Research roadmap for medical applications of ionising radiation

Topic description

Specific Challenge:

Nuclear and ionising radiation technologies have a central place in modern medicine, saving lives and improving the quality of life for patients. In the EU alone, each citizen will undergo on average at least one medical procedure involving ionising radiation each year. This includes a wide variety of diagnostic tests – from simple dental or chest x-rays, through mass screening for female breast cancer, to molecular and advanced imaging, such as positron emission tomography (PET), computed tomography (CT) or hybrid imaging. Radiological imaging is also an integral component of minimally invasive interventional procedures, for example in cardiology and vascular treatments. Radiotherapy is an indispensable tool in the fight against cancer used in about half of the cancer patients in Europe.

The medical applications of ionising radiation have also significant growth and jobs potential. The EUR 20 billion global market of medical radiological equipment has an annual growth of at least 3%. In Europe alone, more than 700,000 healthcare workers are involved in medical procedures using ionising radiation. At least 60,000 people are directly employed by the medical equipment manufacturers which includes EU-based industrial champions and also many SMEs.

The medical applications of ionising radiation experience rapid development, both on the diagnostic and therapeutic side. Modern imaging and therapy are constantly progressing and technologies become more complex. There is a trend towards integrating different imaging modalities, diagnosis and treatment and move towards precision and personalised medicine.

This dynamic environment calls for the development of a co-ordinated and systematic European approach to research and innovation in medical applications of ionising radiation, with the aim to improve patient care and quality of life of the EU citizens, support growth and jobs in the EU and to improve the EU’s position on the global market. The action in this area should be informed by, and co-ordinated with, other Commission work on non-power applications of ionising radiation^[1].

This action should prepare a Strategic Research Agenda (SRA) for research on medical applications of ionising radiation during with the objective of ensuring synergies between the 'Health' cluster of the Horizon Europe Framework Programme for Research and Innovation and the Euratom Research and Training Programme 2021-2025^[2]. Inputs and active involvement of European stakeholders from the clinical, industrial, regulatory, scientific and all other relevant fields should be ensured through their inclusion in the project consortium, by organising dedicated events, workshops and by any other relevant ways of involvement.

Building upon the preparatory activities towards a Strategic agenda for non-power applications [https://ec.europa.eu/info/events/addressing-societal-challenges-through-advancing-medical-industrial-and-research-applications-nuclear-and-radiation-technology-2018-mar-20_en , this action should:

1. Analyse the research needs for the development and delivery of high-quality healthcare for the European citizens including, but not limited to, the long-term supply of radioisotopes, quality and safety of medical applications of ionising radiation and facilitating innovation in medical therapies and imaging involving ionising radiation.
2. Identify the key needs and actions for European research into the medical applications of ionising radiation including diagnostic and therapeutic applications of x-rays, particle accelerators, radioisotopes and research reactors.
3. Identify the needs for European research to support innovation in further medical applications, such as photon, proton and heavy ion radiotherapy, molecular radiotherapy and theranostics, image guided radiotherapy, advanced and hybrid diagnostic imaging, health screening etc.
4. The SRA section on medical radioisotopes should examine the possibility (including advantages and drawbacks) for establishing a European centre of excellence for research into new or improved radioisotope therapies and diagnostic tests as well as into new or improved methods for production of radioisotopes. Other areas of research, e.g. relating to the security of supply of radioisotopes, may also be covered.
5. Identify needs and actions, strengths and weaknesses of European research actors in respect to the various aforementioned fields.
6. Analyse and propose actions, if needed, regarding the EU education and training capabilities and future needs related to the various aforementioned fields.
7. Propose a way forward towards integrating radiation protection and safety aspects of medical applications into a broader framework of quality and safety in healthcare. Aspects relating to clinical research, equipment and drugs authorisation, development and implementation of clinical guidance, equipment quality control and dose measurement, use of e-Health systems, etc. should be examined.

The SRA should also consider improvements to protection of staff, patients, carers, the public and the environment in medical installations against adverse effects of radiation. In this context, the SRA should take account of the existing research agendas^[3] and Euratom actions^[4] on radiation protection in medicine, as well as the principles of radiation protection defined by Council Directive 2013/59/Euratom.

The Commission considers that proposals requesting a contribution from the Euratom Programme up to EUR 2.0 million would allow this specific challenge to be addressed appropriately. Nonetheless, this does not preclude submission and selection of proposals requesting other amounts.

The SRA for research into the medical applications of ionising radiation will provide guidance to stakeholders and the Commission on the steps needed in the coming decades for the development of research activities and knowledge in this area.

[1]https://ec.europa.eu/info/events/addressing-societal-challenges-through-advancing-medical-industrial-and-research-applications-nuclear-and-radiation-technology-2018-mar-20_en

[2]As defined in the Commission proposals for Horizon Europe and Euratom research programmes, COM(2018) 435 and COM(2018) 437

[3]As those developed by the EURAMED and EURADOS platforms.

[4]E.g. the MEDIRAD research project, http://www.medirad-project.eu/.