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All sourcesNASA NTRSDOE OSTI
NASA NTRSDate not supplied

F-ANG+: A 3-D Augmented-Stencil Face-Averaged Nodal-Gradient Cell-Centered Finite-Volume Method for Hypersonic Flows

We describe the extension of a 2-D simplified face-averaged nodal-gradient (F-ANG) method to 3-D and demonstrate that the 3-D simplified F-ANG method is accomplished by augmenting the nodecentered gradient least squares stencil. This augmented stencil F-ANG method is shown to result in advection and diffusion schemes that are stable for hexahedral, prismatic, pyramidal and tetrahedral cells without having to resort to cell-averaged nodal gradients. In addition, we describe the modifications to the augmented stencil required to support the use of wall function boundary conditions. Finally we describe a consistent, face-stencil based multi-dimensional limiter procedure (MLP), and show it to be fully consistent and compatible with the linearity-preserving unstructured- MUSCL (LP-U-MUSCL) scheme for all values of kappa. These methods and schema are implemented in the cell-centered finite-volume code VULCAN-CFD, which is then used to investigate whether the robustness improvements demonstrated in 2-D carry over to 3-D by computing hypersonic flows using mixed-element grids as well as highly adapted tetrahedral grids.

Weighted Least-Squares↗
NASA NTRS2022

International Standard Measures During the AGBRESA Bed Rest Study

The Artificial Gravity Bed Rest with European Space Agency (AGBRESA) study involved 2 campaigns of 60-day bed rest at 6° head down tilt in the:envihab facility in Cologne, Germany, in 2019. The objective was to determine whether centrifugation of supine subjects mitigates physiological changes that occur due to the exposure to the spaceflight analog of 6° head down tilt. A set of international standard measures was used to evaluate bone, muscle, nutritional status, ocular changes, and psychological state and to assess cardiovascular, sensorimotor, and immune systems functions. After 60 days of bed rest, the subjects who were not exposed to centrifugation had significant decreases in mineral density at the hip and lumbar spine, decreased muscle strength of the knee and ankle, reduced maximal aerobic capacity, orthostatic intolerance, and impaired balance and locomotion, as well as significant biochemical, immunological, and psychological alterations. A daily 30-min exposure to 1 Gz supine centrifugation at the center of mass (0.3 Gz at the head, 2 Gz at the feet) mitigated mineral density loss in the femur neck and lumbar spine; and lessened the effects of bed rest on aerobic capacity, biochemistry, and immunology. However, low statistical power could contribute to the non-significant effects that are reported.

Bed rest↗
NASA NTRSDate not supplied

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function for exploration missions. We have identified proprioceptive training and electrical muscle stimulation (EMS) as promising in-flight countermeasures. Since prolonged head down bed rest (HDBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to accelerate the development of these countermeasures. METHODS This study will determine the effects of proprioceptive training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDBR. Subjects will be randomly assigned to one of four groups: 1) an EMS arm, 2) a proprioceptive training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of the quadriceps femoris muscle (30 minutes per session). Proprioceptive training will be performed three days per week (20 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre and post HDBR functional tests that are representative of high priority exploration mission tasks and require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. COUNTERMEASURE UPDATES Proprioceptive countermeasure design enhancements and human in the loop pilot testing continued through the Crew Health Countermeasures (CHC) Systems Capability Leadership Team (SCLT). The primary goals of this work were to enhance the visual feedback system’s capabilities and develop a proprioceptive training program for 60 days of HDBR. Six healthy non-astronaut volunteers participated in four pilot training sessions to systematically examine how each training variable (e.g., axial load, foot placement, and software profile) affects the overall proprioceptive challenge. The resulting training program will maintain an appropriate challenge during 60 days of HDBR by progressively decreasing the subject’s base of support, increasing tilt board target distances, and increasing axial loads using both subjective verbal feedback and objective performance data. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If the countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures.

T R Macaulay↗
NASA NTRSDate not supplied

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function for exploration missions. We have identified proprioceptive training and electrical muscle stimulation (EMS) as promising in-flight countermeasures. Since prolonged head down bed rest (HDBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to facilitate the development of these countermeasures. METHODS This study will determine the effects of proprioceptive training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDBR. Subjects will be randomly assigned to one of four groups: 1)an EMS arm, 2) a proprioceptive training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of selected bilateral lower extremity muscles (30 minutes per session). Proprioceptive training will be performed three days per week (20 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre and post HDBR functional tests that are representative of high priority exploration mission tasks and require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. HARDWARE AND PROTOCOL DEVELOPMENT Proprioceptive countermeasure design enhancements continued as part of the Mars Campaign Office (MCO) Crew Health and Performance (CHP) Crew Health Countermeasures (CHC). The primary goals of this work were to assemble a portable version of the countermeasure system that can be used at the :envihab facility, expand the software feedback system’s capabilities, and develop an actuator loading system that mimics what could be used on the International Space Station. In addition, one major piece of exercise hardware used in previous HDBR studies, the Horizontal Squat Device, was reassembled and restored to full functionality. Human-in-the-loop pilot testing is ongoing, prior to shipping both devices to the :envihab HDBR facility. Evaluations are also underway for the best EMS device technologies and specific methods. Finally, assessment techniques are being translated for administration in the horizontal position (e.g., leg dexterity and foot sole skin sensitivity). Our current goals are to refine the countermeasure training and assessment techniques and integrate protocols across multiple modalities. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If one or more countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures. ACKNOWLEDGEMENT This work is supported by NASA’s Human Research Program Human Health Countermeasures Element and by the Canadian Space Agency (L. Bent).

T R Macaulay↗
NASA NTRSDate not supplied

Exploration Exercise System (EES) Physiology

Exploration class missions will be required to have an exercise device that is lightweight, has a small footprint, and is capable of providing enough physical stimulus and exercise variability to be an effective countermeasure against muscle, bone, aerobic fitness, and sensorimotor loss that results from the microgravity environment. Ground studies, inflight studies, and results analyses are required to inform Moon2Mars Design Reference Missions (DRMs) and vehicle designs. This activity encompasses two related projects, an evaluation study called Zero T2 and a requirements development for an exploration treadmill (ET). Exploration class missions’ mass/power/volume restrictions have resulted in the development of exercise devices that are motorized and flywheel-based to provide both aerobic and resistive training on one platform. These devices provide a variety of full body resistance exercise options as well as rowing and cycling for aerobic exercise, but do not provide ambulatory exercise via a treadmill. Because a treadmill has been available for use on the ISS since 2001, we do not understand the efficacy of exploration exercise modalities on muscle performance, aerobic fitness, bone health, or sensorimotor performance. A retrospective study was performed to quantify the association between total exercise (including specific contributions of treadmill exercise) and functional performance upon landing. Due to the relatively small variation in treadmill usage inflight, there is a need to do a controlled study where inflight crewmembers will not use the ISS treadmill (called T2) for the duration of their flights. There will be 3 arms to the Zero T2 study: 1) participants use all currently available exercise platforms aboard ISS (control group), 2) participants use only ARED and CEVIS, and 3) participants use only European Enhanced Exploration Device (E4D). (Please see the TechPort Entry for Exploration Exercise System Development for further detail on the E4D.) This study started in Oct 2020 and will continue through Sep 2027. In a parallel effort, a team will be developing requirements for an exploration treadmill. This project will be broken into two phases. Phase 1 will develop and implement energy prediction models based on available in-flight exercise data to quantify energy expenditure during 0g treadmill running. Phase 2 will then use the available biomechanical and metabolic evidence from Phase 1 to determine the hardware specification requirements essential to providing the desired exercise stimulus. Subject Matter Experts (SMEs) will then leverage the Standardized Process for Evaluating Exercise Devices (SPEED) developed by the team to 1) assess available technologies for candidate treadmills which meet defined requirements, 2) perform hands-on evaluations of top candidates, 3) provide evaluation outcomes and recommendations to developers. This project will begin in 2025 and continue through Sep 2030.

Kent Lawrence Kalogera↗
NASA NTRSDate not supplied

Next Generation Exercise Device (NGED): Advancing Exercise Capabilities for Future Space Missions Through Biomechanical Modeling

BACKGROUND As space exploration extends to long-duration missions on the Moon and Mars, maintaining astronaut health and fitness becomes increasingly critical. The Next Generation Exercise Device (NGED), developed and tested by the HumanWorks Lab in NASA Johnson Space Center's (JSC) Software, Robotics, and Simulation Division, aims to address this challenge through innovative approaches. This study presents the development and evaluation of an NGED system, focusing on its adaptability to various mission scenarios, including prospective use in a Lunar Pressurized Rover (LPR). Central to this project is the application of biomechanical modeling to optimize exercise efficacy and safety in microgravity and partial gravity environments. The project is a collaborative effort with the Human Health and Performance group at Johnson Space Center, ensuring a comprehensive approach to astronaut well-being that integrates biomechanical principles with practical exercise solutions. The NGED represents the next generation of exercise capabilities for missions in space, on the Moon and Mars, with a specific focus on applications such as the LPR. METHODS AND RESULTS Data collection for NGED development was conducted with two motor-driven Beyond Power Voltra I [1] systems and a custom test structure to allow placement of the cable-based devices on the ground, at shoulder height, and overhead. The collection was performed in JSC’s Prototype Immersive Technology (PIT) Lab, utilizing an OptiTrack motion capture system and AMTI force platform, to enable detailed biomechanical analysis via OpenSim [2,3]. Motion capture data were collected for three subjects representing different body types and statures. The marker set used was an enhanced version of the full-body Plug-in Gait marker set [4], with additional markers strategically placed for the primary objective of informing exercise volume requirements. Subjects performed a series of 17 exercises, carefully selected to engage various muscle groups, including novel spaceflight exercises such as skiing (ergometer style), lateral pulldowns, wood chops, triceps extensions, and flies, with load variations ranging from 10 to 90 pounds to maintain kinematic form. This comprehensive approach allowed for a thorough evaluation of the NGED's performance across a wide range of motions and loads. The biomechanical modeling and analysis were conducted using a modified OpenSim Full Body Rajagopal Model [4,5] and also scaled to the maximum and minimum anthropometry provided in NASA-STD-3001 [6]. Volumetric convex hulls were generated based on model marker trajectories and aggregated into geometric assemblies. These can be placed in models of vehicle designs to assess fit to protect for exercise as well as to adapt NGED exercise to fit available space. Preliminary findings from the collection indicate that the NGED prototype demonstrates significant adaptability across varying user anthropometrics and exercise types. The device showed consistent performance in load-bearing exercises, with subjects able to perform exercises effectively while maintaining proper biomechanical form. CONCLUSION NGED represents a forward-looking advancement in exercise capabilities for future space missions. In the future, this system can be used to capture valuable metrics (e.g., isometric mid-thigh pull for force output measurements, assessments of postural muscle strength, overall isometric strength). Its versatility in accommodating various exercises and user physiques, coupled with the ability to provide targeted biomechanical loading, makes it a promising approach for maintaining astronaut health during long-duration missions to the Moon and Mars. Future work will focus on refining the NGED based on initial biomechanical findings, leveraging the detailed insights provided by motion capture and analysis techniques. Particular emphasis will be placed on optimizing its use within the confined spaces of a LPR and other space habitats. This work contributes significantly to NASA's goals of supporting human health and performance in deep space exploration, paving the way for sustainable long-term presence beyond Low Earth Orbit through advanced, biomechanically-informed exercise solutions.

C Wang↗
DOE OSTI2017

Human-Centered Exoskeleton: Upper Extremity Strength Augmentation in Occupational Settings - 17297

Robotic exoskeletons have a wide variety of applications ranging from rehabilitation to military combat to strength- and performance-augmentation in occupational settings. Currently, the high-cost, complexity, and bio-mechanical limitations prevent these devices from introduction into specialized applications where low-cost and practicality are essential. Here, an initial prototype of Robotic Exoskeleton for Upper Extremity Strength Augmentation is introduced. Expanding upon previous three generations of robotic arms for muscle retraining, the new generation emphasizes high fidelity, low-cost, and practical strength-augmentation with focus on enhancing performance by muscle fatigue reduction and injury prevention. Simplified set up and configurability of the system make it suitable for highly dynamic environments, where time and safety are vital. This prototype demonstrates the feasibility of low-cost and practical exoskeletons; however, further improvements and investigations are necessary to improve and validate its function. (authors)

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
NASA NTRS2003

Vestibular activation of sympathetic nerve activity

AIM: The vestibulosympathetic reflex refers to sympathetic nerve activation by the vestibular system. Animal studies indicate that the vestibular system assists in blood pressure regulation during orthostasis. Although human studies clearly demonstrate activation of muscle sympathetic nerve activity (MSNA) during engagement of the otolith organs, the role of the vestibulosympathetic reflex in maintaining blood pressure during orthostasis is not well-established. Examination of the vestibulosympathetic reflex with other cardiovascular reflexes indicates that it is a powerful and independent reflex. Ageing, which is associated with an increased risk for orthostatic hypotension, attenuates the vestibulosympathetic reflex. The attenuated reflex is associated with a reduction in arterial pressure. CONCLUSION: These findings suggest that the vestibulosympathetic reflex assists in blood pressure regulation in humans, but future studies examining this reflex in other orthostatically intolerant populations are necessary to address this hypothesis.

Review↗
NASA NTRS2002

Cell prestress. II. Contribution of microtubules

The tensegrity model hypothesizes that cytoskeleton-based microtubules (MTs) carry compression as they balance a portion of cell contractile stress. To test this hypothesis, we used traction force microscopy to measure traction at the interface of adhering human airway smooth muscle cells and a flexible polyacrylamide gel substrate. The prediction is that if MTs balance a portion of contractile stress, then, upon their disruption, the portion of stress balanced by MTs would shift to the substrate, thereby causing an increase in traction. Measurements were done first in maximally activated cells (10 microM histamine) and then again after MTs had been disrupted (1 microM colchicine). We found that after disruption of MTs, traction increased on average by approximately 13%. Because in activated cells colchicine induced neither an increase in intracellular Ca(2+) nor an increase in myosin light chain phosphorylation as shown previously, we concluded that the observed increase in traction was a result of load shift from MTs to the substrate. In addition, energy stored in the flexible substrate was calculated as work done by traction on the deformation of the substrate. This result was then utilized in an energetic analysis. We assumed that cytoskeleton-based MTs are slender elastic rods supported laterally by intermediate filaments and that MTs buckle as the cell contracts. Using the post-buckling equilibrium theory of Euler struts, we found that energy stored during buckling of MTs was quantitatively consistent with the measured increase in substrate energy after disruption of MTs. This is further evidence supporting the idea that MTs are intracellular compression-bearing elements.

Non-NASA Center↗
NASA NTRS2002

Cell prestress. I. Stiffness and prestress are closely associated in adherent contractile cells

The tensegrity hypothesis holds that the cytoskeleton is a structure whose shape is stabilized predominantly by the tensile stresses borne by filamentous structures. Accordingly, cell stiffness must increase in proportion with the level of the tensile stress, which is called the prestress. Here we have tested that prediction in adherent human airway smooth muscle (HASM) cells. Traction microscopy was used to measure the distribution of contractile stresses arising at the interface between each cell and its substrate; this distribution is called the traction field. Because the traction field must be balanced by tensile stresses within the cell body, the prestress could be computed. Cell stiffness (G) was measured by oscillatory magnetic twisting cytometry. As the contractile state of the cell was modulated with graded concentrations of relaxing or contracting agonists (isoproterenol or histamine, respectively), the mean prestress ((t)) ranged from 350 to 1,900 Pa. Over that range, cell stiffness increased linearly with the prestress: G (Pa) = 0.18(t) + 92. While this association does not necessarily preclude other interpretations, it is the hallmark of systems that secure shape stability mainly through the prestress. Regardless of mechanism, these data establish a strong association between stiffness of HASM cells and the level of tensile stress within the cytoskeleton.

NASA Discipline Cell Biology↗
NASA NTRS2001

Stimulated single fiber electromyography in the mouse: techniques and normative data

As the number of new transgenic mouse models of human neuromuscular disease continues to increase, the development of sophisticated electrophysiologic techniques for assessing the peripheral nervous system in these models has become important. Neuromuscular junction (NMJ) dysfunction, in particular, is often not detectable by morphologic or other techniques. To enable sensitive testing of murine NMJ function, we developed and tested a method for stimulated single fiber electromyography (S-SFEMG) in the gastrocnemius muscles of anesthetized mice. Jitter was assessed by measuring the mean consecutive latency difference (MCD) of single fiber responses to sciatic nerve stimulation at 2 HZ. Mean MCD values in normothermic mice were in the range of 6-8 micros for different strains, with no MCD values exceeding 25 micros. Reduced core temperature (to 29 degrees--30 degrees C) resulted in increased jitter, whereas intubation and mechanical ventilation of mice did not alter these values. Intraperitoneal and intravenous injection of vecuronium, however, resulted in progressively increased jitter followed by blocking in continuously monitored fibers. These observations validate the utility of S-SFEMG in mice as an index of NMJ function under a variety of physiologic conditions, and suggest that a high safety factor for neuromuscular transmission exists at mouse NMJs. Copyright 2001 John Wiley & Sons, Inc.

Non-NASA Center↗
NASA NTRS1999

Myogenic expression of an injectable protease-resistant growth hormone-releasing hormone augments long-term growth in pigs

Ectopic expression of a new serum protease-resistant porcine growth hormone-releasing hormone, directed by an injectable muscle-specific synthetic promoter plasmid vector (pSP-HV-GHRH), elicits growth in pigs. A single 10 mg intramuscular injection of pSP-HV-GHRH DNA followed by electroporation in three-week-old piglets elevated serum GHRH levels by twofold to fourfold, enhanced growth hormone secretion, and increased serum insulin-like growth factor-I by threefold to sixfold over control pigs. After 65 days the average body weight of the pigs injected with pSP-HV-GHRH was approximately 37% greater than the placebo-injected controls and resulted in a significant reduction in serum urea concentration, indicating a decrease in amino acid catabolism. Evaluation of body composition indicated a uniform increase in mass, with no organomegaly or associated pathology.

Non-NASA Center↗
DOE OSTI2015

A composite approach towards a complete model of the myosin rod

Sarcomeric myosins have the remarkable ability to form regular bipolar thick filaments that, together with actin thin filaments, constitute the fundamental contractile unit of skeletal and cardiac muscle. This has been established for over 50 years and yet a molecular model for the thick filament has not been attained. In part this is due to the lack of a detailed molecular model for the coiled–coil that constitutes the myosin rod. The ability to self–assemble resides in the C–terminal section of myosin known as light meromyosin (LMM) which exhibits strong salt–dependent aggregation that has inhibited structural studies. Here we evaluate the feasibility of generating a complete model for the myosin rod by combining overlapping structures of five sections of coiled–coil covering 164 amino acid residues which constitute 20% of LMM. Each section contains ~7–9 heptads of myosin. The problem of aggregation was overcome by incorporating the globular folding domains, Gp7 and Xrcc4 which enhance crystallization. The effect of these domains on the stability and conformation of the myosin rod was examined through biophysical studies and overlapping structures. In addition, a computational approach was developed to combine the sections into a contiguous model. The structures were aligned, trimmed to form a contiguous model, and simulated for >700 ns to remove the discontinuities and achieve an equilibrated conformation that represents the native state. As a result, this experimental and computational strategy lays the foundation for building a model for the entire myosin rod.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2019

Genotoxic Damages and Bioaccumulation of Cadmium in Geophagus Brasiliensis (Quoy & Gaimard, 1824)

The toxic effects of cadmium (Cd) in Geophagus brasiliensis was investigated in the present study. For this, 32 specimens of G. brasiliensis were exposed in individual aquaria to Cd concentrations (0.00, 0.01, 0.07, and 0.67 mg/L) for 14 days. The micronuclei test did not detect the genotoxic damage at the studied concentrations and time of exposure. However, the comet assay proved to be more efficient, as DNA damage was found in the animals exposed to the higher Cd concentrations. Finally, exposure of G. brasiliensis to Cd was associated with Cd accumulation in the gills, while only the animals exposed to 0.67 mg/L of Cd exhibited muscle accumulation. These results demonstrate that Cd concentrations over 0.07 mg/L caused genotoxic damage, as well as Cd accumulation in G. brasiliensis individuals after a 14 days exposure.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2019

Assessing liver function: diagnostic efficacy of parenchymal enhancement and liver volume ratio of Gd-EOB-DTPA-enhanced MRI study during interstitial and hepatobiliary phase

Aim: To assess the efficacy of signal intensity in interstitial and hepatobiliary phase normalized for liver volume, on gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) study, for the evaluation of liver function through the comparison with Child–Pugh (CP), model for end-stage liver disease (MELD), and biochemical tests. Methods: All dynamic Gd-EOB-DTPA MRI studies performed in patients with suspected liver lesions were retrospectively reviewed. The rate of liver-to-muscle ratio on T1 sequence 70 s (interstitial phase) and 20 min (hepatobiliary phase) after injection of Gd-EOB-DTPA was calculated for each MRI study and then normalized for liver volume (irINTnorm and irHEPnorm). Pearson correlation coefficient was computed to assess the correlation among these values and CP and MELD scores, and biochemical tests. Results: A total of 303 MRI studies, performed on 221 patients, were included. Mean age was 63.8 years ± 12.9 with a majority of male patients (186; 61.4%). A total of 186 out of 303 (61.4%) were cirrhotic patients. The irHEPnorm was significantly lower in cirrhotic than non-cirrhotic patients (0.0004 ± 0.0002 to 0.0005 ± 0.0003, p = 0.010). This value had a moderate, significant correlation with Child–Pugh and MELD scores (R = − 0.292, p < 0.0001 and R = − 0.192, p = 0.010, respectively). In particular, irHEPnorm progressively decreased from Child–Pugh A to C (0.0004–0.0002, p < 0.0001) and from MELD ≤ 10 to 19–24 (0.0004–0.0003, p = 0.018). Among biochemical parameters, total bilirubin, GOT, and albumin had the strongest correlation with irHEPnorm (R = − 0.258, − 0.291, and 0.262, p < 0.0001, respectively). No correlations were found between irINTnorm and CP and MELD scores. Conclusion: irHEPnorm value derived from Gd-EOB-DTPA-enhanced MRI is a reliable, non-invasive, useful tool to quantify liver function and to assess the degree of cirrhosis, offering a strict relationship with clinical scores and biochemical parameters. This could help surgeons in clinical decision-making, allowing them to choose the more suitable surgical approach for cirrhotic patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Can magnetic resonance imaging differentiate among transurethral bulking agent, urethral diverticulum, and periurethral cyst?

Purpose: To evaluate magnetic resonance imaging findings that differentiate among periurethral bulking agents (primarily collagen), urethral diverticulum, and periurethral cyst. Methods: We searched our radiologic database retrospectively from 2001 to 2017 for periurethral cystic lesions, identifying a total of 50 patients with 68 lesions. Final diagnoses in 68 lesions were bulking agents (27), urethral diverticula (29), and periurethral cysts (12). Two abdominal radiologists, blinded to clinical history, independently evaluated T1, T2, and post-contrast images. The readers assessed number, morphological features, location, connection to urethra and mass effect, signal intensity, and enhancement for each lesion. Fisher exact test and logistic regression analysis were performed for each univariate significant feature. The operative and pathologic reports were the reference standard. Results: Magnetic resonance imaging features found more often in bulking agents versus urethral diverticulum were multiple lesions (P = 0.011), upper or upper-mid-urethral location (P ≤ 0.0001), lack of internal fluid/fluid level (P = 0.002), no urethral connection (P = 0.005), T1 isointensity, and T2 mild hyperintensity compared to muscles but lower T2 signal than urine (P < 0.0001). Most cases of urethral diverticula and periurethral cysts were detected at mid- and lower urethra. Urethral diverticula were larger than bulking agents and periurethral cysts (P = 0.005 and P = 0.023) (mean diameter = 24, 16, 15 mm, respectively). Most bulking agents (93%) and urethral diverticula (90%) showed mass effect on urethra, while periurethral cysts (75%) did not (P < 0.0001). Conclusion: Signal intensity and lesion characterization on magnetic resonance imaging can significantly differentiate bulking agent from urethral diverticulum and periurethral cyst. Radiologists should consider differential diagnosis of a bulking agent, especially when distinguishing characteristics described here are present to prevent incorrect diagnosis and ultimately unnecessary surgical intervention.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Feasibility Study on MR-Guided High-Intensity Focused Ultrasound Ablation of Sciatic Nerve in a Swine Model: Preliminary Results

IntroductionSpastic patients often seek neurolysis, the permanent destruction of the sciatic nerve, for better pain management. MRI-guided high-intensity focused ultrasound (MRgHIFU) may serve as a noninvasive alternative to the prevailing, more intrusive techniques. This in vivo acute study is aimed at performing sciatic nerve neurolysis using a clinical MRgHIFU system.MethodsThe HIFU ablation of sciatic nerves was performed in swine (n = 5) using a HIFU system integrated with a 3 T MRI scanner. Acute lesions were confirmed using T1-weighted contrast-enhanced (CE) MRI and histopathology using hematoxylin and eosin staining. The animals were euthanized immediately following post-ablation imaging.ResultsReddening and mild thickening of the nerve and pallor of the adjacent muscle were seen in all animals. The HIFU-treated sections of the nerves displayed nuclear pyknosis of Schwann cells, vascular hyperemia, perineural edema, hyalinization of the collagenous stroma of the nerve, myelin sheet swelling, and loss of axons. Ablations were visible on CE MRI. Non-perfused volume of the lesions (5.8–64.6 cc) linearly correlated with estimated lethal thermal dose volume (4.7–34.2 cc). Skin burn adjacent to the largest ablated zone was observed in the first animal. Bilateral treatment time ranged from 55 to 138 min, and preparation time required 2 h on average.ConclusionThe acute pilot study in swine demonstrated the feasibility of a noninvasive neurolysis of the sciatic nerve using a clinical MRgHIFU system. Results revealed that acute HIFU nerve lesions were detectable on CE MRI, gross pathology, and histology.

62 RADIOLOGY AND NUCLEAR MEDICINE↗