EURAMED The Medical platform for Radiation Protection Research Graciano Paulo IPC-ESTESC Coimbra Health School Ciência 2017 (Lisbon 5th July)

The European Alliance for Medical Radiation Protection Research (EURAMED) represents a consortium of associations involved in the application of ionising radiation in medicine, namely: the European Association of Nuclear Medicine (EANM), the European Federation of Organisations for Medical Physics (EFOMP), the European Federation of Radiographer Societies (EFRS), the European Society of Radiology (ESR), the European Society for Radiotherapy and Oncology (ESTRO), with the goal of jointly improving medical care and its radiation protection issues through sustainable research efforts.

The other platforms are namely: Context EURAMED complements existing established European platforms in several other fields of radiation protection and will thus create visibility for the medical field in this context. The other platforms are namely: Multidisciplinary European Low Dose Initiative (MELODI) European Radiation Dosimetry Group (EURADOS) European Platform for nuclear and radiological emergency response and recovery (NERIS) European Radioecology Alliance (ALLIANCE)

Vision To lead the European research activities in medical RP and to assume an umbrella function for the harmonisation of practice to advance the European RP safety culture in medicine Mission To jointly improve medical care through sustainable research efforts in medical radiation protection Identification of common research areas defined in a common strategic research agenda To serve as a platform for medical radiation protection research, linking researchers and clinicians, adopting a harmonised approach to lobbying at European level to impact the European research funding landscape To develop an aligned approach and response to European research calls

EURAMED Working Group Members: Christoph Hoeschen, Uni Magdeburg/DE, Chair John Damilakis, EFOMP Wolfgang Doerr, ESTRO Guy Frija, ESR Gerhard Glatting, EANM Hans Langendijk, ESTRO Kristoff Muylle, EANM Graciano Paulo, EFRS Wolfram Stiller, ESR Virginia Tsapaki, EFOMP Jonathan McNulty, EFRS Monika Hierath, EIBIR (Support)

Purpose of the Society The Society shall be an apolitical, non-profit organisation, exclusively and directly dedicated to promoting and coordinating the scientific, philanthropic, intellectual and professional activities in the field of medical radiation protection research. The Society’s mission at all times is to serve the health care needs of the general public through the support of science and research and the quality of service in medical imaging and therapy involving ionising radiation.

The research that is seen to be necessary and most urgent for effective medical care, under the best harmonised practice, and efficient in terms of radiation protection can be summarised to the following five main topics: Measurement and quantification in the field of medical applications of ionising radiation Normal tissue reactions, radiation-induced morbidity and long-term health problems Optimisation of radiation exposure and harmonisation of practices Justification of the use of ionising radiation in medical practice Infrastructures for quality assurance

Measurement and quantification in the field of medical applications of ionising radiation A key priority for radiation protection research in radiation oncology, nuclear medicine and also interventional and diagnostic applications of ionising radiation is to improve techniques and methods for measurement and quantification.

Normal tissue reactions, radiation-induced morbidity and long-term health problems A key priority for radiation protection research in radiation oncology, nuclear medicine and also interventional and diagnostic applications of ionising radiation is is to improve health risk estimates.

Optimisation of radiation exposure and harmonisation of practices According to the European Basic Safety Standard (BSS) (2013/59/EURATOM), the radiation protection of individuals subject to public or occupational exposure must be optimised with the aim of keeping the magnitude of individual doses, the likelihood of exposure and the number of individuals exposed as low as reasonably achievable (ALARA) taking into account the current state of technical knowledge, economic and societal factors. The optimisation of the protection of individuals subject to medical exposure should be consistent with the medical purpose of the exposure.

Justification of the use of ionising radiation in medical practice The principle of justification is one of the key pillars of radiation protection underlined in the recently revised European BSS Directive. This principle focusses on weighing the benefits versus the risks. Further important elements are patient communication, as the basis for shared decision-making including the patient rights for influencing the decision, as well as the appropriateness of the radiological procedure with respect to the clinical setting.

Infrastructures for quality assurance To perform investigations on tissue reactions, optimisation procedures as well as risk and benefit evaluations, it is important to rely on optimal, quality assured data, which are gathered under defined conditions and which are necessary for various reasons including legal questions pertaining or specific to the research to be performed. In addition, the clinical system of medical applications of ionising radiation has to be standardised and evaluated concerning its effectiveness in radiation protection.

EURAMED Final Message It is essential that any research in the area of medical ionising radiation is translated into clinical practice to ensure that patients and staff see the direct benefits of this research. There is evidence that this translational research often fails because of the absence of parallel education and training programmes. High quality education and training programmes will raise awareness of ongoing EU research projects and initiatives and ensure their uptake into clinical practice at local, national and European levels. There has been an identified need to also develop high-quality education and training specifically for researchers to help strengthen the medical ionising radiation research community.

EURAMED The Medical platform for Radiation Protection Research Graciano Paulo IPC-ESTESC Coimbra Health School graciano@estescoimbra.pt Ciência 2017 (Lisbon 5th July)