6 (peak of recovery) of LGAE-treated animals were negatively correlated with the size of area supplied by left gastric artery (r = -0.693, P = 0.026). Conclusion: LGAE could suppress the plasma concentration of ghrelin, which results in subcutaneous fat size reduction and weight loss. Compensatory ghrelin production might occur in the remnant gastric fundus after LGAE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Transnodal Lymphangiography in the Diagnosis and Treatment of Genital Lymphedema

Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4-8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Hepatic Arterial Embolization Using Cone Beam CT with Tumor Feeding Vessel Detection Software: Impact on Hepatocellular Carcinoma Response

PurposeDedicated tumor feeding vessel detection software (TFVDS) using cone beam CT has shown a higher sensitivity to detect tumor feeding vessels during hepatic arterial embolization (HAE) of hepatocellular carcinoma (HCC) compared to 2D imaging. Our primary hypothesis was that HCC tumors treated with HAE guided by a TFVDS would show more complete response (CR) than when treated with 2D imaging alone. Secondary analysis of the impact on X-ray exposure was performed.Materials and MethodsNineteen males and 8 females (median age: 69 year, 46–85) with 44 tumors (median size: 38 mm, 6–100) treated with selective HAE between January 2013 and December 2014 were included. Exclusion criteria were: extra-hepatic supply, >4 tumors, tumor size >10 cm, and adjunctive local therapy. Baseline patient and procedure characteristics were reviewed. Differences in CR per modified Response Evaluation Criteria in Solid Tumors were assessed by univariate and multivariate analyses for tumor size, number, location, particles size, and use of TFVDS.ResultsMedian imaging follow-up was 20.1 months (2–33). Use of TFVDS (13 patients, 19 tumors) was the only factor predictive of CR (OR = 3.85 [CI95%: 1.09, 13.67], p = 0.04) on univariate analysis but not on multivariate analysis (OR = 3.26 [0.87, 12.23], p = 0.08). A higher rate of CR was observed for HAE using TFVDS guidance versus 2D imaging alone (68.4%, 13–19, vs. 36%, 9–25, p = 0.03). Median dose area product was lower when TFVDS was used (149.7 Gy.cm{sup 2}, 38–365, vs. 227.8 Gy.cm{sup 2}, 85.3–468.6, p = 0.05).ConclusionsHCC embolized with TFVDS may result in improved local tumor response without increasing the dose exposure.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Imaging of transgender patients: expected findings and complications of gender reassignment therapy

Objectives: Gender dysphoria is defined as a conflict between the biological gender and the gender with which the person identifies. Gender reassignment therapy can alter external sexual features to resemble those of the desired gender and are broadly classified into two types, female to male (FTM) and male to female (MTF). In this paper we describe expected findings and complications of gender reassignment therapy. Methods: Collaborative multi-institutional project supported by Ovarian and Uterine Cancer Disease Focused panel of Society of Abdominal Radiology. Results: Gender dysphoria is defined as a conflict between the biological gender and the gender with which the person identifies. Gender reassignment therapy can alter external sexual features to resemble those of the desired gender and are broadly classified into two types, female to male (FTM) and male to female (MTF). These therapies include hormonal treatment as well as surgical procedures. FTM genital reconstructive therapy includes creation of a neophallus, which can be achieved by metoidioplasty or phalloplasty with mastectomy, along with testosterone administration. MTF gender reassignment surgery includes complete removal of external genitalia with penectomy and orchiectomy, with vaginoplasty, clitoroplasty, labiaplasty, and breast augmentation along with estrogen supplements. Conclusion: Surgical techniques alter the standard anatomy and make imaging interpretation challenging if radiologists are unfamiliar with expected post-operative appearances. It is important to recognize the complications related to surgical and non-surgical treatment of gender dysphoria to avoid interpretation errors. Furthermore, increasing the prevalence of transgender patients requires increased sensitivity when interpreting imaging studies to reduce the potential for misdiagnoses in reporting due to frequently incomplete available clinical history.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Magnonic band structure, complete bandgap, and collective spin wave excitation in nanoscale two-dimensional magnonic crystals

We present the observation of a complete bandgap and collective spin wave excitation in two-dimensional magnonic crystals comprised of arrays of nanoscale antidots and nanodots, respectively. Considering that the frequencies dealt with here fall in the microwave band, these findings can be used for the development of suitable magnonic metamaterials and spin wave based signal processing. We also present the application of a numerical procedure, to compute the dispersion relations of spin waves for any high symmetry direction in the first Brillouin zone. The results obtained from this procedure have been reproduced and verified by the well established plane wave method for an antidot lattice, when magnetization dynamics at antidot boundaries are pinned. The micromagnetic simulation based method can also be used to obtain iso–frequency contours of spin waves. Iso–frequency contours are analogous of the Fermi surfaces and hence, they have the potential to radicalize our understanding of spin wave dynamics. The physical origin of bands, partial and full magnonic bandgaps have been explained by plotting the spatial distribution of spin wave energy spectral density. Although, unfettered by rigid assumptions and approximations, which afflict most analytical methods used in the study of spin wave dynamics, micromagnetic simulations tend to be computationally demanding. Thus, the observation of collective spin wave excitation in the case of nanodot arrays, which can obviate the need to perform simulations, may also prove to be valuable.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗

Image-Guided Cryoablation of the Spine in a Swine Model: Clinical, Radiological, and Pathological Findings with Light and Electron Microscopy

PurposeThis study was designed to present the feasibility of an in vivo image-guided percutaneous cryoablation of the porcine vertebral body.MethodsThe institutional animal care committee approved this study. Cone-beam computed tomography (CBCT)-guided vertebral cryoablations (n = 22) were performed in eight pigs with short, 2-min, single or double-freezing protocols. Protective measures to nerves included dioxide carbon (CO{sub 2}) epidural injections and spinal canal temperature monitoring. Clinical, radiological, and pathological data with light (n = 20) or transmission electron (n = 2) microscopic analyses were evaluated after 6 days of clinical follow-up and euthanasia.ResultsCBCT/fluoroscopic-guided transpedicular vertebral body cryoprobe positioning and CO{sub 2} epidural injection were successful in all procedures. No major complications were observed in seven animals (87.5 %, n = 8). A minor complication was observed in one pig (12.5 %, n = 1). Logistic regression model analysis showed the cryoprobe-spinal canal (Cp-Sc) distance as the most efficient parameter to categorize spinal canal temperatures lower than 19 °C (p < 0.004), with a significant Pearson’s correlation test (p < 0.041) between the Cp-Sc distance and the lowest spinal canal temperatures. Ablation zones encompassed pedicles and the posterior wall of the vertebral bodies with an inflammatory rim, although no inflammatory infiltrate was depicted in the surrounding neural structures at light microscopy. Ultrastructural analyses evidenced myelin sheath disruption in some large nerve fibers, although neurological deficits were not observed.ConclusionsCBCT-guided vertebral cryoablation of the porcine spine is feasible under a combination of a short freezing protocol and protective measures to the surrounding nerves. Ultrastructural analyses may be helpful assess the early modifications of the nerve fibers.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

FLUX AND PHOTON SPECTRAL INDEX DISTRIBUTIONS OF FERMI-LAT BLAZARS AND CONTRIBUTION TO THE EXTRAGALACTIC GAMMA-RAY BACKGROUND

We present a determination of the distributions of the photon spectral index and gamma-ray flux-the so-called log N-log S relation-for the 352 blazars detected with a greater than approximately 7{sigma} detection threshold and located above {+-}20 Degree-Sign Galactic latitude by the Large Area Telescope of the Fermi Gamma-ray Space Telescope in its first year catalog. Because the flux detection threshold depends on the photon index, the observed raw distributions do not provide the true log N-log S counts or the true distribution of the photon index. We use the non-parametric methods developed by Efron and Petrosian to reconstruct the intrinsic distributions from the observed ones which account for the data truncations introduced by observational bias and includes the effects of the possible correlation between the two variables. We demonstrate the robustness of our procedures using a simulated data set of blazars and then apply these to the real data and find that for the population as a whole the intrinsic flux distribution can be represented by a broken power law with high and low indices of -2.37 {+-} 0.13 and -1.70 {+-} 0.26, respectively, and the intrinsic photon index distribution can be represented by a Gaussian with mean of 2.41 {+-} 0.13 and width of 0.25 {+-} 0.03. We also find the intrinsic distributions for the sub-populations of BL Lac and flat spectrum radio quasar type blazars separately. We then calculate the contribution of Fermi blazars to the diffuse extragalactic gamma-ray background radiation. Under the assumption that the flux distribution of blazars continues to arbitrarily low fluxes, we calculate the best-fit contribution of all blazars to the total extragalactic gamma-ray output to be 60%, with a large uncertainty.

79 ASTRONOMY AND ASTROPHYSICS↗

Treatment of Small Hepatocellular Carcinoma (≤2 cm) in the Caudate Lobe with Sequential Transcatheter Arterial Chemoembolization and Radiofrequency Ablation

PurposeTo evaluate technical feasibility and treatment results of sequential transcatheter arterial chemoembolization (TACE) and cone-beam computed tomography-guided percutaneous radiofrequency ablation (CBCT-RFA) for small hepatocellular carcinoma (HCC) in the caudate lobe.Materials and MethodsInstitutional review board approved this retrospective study. Radiologic database was searched for the patients referred to perform TACE and CBCT-RFA for small caudate HCCs (≤2 cm) between February 2009 and February 2014. A total of 14 patients (12 men and 2 women, mean age; 61.3 years) were included. Percutaneous ultrasonography-guided RFA (pUS-RFA) and surgery were infeasible due to poor conspicuity, inconspicuity or no safe electrode pathway, and poor hepatic reserve. Procedural success (completion of both TACE and CBCT-RFA), technique efficacy (absence of tumor enhancement at 1 month after treatment), and complication were evaluated. Treatment results including local tumor progression (LTP), intrahepatic distant recurrence (IDR), overall survival (OS), and progression-free survival (PFS) were analyzed.ResultsProcedural success and technique efficacy rates were 78.6 % (11/14) and 90.9 % (10/11), respectively. Average follow-up period was 45.3 months (range, 13.4–64.6 months). The 1-, 3-, and 5-year LTP probabilities were 0, 12.5, and 12.5 %, respectively. IDR occurred in seven patients (63.6 %, 7/11). The 1-, 3-, and 5-year PFS probabilities were 81.8, 51.9, and 26 %, respectively. The 1-, 3-, and 5-year OS probabilities were 100, 80.8, and 80.8 %, respectively.ConclusionCombination of TACE and CBCT-RFA seems feasible for small HCC in the caudate lobe not amenable to pUS-RFA and effective in local tumor control.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

An Efficient Pipeline for Abdomen Segmentation in CT Images

Computed tomography (CT) scans usually include some disadvantages due to the nature of the imaging procedure, and these handicaps prevent accurate abdomen segmentation. Discontinuous abdomen edges, bed section of CT, patient information, closeness between the edges of the abdomen and CT, poor contrast, and a narrow histogram can be regarded as the most important handicaps that occur in abdominal CT scans. Currently, one or more handicaps can arise and prevent technicians obtaining abdomen images through simple segmentation techniques. In other words, CT scans can include the bed section of CT, a patient’s diagnostic information, low-quality abdomen edges, low-level contrast, and narrow histogram, all in one scan. These phenomena constitute a challenge, and an efficient pipeline that is unaffected by handicaps is required. In addition, analysis such as segmentation, feature selection, and classification has meaning for a real-time diagnosis system in cases where the abdomen section is directly used with a specific size. A statistical pipeline is designed in this study that is unaffected by the handicaps mentioned above. Intensity-based approaches, morphological processes, and histogram-based procedures are utilized to design an efficient structure. Performance evaluation is realized in experiments on 58 CT images (16 training, 16 test, and 26 validation) that include the abdomen and one or more disadvantage(s). The first part of the data (16 training images) is used to detect the pipeline’s optimum parameters, while the second and third parts are utilized to evaluate and to confirm the segmentation performance. The segmentation results are presented as the means of six performance metrics. Thus, the proposed method achieves remarkable average rates for training/test/validation of 98.95/99.36/99.57% (jaccard), 99.47/99.67/99.79% (dice), 100/99.91/99.91% (sensitivity), 98.47/99.23/99.85% (specificity), 99.38/99.63/99.87% (classification accuracy), and 98.98/99.45/99.66% (precision). In summary, a statistical pipeline performing the task of abdomen segmentation is achieved that is not affected by the disadvantages, and the most detailed abdomen segmentation study is performed for the use before organ and tumor segmentation, feature extraction, and classification.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Impact Analyses and Tests of Metal Cask Considering Aircraft Engine Crash - 12308

The structural integrity of a dual purpose metal cask currently under development by the Korea Radioactive Waste Management Cooperation (KRMC) is evaluated through analyses and tests under a high-speed missile impact considering the targeted aircraft crash conditions. The impact conditions were carefully chosen through a survey on accident cases and recommendations from the literature. The missile impact velocity was set at 150 m/s, and two impact orientations were considered. A simplified missile simulating a commercial aircraft engine is designed from an impact load history curve provided in the literature. In the analyses, the focus is on the evaluation of the containment boundary integrity of the metal cask. The analyses results are compared with the results of tests using a 1/3 scale model. The results show very good agreements, and the procedure and methodology adopted in the structural analyses are validated. While the integrity of the cask is maintained in one evaluation where the missile impacts the top side of the free standing cask, the containment boundary is breached in another case in which the missile impacts the center of the cask lid in a perpendicular orientation. A safety assessment using a numerical simulation of an aircraft engine crash into spent nuclear fuel storage systems is performed. A commercially available explicit finite element code is utilized for the dynamic simulation, and the strain rate effect is included in the modeling of the materials used in the target system and missile. The simulation results show very good agreement with the test results. It is noted that this is the first test considering an aircraft crash in Korea. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Qualification Requirements of Guided Ultrasonic Waves for Inspection of Piping in Light Water Reactors

Guided ultrasonic waves (GUW) are being increasingly used for both NDT and monitoring of piping. GUW offers advantages over many conventional NDE technologies due to the ability to inspect large volumes of piping components without significant removal of thermal insulation or protective layers. In addition, regions rendered inaccessible to more conventional NDE technologies may be more accessible using GUW techniques. For these reasons, utilities are increasingly considering the use of GUWs for performing the inspection of piping components in nuclear power plants. GUW is a rapidly evolving technology and its usage for inspection of nuclear power plant components requires refinement and qualification to ensure it is able to achieve consistent and acceptable levels of performance. This paper will discuss potential requirements for qualification of GUW techniques for the inspection of piping components in light water reactors (LWRs). The Nuclear Regulatory Commission has adopted ASME Boiler and Pressure Vessel Code requirements in Sections V, III, and XI for nondestructive examination methods, fabrication inspections, and pre-service and in-service inspections. A Section V working group has been formed to place the methodology of GUW into the ASME Boiler and Pressure Vessel Code but no requirements for technique, equipment, or personnel exist in the Code at this time.

Guided Ultrasonic Waves↗

Stent-Retriever Thrombectomy and Rescue Treatment of M1 Occlusions Due to Underlying Intracranial Atherosclerotic Stenosis: Cohort Analysis and Review of the Literature

Background and Purpose: Data on the management of large vessel occlusion in patients with anterior circulation acute ischemic stroke (AIS) due to underlying intracranial stenosis are scarce. The aim of this retrospective study was to compare endovascular treatment and outcome in AIS patients with and without underlying stenosis of the M1 segment. Materials and Methods: A total of 533 acute stroke patients with an isolated M1 occlusion who underwent mechanical thrombectomy between 02/2010 and 08/2017 were included. Underlying intracranial atherosclerotic stenosis (ICAS) was present in 10 patients (1.9%), whereas 523 patients (98.1%) had an embolic occlusion without stenosis. Results: There was no difference in age, admission National Institutes of Health Stroke Scale, risk factors, Alberta stroke program early CT score or collaterals between the groups. Procedure time (155 vs 40 min, P = 0.001) was significantly longer in the ICAS group where rescue stent-angioplasty was performed in all patients. There was no statistical difference in final modified thrombolysis in cerebral infarction score between both groups (70 vs 88%, P = 0.115). Favorable outcome (modified Rankin Scale ≤ 2) at 90 days was less frequent in patients with ICAS than in the embolic group (0 vs 49.4%, P = 0.004). The mortality rate tended to be higher in the ICAS group (44.4 vs 19.4%, P = 0.082). Conclusion: In patients with AIS, rescue therapy with stent placement to treat underlying ICAS of the M1 segment is technically feasible; however, in our study, a significantly lower rate of favorable outcome was observed in these patients compared to those with thromboembolic M1 occlusions. Level of Evidence: Level 3, non-randomized controlled study.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-F-J-49: IGRT Credentialing in NCTN Trials

Purpose: To make Image Guided Radiation Therapy (IGRT) credentialing a more unified, consistent and efficient process across the entire National Clinical Trial Network (NCTN). Methods: IGRT plays a role in several advanced NCTN trials. Previously an institution had to be IGRT credentialed for each protocol. When institutions were allowed to use previous credentials for new protocols it was limited to the same disease site as the original credentialing. The credentialing was analyzed by the physics PI of the protocol. We consulted with several of these physicists to determine what is important to consider when reviewing submissions and to learn ways to apply credentialing more broadly. Results: For trials open in 2016, IGRT credentialing can be simplified to cover either boney anatomy or soft tissue. This revised credentialing will cover all disease sites based on the type of anatomy, unless otherwise stated within the protocol. Institutions will submit will complete an online questionnaire about their IGRT procedures. Boney anatomy requirements will include submission of data from 2 sequential fraction of both a patient aligned with boney anatomy and pelvic patient. Soft tissue will require similar submissions for a patient aligned using soft tissue and a pelvic patient. Institutions will only be required to submit the pelvic patient once. Data should be in DICOM format and includes planning CT set, RT structure set, RT plan file, RT dose file, localization images and spatial registration file (if available). Reviews will be done by IROC-Houston staff who will continue to provide feedback to the sites. Conclusion: This revised IGRT credentialing process will bring consistency, a savings in time and effort for both the IROC Houston QA office and to those institutions wanting to be credentialed to participate in NCTN Trials. Sponsored by NIH/NCI CA10953.

60 APPLIED LIFE SCIENCES↗