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FES PET/MRI for Occult Disease in Lobular Breast Cancer

30 oktober 2026 bijgewerkt door: University of Wisconsin, Madison

A Diagnostic Accuracy Study of FES PET/MRI for the Detection of Occult Disease in Lobular Breast Cancer

The investigators hope to learn if lobular breast cancer can be identified using a special procedure called a positron emission tomography (PET) magnetic resonance image (MRI) scan, collectively a PET/MRI scan, that uses a radioactive imaging agent called Fluorine 18 fluoroestradiol (18F-FES). This procedure may be able to define the extent of disease more clearly than the standard of care breast imaging exams. 30 participants will be enrolled and be on study for up to 6 months.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

This prospective study aims to estimate the added value of supplemental 18F-FES PET/MRI following standard-of-care (SOC) preoperative assessments for detecting occult disease in ILC. The investigators hypothesize that there is increased sensitivity of 18F-FES PET/MRI for detecting additional locoregional and distant site(s) of disease that is occult on SOC imaging.

Primary Objective: To estimate the increased sensitivity of 18F-FES PET/MRI for detecting disease that is occult on SOC imaging

Secondary Objectives: To characterize the

  • Positive predictive value of additional pathology-confirm disease.
  • Proportion of upstaging (composite T, N and M stages)
  • Frequency of extensive breast disease (e.g., multifocal, multicentric or contralateral).
  • Change in clinical management (e.g., changes in treatment intent, conversion to neoadjuvant therapy).
  • Agreement of ILC tumor size between imaging exams (18F FES PET-MRI and SOC breast MRI, ultrasound and mammogram) and histopathologic exams.
  • Error rate in size measurements between radiology and pathology for primary ILC.
  • Change in surgical management (e.g., conversion to mastectomy).

Exploratory objectives: 1) To correlate 18F-FES standardized uptake value of SUVmax with immunohistochemical quantification of ER expression and ILC cellularity. 2) To define an 18F-FES SUVmax threshold for pathology-confirmed ER-positive ILC.

Studietype

Ingrijpend

Inschrijving (Geschat)

30

Fase

  • Fase 4

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

  • Verenigde Staten
    • Wisconsin
      • Madison, Wisconsin, Verenigde Staten, 53792
        • UW Carbone Cancer Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Vrouw

Beschrijving

Inclusion Criteria:

  • Adults assigned female sex at birth
  • Newly diagnosed ILC confirmed on core-needle biopsy (greater than or equal to 1 percent ER staining per American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines)
  • have undergone or will undergo standard-of-care (SOC) clinical and imaging assessments (e.g., mammography, ultrasound, breast MRI)
  • planning for mastectomy or breast-conserving surgery within 12 months of their initial diagnosis
  • Provision of signed and dated informed consent form

Exclusion Criteria:

  • Patients with history of ipsilateral axillary lymph node dissection

  • Patients who received anti-estrogen therapy such as selective estrogen receptor degrader (SERD, e.g., fulvestrant, elacestrant) in the last 28 weeks or selective estrogen receptor modulator (SERM, e.g., tamoxifen, raloxifene) in the last 8 weeks.

  • Pregnancy or breastfeeding

  • Patients with known allergic or hypersensitivity reactions to previously administered GBCAs or related drug.

  • Patients with a contraindication to MRI, or who cannot be positioned within the scanner because their body weight or diameter exceeds the scanner limits.

  • Patients requiring intravenous (IV) conscious sedation for imaging are not eligible; patients requiring mild, oral anxiolytics for the clinical MRI will be allowed to participate as long as the following criteria are met:

    1. The subject has their own prescription for the medication
    2. The informed consent process is conducted prior to the self-administration of this medication
    3. They come to the research visit with a driver

  • Concurrent participation in another clinical study that, in the judgment of the PI, would interfere with study procedures, endpoint assessment, interpretation of imaging findings, or participant safety.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Diagnostisch
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Participants with Lobular Breast Cancer

Participants will undergo FES PET/MRI imaging after SOC imaging, followed by SOC breast surgery / biopsy
Geneesmiddel: 18Fluoroestradiol (18F-FES)
  • Dose: Approximately 6 millicuries (mCi) (222 megabecquerels (MBq)) ± 20%
  • Administration: IV injection, contralateral to the primary tumor site
  • Physical Half-life: ~110 minutes
  • Mechanism: FES binds to estrogen receptors expressed on tumor cells, enabling visualization of ER-positive disease sites.
Andere namen:
  • Cerianna
  • Fluoroestradiol
  • 18F-FES
  • PET radiopharmaceutical
Apparaat: MRI

Participant undergoes PET/MRI scan to image ER-positive disease sites

Andere namen:
  • magnetische resonantie beeldvorming
  • PET/MRI
Geneesmiddel: Gadolinium-based contrast agent (GBCA)

Administered during the MRI portion of the examination

Andere namen:
  • GBCA

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Percent of Participants where Disease is Detected using 18F-FES-PET/MRI
Tijdsspanne: up to 6 months

The number of participants for which disease is detected using 18F-FES-PET/MRI compared to the number of samples identified with disease (histopathology) will be reported to estimate the sensitivity of 18F-FES-PET/MRI for detecting disease that is occult (hidden) on SOC imaging.
up to 6 months

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Participant Level Positive Predictive Value (PPV)
Tijdsspanne: up to 6 months

Defined by histopathology as the reference standard. This is the odds of 18F-FES-PET/MRI imaging predicting disease.
up to 6 months
Proportion of Participants Upstaged using a composite of the T, N, and M stages
Tijdsspanne: up to 6 months

A cancer is staged by describing the: the size of the Tumor, whether the cancer has spread to lymph Nodes, and whether the cancer has spread to other organs, or Metastasized (TNM staging). TNM upstaging is when a patient is discovered to have more advanced cancer than initially imaging.
up to 6 months
Proportion of patients who are diagnosed with pathology-proven multifocal, multicentric or contralateral disease
Tijdsspanne: up to 6 months

The proportion of patients who are diagnosed with pathology-proven multifocal, multicentric or contralateral disease will be measured to characterize the frequency of the detection of extensive breast involvement by 18F-FES-PET/MRI.
up to 6 months
Percent of participants where 18F-FES-PET/MRI changed clinical care compared to SOC image
Tijdsspanne: up to 6 months

The following will be reviewed: frequency of changes in treatment intent from curative to palliative after detecting occult metastatic disease; conversion to neoadjuvant therapy after detecting occult locally advanced disease; and changes in axillary surgery from sentinel lymph node biopsy to targeted axillary dissection or complete axillary lymph node dissection after detecting occult axillary metastases in order to characterize the clinical impact of 18F-FES-PET/MRI on treatment decision.
up to 6 months
Lesion-level agreement of the maximal tumor dimension
Tijdsspanne: up to 6 months

The lesion-level agreement of the maximal tumor dimension for the indexed ILC lesion, comparing imaging measurements with pathology measurements among patients who underwent definitive surgery will be reported to characterize the agreement of ILC tumor size between imaging exams (18F FES PET-MRI and SOC breast MRI, ultrasound and mammogram) and histopathologic exams.
up to 6 months
Lesion-level error rate in maximal tumor dimension
Tijdsspanne: up to 6 months

The lesion-level error rate in maximal tumor dimension using pre-specified relative threshold of less than or equal to 25 percent difference between imaging and pathology measurements will be reported to characterize the error rate in size measurements between radiology and pathology for primary ILC.
up to 6 months
Percent of participants where 18F-FES-PET/MRI changed surgical planning
Tijdsspanne: up to 6 months

The frequency of changed surgical planning (conversion from planned lumpectomy to mastectomy due to extensive breast involvement; margin re-excision in those undergoing lumpectomy; conversion to mastectomy in those initially managed with lumpectomy) will be reported to characterize the clinical impact of 18F-FES-PET/MRI on surgical planning.
up to 6 months

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

University of Wisconsin, Madison

Medewerkers

GE Healthcare

Onderzoekers

  • Hoofdonderzoeker: Wenhui Zhou, MD, PhD, UW School of Medicine and Public Health

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 november 2026

Primaire voltooiing (Geschat)

1 november 2028

Studie voltooiing (Geschat)

1 november 2028

Studieregistratiedata

Eerst ingediend

26 oktober 2026

Eerst ingediend dat voldeed aan de QC-criteria

26 oktober 2026

Eerst geplaatst (Werkelijk)

2 november 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

3 november 2026

Laatste update ingediend die voldeed aan QC-criteria

30 oktober 2026

Laatst geverifieerd

1 oktober 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 2026-1072
  • SMPH | Radiology (Andere identificatie: UW Madison)
  • Protocol Version 8/14/26 (Andere identificatie: UW Madison)
  • UW26018 (Andere identificatie: OnCore ID)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

JA

IPD delen Ondersteunend informatietype

  • LEERPROTOCOOL
  • SAP

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Ja

product vervaardigd in en geëxporteerd uit de V.S.

Ja

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