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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 1,639 records · Page 91
All sourcesNASA NTRSDOE OSTI
DOE OSTI2017

The biodistribution and pharmacokinetics of the oxime acetylcholinesterase reactivator RS194B in guinea pigs

Organophosphorus-based (OP) nerve agents represent some of the most toxic substances known to mankind. The current standard of care for exposure has changed very little in the past decades, and relies on a combination of atropine to block receptor activity and oxime-type acetylcholinesterase (AChE) reactivators to reverse the OP binding to AChE. Although these oximes can block the effects of nerve agents, their overall efficacy is reduced by their limited capacity to cross the blood-brain barrier (BBB). RS194B, a new oxime developed by Radic et al. (J. Biol. Chem., 2012) has shown promise for enhanced ability to cross the BBB. To fully assess the potential of this compound as an effective treatment for nerve agent poisoning, a comprehensive evaluation of its pharmacokinetic (PK) and biodistribution profiles was performed using both intravenous and intramuscular exposure routes. The ultra-sensitive technique of accelerator mass spectrometry was used to quantify the compound’s PK profile, tissue distribution, and brain/plasma ratio at four dose concentrations in guinea pigs. PK analysis revealed a rapid distribution of the oxime with a plasma t1/2 of ~1 hr. Kidney and liver had the highest concentrations per gram of tissue followed by lung, spleen, heart and brain for all dose concentrations tested. The Cmax in the brain ranged between 0.03-0.18% of the administered dose, and the brain-to-plasma ratio ranged from 0.04 at the 10 mg/kg dose to 0.18 at the 200 mg/kg dose demonstrating dose dependent differences in brain and plasma concentrations. In vitro studies show that both passive diffusion and active transport contribute little to RS194B traversal of the BBB. These results indicate that biodistribution is widespread, but very low quantities accumulate in the guinea pig brain, indicating this compound may not be suitable as a centrally active reactivator.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2022

Towards fast-charging high-energy lithium-ion batteries: From nano- to micro-structuring perspectives

Electric vehicles (EVs) have been playing an indispensable role in reducing greenhouse gas emissions for our modern society. However, current EVs are difficult to meet people’s diverse travel needs, especially in long endurance and fast-charging capacities. At the heart of this issue is the physicochemical limit of current lithium-ion batteries (LIBs), which are the core parts for powering the vehicles. Hence, LIBs with simultaneous high energy and power are critically required to further promote the development of EVs. Here, in this review, we first summarize the key electrochemical processes in electrochemical reactions which lead to the corresponding overpotentials in or between multiple battery components. Furthermore, numerical simulations are employed to quantitatively analyze the effects of versatile electrode parameters on electrochemical properties in high-energy NMC811//graphite systems. On the basis of the in-depth understandings from simulation, recent experimental efforts on designing electroactive materials and electrode architectures across multiple length scales are discussed. Among them, nano-structuring can promote local mass transport and stabilize the interfaces at the particle level, while micro-structuring can establish efficient pathways for charge carriers at the electrode level. Finally, we conclude that a tight feedback loop among structure engineering, characterization and simulation should be followed to speed up the understanding of the deficiencies existing in current electrode designs as well as point out the possible electrode optimization routes for next-generation fast-charging LIBs.

25 ENERGY STORAGE↗
DOE OSTI2024

Diversifying hierarchical ionic assembly by docking cations to anions as salt bridges

Here, we expand the diversity of building blocks available for ionic assembly by introducing tertiary (3°) ammonium cations into anion complexes. We use proton transfer between 3° amines and organo-phosphoric acids to generate H-bonding cations (R 3 NH + ) and anions (RHPO 4 – ) that co-assemble with cyanostar macrocycles into assemblies with 2:2:2 stoichiometry. At the heart is a supramolecular dimer where phosphate anions form salt bridges by H-bonding with cations. Unlike conventional 4° ammonium cations, 3,000 commercial amines provide diversity for high-throughput screening of 72 combinations (9 nitrogen bases and 8 acids), producing 13 privileged partners for quantitative assembly. Yields depend on the solvent and sterics of salt bridge formation. Ten more nitrogen bases connect to fluorophores (pyrene), photocatalysts (quinoline), drugs (Cipralex, Zytiga), and ionic liquids (imidazole). The synthesis and examination of 82 new salts exemplify how acid-base chemistry can open a pipeline to a diversity of building blocks for exploring hierarchical ionic assembly.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2022

Comparison of Machine Learning and Deep Learning for View Identification from Cardiac Magnetic Resonance Images

Background: Artificial intelligence is increasingly utilized to aid in the interpretation of cardiac magnetic resonance (CMR) studies. One of the first steps is the identification of the imaging plane depicted, which can be achieved by both deep learning (DL) and classical machine learning (ML) techniques without user input. We aimed to compare the accuracy of ML and DL for CMR view classification and to identify potential pitfalls during training and testing of the algorithms. Methods: To train our DL and ML algorithms, we first established datasets by retrospectively selecting 200 CMR cases. The models were trained using two different cohorts (passively and actively curated) and applied data augmentation to enhance training. Once trained, the models were validated on an external dataset, consisting of 20 cases acquired at another center. We then compared accuracy metrics and applied class activation mapping (CAM) to visualize DL model performance. Results: The DL and ML models trained with the passively-curated CMR cohort were 99.1% and 99.3% accurate on the validation set, respectively. However, when tested on the CMR cases with complex anatomy, both models performed poorly. After training and testing our models again on all 200 cases (active cohort), validation on the external dataset resulted in 95% and 90% accuracy, respectively. The CAM analysis depicted heat maps that demonstrated the importance of carefully curating the datasets to be used for training. Conclusions: Both DL and ML models can accurately classify CMR images, but DL outperformed ML when classifying images with complex heart anatomy.

artificial intelligence↗
DOE OSTI2025

MetaHeart: Metasurface enabled biometrics camouflage

Privacy-invading biometrics monitoring is becoming a prominent security threat as modern sensing systems move to higher operating frequencies (mmWave, sub-THz), increasing sensing resolution and accuracy. As such, developing systems that can protect or obfuscate biometrics from adversarial intrusion becomes pivotal to preserving user privacy. In this work, we develop and implement MetaHeart, a real-time biometrics misinformation system based on reflective, programmable metasurfaces and dynamic phase-front manipulation of radar inferences. MetaHeart’s key goal is to prevent the leakage of a legitimate user’s heartbeat biometrics by spoofing fake heartbeat signals at a malicious, radar-equipped, heart rate sensing intruder. Furthermore, we experimentally demonstrate MetaHeart’s ability to fake Alice’s presence when she is not there and to fool Trudy’s inferences even when Alice is present, achieving an overall accuracy above 98%. Finally, we conduct a robustness analysis to determine MetaHeart’s required spatial placement within the intruder’s monitoring area that would allow for effective spoofing.

77 NANOSCIENCE AND NANOTECHNOLOGY↗
DOE OSTI2015

Recent advances in small-scale mechanical property measurement by nanoindentation

Since its initial development in the early 1980’s [1], nanoindentation has matured into one of the premier testing techniques for measuring mechanical properties at the micrometer and sub-micrometer scales and has emerged as a critical tool that has helped to shape the nanotechnology revolution. At the heart of the technique are testing systems with simple but precise force actuators and displacement measuring devices that record the force–displacement record as a diamond indenter, usually the form of a pyramid or a sphere, is pressed into and withdrawn from a small region in the surface of a material of interest. The nano-scale force–displacement data, which can be obtained with a spatial resolution as small as a few nanometers, contains a wealth of information about the local mechanical properties [2], [3] and [4]. This enables the mechanical characterization of very thin films, like those used in the semiconductor, magnetic storage, and hard coatings industries, as well as very small precipitates, particles and second phases, many of which may not exist in bulk form and cannot be characterized by traditional mechanical testing methods. Here, computer automation of nanoindentation testing systems now routinely provides for complete two-dimensional mapping of properties over regions stretching from sub-micron to millimeters in scale.

77 NANOSCIENCE AND NANOTECHNOLOGY↗
DOE OSTI2018

Dynamics in hard condensed matter probed by X-ray photon correlation spectroscopy: Present and beyond

Insight into the spatial ordering and dynamics of structural heterogeneity in materials is at the heart of understanding their structure and function. X-ray photon correlation spectroscopy (XPCS) measures the dynamic structure factor providing S(Q,t) information on the spontaneous low-energy dynamics intrinsic to many materials. Combined with in situ and in operando capabilities, XPCS provides unique insight into a variety of scientific areas, including phase separation in binary alloys, aging in metallic glasses, surface dynamics during growth, domain wall dynamics in ferroic complex oxides and charge and spin density wave motion in quantum materials. In conclusion, this review summarizes some recent XPCS work in these areas and discusses scientific opportunities that will be made possible with the many-fold increase in coherent flux provided by the world-wide construction and commissioning of X-ray sources based on multi-bend achromat (MBA) storage ring (SR) lattices and high repetition rate free electron lasers (FELs).

74 ATOMIC AND MOLECULAR PHYSICS↗
DOE OSTI2026

Lethality is Local, but Survival is Systemic: Temporal and Multi-Organ Responses to Chlorine Gas Exposure in a Murine Model

Chlorine gas (Cl2) is a highly toxic chemical associated with both localized lung injury and systemic health effects. While pulmonary damage has been well characterized, the systemic inflammatory and metabolic responses remain poorly understood. We aimed to define the temporal and multi-organ responses to Cl2 exposure in a murine model, with a focus on identifying spatiotemporal inflammation and its impact on survival and lethality. SKH1 mice were exposed for 10 min to varying concentrations of Cl2 (94.4–810 ppm, representative of non-lethal, LD10, and LD50 doses) and monitored for respiratory function, perfusion, and acidosis using organ-specific imaging. At multiple time points (40 min, 6 h, 24 h, and 7 d), we measured phosphoproteins, cytokines, chemokines, growth factors, and metabolic hormones in the lungs, heart, cortex, and plasma. Statistical modeling and logistic regression were used to identify biomarkers associated with lethality and survival. We found that lung injury was the primary cause of potential lethality, particularly via early phosphoprotein signaling disruptions. However, survival correlated with early systemic coordination of inflammatory and metabolic signals across organs. Perfusion and acidosis imaging were strongly associated with chemokine and hormone responses. Key survival-associated plasma biomarkers included decreased insulin, increased ghrelin, and decreased eotaxin. While potential lethality from Cl2 exposure is locally driven by pulmonary injury, survival depends on systemic, multi-organ responses that occur rapidly post-exposure. Within this model, our findings identify a potential therapeutic window to enhance survival and suggest candidate biomarkers that may be explored translationally for both triage and treatment of chlorine-related incidents.

chlorine gas↗
DOE OSTI2023

Developing and tuning a community scale energy model for a disadvantaged community

This work describes the development of a community-scale energy model for a mixed-use low-income community located in Huntington Beach, CA. An accurate community-scale energy model is useful for evaluating the use of limited capital resources used to invest in clean energy technologies. This work lays out the process of developing such a model while relying primarily on publicly available data and highlighting critical partnerships necessary for model development success. The primary contribution of this work is the demonstration of the process used to develop an accurate energy model for a disadvantaged community when minimal building and energy use data is available. The heart of the model is the physics-based community scale energy modeling platform URBANopt. Using a bottom-up load modeling approach, energy simulated energy use falls within 3% or less of aggregate annual utility data, and within 10% or less aggregate monthly utility data. The demonstrated model development and tuning process can be used by others to characterize other atypical communities, which may differ significantly from prototypical models.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2018

Cadmium and atherosclerosis: A review of toxicological mechanisms and a meta-analysis of epidemiologic studies

Cadmium has been proposed to be the one of the factors of atherosclerosis development, although the existing data are still controversial. The primary objective of the present study is the review and the meta-analysis of studies demonstrating the association between Cd exposure and atherosclerosis as well as review of the potential mechanisms of such association. We performed a systematic search in the PubMed-Medline database using the MeSH terms cadmium, cardiovascular disease, atherosclerosis, coronary artery disease, myocardial infarction, stroke, mortality and humans up through December 20, 2017. Elevated urinary Cd levels were associated with increased mortality for cardiovascular disease (HR = 1.34, 95% CI: 1.07–1.67) as well as elevated blood Cd levels (HR = 1.78, 95% CI: 1.24–2.56). Analysis restricted to never smokers showed similar, though more imprecise, results. Consistently, we also observed an association between Cd exposure markers (blood and urine) and coronary heart disease, stroke, and peripheral artery disease. Moreover, Cd exposure was associated with atherogenic changes in lipid profile. High Cd exposure was associated with higher TC levels (OR = 1.48, 95% CI: 1.10–2.01), higher LDL-C levels (OR = 1.31, 95% CI 0.99–1.73) and lower HDL-C levels (OR = 1.96, 95% CI: 1.09–3.55). The mechanisms of atherogenic effect of cadmium may involve oxidative stress, inflammation, endothelial dysfunction, enhanced lipid synthesis, up-regulation of adhesion molecules, prostanoid dysbalance, as well as altered glycosaminoglycan synthesis.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2018

Local pollutants go global: The impacts of intercontinental air pollution from China on air quality and morbidity in California

Highlights: • Heavy sandstorms are a major pollution source in China. • Trans-Pacific air pollution from sandstorms in China affect health in California. • Policymakers could plan for worsened air quality in California following sandstorms. China is among the greatest emitters of air pollution in the world and one concern is the effects of intercontinental air pollution traveling across the Pacific Ocean from China to the U.S. We exploit a natural experiment by observing the effects of changes in intercontinental air pollution associated with Chinese New Year, a 7-day national holiday, and sandstorms from China on air quality and morbidity in California. The timing of these events are unlikely correlated to other factors affecting air quality and health in California. Chinese New Year follows the Lunar New Year which varies each traditional calendar year while sandstorms are a naturally occurring phenomenon. We examine effects on morbidity using restricted emergency department and inpatient hospitalization data for the universe of patients with respiratory and heart disease between 2005 and 2012 in California. This is the first study to use patient-level data to examine the effects of trans-Pacific air pollution from China on morbidity in the U.S. We show that heavy sandstorms are associated with a modest increase in acute respiratory disease per capita, representing 0.5–4.6% of average weekly hospitalizations. However, we find no significant effect on morbidity in California from Chinese New Year. Results suggest that policymakers could prepare for changes in air quality following major sandstorms in China.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2017

A characterization of workflow management systems for extreme-scale applications

We present that the automation of the execution of computational tasks is at the heart of improving scientific productivity. Over the last years, scientific workflows have been established as an important abstraction that captures data processing and computation of large and complex scientific applications. By allowing scientists to model and express entire data processing steps and their dependencies, workflow management systems relieve scientists from the details of an application and manage its execution on a computational infrastructure. As the resource requirements of today’s computational and data science applications that process vast amounts of data keep increasing, there is a compelling case for a new generation of advances in high-performance computing, commonly termed as extreme-scale computing, which will bring forth multiple challenges for the design of workflow applications and management systems. This paper presents a novel characterization of workflow management systems using features commonly associated with extreme-scale computing applications. We classify 15 popular workflow management systems in terms of workflow execution models, heterogeneous computing environments, and data access methods. Finally, the paper also surveys workflow applications and identifies gaps for future research on the road to extreme-scale workflows and management systems.

97 MATHEMATICS AND COMPUTING↗
DOE OSTI2022

A review on nearly isothermal compression technology

Compressors can be described as the heart of a vapor compression refrigeration system, circulating the working fluid in the system. Significant benefits can be gained from improving its efficiency since energy consumption is responsible for almost the entire system's power input. An effort has been made to achieve isothermal compression through liquid refrigerant injection or inter-stage cooling in refrigeration systems. In recent years, much effort has been invested into isothermal compression technology for air compressors or compressed air energy storage systems with the rise of renewable energy. Here, this work has explored the advancements made in this area and categorized them to discuss the benefits, limitations, and tradeoffs. Evidently, increasing heat transfer area is a significant aid in improving heat transfer, resulting in better isothermal compression. However, liquid pistons open more avenues for this to be pursued, and therefore, are limited to air compression applications. In addition, water injection proved to be the most effective among the methods. Finally, there is a need for more experimental research on refrigeration applications and the field is still in its infancy.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2014

Stereotactic Ablative Radiation Therapy for Centrally Located Early Stage or Isolated Parenchymal Recurrences of Non-Small Cell Lung Cancer: How to Fly in a “No Fly Zone”

Purpose: We extended our previous experience with stereotactic ablative radiation therapy (SABR; 50 Gy in 4 fractions) for centrally located non-small cell lung cancer (NSCLC); explored the use of 70 Gy in 10 fractions for cases in which dose-volume constraints could not be met with the previous regimen; and suggested modified dose-volume constraints. Methods and Materials: Four-dimensional computed tomography (4DCT)-based volumetric image-guided SABR was used for 100 patients with biopsy-proven, central T1-T2N0M0 (n=81) or isolated parenchymal recurrence of NSCLC (n=19). All disease was staged with positron emission tomography/CT; all tumors were within 2 cm of the bronchial tree, trachea, major vessels, esophagus, heart, pericardium, brachial plexus, or vertebral body. Endpoints were toxicity, overall survival (OS), local and regional control, and distant metastasis. Results: At a median follow-up time of 30.6 months, median OS time was 55.6 months, and the 3-year OS rate was 70.5%. Three-year cumulative actuarial local, regional, and distant control rates were 96.5%, 87.9%, and 77.2%, respectively. The most common toxicities were chest-wall pain (18% grade 1, 13% grade 2) and radiation pneumonitis (11% grade 2 and 1% grade 3). No patient experienced grade 4 or 5 toxicity. Among the 82 patients receiving 50 Gy in 4 fractions, multivariate analyses showed mean total lung dose >6 Gy, V{sub 20} >12%, or ipsilateral lung V{sub 30} >15% to independently predict radiation pneumonitis; and 3 of 9 patients with brachial plexus D{sub max} >35 Gy experienced brachial neuropathy versus none of 73 patients with brachial D{sub max} <35 Gy (P=.001). Other toxicities were analyzed and new dose-volume constraints are proposed. Conclusions: SABR for centrally located lesions produces clinical outcomes similar to those for peripheral lesions when normal tissue constraints are respected.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Improving Outcomes for Esophageal Cancer using Proton Beam Therapy

Radiation therapy (RT) plays an essential role in the management of esophageal cancer. Because the esophagus is a centrally located thoracic structure there is a need to balance the delivery of appropriately high dose to the target while minimizing dose to nearby critical structures. Radiation dose received by these critical structures, especially the heart and lungs, may lead to clinically significant toxicities, including pneumonitis, pericarditis, and myocardial infarction. Although technological advancements in photon RT delivery like intensity modulated RT have decreased the risk of such toxicities, a growing body of evidence indicates that further risk reductions are achieved with proton beam therapy (PBT). Herein we review the published dosimetric and clinical PBT literature for esophageal cancer, including motion management considerations, the potential for reirradiation, radiation dose escalation, and ongoing esophageal PBT clinical trials. We also consider the potential cost-effectiveness of PBT relative to photon RT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Dosimetric Factors and Toxicity in Highly Conformal Thoracic Reirradiation

Purpose: We determined cumulative dose to critical structures, rates of toxicity, and outcomes following thoracic reirradiation. Methods and Materials: We retrospectively reviewed our institutional database for patients treated between 2008 and 2014, who received thoracic reirradiation with overlap of 25% prescribed isodose lines. Patients received courses of hyperfractionated (n=5), hypofractionated (n=5), conventionally fractionated (n=21), or stereotactic ablative radiation therapy (n=51). Doses to critical structures were converted to biologically effective dose, expressed as 2 Gy per fraction equivalent dose (EQD2; α/β = 2 for spinal cord; α/β = 3 for other critical structures). Results: We identified 82 courses (44 for retreatment) in 38 patients reirradiated at a median 16 months (range: 1-71 months) following initial RT. Median follow-up was 17 months (range: 3-57 months). Twelve- and 24-month overall survival rates were 79.6% and 57.3%, respectively. Eighteen patients received reirradiation for locoregionally recurrent non-small cell lung cancer with 12-month rates of local failure and regional recurrence and distant metastases rates of 13.5%, 8.1%, and 15.6%, respectively. Critical structures receiving ≥75 Gy EQD2 included spinal cord (1 cm{sup 3}; n=1), esophagus (1 cm{sup 3}; n=10), trachea (1 cm{sup 3}; n=11), heart (1 cm{sup 3}; n=9), aorta (1 cm{sup 3}; n=16), superior vena cava (1 cm{sup 3}; n=12), brachial plexus (0.2 cm{sup 3}; n=2), vagus nerve (0.2 cm{sup 3}; n=7), sympathetic trunk (0.2 cm{sup 3}; n=4), chest wall (30 cm{sup 3}; n=12), and proximal bronchial tree (1 cm{sup 3}; n=17). Cumulative dose-volume (D cm{sup 3}) toxicity following reirradiation data included esophagitis grade ≥2 (n=3, D1 cm{sup 3} range: 41.0-100.6 Gy), chest wall grade ≥2 (n=4; D30 cm{sup 3} range: 35.0-117.2 Gy), lung grade 2 (n=7; V20{sub combined-lung} range: 4.7%-21.7%), vocal cord paralysis (n=2; vagus nerve D0.2 cm{sup 3} range: 207.5-302.2 Gy), brachial plexopathy (n=1; D0.2 cm{sup 3} = 242.5 Gy), and Horner's syndrome (n=1; sympathetic trunk D0.2 cm{sup 3} = 130.8 Gy). No grade ≥4 toxicity was observed. Conclusions: Overlapping courses of reirradiation can be safely delivered with acceptable toxicity. Some toxicities occurred acutely at doses considered safe for a single course of therapy (esophagus). We observed rib fracture, brachial plexopathy, and Horner's syndrome for patients receiving high cumulative doses to corresponding critical structures.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Modern Radiation Therapy and Cardiac Outcomes in Breast Cancer

Purpose: Adjuvant radiation therapy, which has proven benefit against breast cancer, has historically been associated with an increased incidence of ischemic heart disease. Modern techniques have reduced this risk, but a detailed evaluation has not recently been conducted. The present study evaluated the effect of current radiation practices on ischemia-related cardiac events and procedures in a population-based study of older women with nonmetastatic breast cancer. Methods and Materials: A total of 29,102 patients diagnosed from 2000 to 2009 were identified from the Surveillance, Epidemiology, and End Results–Medicare database. Medicare claims were used to identify the radiation therapy and cardiac outcomes. Competing risk models were used to assess the effect of radiation on these outcomes. Results: Patients with left-sided breast cancer had a small increase in their risk of percutaneous coronary intervention (PCI) after radiation therapy—the 10-year cumulative incidence for these patients was 5.5% (95% confidence interval [CI] 4.9%-6.2%) and 4.5% (95% CI 4.0%-5.0%) for right-sided patients. This risk was limited to women with previous cardiac disease. For patients who underwent PCI, those with left-sided breast cancer had a significantly increased risk of cardiac mortality with a subdistribution hazard ratio of 2.02 (95% CI 1.23-3.34). No other outcome, including cardiac mortality for the entire cohort, showed a significant relationship with tumor laterality. Conclusions: For women with a history of cardiac disease, those with left-sided breast cancer who underwent radiation therapy had increased rates of PCI and a survival decrement if treated with PCI. The results of the present study could help cardiologists and radiation oncologists better stratify patients who need more aggressive cardioprotective techniques.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Consensus Statement on Proton Therapy in Early-Stage and Locally Advanced Non–Small Cell Lung Cancer

Radiation dose escalation has been shown to improve local control and survival in patients with non–small cell lung cancer in some studies, but randomized data have not supported this premise, possibly owing to adverse effects. Because of the physical characteristics of the Bragg peak, proton therapy (PT) delivers minimal exit dose distal to the target volume, resulting in better sparing of normal tissues in comparison to photon-based radiation therapy. This is particularly important for lung cancer given the proximity of the lung, heart, esophagus, major airways, large blood vessels, and spinal cord. However, PT is associated with more uncertainty because of the finite range of the proton beam and motion for thoracic cancers. PT is more costly than traditional photon therapy but may reduce side effects and toxicity-related hospitalization, which has its own associated cost. The cost of PT is decreasing over time because of reduced prices for the building, machine, maintenance, and overhead, as well as newer, shorter treatment programs. PT is improving rapidly as more research is performed particularly with the implementation of 4-dimensional computed tomography–based motion management and intensity modulated PT. Given these controversies, there is much debate in the oncology community about which patients with lung cancer benefit significantly from PT. The Particle Therapy Co-operative Group (PTCOG) Thoracic Subcommittee task group intends to address the issues of PT indications, advantages and limitations, cost-effectiveness, technology improvement, clinical trials, and future research directions. This consensus report can be used to guide clinical practice and indications for PT, insurance approval, and clinical or translational research directions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗