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At least 613 records · Page 34

SU-F-R-51: Radiomics in CT Perfusion Maps of Head and Neck Cancer

Purpose: The aim of this study was to test the predictive value of radiomics features of CT perfusion (CTP) for tumor control, based on a preselection of radiomics features in a robustness study. Methods: 11 patients with head and neck cancer (HNC) and 11 patients with lung cancer were included in the robustness study to preselect stable radiomics parameters. Data from 36 HNC patients treated with definitive radiochemotherapy (median follow-up 30 months) was used to build a predictive model based on these parameters. All patients underwent pre-treatment CTP. 315 texture parameters were computed for three perfusion maps: blood volume, blood flow and mean transit time. The variability of texture parameters was tested with respect to non-standardizable perfusion computation factors (noise level and artery contouring) using intraclass correlation coefficients (ICC). The parameter with the highest ICC in the correlated group of parameters (inter-parameter Spearman correlations) was tested for its predictive value. The final model to predict tumor control was built using multivariate Cox regression analysis with backward selection of the variables. For comparison, a predictive model based on tumor volume was created. Results: Ten parameters were found to be stable in both HNC and lung cancer regarding potentially non-standardizable factors after the correction for inter-parameter correlations. In the multivariate backward selection of the variables, blood flow entropy showed a highly significant impact on tumor control (p=0.03) with concordance index (CI) of 0.76. Blood flow entropy was significantly lower in the patient group with controlled tumors at 18 months (p<0.1). The new model showed a higher concordance index compared to the tumor volume model (CI=0.68). Conclusion: The preselection of variables in the robustness study allowed building a predictive radiomics-based model of tumor control in HNC despite a small patient cohort. This model was found to be superior to the volume-based model. The project was supported by the KFSP Tumor Oxygenation of the University of Zurich, by a grant of the Center for Clinical Research, University and University Hospital Zurich and by a research grant from Merck (Schweiz) AG.

60 APPLIED LIFE SCIENCES↗

WE-AB-207B-09: Margin Reduction for Planning Target Volume (PTV) in Patients with Localized Prostate Cancer: Impact On Delivered Dose and Quality of Life

Purpose: To estimate the delivered (cumulative) dose to targets and organs at risk for localized prostate cancer patients treated with reduced PTV margins and to evaluate preliminary patient reported quality-of-life (QOL). Methods: Under an IRB-approved protocol, 20 prostate cancer patients (including 11 control patients) were treated with reduced planning margins (5 mm uniform with 4 mm at prostate/rectum interface). Control patients had standard margin (10/6 mm)-based treatments. A parameter-optimized Elastix algorithm along with energy-mass mapping was used to deform and resample dose of the day onto the planning CT for each fraction to estimate the delivered dose over all fractions. QOL data were collected via Expanded Prostate cancer Index Composite (EPIC-26) questionnaires at time points pre-treatment, post-treatment, and at 2, 6, 12, 18 month follow-ups. Standardized QOL scores [range: 0–100] were determined and baseline-corrected by subtracting pre-treatment QOL data. Mean QOL differences between the margin reduced group and control group (QOLmr-QOLcontrol) were calculated for first 18 months. Results: The difference between the cumulative mean dose (Dmean) and the planned mean dose (±SD) for PTV, prostate, bladder, and rectum were −2.2±1.0, 0.3±0.5, −0.7±2.6, and −2.1±1.3 Gy respectively for the margin-reduced group, and −0.8±2.0, 0.9±1.4, - 0.7±3.1 and −1.0±2.4 Gy for the control group. Difference between the two groups was statistically insignificant (p=0.1). Standardized and baseline corrected QOLmr-QOLcontrol for EPIC domains categorized as “Urinary Incontinence”, “Urinary Irritative/Obstructive”, “Bowel”, “Sexual”, and “Hormonal” were 0.6, 12.1, 9.1, 13.3, and −0.9 for the 18 months following radiation therapy (higher values better). Delivered dose to rectum showed a weak correlation to “Bowel” domain (Pearson’s coefficient −0.24, p<0.001), while bladder dose did not correlate to Urinary Incontinence/Irritative/Obstructive QOL domains. Conclusion: The margin-reduced group exhibited clinically meaningful improvement of QOL without compromising the PTV dose. A larger number of patients and greater follow-up is needed to draw unequivocal conclusions. This work was supported in part by a research grant from Varian Medical Systems, Palo Alto, CA.

60 APPLIED LIFE SCIENCES↗

Weathering and erosion of fractured bedrock systems: Weathering and erosion of fractured bedrock systems

We explore the contribution of fractures (joints) in controlling the rate of weathering advance for a low-porosity rock by using methods of homogenization to create averaged weathering equations. The rate of advance of the weathering front can be expressed as the same rate observed in non-fractured media (or in an individual block) divided by the volume fraction of non-fractured blocks in the fractured parent material. In the model, the parent has fractures that are filled with a more porous material that contains only inert or completely weathered material. The low-porosity rock weathers by reaction-transport processes. As observed in field systems, the model shows that the weathering advance rate is greater for the fractured as compared to the analogous non-fractured system because the volume fraction of blocks is <1. The increase in advance rate is attributed both to the increase in weathered material that accompanies higher fracture density, and to the increase in exposure of surface of low-porosity rock to reaction-transport. For constant fracture aperture, the weathering advance rate increases when the fracture spacing decreases. Equations describing weathering advance rate are summarized in the “List of selected equations”. If erosion is imposed at a constant rate, the weathering systems with fracture-bounded bedrock blocks attain a steady state. In the erosional transport-limited regime, bedrock blocks no longer emerge at the air-regolith boundary because they weather away. In the weathering-limited (or kinetic) regime, blocks of various size become exhumed at the surface and the average size of these exposed blocks increases with the erosion rate. For convex hillslopes, the block size exposed at the surface increases downslope. This model can explain observations of exhumed rocks weathering in the Luquillo mountains of Puerto Rico.

54 ENVIRONMENTAL SCIENCES↗

Primary Tumor Volume Is an Important Predictor of Clinical Outcomes Among Patients With Locally Advanced Squamous Cell Cancer of the Head and Neck Treated With Definitive Chemoradiotherapy

Purpose: The tumor volume has been established as a significant predictor of outcomes among patients with head-and-neck cancer undergoing radiotherapy alone. The present study attempted to add to the existing data on tumor volume as a prognostic factor among patients undergoing chemoradiotherapy. Methods and Materials: A total of 78 patients who had undergone definitive chemoradiotherapy for Stage III-IV squamous cell cancer of the hypopharynx, oropharynx, and larynx were identified. The primary tumor volumes were calculated from the treatment planning computed tomography scans, and these were correlated to the survival and tumor control data obtained from the retrospective analysis. Results: The interval to progression correlated with the primary tumor volume (p = .007). The critical cutoff point for the tumor volume was identified as 35 cm{sup 3}, and patients with a tumor volume <35 cm{sup 3} had a significantly better prognosis than those with a tumor volume >35 cm{sup 3} at 5 years (43% vs. 71%, p = .010). Longer survival was also correlated with smaller primary tumor volumes (p = .022). Similarly, patients with a primary tumor volume <35 cm{sup 3} had a better prognosis in terms of both progression-free survival (61% vs. 33%, p = .004) and overall survival (84% vs. 41%, p = < .001). On multivariate analysis, the primary tumor volume was the best predictor of recurrence (hazard ratio 4.7, 95% confidence interval 1.9-11.6; p = .001) and survival (hazard ratio 10.0, 95% confidence interval 2.9-35.1; p = < .001). In contrast, the T stage and N stage were not significant factors. Analysis of variance revealed that tumors with locoregional failure were on average 21.6 cm{sup 3} larger than tumors without locoregional failure (p = .028) and 27.1-cm{sup 3} larger than tumors that recurred as distant metastases (p = .020). Conclusion: The results of our study have shown that the primary tumor volume is a significant prognostic factor in patients with advanced cancer of the head and neck undergoing definitive chemoradiotherapy and correlated with the treatment outcomes better than the T or N stage.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Complex SnO2 nanoparticles and nanosheets with enhanced visible-light photocatalytic activity

Highlights: • The complex SnO{sub 2} nanoparticles and nanosheets have grown by a hydrothermal method. • The concentration of urea can control the morphology of SnO{sub 2} nanostructures. • The complex SnO{sub 2} nanoparticles and nanosheets exhibit high photocatalytic activity. • The novel structures exhibit higher photodegradation than ZnO and TiO{sub 2} nanopowders. - Abstract: The complex SnO{sub 2} nanoparticles and nanosheets have been synthesized by a facile hydrothermal method. The concentrations of urea play an important role to control the morphology of SnO{sub 2} nanostructures. The complex SnO{sub 2} nanoparticles and nanosheets have excellent photocatalytic activity, which are ascribed to stronger defect emission, higher light harvesting ability in the visible light region, and higher surface-to-volume ratio, which exhibit a much better photocatalytic activity rather than commercial ZnO and TiO{sub 2} nanopowders under a blue light LED irradiation. The complex SnO{sub 2} nanoparticles and nanosheets provide a facile, low cost, high surface-to-volume ratio, high efficiency and stability visible-light-driven photocatalysts for environmental remediation and energy conversion.

77 NANOSCIENCE AND NANOTECHNOLOGY↗

SU-C-19A-02: An Innovative Critical Organ Repositioner Device for Use During Radiotherapy Treatments

Purpose: In most radiation oncology applications the use of shape memory alloy (SMA) actuation can be extremely beneficial in sparing normal structures by relocating them away from the path of the external beam, or placing distance between the structure and radiation source such as in Brachytherapy. Implementation of this organ repositioner device in conjunction with IMRT could open new possibilities for dose escalation and significant dose reduction to normal tissues. Similarly, in high dose rate brachytherapy applications, the ideal effective dose may not be delivered to the target volume due to toxicity concerns to adjacent critical structures. Here we present a dual functioning device manufactured from SMA materials to: 1) provide a desirable tool to reposition the organ at risk away from the radiation source, and 2) facilitate localization when imaging the area. Methods: A Nitinol based actuator with controlled force and displacement will be incorporated in the design of an organ repositioner (e.g., a rectal marker) with the ability to recall a pre-defined shape at temperature T1 (body temp) and shift back to its original shape at temperature T2 (to facilitate removal). An open distal end permits the marker to function as a part of a barium delivery system. Results: An example of this SMA manufactured in our laboratory for atrial fibrillation radio frequency ablation is the esophagus SMA positioner, designed to position the esophagus away from the ablation area. This device shows the maximum strain in the deflected esophagus to be less than 3%. The prototype positioner deflected the organ at risk by 5 cm away from the site of ablation. Conclusions: The organ repositioner device is feasible for use in clinics, provides patient comfort due to its gradual deflection, and has dual functionality in repositioning the organ at risk as well as serving as a localization device.

60 APPLIED LIFE SCIENCES↗

Anatomical pulmonary magnetic resonance imaging segmentation for regional structure-function measurements of asthma

Purpose: Pulmonary magnetic-resonance-imaging (MRI) and x-ray computed-tomography have provided strong evidence of spatially and temporally persistent lung structure-function abnormalities in asthmatics. This has generated a shift in their understanding of lung disease and supports the use of imaging biomarkers as intermediate endpoints of asthma severity and control. In particular, pulmonary {sup 1}H MRI can be used to provide quantitative lung structure-function measurements longitudinally and in response to treatment. However, to translate such biomarkers of asthma, robust methods are required to segment the lung from pulmonary {sup 1}H MRI. Therefore, their objective was to develop a pulmonary {sup 1}H MRI segmentation algorithm to provide regional measurements with the precision and speed required to support clinical studies. Methods: The authors developed a method to segment the left and right lung from {sup 1}H MRI acquired in 20 asthmatics including five well-controlled and 15 severe poorly controlled participants who provided written informed consent to a study protocol approved by Health Canada. Same-day spirometry and plethysmography measurements of lung function and volume were acquired as well as {sup 1}H MRI using a whole-body radiofrequency coil and fast spoiled gradient-recalled echo sequence at a fixed lung volume (functional residual capacity + 1 l). We incorporated the left-to-right lung volume proportion prior based on the Potts model and derived a volume-proportion preserved Potts model, which was approximated through convex relaxation and further represented by a dual volume-proportion preserved max-flow model. The max-flow model led to a linear problem with convex and linear equality constraints that implicitly encoded the proportion prior. To implement the algorithm, {sup 1}H MRI was resampled into ∼3 × 3 × 3 mm{sup 3} isotropic voxel space. Two observers placed seeds on each lung and on the background of 20 pulmonary {sup 1}H MR images in a randomized dataset, on five occasions, five consecutive days in a row. Segmentation accuracy was evaluated using the Dice-similarity-coefficient (DSC) of the segmented thoracic cavity with comparison to five-rounds of manual segmentation by an expert observer. The authors also evaluated the root-mean-squared-error (RMSE) of the Euclidean distance between lung surfaces, the absolute, and percent volume error. Reproducibility was measured using the coefficient of variation (CoV) and intraclass correlation coefficient (ICC) for two observers who repeated segmentation measurements five-times. Results: For five well-controlled asthmatics, forced expiratory volume in 1 s (FEV{sub 1})/forced vital capacity (FVC) was 83% ± 7% and FEV{sub 1} was 86 ± 9%{sub pred}. For 15 severe, poorly controlled asthmatics, FEV{sub 1}/FV C = 66% ± 17% and FEV{sub 1} = 72 ± 27%{sub pred}. The DSC for algorithm and manual segmentation was 91% ± 3%, 92% ± 2% and 91% ± 2% for the left, right, and whole lung, respectively. RMSE was 4.0 ± 1.0 mm for each of the left, right, and whole lung. The absolute (percent) volume errors were 0.1 l (∼6%) for each of right and left lung and ∼0.2 l (∼6%) for whole lung. Intra- and inter-CoV (ICC) were <0.5% (>0.91%) for DSC and <4.5% (>0.93%) for RMSE. While segmentation required 10 s including ∼6 s for user interaction, the smallest detectable difference was 0.24 l for algorithm measurements which was similar to manual measurements. Conclusions: This lung segmentation approach provided the necessary and sufficient precision and accuracy required for research and clinical studies.

60 APPLIED LIFE SCIENCES↗

Detection of gas leakage

A method of detecting leaks and measuring volumes as well as an apparatus, the Power-free Pump Module (PPM), that is a self-contained leak test and volume measurement apparatus that requires no external sources of electrical power during leak testing or volume measurement, where the invention is a portable, pneumatically-controlled instrument capable of generating a vacuum, calibrating volumes, and performing quantitative leak tests on a closed test system or device, all without the use of alternating current (AC) power. Capabilities include the ability is to provide a modest vacuum (less than 10 Torr), perform a pressure rise leak test, measure the gas's absolute pressure, and perform volume measurements. All operations are performed through a simple rotary control valve which controls pneumatically-operated manifold valves.

47 OTHER INSTRUMENTATION↗

Dose-Painted Intensity-Modulated Radiation Therapy for Anal Cancer: A Multi-Institutional Report of Acute Toxicity and Response to Therapy

Purpose: Chemoradiation for anal cancer yields effective tumor control, but is associated with significant acute toxicity. We report our multi-institutional experience using dose-painted IMRT (DP-IMRT). Patients and Methods: Between August 2005 and May 2009, 43 patients were treated with DP-IMRT and concurrent chemotherapy for biopsy-proven, squamous cell carcinoma of the anal canal at two academic medical centers. DP-IMRT was prescribed as follows: T2N0: 42 Gy, 1.5 Gy/fraction (fx) to elective nodal planning target volume (PTV) and 50.4 Gy, 1.8 Gy/fx to anal tumor PTV; T3-4N0-3: 45 Gy, 1.5 Gy/fx to elective nodal PTV, and 54 Gy, 1.8 Gy/fx to the anal tumor and metastatic nodal PTV >3 cm with 50.4 Gy, 1.68 Gy/fx to nodal PTVs {<=}3 cm in size. Acute and late toxicity was reported by the treating physician. Actuarial analysis was performed using the Kaplan-Meier method. Results: Median age was 58 years; 67% female; 16% Stage I, 37% II; 42% III; 5% IV. Fourteen patients were immunocompromised: 21% HIV-positive and 12% on chronic immunosuppression. Median follow-up was 24 months (range, 0.6-43.5 months). Sixty percent completed chemoradiation without treatment interruption; median duration of treatment interruption was 2 days (range, 2-24 days). Acute Grade 3+ toxicity included: hematologic 51%, dermatologic 10%, gastrointestinal 7%, and genitourinary 7%. Two-year local control, overall survival, colostomy-free survival, and metastasis-free survival were 95%, 94%, 90%, and 92%, respectively. Conclusions: Dose-painted IMRT appears effective and well-tolerated as part of a chemoradiation therapy regimen for the treatment of anal canal cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Validation of High-Resolution CFD Method for Slosh Damping Extraction of Baffled Cryogenic Propellant Tanks

Propellant slosh is a potential source of disturbance critical to the stability of space vehicles. The slosh dynamics are typically represented by a mechanical model of a spring-mass-damper. This mechanical model is then included in the equation of motion of the entire vehicle for Guidance, Navigation and Control analysis. A Volume-Of-Fluid (VOF) based Computational Fluid Dynamics (CFD) program developed at MSFC was applied to extract slosh damping in the baffled tank from the first principle. First the experimental data using water with sub-scale smooth wall tank were used as the baseline validation. It is demonstrated that CFD can indeed accurately predict low damping values from the smooth wall at different fill levels. The damping due to a ring baffles at different depths from the free surface was then simulated, and fairly good agreement with experimental measurement was observed. Comparison with an empirical correlation of Miles equation is also made.

Yang, H. Q.↗

A simple technique to reduce evaporation of crystallization droplets by using plate lids with apertures for adding liquids

This article describes the use of evaporation control lids that are fitted to crystallization plates to improve the reproducibility of trials using as little as 5 nl. The plate lids contain apertures which are large enough for the transfer of protein containing droplets, but small enough to greatly reduce the rate of evaporation during the time needed to prepare the plate. A method is described for using plate lids to reduce evaporation in low-volume vapor-diffusion crystallization experiments. The plate lids contain apertures through which the protein and precipitants were added to different crystallization microplates (the reservoir was filled before fitting the lids). Plate lids were designed for each of these commonly used crystallization microplates. This system minimizes the dehydration of crystallization droplets containing just a few nanolitres of protein and precipitant, and results in more reproducible diffraction from the crystals. For each lid design, changes in the weight of the plates were used to deduce the rate of evaporation under different conditions of temperature, air movement, droplet size and precipitant. For comparison, the state of dehydration was also visually assessed throughout the experiment. Finally, X-ray diffraction methods were used to compare the diffraction of protein crystals that were conventionally prepared against those that were prepared on plates with plate lids. The measurements revealed that the plate lids reduced the rate of evaporation by 63–82%. Crystals grown in 5 nl drops that were set up with plate lids diffracted to higher resolution than similar crystals from drops that were set up without plate lids. The results demonstrate that plate lids can be instrumental for improving few-nanolitre crystallizations.

75 CONDENSED MATTER PHYSICS, SUPERCONDUCTIVITY AND↗

Randomized prospective phase III trial of 68 Ga-PSMA-11 PET/CT molecular imaging for prostate cancer salvage radiotherapy planning [PSMA-SRT]

Salvage radiotherapy (SRT) for prostate cancer (PCa) recurrence after prostatectomy offers long-term biochemical control in about 50–60% of patients. SRT is commonly initiated in patients with serum PSA levels < 1 ng/mL, a threshold at which standard-of-care imaging is insensitive for detecting recurrence. As such, SRT target volumes are usually drawn in the absence of radiographically visible disease. 68 Ga-PSMA-11 (PSMA) PET/CT molecular imaging is highly sensitive and may offer anatomic localization of PCa biochemical recurrence. However, it is unclear if incorporation of PSMA PET/CT imaging into the planning of SRT could improve its likelihood of success. The purpose of this trial is to evaluate the success rate of SRT for recurrence of PCa after prostatectomy with and without planning based on PSMA PET/CT. Methods We will randomize 193 patients to proceed with standard SRT (control arm 1, n = 90) or undergo a PSMA PET/CT scan (free of charge for patients) prior to SRT planning (investigational arm 2, n = 103). The primary endpoint is the success rate of SRT measured as biochemical progression-free survival (BPFS) after initiation of SRT. Biochemical progression is defined by PSA ≥ 0.2 ng/mL and rising. The randomization ratio of 1:1.13 is based on the assumption that approximately 13% of subjects randomized to Arm 2 will not be treated with SRT because of PSMA-positive extra-pelvic metastases. These patients will not be included in the primary endpoint analysis but will still be followed. The choice of treating the prostate bed alone vs prostate bed and pelvic lymph nodes, with or without androgen deprivation therapy (ADT), is selected by the treating radiation oncologist. The radiation oncologist may change the radiation plan depending on the findings of the PSMA PET/CT scan. Any other imaging is allowed for SRT planning in both arms if done per routine care. Patients will be followed until either one of the following conditions occur: 5 years after the date of initiation of randomization, biochemical progression, diagnosis of metastatic disease, initiation of any additional salvage therapy, death. Discussion This is the first randomized phase 3 prospective trial designed to determine whether PSMA PET/CT molecular imaging can improve outcomes in patients with PCa early BCR following radical prostatectomy.

60 APPLIED LIFE SCIENCES↗

SU-E-T-471: Improvement of Gamma Knife Treatment Planning Through Tumor Control Probability for Metastatic Brain Tumors

Purpose: The dose–volume histogram (DVH) has been normally accepted as a tool for treatment plan evaluation. However, spatial information is lacking in DVH. As a supplement to the DVH in three-dimensional treatment planning, the differential DVH (DDVH) provides the spatial variation, the size and magnitude of the different dose regions within a region of interest, which can be incorporated into tumor control probability model. This study was to provide a method in evaluating and improving Gamma Knife treatment planning. Methods: 10 patients with brain metastases from different primary tumors including melanoma (#1,#4,#5, #10), breast cancer (#2), prostate cancer (#3) and lung cancer (#6–9) were analyzed. By using Leksell GammaPlan software, two plans were prepared for each patient. Special attention was given to the DDVHs that were different for different plans and were used for a comparison between two plans. Dose distribution inside target and tumor control probability (TCP) based on DDVH were calculated, where cell density and radiobiological parameters were adopted from literature. The plans were compared based on DVH, DDVH and TCP. Results: Using DVH, the coverage and selectivity were the same between plans for 10 patients. DDVH were different between two plans for each patient. The paired t-test showed no significant difference in TCP between the two plans. For brain metastases from melanoma (#1, #4–5), breast cancer (#2) and lung cancer (#6–8), the difference in TCP was less than 5%. But the difference in TCP was about 6.5% for patient #3 with the metastasis from prostate cancer, 10.1% and 178.7% for two patients (#9–10) with metastasis from lung cancer. Conclusion: Although DVH provides average dose–volume information, DDVH provides differential dose– volume information with respect to different regions inside the tumor. TCP provides radiobiological information and adds additional information on improving treatment planning as well as adaptive radiotherapy. Further clinical validation is necessary.

60 APPLIED LIFE SCIENCES↗

Lipiodol: A Potential Direct Surrogate for Cone-Beam Computed Tomography Image Guidance in Radiotherapy of Liver Tumor

Purpose: To investigate the feasibility of using lipiodol as a direct surrogate for target localization using cone-beam CT (CBCT) image guidance in radiotherapy (RT) of patients with unresectable liver tumors after transarterial chemoembolization. Methods and Materials: Forty-six patients with an unresectable solitary liver tumor were enrolled for RT using active breathing control (ABC) and CBCT image guidance after transarterial chemoembolization. Each patient had pre- and posttreatment CBCT in the first 10 fractions of treatment. Lipiodol retention was evaluated using daily CBCT scans, and volume of lipiodol retention in the liver was calculated and compared between planning CT and post-RT CT. Influence of lipiodol on dosimetry was evaluated by measuring doses using an ion chamber with and without the presence of lipiodol. Margin analysis was performed on the basis of both inter- and intrafractional target localization errors. Results: Twenty-eight patients successfully completed the study. The shape and size of lipiodol retention did not vary substantially during the course of treatment. The mean Dice similarity coefficient for the lipiodol volume in pretreatment CT and that in posttreatment CT was 0.836 (range, 0.817-0.885). The maximum change (ratio of the lipiodol volume in pretreatment CT to that in posttreatment CT) was 1.045. The mean dose changes with the presence of <10 mL lipiodol were -1.44% and 0.13% for 6 MV and 15 MV, respectively. With ABC and online CBCT image guidance, clinical target volume-planning target volume margins were determined to be 2.5 mm in the mediolateral direction, 2.9 mm in the anteroposterior direction, and 4.0 mm in the craniocaudal direction. Conclusions: Lipiodol could be used as a direct surrogate for CBCT image guidance to improve the localization accuracy for RT of liver tumors. Combination of ABC and CBCT image guidance with lipiodol can potentially reduce the clinical target volume-planning target volume margin.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Modeling ozone episodes in the Baltimore-Washington region

Surface ozone (O3) concentrations in excess of the National Ambient Air Quality Standard (NAAQS) continue to occur in metropolitan areas in the United States despite efforts to control emissions of O3 precursors. Future O3 control strategies will be based on results from modeling efforts that have just begun in many areas. Two initial questions that arise are model sensitivity to domain-specific conditions and the selection of episodes for model evaluation and control strategy development. For the Baltimore-Washington region (B-W), the presence of the Chesapeake Bay introduces a number of issues relevant to model sensitivity. In this paper, the specific questions of the determination of model volume (mixing height) for the Urban Airshed Model (UAM) is discussed and various alternative methods compared. For the latter question, several analytic approaches, Cluster Analysis and classification and Regression Tree (CART) analysis are undertaken to determine meteorological conditions associated with severe O3 events in the B-W domain.

Ryan, William F.↗

Submaximal exercise VO2 and Qc during 30-day 6 degrees head-down bed rest with isotonic and isokinetic exercise training

BACKGROUND: Maintaining intermediary metabolism is necessary for the health and well-being of astronauts on long-duration spaceflights. While peak oxygen uptake (VO2) is consistently decreased during prolonged bed rest, submaximal VO2 is either unchanged or decreased. METHODS: Submaximal exercise metabolism (61 +/- 3% peak VO2) was measured during ambulation (AMB day-2) and on bed rest days 4, 11, and 25 in 19 healthy men (32-42 yr) allocated into no exercise (NOE, N = 5) control, and isotonic exercise (ITE, N = 7) and isokinetic exercise (IKE, N = 7) training groups. Exercise training was conducted supine for two 30-min periods per day for 6 d per week: ITE training was intermittent at 60-90% peak VO2; IKE training was 10 sets of 5 repetitions of peak knee flexion-extension force at a velocity of 100 degrees s-1. Cardiac output was measured with the indirect Fick CO2 method, and plasma volume with Evans blue dye dilution. RESULTS: Supine submaximal exercise VO2 decreased significantly (*p < 0.05) by 10.3%* with ITE and by 7.3%* with IKE; similar to the submaximal cardiac output decrease of 14.5%* (ITE) and 20.3%* (IKE), but different from change in peak VO2 (+1.4% with ITE and -10.2%* with IKE) and decrease in plasma volume of -3.7% (ITE) and -18.0%* (IKE). Reduction of submaximal VO2 during bed rest correlated 0.79 (p < 0.01) with submaximal Qc, but was not related to change in peak VO2 or plasma volume. CONCLUSION: Reduction in submaximal oxygen uptake during prolonged bed rest is related to decrease in exercise but not resting cardiac output; perturbations in active skeletal muscle metabolism may be involved.

NASA Discipline Regulatory Physiology↗

Single-fraction Radiosurgery for Presumed Intracranial Meningiomas: Efficacy and Complications From a 22-Year Experience

Purpose: To define the rate of tumor control and factors associated with radiation-related complications after single-fraction radiosurgery (SRS) for patients with imaging defined intracranial meningiomas. Materials and Methods: Retrospective review of 251 patients (192 women, 59 men) having SRS for imaging-defined intracranial meningiomas between 1990 and 2008. Excluded were patients with radiation-induced tumors, meningiomatosis, or neurofibromatosis. The mean patient age was 58.6 {+-} 13.4 years. The majority of tumors involved the skull base/tentorium (n = 210, 83.7%). The mean treatment volume was 7.7 {+-} 6.2 cm{sup 3}; the mean tumor margin dose was 15.8 {+-} 2.0 Gy. Follow-up (mean, 62.9 {+-} 43.9 months) was censored at last evaluation (n = 224), death (n = 22), or tumor resection (n = 5). Results: No patient died from tumor progression or radiation-related complications. Tumor size decreased in 181 patients (72.1%) and was unchanged in 67 patients (26.7%). Three patients (1.2%) had in-field tumor progression noted at 28, 145, and 150 months, respectively. No patient had a marginal tumor progression. The 3- and 10-year local control rate was 99.4%. One patient had distant tumor progression at 105 months and underwent repeat SRS. Thirty-one patients (12.4%) had either temporary (n = 8, 3.2%) or permanent (n = 23, 9.2%) symptomatic radiation-related complications including cranial nerve deficits (n = 14), headaches (n = 5), hemiparesis (n = 5), new/worsened seizure (n = 4), cyst-formation (n = 1), hemifacial spasm (n = 1), and stroke (n = 1). The 1- and 5-year complication rates were 8.3% and 11.5%, respectively. Radiation-related complications were associated with convexity/falx tumors (HR = 2.8, 95% CI 1.3-6.1, p = 0.009) and increasing tumor volume (HR = 1.05, 95% CI 1.0-1.1, p = 0.04) on multivariate analysis. No patient developed a radiation-induced tumor. Conclusions: Single-fraction SRS at the used dose range provides a high rate of tumor control for patients with imaging defined intracranial meningiomas. However, treatment failures were noted after 10 years emphasizing the need for long-term imaging follow-up after meningioma SRS.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Modal Interpolation Program, L 215 (INTERP): Supplemental System Design and Maintenance Document - Volume 2

The design, structure, and usage of the modal interpolation program L215 are presented. The program uses modal data sets of arrays containing interpolation coefficients. The interpolation arrays are used to determine displacements at various aerodynamic control points. The displacements consist of translations normal to the aerodynamic surface and surface slopes that are parallel and perpendicular to the free stream direction. Five different interpolation methods are available.

Hirayama, M. Y.↗