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Quantitative mpMRI to Predict Metastatic Potential of Prostate Cancer (QmpMRI)

18 juni 2022 uppdaterad av: Radboud University Medical Center
The primary aim of this study is to assess the potential of quantitative MRI measurements to predict localized prostate cancer T-stage and disease spread to nodes (N-stage) by correlating quantitative MRI measurements of the local prostate to the presence of metastases as seen on PSMA-PET/CT.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Patients diagnosed with prostate cancer will likely not die from the primary tumor, but from (extended) metastatic disease. One of the first steps towards extended metastatic disease is the presence of lymph node metastases, which is an important factor in determining therapy and prognosis. Although historically all patients with lymph node metastases are considered incurable, research has shown that patients with only a limited number of small (<8 mm) nodal metastases have a better prognosis as compared to patients with more extensive involvement. In patients with only a limited number of small nodal metastases (oligo-metastatic), therapy with curative intent might be pursued, e.g. by surgical resection or loco-regional radiotherapy. With continuously improving opportunities to very selectively treat small numbers of metastatic sites it is of utmost importance to accurately diagnose the first signs of oligo-metastatic disease and to define its extent.

It is hypothesized that magnetic resonance imaging (MRI) can obtain more information from the local prostate than what is now used in the clinic to stage localized prostate cancer and oligo-metastatic disease. In recent years positron emission tomography (PET) in combination with computerized tomography (CT) and Prostate Specific Membrane Antigen (PSMA) tracers (PSMA-PET/CT) has emerged as an imaging modality to visualize (early) metastatic disease, but its accuracy in detecting oligo-metastatic spread is unknown, as small nodal metastases can be missed. In this study, the correlation is assessed between functional, quantitative and metabolic local tumor characteristics with PSMA-PET/CT-proven nodal involvement, to be able to predict metastatic potential from quantitative MRI parameters of the localized tumor. If the study shows potential for predicting presence of metastatic disease, future patients will benefit from improved nodal staging, potentially leading to more accurate and personalized treatment of the correct disease stage.

Studietyp

Observationell

Inskrivning (Förväntat)

30

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

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Studieorter

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

50 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Manlig

Testmetod

Icke-sannolikhetsprov

Studera befolkning

Patients, diagnosed with prostate cancer by prostate biopsy and having a high risk of nodal metastases, will be recruited at the Radboudumc in Nijmegen. This research population will be a suitable reflection of the potential patient group who will eventually benefit from this new diagnostic mpMRI approach, in case the results match the hypothesis. Characteristics of this group will comprise all men with an expected age in the range of 50-75 years.

Patients will be informed about the ongoing study by their treating physician. Patients will receive the patient information folder and will be contacted by one of the researchers. Upon approval, informed consent paperwork will be handed.

Beskrivning

Inclusion Criteria:

  • Histologically proven primary cancer of the prostate, based on prostate biopsy-core analysis.
  • Patient is scheduled and fit for PSMA-PET/CT
  • Age≥50 years. Ability to give voluntary written informed consent to participate in this study.

Exclusion Criteria:

  • Contraindication for MRI-scanning, i.e. claustrophobia, intracranial metal clips, metallic bodies in the eye, implanted electric and electronic devices not eligible for MRI (pacemakers, insulin pumps, cochlear implants, neurostimulators).
  • Prior prostate cancer treatment.
  • Prior pelvic surgery, associated with pelvic lymphadenopathy
  • Presence of any medical condition that in the opinion of the investigator/treating physician will affect patients' clinical status by participating in this trial.
  • Inability to lie still for 45 minutes or comply with imaging.
  • The patient is already enrolled in one or more concurrent studies, which could confound the results of this study, according to the investigators.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Observationsmodeller: Endast fall
  • Tidsperspektiv: Blivande

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
optimal combination of quantitative MRI parameters that best correlates to the presence of (lymph node) metastases in prostate cancer as seen on PSMA-PET/CT.
Tidsram: within 14 days of PSMA-PET/CT scan, before any therapy
To find the optimal combination of quantitative parameters for discriminating between positive and negative PSMA-PET/CT, logistic regression modelling will be used. The performance of the model will be evaluated using receiver operating characteristic curve analysis.
within 14 days of PSMA-PET/CT scan, before any therapy

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
the performance of individual quantitative MRI parameters discriminating localized from (oligo-)metastatic disease
Tidsram: within 14 days of PSMA-PET/CT scan, before any therapy
To test the individual quantitative MRI parameters for a significant difference between localized and (oligo-)metastatic disease, non-parametric tests for independent groups (Mann-Whitney U test) will be used. The ability of each parameter to discriminate between positive and negative PSMA-PET/CT is assessed using receiver operating characteristic curve analysis, which allows comparison to the logistic regression model performance.
within 14 days of PSMA-PET/CT scan, before any therapy
MR parameters that correlate to the amount of metastases as found on PSMA-PET/CT
Tidsram: within 14 days of PSMA-PET/CT scan, before any therapy
Participants with a positive PET/CT scan result will be divided in groups according to the number of positive lymph nodes detected (if variance within participants allows). To test for significant differences between these groups for each of the quantitative parameters, the non-parametric tests for multiple independent groups (Kruskal Wallis) will be used.
within 14 days of PSMA-PET/CT scan, before any therapy
MR parameters that correlate to local prostate PSMA-PET intensity
Tidsram: within 14 days of PSMA-PET/CT scan, before any therapy
To test for a correlation between the quantitative parameters and the local prostate PSMA-PET intensity, a spearmans rho test for correlation between two continuous variables will be used.
within 14 days of PSMA-PET/CT scan, before any therapy

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Radboud University Medical Center

Utredare

  • Huvudutredare: Tom Scheenen, Radboud University Medical Center

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Förväntat)

1 juli 2022

Primärt slutförande (Förväntat)

1 december 2022

Avslutad studie (Förväntat)

1 mars 2023

Studieregistreringsdatum

Först inskickad

8 februari 2022

Först inskickad som uppfyllde QC-kriterierna

22 februari 2022

Första postat (Faktisk)

23 februari 2022

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

22 juni 2022

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

18 juni 2022

Senast verifierad

1 februari 2022

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • NL77789.091.21

Läkemedels- och apparatinformation, studiedokument

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