FES PET/MRI for Occult Disease in Lobular Breast Cancer
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.
研究概览
地位
条件
详细说明
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.
研究类型
注册 (估计的)
阶段
- 第四阶段
联系人和位置
学习联系方式
- 姓名:Cancer Connect
- 电话号码:800-622-8922
- 邮箱:clinicaltrials@cancer.wisc.edu
学习地点
-
-
Wisconsin
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Madison、Wisconsin、美国、53792
- UW Carbone Cancer Center
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-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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:
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Patients with history of ipsilateral axillary lymph node dissection
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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.
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Pregnancy or breastfeeding
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Patients with known allergic or hypersensitivity reactions to previously administered GBCAs or related drug.
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Patients with a contraindication to MRI, or who cannot be positioned within the scanner because their body weight or diameter exceeds the scanner limits.
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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:
- The subject has their own prescription for the medication
- The informed consent process is conducted prior to the self-administration of this medication
- They come to the research visit with a driver
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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.
学习计划
研究是如何设计的?
设计细节
- 主要用途:诊断
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的:Participants with Lobular Breast Cancer
Participants will undergo FES PET/MRI imaging after SOC imaging, followed by SOC breast surgery / biopsy |
其他名称:
Participant undergoes PET/MRI scan to image ER-positive disease sites
其他名称:
Administered during the MRI portion of the examination
其他名称:
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Percent of Participants where Disease is Detected using 18F-FES-PET/MRI
大体时间: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
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Participant Level Positive Predictive Value (PPV)
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
大体时间: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
|
合作者和调查者
合作者
调查人员
- 首席研究员:Wenhui Zhou, MD, PhD、UW School of Medicine and Public Health
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- 2026-1072
- SMPH | Radiology (其他标识符:UW Madison)
- Protocol Version 8/14/26 (其他标识符:UW Madison)
- UW26018 (其他标识符:OnCore ID)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 共享支持信息类型
- 研究方案
- 树液
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
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