The SINFONIA Project

Reinforced risk appraisal of medical exposure is needed due to an extensive use of ionising radiation for diagnosis and therapy. The main objective of the 4-year SINFONIA project is to 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 scientific work will (1) develop novel AI-powered personalised dosimetry and risk appraisal methods and tools to estimate the radiation burden on patients undergoing state-of-the-art radiological, nuclear medicine and radiation therapy procedures, (2) reinforce risk appraisal for exposed staff, comforters, the public and the environment during nuclear medicine and proton therapy procedures, (3) determine the degree of patient variability in radiation sensitivity for the risk of developing secondary malignancies and (4) design and develop data management techniques for managing data from imaging and non-imaging examinations and radiation therapy sessions. 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. Additionally, radiation biology studies will identify individuals with increased susceptibility of developing cancer from ionising radiation exposure. SINFONIA also will organise highlevel multidisciplinary training in the field of radiation dosimetry, risk appraisal and radiation protection and develop recommendations on radiological protection.

Facts and figures

Context

Context

The speed, versatility, accuracy, and non-invasiveness of medical imaging with ionising radiation have resulted in a rapid increase in its use. In particular the potential risks of radiation-induced carcinogenesis from diagnostic radiology and nuclear medicine imaging with certain emphasis on CT and PET/CT need special attention. With advances in radiation therapy modalities and techniques, the number of long-term cancer survivors has significantly increased. Research is needed on out-of-field doses from radiotherapy and risks of second malignant neoplasms (SMN). Assessment of detrimental health effects from low-dose exposure in radiation therapy imaging is largely under-researched. The increased use of radiation and radioactive tracers in medicine poses not only a burden for patients but also for personnel, public and environment a thorough assessment of the burden and mitigation strategies require more attention.
Lymphomas are the most common cancers in teenagers and young adults and the third most common group of cancers in childhood, after leukaemia and brain tumours. A lymphoma patient undergoes several low-dose but often full-body medical radiation exposures, in a wide variety of modalities, including those associated with treatment options.
Brain benign and malignant tumours are the most common solid tumours affecting children. Progress in genomics has defined a new era in neuro-oncology and holds promise for diagnostic and therapeutic improvement. Brain tumours are usually treated with radiation therapy as the standard choice at the cost of severe late secondary effects, specifically for children and young adults.
Lymphoma and brain tumour patients are representative examples of sensitive, extensive and long-lasting followed-up category of patients experiencing successive medical exposures in radiology, nuclear medicine and radiation therapy.