Table 1.

Summary table.

Objectives Enhance the scientific basis and clinical practice of radiation protection in medicine. Investigate the relationship between early-life exposure to ionizing radiation and development of cancer and non-cancer effects Provide the infrastructure for long-term follow-up of pediatric cancer and cardiac patients Appraisal of detrimental effects of medical exposure for treatment of lymphoma or brain tumours. Develop a European consensus on research needs and priorities in medical radiation application and RP to optimize the use of ionizing radiation in medicine, thereby improving its benefit to Europe’s patients.
Optimisation Improve organ dose estimation and registration to optimise doses for CT scans and nuclear medicine (NM) applications. Develop tools for real-time dose estimation. Develop a dose and imaging biobank. Improve estimation of patient-specific organ doses, and non-targeted organs in radiotherapy (RT). Real-time dose estimation and augmented reality tools. Develop novel personalised dosimetry methods and tools to estimate the radiation burden to brain tumours and lymphoma patients undergoing radiological, NM and RT procedures. Estimation of staff doses in proton therapy. Development of a simulation software tool for optimisation of staff doses in NM. A common approach bringing together the disease diagnosis and treatment perspective and the radiation protection perspective is needed to improve the benefit/risk balance in the medical use of IR.
Risk Evaluate and understand the effects of low-dose medical exposures, focusing on the two major endpoints of public health relevance:
  • Cardiovascular effects of low to moderate doses of radiation from RT in breast cancer treatment, including early markers of damage;

  • Cancer risk of low doses from CT in children.

Develop a protocol for the follow-up of patients treated with radioactive iodine for thyroid cancer. Conduct research on factors that increase susceptibility to radiation-induced cancer.
Investigate the late health effects of low, moderate and high radiation doses from modern RT using protons or photons with focus on cancer and non-cancer effects (endocrine, neuro and cardiovascular, QoL). Investigate the relationship between early-life exposure to ionising radiation from X-ray-guided procedures and development of cancer in paediatric patients with cardiac defects. Investigate radiation-induced cellular responses and the mechanisms involved in the processes that may lead to cancer and vascular diseases. Development of a risk appraisal tool that will consider, (a) the best radiation-induced cancer risk models, (b) accurate patient organ dose data based on personalised dosimetry methods developed within the project, (c) age-at-exposure and sex-related differences in radiation risk,(d) radiation quality, and (e) SINFONIA results related to variations in radiation susceptibility between individuals. Evaluation of risk to the public and the environment associated with the management of radiopharmaceuticals used in NM. Risk will be considered as part of an intensive risk/benefit analysis for which criteria are to be developed within the project. Different research fields are integrated to identify unanswered research questions.
Interdisciplinarity Clinicians (pediatric oncologists, radiation oncologists, cardiologists), epidemiologists, biologists, medical physicists, and sociologists; patients and regulators in stakeholder groups. Clinicians (pediatric oncologists, radiation oncologists, cardiologists), epidemiologists, biologists, medical physicists, and sociologists. Clinical dosimetry, medical physics, NM, radiology, radiation oncology, radiation biology, computing and artificial intelligence. Clinicians (oncologists, neurovascular and cardiovascular doctors, paediatricians), medical physicists, experts in biology, physics etc., educators, ethicists, regulators, industry and patient representatives. Integrate the digitisation research community in addition to the health and radiation science communities.
Translationinto practice Set of science-based consensus policy recommendations for the effective protection of patients and staff were prepared, discussed with stakeholders and issued – Deliverables 6.5–6.8. Provide guidelines on optimization techniques to guide treatments. Science-based recommendations on radiological protection for the development of new applications of radiation in medical care, per category and per procedure. The SRA will ultimately impact patients throughout Europe with better high-quality and safe healthcare. It will enable the European industry to better orientate their products towards clinical needs.
Education The importance of education and training is highlighted invarious elements of the science-based MEDIRAD Recommendations targeted at policymakers and the scientific/medical communities. Training of pre-and post-doctoral students within the partners institutions. Dedicated work package on education and training with implementation of various specific courses on radiation biology, AI applications etc. Provide an education and training guidance system to foster the concepts for medical application of IR and corresponding medical RP. Design and pilot an education and training framework for health professionals and researchers to foster the transfer into clinical practice.
Ethics Ethics approvals have been obtained from the appropriate authorities. Informed decisions of patients. Data Protection. Ethics approvals are obtained from the appropriate authorities. Informed decisions of patients. Data Protection. Ethics approvals have been obtained from the appropriate authorities. All data managed in the repository are stored in a secure manner and are de-identified. Ethics and data protection of AI applications in diagnosis, personalized therapy, and digitalization in healthcare. Stakeholders’ understanding of radiological risk and decision-making in medical procedures involving IR related to new medical applications.

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