The European Institute for Biomedical Imaging Research (EIBIR) supports the future of medical imaging and is coordinating or managing several European research projects funded by the Horizon 2020 framework programme.

Horizon 2020 is the European Commission’s eighth framework programme funding research, technological development, and innovation. EIBIR currently supports several projects related to biomedical imaging. This includes large projects investigating radiation protection, but also projects using imaging to improve the treatment and diagnosis of stroke and Alzheimer’s disease, as well as various cancers.

The MEDIRAD project

MEDIRAD – the first EURATOM project dedicated to researching the implications of medical low-dose radiation – specifically aims to enhance the scientific bases and clinical practice of radiation protection in the medical field and 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. MEDIRAD has three major operational objectives: 1) to improve organ dose estimation and registration; 2) to evaluate and understand the mechanisms of the effects of medical radiation exposures, particularly on the cardiovascular system; and 3) to develop science-based policy recommendations for effective radiation protection.

The project is close to completing its third year and has achieved several major milestones 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 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.

MEDIRAD currently comprises 34 partner organisations, spanning 14 European countries, as main participants in the €10 million project. The European Commission recently agreed to a cost-neutral 9-month extension of the project which will now conclude in February 2022.

MEDIRAD is led by Prof. Guy Frija from Université Paris Descartes, and Prof. Elisabeth Cardis from ISGLobal (Barcelona, ES). EIBIR leads the project management and dissemination activities of the project. More information about the project can be found at http://www.medirad-project.eu/.

The CoSTREAM project

The Common mechanisms and pathways in stroke and Alzheimer’s disease (CoSTREAM) project builds upon extensive sets of longitudinal follow-up studies, spanning up to 25 years, seeking to further our understanding of the relationships behind the frequent co-occurrence of stroke and Alzheimer’s disease. CoSTREAM thus impressively combines genetics, metabolomics, imaged brain structures, and cognition data on both diseases as separate clinical outcomes.

The core concept of the project is that stroke and Alzheimer’s disease are sequential diseases with overlapping pathophysiological mechanisms and shared risk factors. CoSTREAM focuses on finding these common mechanisms to reveal the timing and the processes causing the emergence of each disease.

Major progress has already been achieved in the analyses of genetics and metabolomics data sets, including the identification of candidate genes and metabolites causing stroke, Alzheimer’s or acting as crucial links between them. Compensatory mechanisms have also been identified as part of epidemiological analyses. Furthermore, imaging studies revealed and validated the conclusion that amyloid and the volume of particular brain regions can be predictors of disease. Finally, an in vitro cell culture model which co-cultures endothelial cells, neurons, astrocytes, and pericytes was established as a functional model of the neurovascular unit and the blood-brain barrier for high-throughput pharmaceutical testing.

CoSTREAM is led by Prof. Cornelia van Duijn from Erasmus MC (Rotterdam/NL). EIBIR leads the project management and dissemination activities of the project. More information about the project can be found at www.costream.eu.

The HYPMED project

The project Digital Hybrid Breast PET/MRI for Enhanced Diagnosis of Breast Cancer (HYPMED) is coordinated by EIBIR and is developing a fully digital, MRI-transparent, PET detector with a novel, multi-channel, PET-transparent, MRI surface coil. This PET-RF insert facilitates the imaging of breast cancer with high-resolution and ultra-high sensitivity PET, combined with high-level structural and functional MRI, allowing minimally invasive MR and PET-guided targeted biopsy. This combination of MRI and PET has never been possible before and has the potential to greatly improve the detection and diagnosis of breast cancer, as well as tumour characterisation. This ground-breaking combination of PET and MRI is also likely to have major benefits in other applications, such as prostate cancer detection and hybrid cardiac imaging. With the insert, it is expected that any regular clinical MR machine can be turned into a hybrid system when required. This will lead to a paradigm shift in the field of PET/MR hybrid imaging with many new applications in other diseases.

EIBIR acts as the project coordinator for the project, while Prof. Christiane Kuhl (Aachen/DE) is the scientific coordinator. More information about the project can be found at www.hypmed.eu.