MEDIRAD

The MEDIRAD project aims to enhance the scientific bases and clinical practice of radiation protection in the medical field and thereby addresses the need to better understand and evaluate the health effects of low-dose ionising radiation exposure from diagnostic and therapeutic imaging and from off-target effects in radiotherapy.

The MEDIRAD project was recently granted a 9-month cost-neutral extension by the European Commission, with a new conclusion date of February 2022. Several major milestones have recently been achieved, including the setup and testing of a central DICOM repository for dosimetry, imaging meta-data, and biobanking. Data collection efforts for the first-ever establishment of European DRLs for specific applications of CT in nuclear medicine have also just been finalised. Moreover, the assessment of low-dose radiation exposure from I-131 radioiodine ablation therapy of thyroid cancer is in full swing, laying the foundation for the first epidemiological investigations within nuclear medicine.

MEDIRAD has also significantly progressed towards improving the understanding of low-dose ionising radiation risks associated with major medical radiation procedures, by combining for the first time, clinical and preclinical studies to get further insight into the biological mechanisms and biomarkers that may play a role in the development and prediction of cardiac complications, and to use these insights for the development of predictive models. The clinical studies EARLY-HEART and BRACE are thus close to completion. Furthermore, the pre-clinical studies to identify mechanisms of radiation-induced cardiovascular toxicity are ongoing.

The first-ever nested case-control study in a cohort of CT-scan-exposed individuals, commenced its study into the long-term effects of the associated low doses on cancer risks in children. In this study, the interaction between genetic and epigenetic factors along with radiation dosage on cancer risk will be assessed, with the results having the potential to significantly impact the medical radiation protection field at large.

In addition, the stakeholder forum and a consensus-building infrastructure for the development of the recommendations – based on the scientific evidence emerging from MEDIRAD’s research results – have been established, and work on the recommendations has started with the aim to enhance medical radiation protection in Europe. The MEDIRAD project is thus well on track in its stated goals to significantly enhance the scientific bases and clinical practice of radiation protection in the medical field.

SINFONIA

The 4-year SINFONIA project will develop novel methodologies and tools that will provide a comprehensive a risk appraisal for detrimental effects of radiation exposure on patients, workers, carers and comforters, the public and the environment during the management of patients suspected or diagnosed with lymphoma and brain tumours. The project started in September 2020. The multidisciplinary project consortium combines the expertise of 14 partners from 8 countries. It includes major universities, research institutes, hospitals and industry partners. A data repository will be developed for storing data as well as for the deployment of AI algorithms on an online platform. SINFONIA research outcomes for the two clinical examples, lymphoma and brain tumours, will be also applicable to other diseases. AI-powered personalised dosimetry tools will provide advanced knowledge on parameters affecting radiation detriment. This will help balancing risks and benefits of ionising radiation procedures and developing dose optimisation strategies. SINFONIA also will organise high level multidisciplinary training in the field of radiation dosimetry, risk appraisal and radiation protection and develop decommendations on radiological protection. The project is coordinated by EIBIR with Prof. John Damilakis (University of Crete) acting as Scientific Coordinator.

EURAMED rocc-n-roll

The 3-year EURAMED rocc-n-roll project will produce a strategic research agenda in the field of medical radiation protection based on wide stakeholder input and consultation, a corresponding roadmap, and an interlink document, integrating the views and identifying synergies from the areas of radiation protection, health research and digitization with impactful guidance to the EC and stakeholders on future research.

A fully integrated and coordinated European approach based on stakeholder consensus and existing activities in the field will be ensured. The EURAMED rocc-n-roll consortium brings together relevant disciplines including radiation biology, dosimetry for medical applications, ethics, and clinical expertise, complemented by regulatory and health policy, AI, and industry experts.

EURAMED rocc-n-roll will analyse research and radiation protection needs in the clinical disciplines using ionising radiation with the aim to generate the largest benefit for the European population in an equal, safe, high-quality way throughout Europe by fostering clinical translation while also strengthening economic growth and industrial competitiveness supported by medical radiation protection research and innovation. Moreover, education and training schemes for health workforce and scientists will be developed to increase Europe’s research capacity in the field.

The EURAMED rocc-n-roll consortium brings together 29 partners from 17 European countries and includes representation of relevant radiation protection disciplines, ethics, clinical, regulatory and health policy, AI, and industrial expertise. This multidisciplinary and integrative approach will enable a broader framework of quality and safety in healthcare. The project is coordinated by EIBIR and runs from September 2020 to August 2023.

HYPMED

The HYPMED project is developing a hybrid system of two medical imaging modalities (MRI and PET) for improved diagnosis of breast cancer and personalised therapy control. The developed radiofrequency coil can be connected to any regular clinical MR scanner and transform the device into a high-resolution PET/MRI hybrid system.

In 2020 significant progress on the mechanical side was made and the final steps in the integration, functional testing, and physical characterization of the device will start soon. The electronics that need to be integrated into the device is close to finalization and everything is in place for a fast and effective integration phase. EIBIR acts as the project coordinator and runs project management and dissemination activities.

CHAIMELEON

CHAIMELEON aims to set up a structured repository for health imaging data to be openly reused in Artificial Intelligence (AI) experimentation for cancer management. An EU-wide repository will be built as a distributed infrastructure and populated with multimodality imaging and related clinical data for historic and newly diagnosed lung, prostate and colorectal cancer patients.

The CHAIMELEON repository will be designed to meet the need for access to large datasets of high quality in interoperable repositories enabling secure sharing across Europe with the specific purpose of constituting an open, accessible, intuitive resource for the community of developers of AI-based solutions for cancer management. A multimodal analytical data engine will facilitate interpretation, extraction, and exploitation of the stored information. In a comprehensive validation phase, the partners will ensure the usability and performance of the repository as a tool fostering AI experimentation.

The project brings together public and private organisations from across Europe to perform collaborative research and development. The interdisciplinary CHAIMELEON consortium is made up of 18 partners from 10 countries and constitutes a pan-European ecosystem of knowledge, infrastructures, biobanks and technologies on oncology, AI/in-silico and cloud computing addressed to health. CHAIMELEON kicked off in September 2020 and will run until August 2024. EIBIR leads the project’s dissemination efforts.

EuCanImage

The goal of EuCanImage is to build a highly secure, federated and large-scale European cancer imaging platform, with capabilities that will greatly enhance the potential of artificial intelligence (AI) in oncology. The platform will be populated with a completely new data resource (over 25,000 single subjects), which will allow to investigate unmet clinical needs like such as for the detection of small liver lesions and metastases of colorectal cancer, or for estimating molecular subtypes of breast tumours and pathological complete response. The platform will be cross-linked to biological and health repositories through the European Genome-phenome Archive, allowing to develop multi-scale AI solutions that integrate organ-level, molecular and other clinical predictors into dense patient specific cancer fingerprints. The project is coordinated by Karim Lekadir (University of Barcelona, ES) and EIBIR leads communication and outreach activities. The consortium will build upon several key European initiatives in data sharing for personalised medicine research, including EUCANCAN (cancer genomics and health data sharing), euCanSHare (cardiac imaging and omics data sharing) and EUCAN-Connect (federated data analytics) as well as the Cancer Imaging Archive (TCIA), the US cancer imaging repository.

AlternativesToGd

The AlternativesToGd project is developing a new type of contrast agent for medical imaging which is safe and completely cleared from the body. The new contrast agents that will be metal-free, small endogenous molecules, which are hyperpolarised to ensure high sensitivities even at very low doses.

Currently, the consortium published three papers on:

• demonstrating serial transfer of hyperpolarization from 15N to 1H in urea and imaging of the polarized protons;
• hyperpolarized water signals equivalent to pure water in a magnetic field of 10,000 T, by employing dDNP via UV-generated, labile radicals and;
• on the preparation of NV-rich nanodiamonds by laser ablation.

Furthermore, proton GRE images were acquired with the independent console; TX and gradient pulses were executed by the Clinical MRI console. Concerning the parahydrogen polarization (PHIP-SAH) of molecules to be used as tracers for angiography, partners focused on 1-13C acetate. The 13C-polarization level that they were able to obtain on the ester precursor (propagyl-[1-13C] Acetate) is 7 ± 0.5 %.

SOLUS

The SOLUS project is developing a new hybrid imaging system that can detect and classify breast lesions in a non-invasive manner. This system offers a significant improvement in the ability to differentiate between benign and malignant tumours over current imaging systems. Similarly to thyroid nodule screening, invasive procedures, such as biopsies, are currently carried out in an unnecessarily high number of cases. SOLUS can help avoid such unnecessary biopsies in breast cancer screening by improving the characterisation of lesions in the breast.

The innovative, multi-modal tomographic system that SOLUS is developing combines diffuse optical tomography and ultrasound/shear wave elastography to support the in vivo diagnosis of breast cancer. This will achieve a substantially improved in-depth diagnosis of breast lesions with higher specificity, as well as more effective treatment of breast cancer than conventional ultrasound or MRI imaging.

The SOLUS project entered its final year. The novel components and subunits for the SOLUS system prototype have been integrated into a smart optode for optical tomography measurements. This smart optode is combined with a regular ultrasound probe to form the multimodal probe of the device, which is still being completed and integrated into the full system. Calibration and technical validation efforts have also been started.

A pilot clinical study will start in Summer 2021.