Initial Assessment of 18FDG-PET/MRIin Determining the Extent of Systemic Disease in Breast Cancer Patients
Initial Assessment of 18FDG-PET/MRI in Determining the Extent of Systemic Disease in Breast Cancer Patients.
調査の概要
詳細な説明
This study is an initial assessment of the ability of 18FDG-PET/MR imaging to detect systemic disease in breast cancer patients as compared with conventional 18FDG-PET/CT.
Rationale: Accurate assessment of the extent systemic disease in breast cancer patients both initially and throughout treatment and surveillance comprises the basis for clinical care including surgical planning, radiation and drug selection. Shortcomings in FDG-PET/CT, a common current method of disease detection and surveillance, include decreased sensitivity in brain, liver and bone and a relatively high radiation dose, which could cause up to 5 new cancers per 1,000 patients (young American women) per scan. Initial studies assessing whole body MRI, a technique which involves no radiation, in the staging of breast cancer patients show promise, but can suffer from decreased ability to detect nodal disease and from detection of false positive lesions. Manual fusion of PET and MRI data in bowel and breast organ systems has been shown to decrease false positive lesions as compared with MRI alone. In the past year, molecular MRI imaging machines which combine PET and MRI imaging have become available for research purposes.
Hypothesis 1: We therefore hypothesize that FDG-PET/MRI will provide concordant or improved lesion detection as compared with FDG-PET/CT in breast cancer patients at a decreased radiation dose.
Hypothesis 2: In addition, the simultaneously acquired PET and MRI data allows for analysis of local tumor characteristics including perfusion, cellularity and glucose metabolism. In the subgroup of patients with an index breast cancer, we hypothesize that these local tumor metrics correlate with number and sites of systemic lesions.
Methods: All newly diagnosed breast cancer patients who are undergoing imaging evaluation for initial extent of disease or disease surveillance at NYU Cancer Center and Bellevue hospital are candidates for study in this protocol. Patients will be invited for follow-up FDG-PET/MRI imaging at any time they are undergoing FDG-PET/CT as part of their clinical care.
Subjects are undergoing FDG-PET/CT at the Cancer Center on 34th St and Lexington Avenue as part of routine care and will be transferred directly to the 38th St. facility by car in a timely manner so that an additional dose of 18-FDG labeled glucose will be unnecessary for the experimental FDG-PET/MRI.
FDG-PET/MRI will be performed and is estimated to 45-60 minutes of scanning time. The patient will then be free to leave the department. Data will be transferred to a workstation and interpreted by two independent radiologists. Size and location of each lesion will be recorded in a confidentiality protected spreadsheet for each component of the scan and the lesion load will be defined by the union of all detected lesions from all three components (DCE-MRI, diffusion-weighted imaging (DWI), FDG-PET). Data will be compared on a per lesion, per organ system and per patient basis with the patient's routine FDG-PET/CT for presence of metastatic disease and size and number of metastatic lesions.
In the case where PET/MRI demonstrates metastatic disease not seen on routine modalities, the referring physician will be alerted. Additional dedicated radiologic studies and biopsy may be recommended and performed at the discretion of the referring physician.
Results: Results of FDG-PET/MRI and FDG-PET/CT findings will be reported in a descriptive format together with related biopsy results and histopathologic correlation. An exact 95% confidence interval will be derived for the true percentage of times the assessment of disease state lesion, per organ system and per patient from FDG-PET/MRI will be concordant with the assessments derived for the same patient using the FDG-PET/CT. In patients with an index breast cancer, Pearson and Spearman rank correlations will be used to characterize the association between local tumor metrics and metastatic burden and location.
Potential benefits: 1. Equal or improved ability to detect metastatic disease in breast cancer patients at a decreased radiation dose. 2. An improved understanding of index tumor metrics help stratify risk for metastatic disease based on the index tumor and enable individually tailored surveillance.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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New York
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New York、New York、アメリカ、10016
- NYU School of Medicine
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
Any patient with a history or breast cancer undergoing PET/CT either for initial staging or for disease surveillance
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Exclusion Criteria:
- Pregnant patients and patients with known contraindications for whole body MR imaging (e.g., pacemakers, recent surgery, brain vascular clips, etc.) will be excluded from the study. Patients will be screened with a questionnaire to be sure they have no medical devices that could make the procedure unsafe. Patients with glomerular filtration rate (GFR) < 15 ml/min/1.73m2 or who are on dialysis will be excluded from the study.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:診断
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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他の:PET/MRI
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PET/MRI
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
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Number of metastatic lesions seen on PET/MRI as compared with PET/CT
時間枠:1 year
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1 year
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二次結果の測定
結果測定 |
時間枠 |
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Patient stage as imaged by PET/MRI as compared with PET/CT
時間枠:1 year
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1 year
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協力者と研究者
スポンサー
捜査官
- 主任研究者:Laura Heacock, MD、NYU School of Medicine
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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