Periodic Reporting for period 2 - SINFONIA (Radiation risk appraisal for detrimental effects from medical exposure during management of patients with lymphoma or brain tumour)
Berichtszeitraum: 2022-03-01 bis 2023-08-31
The SINFONIA project aims at developing novel methodologies and tools that will provide a comprehensive 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’s main objectives are to:
- develop dose estimation tools based on personalised dosimetry methods and advanced computational tools, powered by artificial intelligence (AI),
- perform research on individual sensitivity to radiation and susceptibility to second malignant neoplasms (SMN) for risk appraisal in medicine,
- develop a novel patient radiation risk appraisal tool and estimate uncertainties conduct research to support radiation risk appraisal for staff, comforters, the public and the environment,
- develop and operate a platform for dose, imaging and non-imaging data,
- provide multidisciplinary education and training.
The project’s main objectives are to:
- develop dose estimation tools based on personalised dosimetry methods and advanced computational tools, powered by artificial intelligence (AI),
- perform research on individual sensitivity to radiation and susceptibility to second malignant neoplasms (SMN) for risk appraisal in medicine,
- develop a novel patient radiation risk appraisal tool and estimate uncertainties conduct research to support radiation risk appraisal for staff, comforters, the public and the environment,
- develop and operate a platform for dose, imaging and non-imaging data,
- provide multidisciplinary education and training.
Details of the activities performed are summarised below, by WP.
WP1 (Coordination and project management): WP1 established the project governance and management procedures and organised several project meetings. Plans for quality assurance and risk management, and data management were prepared.
WP2 (Novel patient dose estimation methods, risk assessment and uncertainty evaluation): Patient data was collected and personalised Monte Carlo simulations were performed to develop tools for the estimation of patient dose from various diagnostic X-ray modalities. Research on PET/CT focused on the development of tools for patient-specific internal radiation dosimetry calculations using deep learning techniques. A novel web-based dose calculation tool for radiation therapy relevant imaging procedures including treatment planning CTs, pre-treatment kV-CBCT and planar x-ray imaging for patient positioning on patients with lymphomas and brain was developed. Moreover, out-of-field doses during the treatment of Hodgkin lymphoma and brain patients receiving photon and proton treatments were evaluated, and, the first version of the radiogenic risk appraisal tool was developed.
WP3 (Dose and risk assessment of staff, comforters, the public and the environment): An AI-assisted computational system for real time staff dose assessment in nuclear medicine (NM) is under development. WP3 is evaluating the performance and accuracy of a computational framework based on Monte Carlo simulations developed within the SINFONIA framework for the radiation exposure of caregivers, family members and staff when in close contact with nuclear medicine patients after injection with radiopharmaceuticals. The impact on human and biota from the release of radiopharmaceuticals by hospitals was assessed by developing appropriate transport models. A survey on staff dosimetry practices and doses measured on staff working in proton therapy centres in Europe was carried out and the results were analysed.
WP4 (Individual sensitivity to radiation): The collection of blood samples to determine the degree of intra-, and inter-individual variability in the level of radiotherapy-induced, SMN-related mutations is progressing well. Procedure on type of tests and distribution among the WP4 partners was set up based on scores of the homogeneity tests. The group of patients with primary cancers was extended by including breast cancer patients.
WP5 (Data collection): Α prototype repository was released to provide SINFONIA partners a usable data sharing tool. A first version of the repository was initially implemented based on the architecture defined under Task 5.1. Subsequently, Y2 and Y3 iterations were released for the addition of components such as a DICOM server, a web application framework, and several embedded web viewers.
WP6 (Education and training): A survey was conducted to draw up conclusions at EU level on gaps and good practices in dosimetry, radiobiology and radiation protection education and training. SINFONIA organised 4 sustainable, high-level training courses and relevant announcements were uploaded on SINFONIA’s website.
WP7 (Dissemination and recommendations): The communication and dissemination plan was prepared. The SINFONIA visual identity was developed, including a presentation video, and an interactive website was set up. The first information materials (factsheets) for the non-expert audience were produced and made available via the project’s website. Moreover, a table of content was prepared and panels were established to work on the main topics of the recommendations.
WP8 (Ethics): the ethics requirements were prepared and acquired for the issues relevant for the project’s work: (1) humans, (2) human cells and tissues, (3) processing of personal data, (4) non- countries and (5) environmental protection and safety.
WP1 (Coordination and project management): WP1 established the project governance and management procedures and organised several project meetings. Plans for quality assurance and risk management, and data management were prepared.
WP2 (Novel patient dose estimation methods, risk assessment and uncertainty evaluation): Patient data was collected and personalised Monte Carlo simulations were performed to develop tools for the estimation of patient dose from various diagnostic X-ray modalities. Research on PET/CT focused on the development of tools for patient-specific internal radiation dosimetry calculations using deep learning techniques. A novel web-based dose calculation tool for radiation therapy relevant imaging procedures including treatment planning CTs, pre-treatment kV-CBCT and planar x-ray imaging for patient positioning on patients with lymphomas and brain was developed. Moreover, out-of-field doses during the treatment of Hodgkin lymphoma and brain patients receiving photon and proton treatments were evaluated, and, the first version of the radiogenic risk appraisal tool was developed.
WP3 (Dose and risk assessment of staff, comforters, the public and the environment): An AI-assisted computational system for real time staff dose assessment in nuclear medicine (NM) is under development. WP3 is evaluating the performance and accuracy of a computational framework based on Monte Carlo simulations developed within the SINFONIA framework for the radiation exposure of caregivers, family members and staff when in close contact with nuclear medicine patients after injection with radiopharmaceuticals. The impact on human and biota from the release of radiopharmaceuticals by hospitals was assessed by developing appropriate transport models. A survey on staff dosimetry practices and doses measured on staff working in proton therapy centres in Europe was carried out and the results were analysed.
WP4 (Individual sensitivity to radiation): The collection of blood samples to determine the degree of intra-, and inter-individual variability in the level of radiotherapy-induced, SMN-related mutations is progressing well. Procedure on type of tests and distribution among the WP4 partners was set up based on scores of the homogeneity tests. The group of patients with primary cancers was extended by including breast cancer patients.
WP5 (Data collection): Α prototype repository was released to provide SINFONIA partners a usable data sharing tool. A first version of the repository was initially implemented based on the architecture defined under Task 5.1. Subsequently, Y2 and Y3 iterations were released for the addition of components such as a DICOM server, a web application framework, and several embedded web viewers.
WP6 (Education and training): A survey was conducted to draw up conclusions at EU level on gaps and good practices in dosimetry, radiobiology and radiation protection education and training. SINFONIA organised 4 sustainable, high-level training courses and relevant announcements were uploaded on SINFONIA’s website.
WP7 (Dissemination and recommendations): The communication and dissemination plan was prepared. The SINFONIA visual identity was developed, including a presentation video, and an interactive website was set up. The first information materials (factsheets) for the non-expert audience were produced and made available via the project’s website. Moreover, a table of content was prepared and panels were established to work on the main topics of the recommendations.
WP8 (Ethics): the ethics requirements were prepared and acquired for the issues relevant for the project’s work: (1) humans, (2) human cells and tissues, (3) processing of personal data, (4) non- countries and (5) environmental protection and safety.
SINFONIA’s initial results are going from the current generalised approach in risk appraisal to a personalised-driven methodology which will significantly improve the state-of-the-art of medical radiation protection.
Personalised dosimetry-based methods and AI-assisted tools to estimate the radiation burden to patients with suspected or diagnosed brain tumours and lymphomas undergoing radiological, nuclear medicine (NM) and radiation therapy procedures have already been developed or are currently being developed. Research on PET/CT has been focused on the development of tools for patient-specific internal radiation dosimetry calculations using deep learning techniques. The above tools will support the SINFONIA risk appraisal tool and will help clinicians to properly balance risks and benefits of ionising radiation procedures and practitioners and medical physicists to develop dose optimisation strategies. The development of AI tools will promote AI in the scientific community and will involve healthcare providers in AI high-performance tasks.
The development of a novel online dosimetry system for real-time calculation of occupational doses from preparing and injecting radiopharmaceuticals in NM practice is in progress to reduce staff doses. To detect the laboratory objects, the most advanced techniques of computer vision and machine learning have been used. These accurate organ dose assessments will lead to the more precise estimation of the dose-risk relation in nuclear medicine staff.
The impact on human and biota from the release of radiopharmaceuticals by hospitals has been assessed by developing appropriate transport models. A comprehensive database of radiological parameters for freshwater biota for radionuclides, relevant in NM applications, has been set-up. A river transport model, which predicts the water flows, has been constructed and validated for a specific scenario location. This knowledge gained will provide new insight on how to set up mathematical models that allow to estimate the impact of radioactive releases into aquatic systems from the source to biota and human.
Research work is in progress to determine the degree of intra-, and inter-individual variability in the level of radiotherapy induced, second malignant neoplasms-related mutations in peripheral blood lymphocytes of patients with lymphoma and brain cancer. It has been recently decided to include breast cancer patients in this SINFONIA study. Results are expected to contribute to the development of personalised radiotherapy treatment with focus on minimising the risk of second malignancies.
Personalised dosimetry-based methods and AI-assisted tools to estimate the radiation burden to patients with suspected or diagnosed brain tumours and lymphomas undergoing radiological, nuclear medicine (NM) and radiation therapy procedures have already been developed or are currently being developed. Research on PET/CT has been focused on the development of tools for patient-specific internal radiation dosimetry calculations using deep learning techniques. The above tools will support the SINFONIA risk appraisal tool and will help clinicians to properly balance risks and benefits of ionising radiation procedures and practitioners and medical physicists to develop dose optimisation strategies. The development of AI tools will promote AI in the scientific community and will involve healthcare providers in AI high-performance tasks.
The development of a novel online dosimetry system for real-time calculation of occupational doses from preparing and injecting radiopharmaceuticals in NM practice is in progress to reduce staff doses. To detect the laboratory objects, the most advanced techniques of computer vision and machine learning have been used. These accurate organ dose assessments will lead to the more precise estimation of the dose-risk relation in nuclear medicine staff.
The impact on human and biota from the release of radiopharmaceuticals by hospitals has been assessed by developing appropriate transport models. A comprehensive database of radiological parameters for freshwater biota for radionuclides, relevant in NM applications, has been set-up. A river transport model, which predicts the water flows, has been constructed and validated for a specific scenario location. This knowledge gained will provide new insight on how to set up mathematical models that allow to estimate the impact of radioactive releases into aquatic systems from the source to biota and human.
Research work is in progress to determine the degree of intra-, and inter-individual variability in the level of radiotherapy induced, second malignant neoplasms-related mutations in peripheral blood lymphocytes of patients with lymphoma and brain cancer. It has been recently decided to include breast cancer patients in this SINFONIA study. Results are expected to contribute to the development of personalised radiotherapy treatment with focus on minimising the risk of second malignancies.