Big data for small patients - Building "child-size" individual predictive models for life after childhood cancer

Lead Research Organisation: University of Manchester
Department Name: School of Medical Sciences

Abstract

Many children with cancer have radiation treatment as part of their care. As for all cancer treatments, there is a risk of lasting side-effects such as learning problems and reduced growth. Research is needed to reduce such side-effects, which is particularly important for children because of their long life expectancy. Radiation treatment is planned to give maximal dose to the tumour and minimal doses to nearby healthy organs. However, even with the most advanced ways of giving radiation (e.g. using the new Proton Beam Therapy machine in Manchester) it will never be possible to avoid all healthy organs.

This fellowship will find which parts of healthy organs are particularly damaged by radiation ('the important regions'). This knowledge would be incredibly useful when planning radiation treatments, because it is often possible to spare the important regions of an organ close to the tumour but not the whole organ. Hence, finding these important regions would be a step toward allowing reduced side-effects in many children with cancer.

The cancer centre with the most and the best documented children's health data in the world is St Jude Children's Research Hospital in Memphis, Tennessee. Children treated with radiation at St Jude have a very detailed and complete follow-up, and their side effects are measured using the most up-to-date methods.

In this project, we will:

(1) Set up a joint data analysis structure to show that our new method can be used on St Jude's data; with this, we will discover, for example, regions of the brain where radiation causes the most learning problems.

(2) Measure the changes in organ size and shape between children of different ages and sizes. For this we will use images from St Jude patients as well as from 500 healthy children in the United States, aged from 6 months to 16 years that were scanned every 2 years (we have permission to use these data for research). This information will help us make our method even more precise and able to find smaller "important regions". We will also use those images to build models of growth of the organs of interest (e.g. language center, hormone glands) in children, which will be useful for researchers studying other childhood diseases.

(3) Develop new and better ways to measure side-effects, using all the follow-up information obtained about a child's health as they grow into adulthood. This will mean, for example, that we can use images showing the health of each child even though taken many years after treatment.

This will be the first project of this kind focused on understanding side effects in children with cancer. In the future, the results from this project will help doctors give 'smarter' radiation treatments, with fewer side-effects. The models of growing organs will also be useful for research in other childhood diseases.

Planned Impact

Economic and social impact:
Every year in the UK, 1400 children under the age of 15 are diagnosed with cancer. Thanks to advances in treatment, 80% of them survive for at least 5 years. It is estimated that around 20,000 people in England and up to 500,000 European citizens alive today are survivors of childhood cancer, and these numbers will increase with time and advancing therapies. However, many survivors face serious and life-threatening long-term effects as a result of their treatment-related toxicities. It is estimated that most (80%) childhood cancer survivors have one or more chronic health conditions, and that many (~50%) will experience severe or life-threatening complications up to several decades after treatment. US research has demonstrated that, compared to the general population, adult survivors of childhood cancer are twice as likely to report being unable to work because of health issues.
The economic burden of the life-long side effects associated with having cancer and its necessary treatment is considerable. Moreover, at the societal level, it has been shown that the lifetime costs in terms of decreased productivity or lost productivity due to premature death are much higher than direct health costs. By furthering our understanding of which dose to healthy organs/substructures is responsible for long-term side effects, this proposal will contribute to optimising cancer treatment and reducing side-effects in children. This project will therefore translate into increased quality of life, and preserved productivity for children treated in the future and their families.

Clinical impact:
The outputs of this project will enable clinicians to generate "smarter" radiotherapy plans to make sure that radiation doses avoid the sensitive areas identified through this fellowship. Such plans will minimise the incidence of side effects in children with cancer without affecting tumour control. This means that children will have a much better life after cancer treatment. In cases where it is not possible to avoid giving dose to sensitive areas, the doctors will be better able to inform each patient about their chances of getting particular side effects. This will enable patients to make more informed treatment decisions, know what to expect following treatment, and allow directed tests and interventions during follow-up to reduce the impact of the side effects.

Publications

10 25 50

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Aznar MC (2023) ESTRO-ACROP guideline: Recommendations on implementation of breath-hold techniques in radiotherapy. in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

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Bates JE (2023) Cardiac Disease in Childhood Cancer Survivors Treated With Radiation Therapy: A PENTEC Comprehensive Review. in International journal of radiation oncology, biology, physics

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Gaito S (2023) Proton Beam Therapy in the Reirradiation Setting of Brain and Base of Skull Tumour Recurrences. in Clinical oncology (Royal College of Radiologists (Great Britain))

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Gaito S (2023) Assessing Equity of Access to Proton Beam Therapy: A Literature Review. in Clinical oncology (Royal College of Radiologists (Great Britain))

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Hardcastle N (2024) Multi-centre evaluation of variation in cumulative dose assessment in reirradiation scenarios. in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

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López-Fernández T (2023) European Society of Cardiology Core Curriculum for cardio-oncology. in European journal of heart failure

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Olch AJ (2023) Physics Considerations for Evaluation of Dose for Dose-Response Models of Pediatric Late Effects From Radiation Therapy. in International journal of radiation oncology, biology, physics

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Taylor PA (2023) Prioritizing clinical trial quality assurance for photons and protons: A failure modes and effects analysis (FMEA) comparison. in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

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Trnkova P (2023) A survey of practice patterns for adaptive particle therapy for interfractional changes. in Physics and imaging in radiation oncology

 
Description 2022 ESC guidelines on cardio-oncology
Geographic Reach Multiple continents/international 
Policy Influence Type Contribution to new or improved professional practice
Impact The guidelines recommend guidelines for how patients (including children) treated with radiation to the chest are followed up by their clinical care team. This will impact the lives of cancer survivors.
 
Description BRAINatomy2 award
Amount $4,999,914 (USD)
Organisation Stand up to Cancer 
Sector Charity/Non Profit
Country United States
Start 01/2024 
End 12/2027
 
Description BRAINatomy: a validated anatomical altas of childhood neuroradiation damage
Amount $1,000,000 (USD)
Funding ID SU2C#RT6186 
Organisation Stand up to Cancer 
Sector Charity/Non Profit
Country United States
Start 03/2021 
End 03/2023
 
Description HEE/NIHR Pre-Doctoral Bridging Programme Award
Amount £10,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 11/2022 
End 05/2023
 
Description LINKER: LONGITUDINAL IMAGING LINKING OUTCOMES AND INTERVENTIONS
Amount £49,421 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 07/2023 
End 07/2024
 
Description MMT Search Pump priming award for a training visit for a group of researchers from Radiotherapy Related Research to Princess Margaret Hospital in Toronto
Amount £7,500 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 01/2023 
End 07/2023
 
Description NIHR Academy Awards Doctoral Fellowship for Emma Foster
Amount £272,238 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 08/2023 
End 08/2027
 
Description NIHR Doctoral Fellowship
Amount £239,036 (GBP)
Funding ID NIHR302988 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 08/2023 
End 08/2026
 
Description PhD Scholarship for Love Goyal sponsored by the Christie Proton Therapy centre
Amount £180,123 (GBP)
Organisation The Christie NHS Foundation Trust 
Sector Public
Country United Kingdom
Start 01/2024 
End 12/2027
 
Description SMILE: MinimiSing long-terM Impact on dentition and faciaL asymmEtry in chIldhood cancer survivors
Amount £5,000 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 05/2022 
End 07/2023
 
Description TIMELINESS: longiTudinal IMage processing for early dEtection of Late effects IN childhood cancEr Survivors.
Amount £21,233 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 07/2023 
End 07/2024
 
Description The Christie Proton Beam Therapy Research Funding
Amount £2,432 (GBP)
Organisation The Christie NHS Foundation Trust 
Sector Public
Country United Kingdom
Start 03/2024 
End 02/2025
 
Description Artifical intelligence for treatment planning 
Organisation Toronto Princess Margaret Hospital
Country Canada 
Sector Hospitals 
PI Contribution Funding for scientific visit to kick start collaboration Expertise in AI-based segmentation for thoracic treatments Validation of the PMH model on patient cohort from Manchester/ Christie
Collaborator Contribution Gave us access to the AI-based model developed for prostate treatment Provided expertise in how to implement AI-based treatment planning (training, safeguarding, etc...)
Impact No outcome yet. Several publications, and a change in clinical practice at the Christie NHS are expected.
Start Year 2023
 
Description Collaboration with UMC Utrecht and the Princess Máxima Center 
Organisation Princess Máxima Center
Country Netherlands 
Sector Hospitals 
PI Contribution Several discussions with Marinka on late side effects and possible link to treatment toxicities. Marinka was invites to Manchester to attend the SMILE workshop in March 2023 where discussions continued.
Collaborator Contribution New collaboration with these organisations principally through Dr Marinka Hol to explore late side effects in paediatric patients following radiotherapy. Focus on dento-facial effects. Marinka has significant expertise in treating patients with Rhabdomyosarcoma and their side effects.
Impact Still underway
Start Year 2022
 
Description Collaboration with UMC Utrecht and the Princess Máxima Center 
Organisation University Medical Center Utrecht (UMC)
Country Netherlands 
Sector Academic/University 
PI Contribution Several discussions with Marinka on late side effects and possible link to treatment toxicities. Marinka was invites to Manchester to attend the SMILE workshop in March 2023 where discussions continued.
Collaborator Contribution New collaboration with these organisations principally through Dr Marinka Hol to explore late side effects in paediatric patients following radiotherapy. Focus on dento-facial effects. Marinka has significant expertise in treating patients with Rhabdomyosarcoma and their side effects.
Impact Still underway
Start Year 2022
 
Description ESTRO HERO (Health Economics in Radiation Oncology) 
Organisation Bellvitge Biomedical Research Institute
Country Spain 
Sector Academic/University 
PI Contribution The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology.
Collaborator Contribution Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology.
Impact please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1
Start Year 2021
 
Description ESTRO HERO (Health Economics in Radiation Oncology) 
Organisation European Society for Radiotherapy and Oncology (ESTRO)
Country Belgium 
Sector Charity/Non Profit 
PI Contribution The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology.
Collaborator Contribution Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology.
Impact please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1
Start Year 2021
 
Description ESTRO HERO (Health Economics in Radiation Oncology) 
Organisation Ghent University Hospital
Country Belgium 
Sector Hospitals 
PI Contribution The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology.
Collaborator Contribution Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology.
Impact please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1
Start Year 2021
 
Description ESTRO HERO (Health Economics in Radiation Oncology) 
Organisation Gustave-Roussy Institute
Department Gustave-Roussy Institute of Oncology
Country France 
Sector Academic/University 
PI Contribution The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology.
Collaborator Contribution Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology.
Impact please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1
Start Year 2021
 
Description ESTRO HERO (Health Economics in Radiation Oncology) 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Country United Kingdom 
Sector Academic/University 
PI Contribution The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology.
Collaborator Contribution Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology.
Impact please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1
Start Year 2021
 
Description ESTRO HERO (Health Economics in Radiation Oncology) 
Organisation Trinity St James’s Cancer Institute
Country Ireland 
Sector Hospitals 
PI Contribution The HERO project (Health Economics in Radiation Oncology) is developing a knowledge base and a cost accounting model estimating the national cost of radiotherapy (RT). The overall aim is to provide solid data to the RT community to engage with governments, funders and decision makers, and advocate for better funding for RT, better resource planning and ultimately better care for cancer patients. The project is carried out in close collaboration with the European national societies of radiation oncology. A task force has been formed, consisting of international specialists in the field, including myself since 2021. I provide medical physics expertise, especially around technical innovations in advanced practice of radiation oncology.
Collaborator Contribution Prof Lievens (Gent) leads this group of international expert. The group is developing a frameword which will enable the definition and classification of innovations in radiation oncology.
Impact please note that as of March 14th 2023, the webpage above was not updated (hence doesn't include the most recent members of the group,including myself). First output (in press in Radiotherapy and Oncology) Title A systematic literature review of definitions and classification systems for radiotherapy innovation: a first step towards building a value-based assessment tool for radiation oncology. Author names and affiliations Miet Vandemaelea, Marianne Aznarb, 1, Pierre Blanchardc, Josep M Borrasd, Michelle Leeche, Ajay Aggarwalf, 1, Yolande Lievensa, 1
Start Year 2021
 
Description European working group on dentofacial effects after radiotherapy for childhood cancer 
Organisation European Society of Paediatric Oncology (SIOPE)
Country Belgium 
Sector Charity/Non Profit 
PI Contribution With Dr Shermaine Pan, clinical oncologist at the Christie NHS, I have co-funded a working group on dento-facial effects under the umbrella of SIOpe, the European Society of Paediatric Oncology. We distributed a survey to collect information on clinical practice and dose to dento-facial structures, receiving 60 responses from leading paeidiatric oncology centres in Europe, Australia and New Zealand. based on these replies, selected members will be invited to form the working group at the Pediatric Radiation ocnology Society meeting in Essen in June 2022.
Collaborator Contribution Access to the network of experts of SIOpe contribution to the design of the survey will co-author publication on survey outputs.
Impact Survey completed. Invited presentation at SIOP Europe Annual meeting (march 23 2022). SMILE international workshop (March 2023)
Start Year 2022
 
Description European working group on dentofacial effects after radiotherapy for childhood cancer 
Organisation Princess Máxima Center
Country Netherlands 
Sector Hospitals 
PI Contribution With Dr Shermaine Pan, clinical oncologist at the Christie NHS, I have co-funded a working group on dento-facial effects under the umbrella of SIOpe, the European Society of Paediatric Oncology. We distributed a survey to collect information on clinical practice and dose to dento-facial structures, receiving 60 responses from leading paeidiatric oncology centres in Europe, Australia and New Zealand. based on these replies, selected members will be invited to form the working group at the Pediatric Radiation ocnology Society meeting in Essen in June 2022.
Collaborator Contribution Access to the network of experts of SIOpe contribution to the design of the survey will co-author publication on survey outputs.
Impact Survey completed. Invited presentation at SIOP Europe Annual meeting (march 23 2022). SMILE international workshop (March 2023)
Start Year 2022
 
Description Global Harmonisation Group on clinical trial QA 
Organisation National Cancer Research Institute (NCRI)
Department NCRI Radiotherapy Trials Quality Assurance Team (RTTQA)
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution I provided expertise rearding the use of image guidance in clinical trials, especially for children.
Collaborator Contribution This work was led by MD Anderson, and identified some gaps in photon vs proton clinical trial QA.
Impact Paper published in Radiotherapy & Oncology doi: 10.1016/j.radonc.2023.109494.
Start Year 2022
 
Description Global Harmonisation Group on clinical trial QA 
Organisation University of Texas
Department M. D. Anderson Cancer Center
Country United States 
Sector Academic/University 
PI Contribution I provided expertise rearding the use of image guidance in clinical trials, especially for children.
Collaborator Contribution This work was led by MD Anderson, and identified some gaps in photon vs proton clinical trial QA.
Impact Paper published in Radiotherapy & Oncology doi: 10.1016/j.radonc.2023.109494.
Start Year 2022
 
Description Joint grant application to Informatics Technology for Cancer Research with St Jude 
Organisation St Jude Children's Hospital
Country United States 
Sector Hospitals 
PI Contribution Installation of the Image based data mining platform at St Jude. Leadership of the grant application. Co-investigator
Collaborator Contribution Lead investigators.
Impact Following the clinical collaboration of this award , I have developped a collaboration with teh technical radiotherapy leads at St Jude. This ITCR grant application will further develop the aims of this awards, but adds a platform for direct comparison with traditional dose-relationship methodologies.
Start Year 2022
 
Description Leadership for women in medical physics 
Organisation European Society for Radiotherapy and Oncology (ESTRO)
Country Belgium 
Sector Charity/Non Profit 
PI Contribution Dr Marianne Aznar obtained industry funding and directed 4 webinars on leadership for omen in medical physics (with ESTRO)
Collaborator Contribution NA
Impact 4 webinars directed on leadership for women in medical physics
Start Year 2023
 
Description PTCOG base of skull sub-committee 
Organisation Emory University
Country United States 
Sector Academic/University 
PI Contribution PSI, Emory and the Christie NHS are jointly leading an inter-observer study to quantify, and alter minimise (through guidelines) variations in the definition of base of skull tumours. They are providing their own clinical expertise, as well as access to an international network of experts who will participate in the study.
Collaborator Contribution I am providing technical expertise to enable the study, i.e. distributions of images, collection and analysis of data.
Impact Paper with recommendations for clinical practice. Less variations on tumour definition is expected to have direct impact on patient outcomes worldwide.
Start Year 2022
 
Description PTCOG base of skull sub-committee 
Organisation Paul Scherrer Institute
Country Switzerland 
Sector Academic/University 
PI Contribution PSI, Emory and the Christie NHS are jointly leading an inter-observer study to quantify, and alter minimise (through guidelines) variations in the definition of base of skull tumours. They are providing their own clinical expertise, as well as access to an international network of experts who will participate in the study.
Collaborator Contribution I am providing technical expertise to enable the study, i.e. distributions of images, collection and analysis of data.
Impact Paper with recommendations for clinical practice. Less variations on tumour definition is expected to have direct impact on patient outcomes worldwide.
Start Year 2022
 
Description Patterns of pratice in image guidance for paediatric radiotherapy 
Organisation Rigshospitalet
Department Department of Oncology
Country Denmark 
Sector Hospitals 
PI Contribution Dr Maja Maraldo from Copenhagen and myself are jointly leading this initiative to collect exact information on image guidance practice in children, define recommendations and encourage the proper use of images in children to maximise treatment accuracy with the lowest imaging burden.
Collaborator Contribution Dr Maja Maraldo from Copenhagen and myself are jointly leading this initiative to collect exact information on image guidance practice in children, define recommendations and encourage the proper use of images in children to maximise treatment accuracy with the lowest imaging burden.
Impact Outcomes will include: a paper outlining the results of a European survey; recommendations and guidelines.
Start Year 2021
 
Description A talk at the "Womxn in Physics" conference, Kings College London 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk at the "Womxn in Physics" conference held at Kings College London on the 17th February 2022. Talk titled Medical Physics in Cancer Research.

The conferences aim is: To address issues surrounding the underrepresentation of womxn in Physics through a series of educational and social events. By providing a safe space for self-identifying womxn and non-binary individuals, we aim to promote gender equality and diversity by bringing womxn together to discuss their experience as a minority group and to combat isolation. Womxn are an underrepresented group in Physics particularly in academia therefore we aim to make everyone aware of gender biases in order to tackle gender stereotypes.

Marianne discussed her role within the medical physics community.
Year(s) Of Engagement Activity 2022
URL https://www.kclwomxninphysics.com/event-details/conference-2022
 
Description AAPM GRSIC Webinar Series on Global Research Excellence and Rising Stars (2023) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Participant in a webinar broadcast on February 23 2023 titled "Maximizing your Research Impact by Understanding the Scientific Publication Process". I was a member of a panel presenting including additional speakers John Boone and Qihui Lyu. The webinar is available online through the AAPM website.
Year(s) Of Engagement Activity 2023
URL https://www.aapm.org/meetings/webinars/GRSICGRERSWebinarSeriesNo1.asp
 
Description CRUK Data Driven Conference poster 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Poster presentation at the CRUK Data Driven conference - "Towards automatic segmentation of dento-facial structures for paediatric head and neck cancers"
Year(s) Of Engagement Activity 2024
 
Description ESTRO 2023 Conference Talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Estro 2023 oral presentation entitled: Automated analysis of internal facial asymmetry in children
Year(s) Of Engagement Activity 2023
 
Description ESTRO Newsletter article 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact ESTRO 2023 Physics Track Report - 'Big data, big headache' joint ESTRO-American Association of Physicists in Medicine session written by Angela Davey
Year(s) Of Engagement Activity 2023
URL https://www.estro.org/About/Newsroom/Newsletter/Physics/ESTRO-2023-Physics-Track-Report-%E2%80%98Big...
 
Description ESTRO Physics workshop 2022 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact ESTRO physics workshop on optimising image-guidance in Lisbon (Portugal) on October 7-8th 2022. I was part of the formal working group.
Year(s) Of Engagement Activity 2022
 
Description Internal Christie Seminar on "current research in paediatric RT" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Dissemination of the aims of my EPSRC fellowship and description of the current paediatric radiotherapy landscape.
Year(s) Of Engagement Activity 2021
 
Description Invited presentation at a joint workshop with St Jude's Children Research Hospital 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited presentations at a joint St Jude's Research Hospital - University of Manchester workshop. Two members of the research team presented work entitled:
Angela Davey - Temporal processes in paediatric outcomes research
Edward Henderson - Deep learning for image segmentation and registration in radiotherapy - paediatric specific challenges and opportunities
Year(s) Of Engagement Activity 2023
 
Description Invited talk at a UCL-UoM workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Three members of the research group were invited to present at this cross-institutional brainstorming workshop. The presentations were entitled:
Marianne Aznar - BRAINatomy: part 1 and part 2
Angela Davey - Temporal modelling of late effects post-radiotherapy in childhood cancer survivors
Edward Henderson - Developing registration tools for image-based data mining in paediatric patients
Year(s) Of Engagement Activity 2024
 
Description McMedHacks Webinar : "Data Mining in Radiotherapy: understanding the link between dose and late effects" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Marianne gave a talk titled "Data mining in radiotherapy: understanding the link between dose and long-term side effects" as part of the McMedHacks - medical image analysis and deep learning in Python session in on July 24th 2021.

The talk abstract is: As survival rates for cancer patients improve, late effects, such as second cancers or heart disease, are an increasing area of concern. In order to continuously improve radiation oncology treatments, it is crucial to understand the drivers of late toxicity, and the interaction between radiotherapy, other cancer treatments and co-morbidities. In this talk, we will review the limitations of current late effect research and explore the role of advanced methods such as data mining. We will also discuss uncertainties in outcome evaluation, and how machine learning approaches can help us evaluate, analyse and predict treatment-related toxicity.
Year(s) Of Engagement Activity 2021
URL https://mcmedhacks.com/team/marianne-aznar/
 
Description Mini-oral presentation at ISORED 2023 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mini-oral presentation on: A descriptive analysis to aid discovery of relationships between radiotherapy for childhood cancer and neurocognitive outcomes.
Year(s) Of Engagement Activity 2023
 
Description NIHR BRC Imaging Group meeting poster presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact NIHR BRC Imaging Group Meeting poster presentation entitled, "Auto-contouring for children and young people requires suitable training data"
Year(s) Of Engagement Activity 2024
 
Description Oral mini talk at ESTRO 2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mini oral awarded based on submitted abstract at ESTRO 2022 from 6-10th May 2022.
Year(s) Of Engagement Activity 2022
 
Description PPIE panel - Topic "Helping your friends better understand radiotherapy" 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact 6 teenagers/young adults who had previously received radiotherapy at the Christie Hospital were included in a patient panel to explore the topic: Helping your friends better understand radiotherapy through social media.

The goal of the discussion was to help generate ideas for social media content (TikTok, Instagram) that young people undergoing radiotherapy can share with their friends, teachers, and wider support network. We used the session to begin these discussion and make a first capture of the information these teenages/young adults wished their friends knew during their treatment, in order to allow them to understand the journey they were going through and ensure these young people were able to access the support they needed.

The group shared their experiences of radiotherapy and their views on using social media in this way. It was identified that the group would like their support network to better understand the differences between types of radiotherapy treatment (i.e. whole body irradiation vs breast), and help debunk some of the myths about radiotherapy. The group also wanted an easier way to access information about long and short-term side effects of radiotherapy that they were not informed about prior to treatment. We are planning a follow-up session for these participants to record their own messages for social media, and aim to connect with Teenager Cancer Trust who have a large social media presence (+40k followers on Instagram) to help promote this material.
Year(s) Of Engagement Activity 2022
 
Description Presentation at ESTRO 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Marianne Aznar spoke at ESTRO 2021 on August 30th on a talk entitled "Starting a networking group in a virtual environment". This was an invited presentation with the aim of mentoring fellow scientists.
Year(s) Of Engagement Activity 2021
URL https://www.estro.org/Congresses/ESTRO-2021/576/makethebestuseofonlineresourcesandmeetingsforremot/2...
 
Description Presentation at the Christie Summer School 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation at the The 5th Christie Advanced Radiotherapy Summer School on 16th June 2021 entitled: "Big Data and late outcome analysis: late effects of cancer treatment". The event is attended by a radiographers, medical physicists, clinicians and academics and is a great way of networking with colleagues within the radiotherapy community.
Year(s) Of Engagement Activity 2021
URL https://www.christie.nhs.uk/media/9693/adv-rt-summer-school-2021-agenda.pdf
 
Description Public engagement event at the University of Manchester community festival 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact We hosted a stall called "Treating cancer with radiation" at the 2023 UoM community festival, where a wide age-range of children were guided through several hands-on activities to gently introduce them and take them through the radiotherapy treatment process.
Year(s) Of Engagement Activity 2023
URL https://www.socialresponsibility.manchester.ac.uk/public-engagement/spotlight-events/community-festi...
 
Description SIOP Conference Poster 2023 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact SIOP Conference Poster entitled: EFFICIENT EVALUATION OF DOSE TO BRAIN STRUCTURES IN CHILDREN TREATED WITH RADIOTHERAPY FOR BRAIN TUMOURS
Year(s) Of Engagement Activity 2023
 
Description SMILE workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A workshop was formed with a large multidisciplinary team, including oncologists who treat patients, radiologists experienced in follow-up imaging, surgeons who perform reconstructive surgery, dentists who routinely encounter dentofacial toxicities and physicists with technical expertise to perform dose-response investigation. The workshop examined the causes and treatment of facial asymmetry following radiotherapy in children. A parent also attended who described her daughters and families experience of dealing with long term side effects following radiotherapy for rhabdomyosarcoma in her cheek. The working group determined key actions for follow up to reduce future long term side-effects in childhood cancer survivors.
Year(s) Of Engagement Activity 2023,2024
 
Description Speaker on the ESTRO debate "This house believes that in 10 years particle therapy will be in a better place than now" 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Speaker for a debate titled "This house believes that in 10 years particle therapy will be in a better place than now" as part of ESTRO 2022 conference held on 6-10th May 2022
Year(s) Of Engagement Activity 2022
 
Description The link between cognitive decline and radiation dose in children treated with brain tumours 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk delivered at CERRO (clinical and experimental research in radiation oncology) a conference strictly by invitation only. The meeting has been designed to provide an opportunity for oncologists, physicists, biologists, and radiation technologists to present work in progress in a format in which stimulates discussion and collaboration.
Year(s) Of Engagement Activity 2023