SONORA

Towards Safe, Optimized and persoNalized radiOlogy

Project objectives and goals

A number of pregnant patients are undergoing diagnostic and therapeutic radiological procedures placing the unborn child at an increased risk due to the use of ionising radiation. The lacking knowledge and patients' anxiety can lead to unnecessary termination of pregnancy. EU BSS requires that when the pregnant patient undergoes medical exposure, special attention should be given to the justification and optimization of the procedure, considering both, the expectant individual and the unborn child.

The project research focuses on improving the accuracy of fetal doses estimation in diagnostic and interventional radiology (DIR) and radiotherapy (RT) to optimize process and improve benefit/risk communication with the patient.

This aims of the project are:

• developing physical phantoms of different pregnancy stages
• developing a library of personalized computational phantoms using available CT or MR images of pregnant patients and a method to select appropriate phantom using clinical parameters
• investigating fetal doses and dosimetry methods for different DIR procedures, RT techniques and patient anatomies using the physical and personalized computational phantoms developed in the project. The investigation includes the doses from imaging in RT process
• identifying the factors that affect the fetal dose estimations by methods used in clinical practice in DIR and give further guidance on the limitations of each method to decrease variability of dose estimation and enable further personalization and optimisation of the procedure considering fetal dose
• developing and testing a clinical tool for estimating the fetal doses in proton RT according to the individual pregnant patient’s anatomy and clinical plan parameters

The project will result in a good practice guide to perform fetal dose estimation in pregnant or potentially pregnant patients undergoing radiology or radiotherapy procedures. Fetal dose and associated risk data will be considered and debated for their ethical aspects to increase the quality of risk-benefit communication with the patient.

WP0 - PROJECT MANAGEMENT (WP leader – FDMZ)
 
WP 1 - STATE OF THE ART: PRACTICES, METHODS AND TOOLS (WP leader – IRSN)
Participants:
Task 1.1: review of the available tools and methods used or recommended for fetal dose assessment in DIR (VIO, IRSN, MEFOS, FDMZ, DUH)
Task 1.2: survey of routine clinical practices for pregnant patient in DIR (VIO, IRSN, STUK, MEFOS, FDMZ, DUH)
Task 1.3: review of the methods used or recommended for fetal dose assessment in RT (IRSN, SCK-CEN, SKANDION,FDMZ)
Task 1.4: survey of routine clinical practices for pregnant patients in RT (IST-ULisboa, STUK, IRSN, SKANDION)
 
WP 2 - PERSONALIZED PREGNANT PATIENTS (WP leader – MEFOS)
Task 2.1. Library of computational phantoms of pregnant patient (MEFOS, FDMZ, UKG, IST, IRSN)
Task 2.2. Develop physical phantoms in each trimester (MEFOS, FDMZ, SCK-CEN, UKG, DUH)
 
WP3 - DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY PROCEDURES DURING PREGNANCY (WP leader -EEAE)
Task 3.1. Determining the fetal dose range in the most frequent DIR procedures using measurements on physical phantoms and MC simulations on computational phantoms (MEFOS, DUH, FDMZ, IST, IRSN, RBI, EEAE, VIO)
Task 3.2. Determining uncertainties and limitations of available methods and software for fetal dose assessment used in clinical practice (EEAE, DUH, MEFOS, FDMZ, IST, IRSN, VIO)
Task 3.3. DIR procedures’ optimization in terms of fetal dose (EEAE, DUH, MEFOS, FDMZ, VIO)
 
WP4 - RADIOTHERAPY DURING PREGNANCY (WP leader - SCK CEN)
Task 4.1. Fetal dose measurements during pregnancy breast radiotherapy (SCK CEN, NPI, MEFOS, IST, SURO, EEAE, RBI, SKANDION, IFJ, DCPT)
Task 4.2. Development of a personalized dosimetry tool for pregnancy proton therapy (DCPT, SKANDION)
Task 4.3. Imaging doses to fetus in breast radiotherapy (IST, STUK, IRSN)
 
WP5 - SOCIAL OUTREACH (WP leader – RBI).
Task 5.1: Project communication and dissemination (RBI, all partners)
Task 5.2: Ethics workshops (SCK CEN, IPL)
Task 5.3: Developing empirically grounded patient communication: (MEFOS, SCK CEN, IPL, FDMZ, VIO, IRSN

Project coordinator

Hrvoje Brkić, J. J. Strossmayer University of Osijek and Faculty of Dental Medicine and Health, Croatia

Project partners

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