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At least 667 records · Page 37

SU-F-T-383: Robustness for Patient Setup Error in Total Body Irradiation Using Volumetric Modulated Arc Therapy (VMAT)

Purpose: Total body irradiation (TBI) and total marrow irradiation (TMI) using Tomotherapy have been reported. A gantry-based linear accelerator uses one isocenter during one rotational irradiation. Thus, 3–5 isocenter points should be used for a whole plan of TBI-VMAT during smoothing out the junctional dose distribution. IGRT provides accurate and precise patient setup for the multiple junctions, however it is evident that some setup errors should occur and affect accuracy of dose distribution in the area. In this study, we evaluated the robustness for patient’s setup error in VMAT-TBI. Methods: VMAT-TBI Planning was performed in an adult whole-body human phantom using Eclipse. Eight full arcs with four isocenter points using 6MV-X were used to cover the entire whole body. Dose distribution was optimized using two structures of patient’s body as PTV and lung. The two arcs were shared with one isocenter and the two arcs were 5 cm-overlapped with the other two arcs. Point absolute dose using ionization-chamber and planer relative dose distribution using film in the junctional regions were performed using water-equivalent slab phantom. In the measurements, several setup errors of (+5∼−5mm) were added. Results: The result of the chamber measurement shows the deviations were within ±3% when the setup errors were within ±3 mm. In the planer evaluation, the pass ratio of gamma evaluation (3%/2mm) shows more than 90% if the errors within ±3 mm. However, there were hot/cold areas in the edge of the junction even with acceptable gamma pass ratio. 5 mm setup error caused larger hot and cold areas and the dosimetric acceptable areas were decreased in the overlapped areas. Conclusion: It can be clinically acceptable for VMAT-TBI when patient setup error is within ±3mm. Averaging effects from patient random error would be helpful to blur the hot/cold area in the junction.

60 APPLIED LIFE SCIENCES↗

Dataset: Inferring Thermal Comfort using Body Shape Information Utilizing Depth Sensors

Thermal comfort is very important for well-being and productivity of building occupants. It has been shown that body shape is a useful feature to determine thermal comfort of individuals [2]. It is because, the heat dissipation rate of individuals depends on the body surface area. As a result, a tall and skinny person can tolerate higher room temperature than a rounded body shape person [5]. In order to test this hypothesis, we performed a year-long experiment in 2017, where we recruited 77 participants and put each of them in a thermally controlled conference room in CMU for 3 hours and recorded their subjective responses regarding thermal comfort at different temperature ranging from 60°F to 80°F. In addition, we collected depth data of individuals using a vertically mounted Microsoft Kinect for XBOX One at the entrance of the conference room to capture their body shape. We also collected biometric features (e.g., Galvanic Skin Response (GSR), skin temperature) using a Microsoft Health Band worn by the subjects. The resulting dataset provides rich information regarding how different features can be used to infer thermal comfort of the individuals.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

Specific Energy Analysis for the Manufacturing of Light-Weight Automobile Body

This manuscript analyses the specific energy requirements to produce two hybridised vehicle structures on current automotive assembly lines. It provides quantitative and specific electric (kWhr/vehicle) and fossil-fuel (MMBtu/vehicle) energy predictions of the body-in-white (BIW) manufacturing processes including body panel forming, welding, painting, and final assembly, in addition to the facility heating ventilation and air conditioning or HVAC consumption. Two hybridised BIW design criteria are analysed; the first is based on minimising the added cost per unit weight saved (+$/-kg), while the second is based on maximising the percentage of weight saved (% -kg). Also a new criterion; that is the added specific-energy per unit weight-saved or (+kWhr/vehicle/-kg) is proposed. The light-weight structures comprise body parts made of aluminium and steel. To compute energy consumptions, the study utilises the energy performance index (EPI) stochastic model in addition to complementing it with a panel-forming energy model. Cost analysis is also provided for all the major vehicle body-panels using an in-house Excel macro. The study reverse engineers a passenger vehicle BIW using a full-size coordinate measuring machine (CMM). The presented work further highlights the monetary value of the associated emissions when increasing the specific energy.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗

Augmentation of blood circulation to the fingers by warming distant body areas

Future activities in space will require greater periods of time in extreme environments in which the body periphery will be vulnerable to chilling. Maintaining the hands and fingers in comfortable conditions enhances finger flexibility and dexterity, and thus effects better work performance. We have evaluated the efficacy of promoting heat transfer and release by the extremities by increasing the blood flow to the periphery from more distant parts of the body. The experimental garment paradigm developed by the investigators was used to manipulate the temperature of different body areas. Six subjects, two females and four males, were evaluated in a stage-1 baseline condition, with the inlet temperature of the circulating water in the liquid cooling/warming garment (LCWG) at 33 degrees C. At stage 2 the total LCWG water inlet temperature was cooled to 8 degrees C, and at stage 3 the inlet water temperature in specific segments of the LCWG was warmed (according to protocol) to 45 degrees C, while the inlet temperature in the rest of the LCWG was maintained at 8 degrees C. The following four body-area-warming conditions were studied in separate sessions: (1) head, (2) upper torso/arm, (3) upper torso/arm/head, and (4) legs/feet. Skin temperature, heat flux and blood perfusion of the fingers, and subjective perception of thermal sensations and overall physical comfort were assessed. Finger temperature (T(fing)) analyses showed a statistically significant condition x stage interaction. Post-hoc comparisons (T(fing)) indicated that at stage 3, the upper torso/arm/head warming condition was significantly different from the head, upper torso/arm and legs/feet conditions, showing an increase in T(fing). There was a significant increase in blood perfusion in the fingers at stage 3 in all conditions. Subjective perception of hand warmth, and overall physical comfort level significantly increased in the stage 3 upper torso/arm/head condition. The findings indicate that physiological methods to enhance heat transfer by the blood to the periphery within protective clothing provide an additional tool for increasing total and local human comfort in extreme environments.

NASA Discipline Life Sciences Technologies↗

Circadian variation of EEG power spectra in NREM and REM sleep in humans: dissociation from body temperature

In humans, EEG power spectra in REM and NREM sleep, as well as characteristics of sleep spindles such as their duration, amplitude, frequency and incidence, vary with circadian phase. Recently it has been hypothesized that circadian variations in EEG spectra in humans are caused by variations in brain or body temperature and may not represent phenomena relevant to sleep regulatory processes. To test this directly, a further analysis of EEG power spectra - collected in a forced desynchrony protocol in which sleep episodes were scheduled to a 28-h period while the rhythms of body temperature and plasma melatonin were oscillating at their near 24-h period - was carried out. EEG power spectra were computed for NREM and REM sleep occurring between 90-120 and 270-300 degrees of the circadian melatonin rhythm, i.e. just after the clearance of melatonin from plasma in the 'morning' and just after the 'evening' increase in melatonin secretion. Average body temperatures during scheduled sleep at these two circadian phases were identical (36.72 degrees C). Despite identical body temperatures, the power spectra in NREM sleep were very different at these two circadian phases. EEG activity in the low frequency spindle range was significantly and markedly enhanced after the evening increase in plasma melatonin as compared to the morning phase. For REM sleep, significant differences in power spectra during these two circadian phases, in particular in the alpha range, were also observed. The results confirm that EEG power spectra in NREM and REM sleep vary with circadian phase, suggesting that the direct contribution of temperature to the circadian variation in EEG power spectra is absent or only minor, and are at variance with the hypothesis that circadian variations in EEG power spectra are caused by variations in temperature.

Non-NASA Center↗

Invariant Manifolds, the Spatial Three-Body Problem and Space Mission Design

The invariant manifold structures of the collinear libration points for the spatial restricted three-body problem provide the framework for understanding complex dynamical phenomena from a geometric point of view. In particular, the stable and unstable invariant manifold 'tubes' associated to libration point orbits are the phase space structures that provide a conduit for orbits between primary bodies for separate three-body systems. These invariant manifold tubes can be used to construct new spacecraft trajectories, such as 'Petit Grand Tour' of the moons of Jupiter. Previous work focused on the planar circular restricted three-body problem. The current work extends the results to the spatial case.

three body problem↗

Implementation of a Body Force Model in OVERFLOW for Propulsor Simulations

We present an implementation of a propulsor model based on body force method into the OVERFLOW computational fluid dynamics code to model turbofan engines and propulsors of similar type. The model estimates the forces imparted on the fluid by the blade camber surfaces as a body force source terms in the momentum and energy equations over grids that represent the rotor and stator of a fan stage. We tested the implementation on three cases: 1) Source Diagnostics Test (SDT) fan with R4 rotors, which has extensive test data on aerodynamic performance and rotor wake surveys, 2) A stand-alone Aeronaut TF8000 propulsor which is an off-the-shelf propulsor used on model aircraft and 3) The D8 aircraft model with TF8000 propulsors placed in a wind tunnel. Despite missing some of the features in the velocity profiles near the endwalls (i.e. hub and casing surfaces), the OVERFLOW simulations with body force model predicted area-averaged flow speed and total pressure rise through the SDT propulsor within a few percent of the LDV (Laser Doppler Velocimetry) measurements. In the case of TF8000 propulsor on the D8 airframe, the model under-predicted mechanical power coefficient by several percent of the wind tunnel test results when the horizontal force balance condition over the airframe is targeted by tuning rotor speed. By investigating the upstream influence of the rotor swirl, it was found out that the induced swirl velocity effects upstream were relatively small and they rapidly vanished before reaching one fan diameter upstream of the fan face. The body force model provided insights on aerothermodynamics and aeromechanics of boundary layer ingesting propulsor; these insights could not be obtained by using the uniform pressure jump model.

Propulsor↗

A Higher-Order Space-Time Finite-Element Method for Moving-Body and Fluid-Structure Interaction Problems

We present a high-order finite-element method for moving body and fluid/structure interaction problems. Our solution strategy is based on a space-time discontinuous Galerkin (DG) spectral-element discretization which extends to arbitrary order of accuracy. The space-time DG discretization is a natural choice for moving body and fluid-structure interaction problems as moving surfaces are incorporated simply by considering curved space-time elements whose space-time faces align with the moving body. We present a discontinuous-Galerkin in time discretization for six-degree of motion modeling of rigid bodies, and a continuous-Galerkin discretization for equations of linear elasticity to generate curved space-time meshes. Numerical results for several simple 2D test cases are presented in order to verify the implementation of the different models. Finally we present a preliminary dynamic simulation of a parachute.

High-Order↗

Effect of Tail Surfaces on the Base Drag of a Body of Revolution at Mach Numbers of 1.5 and 2.0

Wind-tunnel tests were performed at Mach numbers of 1.5 and 2.0 to investigate the influence of tail surfaces on the base drag of a body of revolution without boattailing and having a turbulent boundary layer. The tail surfaces were of rectangular plan form of aspect ratio 2.33 and has symmetrical, circular-arc airfoil section. The results of the investigation showed that the addition of these tail surfaces with the trailing edges at or near the body base incurred a large increase in the base-drag coefficient. For a cruciform tail having a 10-percent-thick airfoil section, this increase was about 70 percent at a Mach number of 1.5 and 35 percent at a Mach number of 2.0. As the trailing edge of the tail was moved forward or rearward of the base by about one tail-chord length, the base-drag increment was reduced to nearly zero. The increments in base-drag coefficient due to the presence of 10-percent-thick tail surfaces were generally twice those for 5-percent-thick surfaces. The base-drag increments due to the presence of a cruciform tail were less than twice those for a plane tail. An estimate of the change in base pressure due to the tail surfaces was made, based on a simple superposition of the airfoil-pressure field onto the base-pressure field behind the body. A comparison of the results with the experimental values indicated that in most cases the trend in the variation of the base-drag increment with changes in tail position could be predicted by this approximate method but that the quantitative agreement at most tail locations was poor.

BOUNDARY LAYER - BODIES OF REVOLUTION↗

Relationship between selenium body burdens and tissue concentrations in fish exposed to coal ash at the Tennessee Valley Authority Kingston spill site

In December 2008, 4.1 million m3 of coal ash were released into the Emory and Clinch Rivers by the Tennessee Valley Authority (TVA) Kingston Fossil Plant. Coal ash contains several contaminants, including the bioaccumulative metalloid selenium (Se). Because Se is predominantly accumulated in aquatic organisms through dietary, rather than aqueous exposure, tissue-based toxicity thresholds for Se are currently being considered. The proposed threshold concentrations range between 4-9 g/g Se (dry wt.) in whole body fish, with a proposed fillet threshold of 11.8 g/g. In the present study we examined the spatial and temporal trends in Se bioaccumulation and examined the relationship between the Se content in fillets and in whole bodies of fish collected around the Kingston spill site to determine whether Se bioaccumulation was a significant concern at the ash spill site. While Se concentrations in fish (whole bodies and fillets) were elevated at sampling locations affected by the Kingston ash spill relative to reference locations, concentrations do not appear to be above risk thresholds and have not been increasing over the five year period since the spill. Our results are not only relevant to guiding the human health and ecological risk assessments at the Kingston ash spill site, but because of current national discussions on appropriate guidelines for Se in fish as well for the disposal of coal combustion wastes, our results are also relevant to the general understanding of Se bioaccumulation in contaminated water bodies.

bioaccumulation↗

Simulation studies of a full-ring, CZT SPECT system for whole-body imaging of 99m Tc and 177 Lu

Single photon emission computed tomography (SPECT) is an imaging modality that has demonstrated its utility in a number of clinical indications. Despite this progress, a high sensitivity, high spatial resolution, multi-tracer SPECT with a large field of view suitable for whole-body imaging of a broad range of radiotracers for theranostics is not available. With the goal of filling this technological gap, we have designed a cadmium zinc telluride (CZT) full-ring SPECT scanner instrumented with a broad-energy tungsten collimator. The final purpose is to provide a multi-tracer solution for brain and whole-body imaging. Our static SPECT does not rely on the dual- and the triple-head rotational SPECT standard paradigm, enabling a larger effective area in each scan to increase the sensitivity. We provide a demonstration of the performance of our design using a realistic model of our detector with simulated body-sized phantoms filled with 99m Tc and 177 Lu. Our SPECT design can resolve 7.9 mm rods for 99m Tc (140 keV) and 9.5 mm for 177 Lu (208 keV) in a hot-rod Derenzo phantom with a 3-min exposure and reach an image contrast of 78% for 99m Tc and 57% for 177 Lu using the NEMA IQ phantom with a 6-min exposure. Our modified scatter correction shows an improved contrast-recovery ratio compared to a standard correction. In this paper, we demonstrate the good performance of our design for whole-body imaging purposes. This adds to our previous demonstration of improved qualitative and quantitative 99m Tc imaging of brain perfusion and 123 I imaging of dopamine transport with respect to state-of-the-art NaI dual-head cameras. We show that our design provides similar IQ and contrast to the commercial full-ring SPECT VERITON for 99m Tc. Regarding 177 Lu imaging of the 208 keV emissions, our design provides similar contrast to that of other state-of-the-art SPECTs with a significant reduction in exposure. In conclusion, the high sensitivity and extended energy range up to 250 keV makes our SPECT design a promising alternative for clinical imaging and theranostics of emerging radionuclides.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

Cyclic steady states of treaded rolling bodies

The analysis of spinning axisymmetric bodies undergoing finite deformation is useful for understanding the behavior of a wide variety of engineering systems - for example, rolling tires. Furthermore, progress beyond the axisymmetric case has been lacking. In this work, we present a methodology for the treatment of treaded rolling bodies by devising a Newton-Krylov shooting scheme for the computation of cyclic steady states of motion. The scheme advocated permits one to determine the entire transient (cyclically steady) motion of a spinning treaded body with consideration of viscoelasticity as well as contact. We demonstrate the viability of the method through three examples, (1) a viscoelastic cylinder with eight sinusoidal tread blocks, (2) a viscoelastic cylinder with 16 square tread blocks, and (3) a viscoelastic oval in which repeated contact and separation from a rigid plane excites distinct transient vibrational modes in the body during each cycle. For practical values of the viscoelastic relaxation time, the new approach is found to converge faster than the naïve approach of evolving an initial guess over many cycles until a cyclic steady state is reached.

42 ENGINEERING↗

Development and cross‐validation of a circumference‐based predictive equation to estimate body fat in an active population

Abstract Objective The U.S. Army uses sex‐specific circumference‐based prediction equations to estimate percent body fat (%BF) to evaluate adherence to body composition standards. The equations are periodically evaluated to ensure that they continue to accurately assess %BF in a diverse population. The objective of this study was to develop and validate alternative field expedient equations that may improve upon the current Army Regulation (AR) body fat (%BF) equations. Methods Body size and composition were evaluated in a representatively sampled cohort of 1904 active‐duty Soldiers (1261 Males, 643 Females), using dual‐energy X‐ray absorptiometry (%BF DXA ), and circumferences obtained with 3D imaging and manual measurements. Sex stratified linear prediction equations for %BF were constructed using internal cross validation with %BF DXA as the criterion measure. Prediction equations were evaluated for accuracy and precision using root mean squared error, bias, and intraclass correlations. Equations were externally validated in a convenient sample of 1073 Soldiers. Results Three new equations were developed using one to three circumference sites. The predictive values of waist, abdomen, hip circumference, weight and height were evaluated. Changing from a 3‐site model to a 1‐site model had minimal impact on measurements of model accuracy and performance. Male‐specific equations demonstrated larger gains in accuracy, whereas female‐specific equations resulted in minor improvements in accuracy compared to existing AR equations. Equations performed similarly in the second external validation cohort. Conclusions The equations developed improved upon the current AR equation while demonstrating robust and consistent results within an external population. The 1‐site waist circumference‐based equation utilized the abdominal measurement, which aligns with associated obesity related health outcomes. This could be used to identify individuals at risk for negative health outcomes for earlier intervention.

Taylor, Kathryn M.↗

Scattering amplitudes and N -body post-Minkowskian Hamiltonians in general relativity and beyond

We present a general framework for calculating post-Minskowskian, classical, conservative Hamiltonians for N non-spinning bodies in general relativity from relativistic scattering amplitudes. Novel features for N > 2 are described including the subtraction of tree-like iteration contributions and the calculation of non-trivial many-body Fourier transform integrals needed to construct position space potentials. A new approach to calculating these integrals as an expansion in the hierarchical limit is described based on the method of regions. As an explicit example, we present the O(G 2 ) 3-body momentum space potential in general relativity as well as for charged bodies in Einstein-Maxwell. The result is shown to be in perfect agreement with previous post-Newtonian calculations in general relativity up to O(G 2 v 4 ). Furthermore, in appropriate limits the result is shown to agree perfectly with relativistic probe scattering in multi-center extremal black hole backgrounds and with the scattering of slowly-moving extremal black holes in the moduli space approximation.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

The motivation and status of two-body resonance decays after the LHC Run 2 and beyond

Searching for two-body resonance decays is a central component of the high energy physics energy frontier research program. While many of the possibilities are covered when the two bodies are Standard Model (SM) particles, there are still significant gaps. If one or both of the bodies are themselves non-SM particles, there is very little coverage from existing searches. We review the status of two-body searches and motivate the need to search for the missing combinations. It is likely that the search program of the future will be able to cover all possibilities with a combination of dedicated and model agnostic search approaches.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Mass measurement using energy spectra in three-body decays

In previous works we have demonstrated how the energy distribution of massless decay products in two body decays can be used to measure the mass of decaying particles. In this study, we show how such results can be generalized to the case of multi-body decays. The key ideas that allow us to deal with multi-body final states are an extension of our previous results to the case of massive decay products and the factorization of the multi-body phase space. The mass measurement strategy that we propose is distinct from alternative methods because it does not require an accurate reconstruction of the entire event, as it does not involve, for instance, the missing transverse momentum, but rather requires measuring only the visible decay products of the decay of interest. To demonstrate the general strategy, we study a supersymmetric model wherein pair-produced gluinos each decay to a stable neutralino and a bottom quark-antiquark pair via an off -shell bottom squark. The combinatorial background stemming from the indistinguishable visible final states on both decay sides can be treated by an “event mixing” technique, the performance of which is discussed in detail. In conclusion, taking into account dominant backgrounds, we are able to show that the mass of the gluino and, in favorable cases, that of the neutralino can be determined by this mass measurement strategy.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Tissue Distribution of Mercury in the Bodies of Wild American Alligators ( Alligator mississippiensis ) from a Coastal Marsh in Louisiana (USA)

Total mercury (THg) concentrations were measured in wild alligators inhabiting a coastal marsh in southern Louisiana, to determine the tissue distribution of THg among various body organs and tissue compartments. Concentrations of THg in claws and dermal tail scutes were compared to those in blood, brain, gonad, heart, kidney, liver, and skeletal muscle to determine if the former tissues, commonly available by non-lethal sampling, could be used as measures of body burdens in various internal organs. Mercury was found in all body organs and tissue compartments. However, overall, THg concentrations measured in alligators were below the FDA action level for fish consumption and were comparable to previous data reported from southwestern Louisiana. Here, our results suggest consumption of meat from alligators found in this region may be of little public health concern. However, the extended period of time between sampling (in this study) and the present-day highlight the need for continuous, additional, and more recent sampling to ensure consumer safety. Total mercury concentrations were highest in the kidney (3.18 ± 0.69 mg/kg dw) and liver (3.12 ± 0.76 mg/kg dw). THg levels in non-lethal samples (blood, claws, and dermal tail scutes) were positively correlated with all tissue THg concentrations (blood: R 2 = 0.513 – 0.988; claw: R 2 = 0.347 – 0.637, scutes: R 2 = 0.333 – 0.649). Because THg concentrations from blood, claws, and scutes were correlated with those of the internal organs, non-lethal sampling methods may be a viable method of estimating levels of THg in other body tissues.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

Rapid kVp switching dual-energy CT in the assessment of urolithiasis in patients with large body habitus: preliminary observations on image quality and stone characterization

Purpose: The purpose of this study was to investigate the image quality (IQ) considerations of rapid kVp switching dual-energy CT (rsDECT) in the assessment of urolithiasis in patients with large body habitus and to evaluate whether it allows stone characterization. Materials and methods: In this IRB-approved, HIPAA compliant retrospective study, 93 consecutive patients (M/F = 72/21, mean age 56.9 years, range 23–83 years) with large body habitus (> 90 kg/198 lbs) who underwent dual-energy (DE) stone protocol CT on a rapid kVp switching DECT scanner between January 2013 and December 2016 were included. Scan acquisition protocol included an initial unenhanced single-energy CT (SECT) scan of KUB followed by targeted DECT in the region of stones. Two readers evaluated both CT data sets (axial 5 mm 120 kVp/140 kVp QC/70 keV monoenergetic, material density water/iodine images and coronal/sagittal 3 mm images) for the assessment of image quality (Scores: 1–4) and characterization of stone composition (reference standard: crystallography). Results: One hundred and five CT examinations were performed in 93 patients (mean body weight 105.12 ± 13.53 kg, range 91–154 kg), and a total of 321 urinary tract calculi (mean size-4.8 ± 3.2 mm, range 1.2–22 mm) were detected. Both SECT and targeted monoenergetic images were of acceptable image quality (mean IQ: 3.77 and 3.83, kappa 0.79 and 0.87 respectively). Material density water and iodine images had lower IQ scores (mean IQ: 2.97 and 3.09 respectively) with image quality deterioration due to severe photon starvation/streak artifacts in 20% (21/105) and 17% (18/105) scans, respectively. Characterization of stone composition into uric acid/non-uric acid stones was achieved in 93.14% (299/321) of calculi (mean size: 4.99 ± 3.3 mm, range 1.2–22 mm), while 7% (22/321) stones could not be characterized (mean size 3.03 ± 1.16 mm, range 1.6–6.4 mm) (p < 0.001). Most common reason for non-characterization was image quality deterioration of the material density iodine images due to severe photon starvation artifacts. On multivariate regression, stone size and patient weight were predictors of stone composition determination on DECT (p < 0.05). The transverse diameter had a weak negative correlation with stone composition determination, but it was not statistically significant. Stone characterization into uric acid vs. non-uric acid stones was accurate in 95% (n = 38/40) of stones in comparison with crystallography. Conclusion: In patients with large body habitus, rsDECT allowed characterization of most calculi (93%) despite image quality deterioration due to photon starvation/streak artifacts in up to 20% of material density images. Stone size and patient weight were predictors of stone composition determination on DECT, and small calculi in very large patients may not be characterized.

62 RADIOLOGY AND NUCLEAR MEDICINE↗