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At least 1,675 records · Page 93

Modeling supercritical CO2 injection induced rupture of a minor fault embedded in a poroelastic layered reservoir-caprock system

CO2 injection for geologic carbon sequestration involves hydromechanical processes that lead to changes in fluid pressure and stresses that can activate existing faults. This paper presents a new method and workflow of modeling fault activation considering more complex three-dimensional geometry of natural faults using the TOUGH-FLAC multiphase fluid flow and geomechanical simulator. In this method and workflow, FLAC3D mechanical interfaces and TOUGH3 finite volume elements are discretized using computer aided design and gridding software along with a tailored mesh translation routine. The method and workflow are demonstrated with a model of a curved minor fault embedded in a poro-elastic layered reservoir-caprock system. The model is used for a comprehensive sensitivity analysis of fault responses to fault length, injection mass rate, injection schedule, well-fault distance, and well locations versus fault location. Four metrics (CO2 plume, shear state of fault, pressure and stress path at fault monitoring points) are selected to assess CO2 migration, pressure change, and the reactivation of faults. The results reveal that CO2 can bypass around the tip of the minor impermeable fault, building up pressure and poro-elastic stress on both sides that tends to impede fault rupture. Our study shows the benefit of carefully designing the injection to achieve the targeted final storage volume, starting at a relatively low rate for considerable time, and then ramping up the injection rate to the full rate of injection. The initial low injection has two distinct benefits: (1) it allows for the formation of an extensive CO2 plume with a much higher mobility through a low viscosity that will result in a lower pressure for a given injection rate, and (2) it allows for gradual build-up of horizontal poro-elastic stress within the reservoir that will tend to impede activation of steeply dipping faults. The injection scenario starting at a low injection rate, denoted here as conservative injection, can significantly reduce the risk of fault activation as high fluid mobility and reservoir strengthening poro-elastic stress has been established long before reaching the peak injection rates. Moreover, simultaneous injection in two injection wells on both sides of fault can provide further reservoir strengthening through poro-elastic stress buildup acting on a fault under normal faulting stress regime. The findings presented in the paper can provide practical and effective guidance on long-term, safe, and reliable geological CO2 storage.

Cao, Meng↗

Single- and Multifraction Stereotactic Radiosurgery Dose/Volume Tolerances of the Brain

As part of the American Association of Physicists in Medicine Working Group on Stereotactic Body Radiotherapy investigating normal tissue complication probability (NTCP) after hypofractionated radiation therapy, data from published reports (PubMed indexed 1995-2018) were pooled to identify dosimetric and clinical predictors of radiation-induced brain toxicity after single-fraction stereotactic radiosurgery (SRS) or fractionated stereotactic radiosurgery (fSRS).

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Current Status of Radiopharmaceutical Therapy

In radiopharmaceutical therapy (RPT), a radionuclide is systemically or locally delivered with the goal of targeting and delivering radiation to cancer cells while minimizing radiation exposure to untargeted cells. Examples of current RPTs include thyroid ablation with the administration of {sup 131}I, treatment of liver cancer with {sup 90}Y microspheres, the treatment of bony metastases with {sup 223}Ra, and the treatment of neuroendocrine tumors with {sup 177}Lu-DOTATATE. New RPTs are being developed where radionuclides are incorporated into systemic targeted therapies. To assure that RPT is appropriately implemented, advances in targeting need to be matched with advances in quantitative imaging and dosimetry methods. Currently, radiopharmaceutical therapy is administered by intravenous or locoregional injection, and the treatment planning has typically been implemented like chemotherapy, where the activity administered is either fixed or based on a patient’s body weight or body surface area. RPT pharmacokinetics are measurable by quantitative imaging and are known to vary across patients, both in tumors and normal tissues. Therefore, fixed or weight-based activity prescriptions are not currently optimized to deliver a cytotoxic dose to targets while remaining within the tolerance dose of organs at risk. Methods that provide dose estimates to individual patients rather than to reference geometries are needed to assess and adjust the injected RPT dose. Accurate doses to targets and organs at risk will benefit the individual patients and decrease uncertainties in clinical trials. Imaging can be used to measure activity distribution in vivo, and this information can be used to determine patient-specific treatment plans where the dose to the targets and organs at risk can be calculated. The development and adoption of imaging-based dosimetry methods is particularly beneficial in early clinical trials. In this work we discuss dosimetric accuracy needs in modern radiation oncology, uncertainties in the dosimetry in RPT, and best approaches for imaging and dosimetry of internal radionuclide therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Establishment of Microbeam Radiation Therapy at a Small-Animal Irradiator

Microbeam radiation therapy is a preclinical concept in radiation oncology. It spares normal tissue more effectively than conventional radiation therapy at equal tumor control. The radiation field consists of peak regions with doses of several hundred gray, whereas doses between the peaks (valleys) are below the tissue tolerance level. Widths and distances of the beams are in the submillimeter range for microbeam radiation therapy. A similar alternative concept with beam widths and distances in the millimeter range is presented by minibeam radiation therapy. Although both methods were developed at large synchrotron facilities, compact alternative sources have been proposed recently.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Microsecond Pulsed Electric Fields: An Effective Way to Selectively Target and Radiosensitize Medulloblastoma Cancer Stem Cells

Cancer stem cells constitute an endless reserve for the maintenance and progression of tumors, and they could be the reason for conventional therapy failure. New therapeutic strategies are necessary to specifically target them. In this context, microsecond pulsed electric fields have been selected to expose D283Med cells, a human medulloblastoma cell line resulted to be rich in cancer stem cells, and normal human astrocytes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Quality of Life: A Prospective Randomized Trial of Palliative Volumetric Arc Therapy Versus 3-Dimensional Conventional Radiation Therapy

Volumetric arc therapy (VMAT) is a radiation therapy (RT) technique that spares normal tissues from high and intermediate RT doses but increases the volume of tissues receiving low doses of RT compared with 3-dimensional conformal RT (3DCRT). We hypothesized that palliative VMAT would reduce the detriment to patient quality of life (QOL) compared with palliative 3DCRT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Clinical Outcomes of a Randomized Trial of Adaptive Plan-of-the-Day Treatment in Patients Receiving Ultra-hypofractionated Weekly Radiation Therapy for Bladder Cancer

Hypofractionated radiation therapy can be used to treat patients with muscle-invasive bladder cancer unable to have radical therapy. Toxicity is a key concern, but adaptive plan-of the day (POD) image-guided radiation therapy delivery could improve outcomes by minimizing the volume of normal tissue irradiated. The HYBRID trial assessed the multicenter implementation, safety, and efficacy of this strategy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Early MRI Blood Volume Changes in Constrictor Muscles Correlate With Postradiation Dysphagia

Predicting individual patient sensitivity to radiation therapy (RT) for tumor control or normal tissue toxicity is necessary to individualize treatment planning. In head and neck cancer, radiation doses are limited by many nearby critical structures, including structures involved in swallowing. Previous efforts showed that imaging parameters correlate with RT dose; here, we investigate the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) blood volume (BV) changes in predicting dysphagia.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Estimates of Alpha/Beta (α/β) Ratios for Individual Late Rectal Toxicity Endpoints: An Analysis of the CHHiP Trial

Changes in fraction size of external beam radiation therapy exert nonlinear effects on subsequent toxicity. Commonly described by the linear-quadratic model, fraction size sensitivity of normal tissues is expressed by the α/β ratio. We sought to study individual α/β ratios for different late rectal effects after prostate external beam radiation therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Deciphering Time-Dependent DNA Damage Complexity, Repair, and Oxygen Tension: A Mechanistic Model for FLASH-Dose-Rate Radiation Therapy

Irradiation with ultrahigh dose rates (FLASH) has reemerged as a promising radiation therapy approach to effectively lower potential damage burden on normal tissue without sacrificing tumor control. However, the large number of recent FLASH studies have been conducted under vastly different experimental conditions and circumstances (ie, investigated biological endpoint, radiation quality, and environmental oxygen level), with unverified biological mechanisms of action and unexplored interplay effect of the main dependencies. To facilitate radiobiological investigation of FLASH phenomena and assessment of clinical applicability, we present an extension of the mechanistic radiobiological model “UNified and VERSatile bio response Engine” (UNIVERSE).

62 RADIOLOGY AND NUCLEAR MEDICINE↗

International Recommendations on Reirradiation by Intensity Modulated Radiation Therapy for Locally Recurrent Nasopharyngeal Carcinoma

Reirradiation for locally recurrent nasopharyngeal carcinoma (NPC) is challenging because prior radiation dose delivered in the first course is often close to the tolerance limit of surrounding normal structures. A delicate balance between achieving local salvage and minimizing treatment toxicities is needed. However, high-level evidence is lacking because available reports are mostly retrospective studies on small series of patients. Pragmatic consensus guidelines, based on an extensive literature search and the pooling of opinions by leading specialists, will provide a useful reference to assist decision-making for these difficult decisions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Integrating Multiomics Information in Deep Learning Architectures for Joint Actuarial Outcome Prediction in Non-Small Cell Lung Cancer Patients After Radiation Therapy

Novel actuarial deep learning neural network (ADNN) architectures are proposed for joint prediction of radiation therapy outcomes—radiation pneumonitis (RP) and local control (LC)—in stage III non-small cell lung cancer (NSCLC) patients. Unlike normal tissue complication probability/tumor control probability models that use dosimetric information solely, our proposed models consider complex interactions among multiomics information including positron emission tomography (PET) radiomics, cytokines, and miRNAs. Additional time-to-event information is also used in the actuarial prediction.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Multicellular Spheroids as In Vitro Models of Oxygen Depletion During FLASH Irradiation

The differential response of normal and tumor tissues to ultrahigh-dose-rate radiation (FLASH) has raised new hope for treating solid tumors but, to date, the mechanism remains elusive. One leading hypothesis is that FLASH radiochemically depletes oxygen from irradiated tissues faster than it is replenished through diffusion. The purpose of this study was to investigate these effects within hypoxic multicellular tumor spheroids through simulations and experiments.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Strategies for Motion Robust Proton Therapy With Pencil Beam Scanning for Esophageal Cancer

Proton therapy of esophageal cancer is superior to photon radiation therapy in terms of normal tissue sparing. However, respiratory motion and anatomical changes may compromise target dose coverage owing to density changes, geometric misses, and interplay effects. Here we investigate the combined effect on clinical target volume (CTV) coverage and compare proton therapy with intensity modulated radiation therapy (IMRT).

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Evaluation of Motion Compensation Methods for Noninvasive Cardiac Radioablation of Ventricular Tachycardia

Noninvasive cardiac radioablation is increasingly used for treatment of refractory ventricular tachycardia. Attempts to limit normal tissue exposure are important, including managing motion of the target. An interplay between cardiac and respiratory motion exists for cardiac radioablation, which has not been studied in depth. The objectives of this study were to estimate target motion during abdominal compression free breathing (ACFB) and respiratory gated (RG) deliveries and to investigate the quality of either implanted cardioverter defibrillator lead tip or the diaphragm as a gating surrogate.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Synchrotron Microbeam Radiation Therapy for the Treatment of Lung Carcinoma: A Preclinical Study

In the past 3 decades, synchrotron microbeam radiation therapy (S-MRT) has been shown to achieve both good tumor control and normal tissue sparing in a range of preclinical animal models. However, the use of S-MRT for the treatment of lung tumors has not yet been investigated. This study is the first to evaluate the therapeutic efficacy of S-MRT for the treatment of lung carcinoma, using a new syngeneic and orthotopic mouse model.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Quantitative Bioluminescence Tomography-Guided Conformal Irradiation for Preclinical Radiation Research

Widely used cone beam computed tomography (CBCT)-guided irradiators in preclinical radiation research are limited to localize soft tissue target because of low imaging contrast. Knowledge of target volume is a fundamental need for radiation therapy (RT). Without such information to guide radiation, normal tissue can be overirradiated, introducing experimental uncertainties. This led us to develop high-contrast quantitative bioluminescence tomography (QBLT) for guidance. The use of a 3-dimensional bioluminescence signal, related to cell viability, for preclinical radiation research is one step toward biology-guided RT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗