CBCT-Guided Navigational Bronchoscopy For Lung Nodules

October 24, 2024 updated by: Adnan Majid, MD, Beth Israel Deaconess Medical Center

Cone Beam Computed Tomography - Guided Navigation Bronchoscopy for Peripheral Pulmonary Nodules: A Randomized Trial

The purpose of this study is to determine if the cone beam computed tomography (CBCT)-guided navigation bronchoscopy is better in diagnosing lung nodules compared to navigation bronchoscopy alone.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

This clinical trial examines the effectiveness of a treatment comparing it to another known treatment.

The U.S. Food and Drug Administration (FDA) has approved the navigation bronchoscopy as a treatment option for this disease.

The U.S. Food and Drug Administration (FDA) has approved the Cone-Beam CT scan as a treatment option for this disease.

This research study involves a screening period, a procedure and follow up visits.

The names of the study interventions involved in this study are:

  • Computed tomography (CBCT)-guided navigation bronchoscopy (CBCT-guided NB)
  • Navigation bronchoscopy alone

Participants will receive the study procedure and will be followed for up to 6 months.

It is expected that about 136 people will take part in this research study.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Massachusetts
      • Boston, Massachusetts, United States, 02215
        • Beth Israel Deaconness Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Participants ≥18 years old.
  • Participants with lesions having an intermediate pre-test probability of malignancy (pCA, 0.05 to 0.65) as determined by Swensen-Mayo nodule risk calculator and in whom bronchoscopic biopsy was determined to be the next best treatment step by the treating pulmonologist.
  • Participants with higher risk lesions (pCA > 0.65) in need of a diagnosis for nonsurgical treatment or prior to surgery.
  • Participants are willing and able to provide informed consent.

Exclusion Criteria:

  • The participant is pregnant as confirmed by urine or serum pregnancy testing.
  • There is a predetermined plan to pursue stereotactic body radiation therapy (SBRT) in the event of a nondiagnostic study procedure in participant's with a nodule in the outer 1/3 lung zone (i.e. The participant would not go on for a CT guided TTNA).
  • Lacked fitness according to physician judgement to undergo bronchoscopy.
  • Contraindication for temporary interruption of the use of anticoagulant therapy.
  • Uncontrolled or irreversible coagulopathy.
  • Known allergy for lidocaine.
  • Uncontrolled pulmonary hypertension.
  • Recent (< 4 weeks) and/or uncontrolled cardiac disease.
  • Compromised upper airway (eg concomitant head and neck cancer or central airway stenosis such that endobronchial access is considered unsafe).
  • ASA classification ≥ 4.
  • COVID-19 positive participant at the time of procedure.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Navigation Bronchoscopy ALONE

This research study involves a screening period, a procedure and follow up visits

  • Procedure Visit Navigation Bronchoscopy Alone
  • Follow-Up Visits at Week 1, 4 and 12
Radiation: Navigation Bronchoscopy
Navigation Bronchoscopy procedure will be performed per product instructions and the institution's standard practice.
Other Names:
  • NB
Experimental: CBCT-GUIDED Navigation Bronchoscopy

This research study involves a screening period, a procedure and follow up visits Procedure Visit- Cone Beam Computed Tomography - Guided Navigation Bronchoscopy for Peripheral Pulmonary Nodules

-Follow-Up Visits at Week 1, 4 and 12
Radiation: Navigation Bronchoscopy
Navigation Bronchoscopy procedure will be performed per product instructions and the institution's standard practice.
Other Names:
  • NB
Radiation: Cone beam computed tomography (CBCT)
Per Protocol

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall Diagnostic Yield
Time Frame: 6 months

The overall diagnostic yield will be calculated by adding the number of true positives (TP) for both malignancy and benign disease in the numerator and dividing by the total number of procedures performed for each arm of the study.

Proportions will be compared with the Chi-Square Test as this test is equivalent to the z-test of two proportions (26). A p-value <0.05 will be considered as statistically significant.
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall Incidence of Procedure-related Complications
Time Frame: 6 months
To compare complications between navigational bronchoscopy alone and CBCT guided bronchoscopy.
6 months
Additional Diagnostic Procedures in Navigational Bronchoscopy Alone and CBCT Guided Bronchoscopy.
Time Frame: 6 Months
To compare the need of additional diagnostic procedures in navigational bronchoscopy alone and CBCT guided bronchoscopy.
6 Months
Navigational Time in Bronchoscopy Alone and CBCT Guided Bronchoscopy.
Time Frame: 6 Months
To compare the navigational time defined as the time between the start of catheter driving after registration until catheter is parked for biopsy.
6 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Beth Israel Deaconess Medical Center

Collaborators

Dana-Farber Cancer Institute
Philips Healthcare

Investigators

  • Principal Investigator: Adnan Majid, MD, Beth Israel Deaconess Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 5, 2021

Primary Completion (Actual)

April 12, 2023

Study Completion (Actual)

April 12, 2023

Study Registration Dates

First Submitted

February 14, 2021

First Submitted That Met QC Criteria

February 14, 2021

First Posted (Actual)

February 17, 2021

Study Record Updates

Last Update Posted (Estimated)

November 19, 2024

Last Update Submitted That Met QC Criteria

October 24, 2024

Last Verified

October 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 20-580

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to Sponsor Investigator or designee. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.

IPD Sharing Time Frame

Data can be shared no earlier than 1 year following the date of publication

IPD Sharing Access Criteria

Contact the Beth Israel Deaconess Medical Center Technology Ventures Office at tvo@bidmc.harvard.edu

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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