Periodic Reporting for period 2 - MaXIMA (Three dimensional breast cancer models for X-ray Imaging research) Reporting period: 2017-04-01 to 2018-12-31 Summary of the context and overall objectives of the project Breast Cancer is by far the most common incident form of cancer for women below seventy years of age with an estimated 1.4 million new cancer cases diagnosed in 2012, and ranks second overall (10.9% of all cancers). Despite the indisputable successes of science in the cancer practice, morbidity and mortality rates are on the rise. Early diagnosis is recognized as a critical factor that improves the chance of survival. Early diagnosis is related to the need of new advanced breast imaging techniques, which development, testing and optimisation is closely dependent on the realism of available computational and physical breast abnormalities. The development of realistic three-dimensional computational and physical models of breast tumours is an urgent requirement. The availability of such models is a powerful instrument in the hands of engineers, physicians and physicists to be used in the development of new technologies for precise definition of the boundaries of these cancers. 3D characterization of the cancer is of major help in determining the recalls from the screening and in the pre-operative work up of cancers. The final phase of the computer-based approaches, however, is related to extensive experimental testing and verification. They both require use of costly laboratory experiments and clinical trials. This is especially difficult for countries like Bulgaria, which has very low R&D performance.The main objective of the MAXIMA action is to increase the research and innovation capacity of the host organisation (Technical University of Varna) in the field of computational modelling of breast tumours and their use in studies of advanced x-ray breast imaging techniques such as breast tomosynthesis and phase-contrast imaging. For this purpose, a close and sustainable collaboration platform has been created between three European research groups (Technical University of Varna, Katholieke University of Leuven and University of Naples - Federico II), which work actively in the field of breast modelling and simulation. The network aims to integrate results of ongoing research, facilitate progress beyond the actual individual possibilities and help the host Bulgarian institution to advance in the research and the successful accomplishment of publications. To achieve this, the following specific objectives (SO) were outlined:- SO1. To promote the close cooperation and twinning actions for upgrading and boosting human potential in the field of modelling and simulations dedicated to x-ray breast imaging;- SO2. To increase the local research capacity through interactions with highly qualified human resources;- SO3. To disseminate the results of the project to the scientific community;- SO4. To create a platform for shared resources;- SO5. To establish the basis for future long-term sustainable collaborative research, training and development actions including joint European and national funded research projects. Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far The MAXIMA project started very intensively since the very beginning in January 2016 with two local workgroup meetings, the 1st General Assembly and Kick-off Meeting held at the Technical University of Varna, and a Workshop on Breast Cancer Awareness that was open to the public. Main issues, concerned during the 1st project year, were training the research teams in imaging of biology samples and understanding the tumour anatomy, which aim at improving the algorithms for modelling breast cancers including these with spiculated shape. During the 2nd project year, research teams were trained in modelling various tumours as the focus was on these with spiculated shapes. The training was performed by distinguished experts from Europe and USA. The 3rd project year was related to training in 3D printing technologies, advanced phase-contrast imaging, and breast CT techniques, implemented at the University of Naples with the participation of top experts from Europe, USA and Brazil. For this purpose, several main training activities were planned, successfully accomplished, and significant outcomes achieved:- 1st training school “Advanced 3D Imaging for biology samples”: theoretical lectures organized at TUV and practical work organized at KU LEUVEN- 2nd training school “Methods for breast tumour modelling and breast imaging”, organised at TUV- 3rd training school “Application of computer models for advancement of x-ray breast imaging techniques”, organised at UNINA- 12 seminars were organised at the 3 institutions, addressing the following issues: ● tumour anatomy and characteristics; ● breast cancer on tomosynthesis images; ● improving computational and physical models of breast and abnormalities; ● 3D printing technologies, principles, materials; ● plagiarism in research; ● intellectual property rights; ● scientific writing- implementation of module MPE05 “Anthropomorphic phantoms for optimization of dose and image quality in radiology” from the EUTEMPE-NET at TUV- organization of a special session on e-Health during the Black Sea Conference 2016 at TUV- a database with both segmented from patient data and modelled tumours- large dissemination of the results to the public through a high number of dissemination, communication and other outreach activitiesTo advance in our research, the members of the three groups performed meetings with more than 18 experts, who transferred their knowledge to us during exiting seminars and planned training events. 56 short term scientific visits, 54 presentations at national and international conferences, and 27 articles in peer review international journals, are the results of the active training and joint work between partners during the whole project. Sixteen new proposals were submitted for funding with the participation of TUV. Five new PhD topics at the host institution were defined in the specific field of breast imaging. To speed up research, specific software tools between organisations were exchanged, while a dedicated platform was established to facilitate such tasks. Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far) Breast cancer is the scourge of our time. In fact, 1 in 8 women in EU-28 develops breast cancer as 20% of the cancers occur in women younger than 50 years old! Unfortunately, as unexpected, the mortality continues to rise in many EU countries including the country of the host institution Bulgaria. We, as researchers working in this area, feel responsible to change this trend line. During this project we performed a huge number of dissemination initiatives and organised events to the public. More than 200 press-releases, invited lectures and interviews were delivered to the public. The host team has received 5 awards during this project:- best poster – for segmenting tumours from tomosynthesis images- best poster – “Business sustainability plan for innovative products”- best project – for the MAXIMA project- first prize in MSCA 2017 awards “Contribution to a better society”;- Varna 2017 award in the field of “Technical Sciences”In addition, at the beginning of May 2018, the European Commission published in the Success Stories section, an article on the MaXIMA project progress. We consider this fact as an objective assessment of the work of the team, which inspires and motivates us to keep working.These honours are high recognition for the excellence of the MAXIMA team in the biomedical engineering field and particularly in modelling and simulation of advanced techniques for breast cancer screening and diagnosing. MAXIMA 1st Training school - Part B MAXIMA action Training seminar MAXIMA 1st Training school - Part A MAXIMA consortium at European Synchrotron Radiation Facility MAXIMA action 3rd General Assembly Meeting MAXIMA action 2nd General Assembly Meeting MAXIMA action 1st General Assembly and Kick-off Meeting MAXIMA 3rd Training school MAXIMA 2nd Training school
