Health effects of cardiac fluoroscopy and modern radiotherapy in paediatrics


The European Commission funded HARMONIC (Health effects of cardiac fluoroscopy and modern radiography in paediatrics) project aims to develop a better understanding of the health effects of medical radiation exposure to ionizing radiation in cardiology and oncology in pediatric patients. The aim is to provide the scientific community with tools for long-term monitoring and assessment of the effects of this type of radiation exposure on children's health. HARMONIC also develops recommendations for optimizing treatment techniques and reducing radiation doses for patients.
In work package 3, the focus is on quantifying the long-term health effects of radiation exposure through diagnostic and/or interventional cardiac applications in pediatric patients. National hospital-based cohorts of exposed patients are set up in the participating countries (Belgium, Germany, France, Italy, Norway, Spain, UK), with the overall aim of pooling the data to increase statistical power.

In Germany, the cohort is set up in two steps: 1) a health insurance claims data-based cohort is established using the pharmacoepidemiological research database (GePaRD) located at the BIPS including patients who have been treated at least once with a diagnostic and/or interventional cardiac procedure. 2) in collaboration with participating university hospitals, cohort data is extracted from existing electronic patient files. In addition, exposure data from these procedures are obtained from electronic hospital databases and image archives; if feasible, further medical radiation exposures from diagnostic radiological examinations are additional used to estimate reliable organ doses for risk assessments, taking dose uncertainties into account. This work is carried out in close cooperation with the study coordination at IS Global, Spain. A particular focus is on leukemia and other tumors located in or near the rib cage (breast, esophagus, lungs and thyroid).

Funding period

Begin:   June 2019
End:   November 2024


  • European Commission (H2020)


 Steffen Dreger

Project coordination (international)

Dr. IsabelleThierry-Chef, Fundacion Privada Instituto de Salud Global, Barcelona, Spanien


HARMONIC - project website