- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07587086
Fluorocholine PET/MR in Breast Cancer
Use of Imaging Markers by Fluorocholine PET/MR to Predict Molecular Subtypes and Clinical Outcomes of Breast Cancer: a Pilot Study
Objectives:
Our study is conducted to use the pre-treatment FCH PET/MR in breast cancer patients, to investigate whether the conventional PET/MR imaging markers (SUVmax, MR spectroscopy-derived choline analysis, dynamic contrast-enhanced MRI, ADC analysis), and FCH/MR radiomic features, deep learning (DL) analysis are associated with molecular subtypes, clinical outcomes, treatment response, survival, and which parameters are more accurate for prediction purposes.
Primary study purposes:
-To investigate whether the pre-treatment FCH PET/MR imaging parameters are associated with molecular subtypes of breast cancers, and to evaluate the diagnostic performance for prediction purpose.
Secondary study purposes:
- To investigate whether the pre-treatment FCH PET/MR imaging parameters are associated with the factors related to clinical outcomes (histologic grade, prognosis) and to analyze which parameters are more accurate for prediction purposes.
Test drug:
Name: 18F- Fluorocholine (18F-FCH) Dosage form: N-([18F]fluoromethyl)-2-hydroxy-N,N-dimethylethan-1-aminium Strength: 3-5 MBq/kg per patient (5-6 mCi/mL at time of injection (TOI)) Dosage and administration: Intravenous injection.
Selection criteria:
- Women aged 25-75 years old.
- Women diagnosed as breast cancer by pathological diagnosis from core biopsy within 3 months and who will receive neoadjuvant chemotherapy (NAC) before surgery; or women with pathologically proven breast cancer within 3 months and who will receive operation (without pre-operative neoadjuvant chemotherapy).
- Women whose ECOG between 0-2 points and life expectancy ≧ 3 months.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study steps / procedures:
- The study participants will receive pre-treatment whole body PET/MR and breast PET/MR examinations.
- The whole body PET/MR:
1). The participant will undergo NPO for at least 6 hours before the examination.
2). After intravenous injection of 5-6 mCi/mL (at time of injection, TOI) 18F-Fluorodeoxyglucose (FDG), the participant will take a bed rest of about 60 minutes, then a 20-25 minutes of whole body PET/MR will be performed. FDG is a commercialized PET tracer and approved for clinical diagnosis.
3. PET/MR of the breast:
- . The participant will undergo NPO for at least 6 hours before the examination.
- . After intravenous injection of 5-6 mCi/mL (at TOI) 18F-Fluorocholine (FCH), the study participant will take a 45-60 minute bed rest, then undergoes a breast PET/MR with prone position. The breast PET/MR will take about 30-35 minutes. The intravenous injection of MRI contrast media will be performed during the examination (MRI-contrast media, Dotarem [Gadoteric acid, Guerbet, France] is commercialized and routinely used in MRI examination). The dosage of MRI contrast media ranges from 10-15 cc according to various body weight (0.1mmol/Kg).
4. The whole body FDG PET/MR, and the breast FCH PET/MR will be performed on different days (interval >= 2 days).
5. The study results will be interpreted by board certified diagnostic radiologists and nuclear medicine physicians, and relayed to the patient's physicians for reference of clinical management.
6. The radiation dose (effective dose equivalent, EDE) of a whole body FDG PET/MR measures about 6.6 mSv, the EDE of a FCH breast PET/MR measures about 3.85 mSv, totally about 10.45 mSv, which is relatively equivalent to that of a chest CT scan (without and with contrast, 10.8 mSv), resulting a very low estimated secondary cancer occurrence (about 5/10000 to 7/10000). Most of the radiation by FDG and FCH will be decayed, and minimal portion of them will be excreted by urine and hepatobiliary system.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Jane Wang, M.D.
- Phone Number: +886938591583
- Email: jwang2@vghtpe.gov.tw
Study Locations
-
-
Taiwan
-
Taipei, Taiwan, Taiwan, 11217
- Recruiting
- Taipei Veterans General Hospital
-
Contact:
- Jane Wang, M.D.
- Phone Number: +886938591583
- Email: jwang2@vghtpe.gov.tw
-
Principal Investigator:
- Jane Wang, M.D.
-
Sub-Investigator:
- Ling-Ming Tseng, M.D
-
Sub-Investigator:
- Ko-Han Lin, M.D.
-
Sub-Investigator:
- Yi-Fang Tsai, M.D.
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Women aged 25-75 years old.
- Women diagnosed as breast cancer by pathological diagnosis from core biopsy within 3 months and who will receive neoadjuvant chemotherapy (NAC) before surgery; or women with pathologically proven breast cancer within 3 months and who will receive operation (without pre-operative neoadjuvant chemotherapy).
- Women whose ECOG between 0-2 points and life expectancy ≧ 3 months.
Exclusion Criteria:
- Women who are unable to cooperate with the examinations
- Women who are pregnant, lactating or are planning to be pregnant
- Women with estimated GFR (eGFR) < 60 ml/min/1.73m2 or acute renal failure within 3 months, past history of renal dialysis.
- Past history of claustrophobia
- Past history of anaphylactoid reactions to MRI contrast agents or PET tracer agents.
- Women with cardiac pacemaker, aneurysmal clip, mechanical valve replacement, recently applied coronary artery stent (<3 months).
- Past history of breast cancer or other malignancy within 5 years.
- Women who underwent chemotherapy within a year.
- Women who are not suitable to join the study according to the assessment by investigators.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
Single arm
Women diagnosed as breast cancer by pathological diagnosis from core biopsy within 3 months and who will receive neoadjuvant chemotherapy (NAC) before surgery; or women with pathologically proven breast cancer within 3 months and who will receive operation (without pre-operative neoadjuvant chemotherapy).
|
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Whether the pre-treatment FCH PET/MR imaging parameters are associated with molecular subtypes of breast cancers, and to evaluate the diagnostic performance for prediction purpose.
Time Frame: From enrollment to the end of study (follow up) at least 40 weeks
|
To investigate whether the pre-treatment FCH PET/MR imaging parameters are associated with molecular subtypes of breast cancers, and to evaluate the diagnostic performance for prediction purpose
|
From enrollment to the end of study (follow up) at least 40 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
To investigate whether the pre-treatment FCH PET/MR imaging parameters are associated with the factors related to clinical outcomes (histologic grade, prognosis) and to analyze which parameters are more accurate for prediction purposes.
Time Frame: From enrollment, at least about 40 weeks (until the completion of chemotherapy, or when the surgical pathology comes out).
|
The results to be predicted, including: clinical outcomes (histologic grade, recurrence rate (at 1, 2, 5 years after surgery), survival (5-year overall survival and disease/recurrence-free survival).
|
From enrollment, at least about 40 weeks (until the completion of chemotherapy, or when the surgical pathology comes out).
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Wang J, Shih TT, Yen RF. Multiparametric Evaluation of Treatment Response to Neoadjuvant Chemotherapy in Breast Cancer Using Integrated PET/MR. Clin Nucl Med. 2017 Jul;42(7):506-513. doi: 10.1097/RLU.0000000000001684.
- Pujara AC, Kim E, Axelrod D, Melsaether AN. PET/MRI in Breast Cancer. J Magn Reson Imaging. 2019 Feb;49(2):328-342. doi: 10.1002/jmri.26298. Epub 2018 Oct 6.
- Grueneisen J, Nagarajah J, Buchbender C, Hoffmann O, Schaarschmidt BM, Poeppel T, Forsting M, Quick HH, Umutlu L, Kinner S. Positron Emission Tomography/Magnetic Resonance Imaging for Local Tumor Staging in Patients With Primary Breast Cancer: A Comparison With Positron Emission Tomography/Computed Tomography and Magnetic Resonance Imaging. Invest Radiol. 2015 Aug;50(8):505-13. doi: 10.1097/RLI.0000000000000197.
- Goorts B, Voo S, van Nijnatten TJA, Kooreman LFS, de Boer M, Keymeulen KBMI, Aarnoutse R, Wildberger JE, Mottaghy FM, Lobbes MBI, Smidt ML. Hybrid 18F-FDG PET/MRI might improve locoregional staging of breast cancer patients prior to neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2017 Oct;44(11):1796-1805. doi: 10.1007/s00259-017-3745-x. Epub 2017 Jun 10.
- Botsikas D, Bagetakos I, Picarra M, Da Cunha Afonso Barisits AC, Boudabbous S, Montet X, Lam GT, Mainta I, Kalovidouri A, Becker M. What is the diagnostic performance of 18-FDG-PET/MR compared to PET/CT for the N- and M- staging of breast cancer? Eur Radiol. 2019 Apr;29(4):1787-1798. doi: 10.1007/s00330-018-5720-8. Epub 2018 Sep 28.
- Jena A, Taneja S, Singh A, Negi P, Sarin R, Das PK, Singhal M. Reliability of 18F-FDG PET Metabolic Parameters Derived Using Simultaneous PET/MRI and Correlation With Prognostic Factors of Invasive Ductal Carcinoma: A Feasibility Study. AJR Am J Roentgenol. 2017 Sep;209(3):662-670. doi: 10.2214/AJR.16.17766. Epub 2017 Jul 5.
- Cho N, Im SA, Cheon GJ, Park IA, Lee KH, Kim TY, Kim YS, Kwon BR, Lee JM, Suh HY, Suh KJ. Integrated 18F-FDG PET/MRI in breast cancer: early prediction of response to neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2018 Mar;45(3):328-339. doi: 10.1007/s00259-017-3849-3. Epub 2017 Nov 4.
- Li H, Zhu Y, Burnside ES, Huang E, Drukker K, Hoadley KA, Fan C, Conzen SD, Zuley M, Net JM, Sutton E, Whitman GJ, Morris E, Perou CM, Ji Y, Giger ML. Quantitative MRI radiomics in the prediction of molecular classifications of breast cancer subtypes in the TCGA/TCIA data set. NPJ Breast Cancer. 2016;2:16012. doi: 10.1038/npjbcancer.2016.12. Epub 2016 May 11.
- Li H, Zhu Y, Burnside ES, Drukker K, Hoadley KA, Fan C, Conzen SD, Whitman GJ, Sutton EJ, Net JM, Ganott M, Huang E, Morris EA, Perou CM, Ji Y, Giger ML. MR Imaging Radiomics Signatures for Predicting the Risk of Breast Cancer Recurrence as Given by Research Versions of MammaPrint, Oncotype DX, and PAM50 Gene Assays. Radiology. 2016 Nov;281(2):382-391. doi: 10.1148/radiol.2016152110. Epub 2016 May 5.
- Guo W, Li H, Zhu Y, Lan L, Yang S, Drukker K, Morris E, Burnside E, Whitman G, Giger ML, Ji Y; Tcga Breast Phenotype Research Group. Prediction of clinical phenotypes in invasive breast carcinomas from the integration of radiomics and genomics data. J Med Imaging (Bellingham). 2015 Oct;2(4):041007. doi: 10.1117/1.JMI.2.4.041007. Epub 2015 Sep 23.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2020-03-005A
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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