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At least 127 records · Page 7

Prospective Clinical Investigation of the Efficacy of Combination Radiation Therapy With Immune Checkpoint Inhibition

Immune checkpoint inhibitors (ICIs) lead to durable responses in a subset of patients with cancer, but most patients do not respond to ICI, prompting interest in combining immunotherapy with other therapeutic regimens. Preclinical evidence supports the potential for therapeutic synergy between immunotherapy and radiation therapy through modulation of the tumor microenvironment and antitumor immune responses. Local therapy also has the potential to overcome localized sites of relative immune suppression and resistance. Prospective clinical trials have been initiated to test these hypotheses in the clinic as well as to investigate the toxicities and adverse events associated with combination immunotherapy and radiation therapy. In this review, we discuss the emerging results from prospective clinical trials of combination immunotherapy and radiation therapy, the safety and efficacy of their combination, concordance with preclinical and retrospective data, and some of the remaining open questions to be addressed by future clinical trials.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

MACCS Theory Manual

This report describes the models of the MACCS computer code as presented in MACCS Version 3.10.0. The purpose of MACCS is to simulate the impact of severe accidents at nuclear power plants on the surrounding environment. MACCS has been developed by Sandia National Laboratories for the U.S. Nuclear Regulatory Commission. From a given release of radioactive material into the atmosphere, MACCS estimates the extent and magnitude of radiological contamination, offsite doses, protective actions, socioeconomic impacts and costs, and health effects. Since the weather at the time of an accident is not predictable, MACCS supports various sampling options to run a representative set of simulations to evaluate weather variability. MACCS simulates atmospheric transport with a straight-line Gaussian plume segment model. From the estimated air and ground concentrations, MACCS models dose projections through several dose exposure pathways. These exposures can be offset by protective actions during the emergency response and long-term recovery of the accident. MACCS users directly specify the evacuation and sheltering area, while other protective actions (e.g., relocation, farmland restrictions, decontamination) are based on user-specified dose or concentration limits. While protective actions help reduce dose accumulation, they also cause social and economic impacts. MACCS models the extent of displaced individuals and land contamination, and the cost of offsite property damage, economic disruptions, and various accident expenditures caused by protective actions. Finally, from the dose accumulation, MACCS estimates early and stochastic health effects according to dose-response models. The purpose of consequence analyses is to be able to understand and estimate the impact of nuclear accidents. Consequence analysis is an essential tool to inform determinations of adequate protection of the public, to understand nuclear power hazards, to measure the value of regulations, and to help us appreciate the importance of nuclear safety. As such, MACCS has a variety of regulatory uses including environmental analyses (10 CFR 51.53, 52.47), regulatory cost-benefit analyses, backfit analyses (10 CFR 50.109), consequence analysis studies such as SOARCA (NUREG-1935), Level 3 PRA studies, and risk-informing of emergency planning (10 CFR 50 App. E and 50.47). This report updates the previous MACCS theory manual (NUREG/CR-4691 Vol. 2; Chanin, Sprung, Ritchie, & Jow, 1990) and accompanies the MACCS User's Guide (SAND-2021-1588) that describes the use and input requirements of the graphical user interface of MACCS known as WinMACCS. The MACCS User's Guide is also a reference guide that describes data input file formats, describes various software components in the MACCS code suite, and provides a set of example tutorials for running WinMACCS. Also, soon to be published is a MACCS input parameter guidance report (NUREG/CR-7270) that provides technical bases for commonly used MACCS input values. This page left blank

97 MATHEMATICS AND COMPUTING↗

The Need for International Consensus and Acceptance of Free Released Material - 20177

World Nuclear Association (WNA) believes that the waste hierarchy is best implemented when a good compromise exists between disposal and reuse/recycling methods of valuable materials and waste generated by the nuclear industry. The rapid normalization of recycling in both domestic and industrial worlds strengthens WNA's position, as new facilities worldwide emerge providing treatment for clearance. As a foundation for reuse and recycling, the International Atomic Energy Agency (IAEA) provided international guidance on clearance (Safety Guide RSG 1.7) [1], defining associated threshold values approved by all member states. Nevertheless, despite this consensus, a lack of alignment of national regulations has occurred as countries have departed for this international guidance, leading to confusion, even between neighborhood countries. As a consequence, this discrepancy between national rules, despite industrial and technical international consensus based on radiological and environmental considerations appeared as a brake, weakening public acceptance as well as nuclear industry credibility. As a matter of fact, what is allowed in one side of a border may be forbidden on the other side. Conversely, an international consensus on clearance would promote: - Sustainability improvements, including preservation of natural and rare resources resulting from optimized recycling and reuse practices; - A broader acceptance of free released materials; - taking advantage of the available technologies worldwide in materials treatment aiming for clearance; - Increased sharing and use of methods, know-how and operators, leading to better efficiency, innovation, improvement as well as technical and financial mastery. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

The United States Department of Energy and National Institutes of Health Collaboration: Medical Care Advances by Discovery in Radiation Detection

A National Institutes of Health (NIH) and U.S. Department of Energy (DOE) Office of Science virtual workshop on shared general topics was held in July of 2021 and reported on in this publication in January of 2023. Following the inaugural 2021 joint meeting representatives from the DOE Office of Science and NIH met to discuss organizing a second joint workshop that would concentrate on radiation detection to bring together teams from both agencies and their grantee populations to stimulate collaboration and efficiency. To meet this scientific mission within the NIH and DOE radiation detection space, the organizers assembled workshop sessions covering the state–of–the–art in cameras, detectors, and sensors for radiation external and internal (diagnostic and therapeutic) to human, data acquisition and electronics, image reconstruction and processing, and the application of artificial intelligence. NIH and DOE are committed to continuing the process of convening a joint workshop every 12–24 months. This Special Report recaps the findings of this second workshop. Beyond showing only the innovations and areas of success, important gaps in our knowledge were defined and presented. Finally, we summarize by defining four areas of greatest opportunity and need that emerged from the unique, dynamic dialogue the in–person workshop provided the attendees.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Comparison of All Solid Cancer Mortality and Incidence Dose-Response in the Life Span Study of Atomic Bomb Survivors, 1958–2009

Recent analysis of all solid cancer incidence (1958–2009) in the Life Span Study (LSS) revealed evidence of upward curvature in the radiation dose response among males but not females. Upward curvature in sex-averaged excess relative risk (ERR) for all solid cancer mortality (1950–2003) was also observed in the 0–2 Gy dose range. As reasons for non-linearity in the LSS are not completely understood, we conducted dose response analyses for all solid cancer mortality and incidence applying similar methods (1958–2009 follow-up, DS02R1 doses, including subjects notin-city (NIC) at the time of the bombing) and statistical models. Incident cancers were ascertained from Hiroshima and Nagasaki cancer registries, while cause of death was ascertained from death certificates over entire Japan. The study included 105,444 LSS subjects who were alive and not known to have cancer before Jan 1, 1958 (80,205 with dose estimates and 25,239 NIC subjects). Between 1958 and 2009, there were 3.1 million person-years (PY) and 22,538 solid cancers for incidence analysis and 3.8 million PY and 15,419 solid cancer deaths for mortality analysis. We fitted sex-specific ERR models adjusted for smoking to both types of data. Over the entire range of doses, solid cancer mortality dose response exhibited a borderline significant upward curvature among males (P=0.062) and significant upward curvature among females (P=0.010); for solid cancer incidence, as before, we found a significant upward curvature among males (P=0.001) but not among females (P=0.624). The sex difference in magnitude of dose response curvature was statistically significant for cancer incidence (P=0.017) but not for cancer mortality (P=0.781). The results of analyses in the 0–2 Gy range and restricted lower dose ranges generally supported inferences made about the sex-specific dose response shape over the entire range of doses for each outcome. Patterns of sex-specific curvature by calendar period (1958–1987 vs 1988–2009) and age at exposure (0–19 vs 20–83) varied between mortality and incidence data, particularly among females, although for each outcome there was an indication of curvature among 0–19 year old male survivors in both calendar periods and among 0–19 year old female survivors in the recent period. Collectively, our findings indicate that the upward curvature in all solid cancer dose response in the LSS is neither specific to males nor to incidence data; it appears to depend on composition of case series and age at exposure or time. Further follow-up and site-specific analyses of cancer mortality and incidence will be important to confirm the emerging trend in dose response curvature among young survivors and unveil the contributing factors and sites.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

Consequence analyses of sabotage-induced radiological releases in high-temperature helium-cooled prismatic microreactors

Here, this study analyzes the radiological dose consequences of sabotage-induced accidents at three high-temperature helium-cooled prismatic microreactors (HTPMs) with thermal power ratings of 1, 10, and 50 MWt. Each HTPM employs uranium oxycarbide tristructural isotropic fuel enriched to 19.75 wt% high-assay low-enriched uranium. Simulations were conducted to estimate reactor core inventory at the point of fuel discharge––when the effective multiplication factor reduced to less than 1––representing peak radionuclide inventory. Postulated sabotage scenarios leading to reactor shutdown were analyzed at two intervals: immediately post-shutdown (0 h) and 3 days after shutdown using the SCALE code for radionuclide inventories and the RASCAL tool for dose consequences. Results show that although HTPMs benefit from inherent safety features and robust fuel design, radiological consequences scale with reactor power because of increased source term inventories. Smaller microreactors exhibited proportionally lower dose consequences. To support the economic and regulatory feasibility of microreactor deployment, this study emphasizes the value of a risk-informed, performance-based approach, as supported by regulations like 10 CFR Parts 100 and 53 in the United States. Microreactor developers should perform site-specific assessments of potential sabotage or low-probability, high-consequence events, especially when considering minimal on-site or full off-site emergency response.

Consequence↗

Salvage Mastectomy Versus Second Conservative Treatment for Second Ipsilateral Breast Tumor Event: A Propensity Score-Matched Cohort Analysis of the GEC-ESTRO Breast Cancer Working Group Database

Second conservative treatment has emerged as an option for patients with a second ipsilateral breast tumor event after conserving surgery and breast irradiation. We aimed to address the lack of evidence regarding second breast event treatment by comparing oncologic outcomes after conservative treatment or mastectomy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Automated nuclear cloud feature extraction from film

Chemical, biological, radiological, nuclear, and explosives incidents require rapid detection and characterization for appropriate response. For a nuclear detonation, visible-light cameras may be used to locate the cloud and characterize fallout deposition when coupled with numerical models. Films from the United States’ nuclear testing era compose the only sizeable collection of imagery depicting high-yield detonations. These films offer unique insights into characteristics of flows involving scales that are difficult to replicate experimentally, and they are a valuable source of data for the validation of models for nuclear fallout transport, either as part of emergency response or forensic activities. In this work, we implement modern computer vision and machine learning techniques to identify and track the cloud automatically and subsequently determine the time dependence of some of its features. We trained a ResNet-18 image classifier on hundreds of images to categorize nuclear cloud morphology. Each category or cloud regime is determined by early cloud evolution and is associated to constitutive properties of the flow, such as distribution of vorticity. Next, we identified keypoint features using the KAZE algorithm and tracked these keypoints in the images, allowing us to determine the dimensions and velocities of the cloud across film frames. These measurements converted to real-world units provide valuable experimental data that can be used in the development and validation of nuclear cloud models. We compared the results of this method against manual cloud rise measurements from two different films. In one, our automated method accelerated the feature extraction process without sacrificing measurement accuracy.

Khristy, Joel [ORNL] (ORCID:0000000209963060)↗

Overview and Lessons From the Preclinical Chemoradiotherapy Testing Consortium

In the current molecular-targeted cancer treatment era, many new agents are being developed so that optimizing therapy with a combination of radiation and drugs is complex. The use of emerging laboratory technologies to further biological understanding of drug-radiation mechanisms of action will enhance the efficiency of the progression from preclinical studies to clinical trials. In 2017, the National Cancer Institute (NCI) solicited proposals through PAR 16-111 to conduct preclinical research combining targeted anticancer agents in the Cancer Therapy Evaluation Program's portfolio with chemoradiation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Use of Multi-Site Radiation Therapy for Systemic Disease Control

Metastatic cancer is a heterogeneous entity, some of which could benefit from local consolidative radiation therapy (RT). Although randomized evidence is growing in support of using RT for oligometastatic disease, a highly active area of investigation relates to whether RT could benefit patients with polymetastatic disease. This article highlights the preclinical and clinical rationale for using RT for polymetastatic disease, proposes an exploratory framework for selecting patients best suited for these types of treatments, and briefly reviews potential challenges. The goal of this hypothesis-generating review is to address personalized multimodality systemic treatment for patients with metastatic cancer. The rationale for using high-dose RT is primarily for local control and immune activation in either oligometastatic or polymetastatic disease. However, the primary application of low-dose RT is to activate distinct antitumor immune pathways and modulate the tumor stroma in efforts to better facilitate T cell infiltration. We explore clinical cases involving high- and low-dose RT to demonstrate the potential efficacy of such treatment. We then group patients by extent of disease burden to implement high- and/or low-dose RT. Patients with low-volume disease may receive high-dose RT to all sites as part of an oligometastatic paradigm. Subjects with high-volume disease (for whom standard of care remains palliative RT only) could be treated with a combination of high-dose RT to a few sites for immune activation, while receiving low-dose RT to several remaining lesions to enhance systemic responses from high-dose RT and immunotherapy. We further discuss how emerging but speculative concepts such as immune function may be integrated into this approach and examine therapies currently under investigation that may help address immune deficiencies. The review concludes by addressing challenges in using RT for polymetastatic disease, such as concerns about treatment planning workflows, treatment times, dose constraints for multiple-isocenter treatments, and economic considerations.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

The Influence of Severe Radiation-Induced Lymphopenia on Overall Survival in Solid Tumors: A Systematic Review and Meta-Analysis

Emerging evidence suggests a detrimental prognostic association between radiation-induced lymphopenia (RIL) and pathologic response, progression-free survival, and overall survival (OS) in patients who undergo radiation therapy for cancer. The aim of this study was to systematically review and meta-analyze the prognostic impact of RIL on OS in patients with solid tumors.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Gantry-Based 5-Fraction Elective Nodal Irradiation in Unfavorable-Risk Prostate Cancer: Outcomes From 2 Prospective Studies Comparing SABR Boost With MR Dose-Painted HDR Brachytherapy Boost

Guidelines from the American Society of Clinical Oncology and Cancer Care Ontario recommend brachytherapy boost for patients with intermediate-risk or high-risk prostate cancer. SABR is an emerging technique for prostate cancer, but its use in high-risk disease is limited. Efficacy, toxic effects, and quality of life (QoL) were compared in patients treated on 2 prospective protocols that used SABR boost or magnetic resonance–guided high-dose-rate brachytherapy (HDR-BT) boost with 6 to 18 months of androgen deprivation therapy (ADT).

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SURVEILLANCE DETECTION FOR TRANSPORTATION OPERATIONS PERSONNEL TO PREVENT HIJACKING, THEFT, SABOTAGE, AND MALICIOUS SECURITY EVENTS DURING TRANSPORTING NUCLEAR MATERIAL

The secure transportation of high-consequence materials, including nuclear and radiological assets, is a critical global priority in the face of escalating terrorism, security threats, and violent protests targeting these operations. Effective surveillance detection—the ability to identify, assess, and respond to potential threats across a continuum of scenarios—is paramount in addressing these challenges. This paper outlines a phased, multi-tiered training program designed to strengthen the surveillance detection capabilities of organizations responsible for nuclear material transport. The proposed training program adopts a progressive approach, gradually increasing in technical complexity to provide participants with comprehensive knowledge and tools for implementing robust security strategies. It targets a wide spectrum of stakeholders, including competent authorities, regulators, inspectors, shippers, carriers, law enforcement, and emergency response personnel, equipping them to plan, evaluate, and safeguard nuclear material transportation effectively. Each phase of the program emphasizes distinct elements of the surveillance detection continuum and transport security, focusing on critical topics such as threat identification, adversary task timelines, protective methodologies, and attack mitigation strategies. The training framework is anchored in technical exchanges and scenario-driven courses that reflect real-world complexities and challenges. By addressing the surveillance detection continuum comprehensively—from early threat assessment to active countermeasures—the program reinforces global efforts to secure nuclear assets. It aligns with international security objectives and fosters a strong security culture within participating organizations, ensuring personnel are prepared to counter potential threats and maintain the safe, secure movement of these materials. Ultimately, this initiative aims to enhance preparedness, security, and response capabilities, supporting the global mission to safeguard high-consequence materials against evolving threats.

Zineddin, Dr. Z. [ORNL] (ORCID:0009000848740725)↗

2020 State of the Science Report, Chapter 1: Marine Renewable Energy and Ocean Energy System

Research, development, and deployment of marine renewable energy (MRE) conversion technologies that harvest all forms of ocean renewable resources are being advanced around the world. The potential benefits derived from capturing the abundant energy of tides, waves, ocean currents, as well as thermal and salinity gradients, continue to drive the development of the emerging MRE industry. Stakeholder understanding of the potential benefits of MRE as a renewable energy source is informed by increased science-based understanding of the potential effects of MRE installations worldwide. The international Ocean Energy Systems (OES)-Environmental collaboration continues to promote global technology cooperation and information exchange to accelerate environmentally acceptable development of viable ocean energy systems. https://tethys.pnnl.gov/publications/state-of-the-science-2020-chapter-1-MRE-OES

13 HYDRO ENERGY↗

Summary of Factory Fueling and Testing Risks to Support the Transformation of Regulatory Requirements for Microreactors

Microreactors have the potential to open new markets and applications for nuclear energy. New manufacturing and operational regimes, such as factory fueling and testing prior to site installation, are being proposed to meet these new markets. The radiological hazards associated with traditional commercial power reactors are not the same as the hazards of a reactor being constructed in a factory. Currently, a reactor operating license specified under 10 CFR Part 50, Part 52, or (in the near future) Part 53 is required prior to loading fuel in the reactor. This is logical for plants that are immediately to begin full-power operations soon after fuel loading. However, for microreactors, this may not be the case. Some deployment concepts may stage reactors as “ready to go” in a factory prior to site installation and startup. This approach is being considered in the case of diesel generator replacements, mobile or roaming mining operations, and emergency response situations, such as after a major disaster event. Therefore, it is necessary to evaluate hazards assuming low power operation for a short irradiation time. This report investigates the primary hazards unique to microreactors associated with low power reactor and physics tests necessary to confirm core safety assumptions, neutronic and core design performance parameters, and other assumptions.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

WORKSHOP ON URBAN SCALE PROCESSES AND THEIR REPRESENTATION IN HIGH SPATIAL RESOLUTION EARTH SYSTEM MODELS

It is essential that numerical models used to study physics, chemistry, and biology affecting the Earth system at regional and global scales represent the effects of urban areas on climate and the effects of changing the climate on urban areas. At the same time, it is essential to develop state of the art, simple and accurate urban models to better understand the relevant processes and also toaddress issues related to urban security against the spectra of chemical, biological and radiological (CBR) hazards. Towards bringing these communities together, a 2.5-day international workshop was held at Argonne National Laboratory (ANL) in the Chicago area on May 22-24, 2019. This workshop brought together national and international experts to develop a roadmap for a better understanding of the issues associated with urban areas and at enhancing the capabilities of regional and global Earth System models (ESMs) in representing the atmospheric dynamics and chemistry, unique aspects of the biosphere and land use, and human dimensions of the urban environment. This workshop was especially important to those developing very high-resolution versions of regional and global models. The workshop also discussed existing datasets, including in situ and satellite observations, and the emerging smart city sensing technologies and their possible use in model development (e.g., the NSF-funded Array of Things network currently operating in Chicago and expanding to other cities).

54 ENVIRONMENTAL SCIENCES↗

Multiscale Modeling Meets Machine Learning: What Can We Learn?

Machine learning is increasingly recognized as a promising technology in the biological, biomedical, and behavioral sciences. There can be no argument that this technique is incredibly successful in image recognition with immediate applications in diagnostics including electrophysiology, radiology, or pathology, where we have access to massive amounts of annotated data. However, machine learning often performs poorly in prognosis, especially when dealing with sparse data. This is a field where classical physics-based simulation seems to remain irreplaceable. In this review, we identify areas in the biomedical sciences where machine learning and multiscale modeling can mutually benefit from one another: Machine learning can integrate physics-based knowledge in the form of governing equations, boundary conditions, or constraints to manage ill-posted problems and robustly handle sparse and noisy data; multiscale modeling can integrate machine learn- ing to create surrogate models, identify system dynamics and parameters, analyze sensitivities, and quantify uncertainty to bridge the scales and understand the emergence of function. With a view towards applications in the life sciences, we discuss the state of the art of combining machine learning and multiscale modeling, identify applications and opportunities, raise open questions, and address potential challenges and limitations. We anticipate that it will stimulate discussion within the community of computational mechanics and reach out to other disciplines including mathematics, statistics, computer science, artificial intelligence, biomedicine, systems biology, and precision medicine to join forces towards creating robust and efficient models for biological systems.

machine learning, multiscale modeling, physics-bas↗

Consequence analyses of sabotage-induced radiological releases in sodium-cooled fast microreactors

Analysis of three sodium-cooled fast microreactors (SFMs) with thermal powers of 10, 30, and 50 MWt showed that smaller reactors result in lower radiological consequences during a postulated sabotage-induced event because of their reduced core inventory. All SFMs used U-10Zr metal fuel enriched to 15 wt% high-assay low-enriched uranium and operated until their respective effective multiplication factor (k eff ) reduced to less than 1 or until the end of their operational lifespan. Sabotage scenarios were simulated at this point, when the fuel inventory within the core contains the highest-level of radioactivity. Radionuclide core inventories were calculated using the SCALE code at shutdown and 3 days post-shutdown. Dose consequence analyses were performed for three sabotage scenarios using the RASCAL tool. As microreactor developers plan for minimal on-site or complete off-site emergency response, it remains essential to evaluate their physical protection needs and potential hazards, including assessing postulated sabotage-induced events that could become more relevant. SFM licensees should identify a credible worst-case, major accident, estimate release source terms, and perform dose consequence analyses to evaluate site-specific physical protection measures. In conclusion, this recommendation supports a risk-informed, performance-based approach, aligning with applicable regulatory requirements, i.e., 10 CFR Parts 100 and 53 rulemaking in the United States.

98 NUCLEAR DISARMAMENT, SAFEGUARDS, AND PHYSICAL P↗