Lung CancerNCT00598065
The Use of Breathing Synchronized PET/CT Imaging In the Detection and Quantification of FDG Uptake in Lung Nodules
A study testing PET/CT in people with Lung Cancer, run by Memorial Sloan Kettering Cancer Center at 1 site in United States.
Trial summary
The purpose of this study is to see if researchers can improve the detection of lung cancer by using a new method which will help us to take multiple snapshot images of the lungs while the patient is breathing. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Lung Cancer
- What is being tested?
- PET/CT
- How many people
- 26 participants
- Where
- 1 siteUnited States
- Study dates
- Mar 2004to Dec 2009
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years old
- Patients must have at least one lung lesion or lung cancer on prior chest Xray or chest CT.
- Sign informed consent. Eligible patients should give their consent at the beginning of the clinical PET scan. Following clinical CT and PET scans, breathhold CT should follow. Then, these breath-hold CT images will be reviewed by one of the investigating physicians to determine if the patient qualifies for the study. If there is a small lesion (< 5 mm) gated PET images will be acquired.
Who cannot join
- Pregnant women are ineligible.
- Patients who are unable to follow breathing instructions either due to language difficulties or hearing impairment This will be determined by one of the consenting individuals when they approach the patient to ask for informed consent.
- Patients who are too ill to hold their breath.
Trial locations and contacts
1 site in 1 country.
United States1 site
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
About this study
The purpose of this study is to see if researchers can improve the detection of lung cancer by using a new method which will help us to take multiple snapshot images of the lungs while the patient is breathing. We are also investigating whether with the help of this new method we can better measure the actual amount of radioactivity that is taken up by the cancer. The name of this new method is respiratory gated PET/CT. Previous research has shown that PET scans may be useful in investigating whether cancer has spread to other parts of the lung or body. Using our standard method, smaller cancers are sometimes difficult to detect in the lungs because the PET images are taken over several minutes and the patient is breathing during that time. That means the cancer may appear "blurred" on the images (like a poor photograph) or may not be identified at all. In this study, in addition to the images that were ordered by your doctor, we will take additional images of your lungs while you are following a breathing command ("breath in-hold-breath out"). We will then compare the images of your cancer during the regular PET study with those taken during the breathing commands.
The hypotheses to be tested in this pilot study are:
- Respiratory gated image acquisition reduces partial volume effects on PET image that may render lung lesions undetectable.
- Breath-hold CT may detect small lung lesions that are beyond the limit of detection in shallow-breathing CT scans, related to respiratory motion which causes blurring artifacts around smaller lung lesions.
Read the detailed description
Positron emission tomography is now a clinically accepted imaging modality for the evaluation of pulmonary nodules as well as for the staging of patients with lung cancer. PET imaging with the radiotracer 18 Fluoro-deoxy-glucose (FDG) has a high accuracy for the differentiation between benign and malignant lung lesions and for the detection of nodal metastases. This is because malignant tumors are characterized by an increase in glucose metabolism as compared to most normal tissues. In clinical practice, PET images are interpreted visually or semiquantitatively, using a standardized uptake value (SUV). Previous studies have shown that SUV thresholds can be used with high accuracy to distinguish between benign and malignant lesions that exhibit increased uptake of FDG. In addition, the SUV is frequently used as a surrogate marker for the evaluation of a response to chemo- or radiation therapy. Unfortunately, the accuracy of SUV measurements may be affected by lesion motion during the image acquisition. This is a particular problem in PET imaging of the lung. Normal respiratory motion, and hence lesion motion, causes a smearing effect, whereby the concentration of radiotracer within a given lesion is spread out over a larger area. For the same reason small lesions and lesions with relatively low uptake of radiotracer may become undetectable during normal breathing (partial volume effect). PET images are acquired for several minutes, image acquisition during breath hold is therefore not an option for clinical scans. However recently published work from UCLA (Auerbach et al. J Nucl Med., February 2006) shows that 3 lesions per patient on average can be missed on shallow breathing scans compared to breath-hold CT scans. These lesions did not show any FDG uptake on clinical PET scans. The goal of this pilot study is to evaluate whether respiratory gating during PET image acquisition enables the detection of those lesions which are identified during the breath-hold CT scan.
- Conditions
- Lung Cancer
- Being tested
- PET/CT
- Keywords
- lung
- Medical subject headings
- Lung Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PET/CTOther
Synchronized PET/CT Imaging
What is being measured
The primary outcome is the main question the study is designed to answer.
Pts w/suspected lung lesions will undergo more breath-hold CT scan & if visible lesion(s), gated-PET will be acquired plus clinical PET/CT. Scans will be used to compare how often additional lung lesions can be identified on breath-hold CT, if lesions
Measured: 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jan 2008 (estimated)
- Study startMar 2004
- Primary completionDec 2009
- Study completionDec 2009
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Lung CancerStudies of the same condition, open and under way.
- More trials run by Memorial Sloan Kettering Cancer CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 26 participants (actual)
Sponsor and investigators
- Lead sponsor
- Memorial Sloan Kettering Cancer Center
- Sponsor type
- University, hospital or other
- Investigators
- Heiko Schoder, MD, Principal investigator, Memorial Sloan Kettering Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00598065
- Sponsor's protocol ID
- 04-025
- Status last verified
- Dec 2009
- First submitted
- 9 Jan 2008
- Last updated
- 3 Dec 2009
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 3 Dec 2009. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Use of Breathing Synchronized PET/CT Imaging In the Detection and Quantification of FDG Uptake in Lung Nodules
- ClinicalTrials.gov ID
- NCT00598065
- Acronym / sponsor ID
- 04-025
- Conditions
- Lung Cancer
- Keywords
- lung
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 26 participants (actual)
- Lead sponsor
- Memorial Sloan Kettering Cancer CenterUniversity, hospital or other
- Study start
- Mar 2004
- Primary completion
- Dec 2009 (actual)
- Study completion
- Dec 2009 (actual)
- First posted
- 18 Jan 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to see if researchers can improve the detection of lung cancer by using a new method which will help us to take multiple snapshot images of the lungs while the patient is breathing. We are also investigating whether with the help of this new method we can better measure the actual amount of radioactivity that is taken up by the cancer. The name of this new method is respiratory gated PET/CT. Previous research has shown that PET scans may be useful in investigating whether cancer has spread to other parts of the lung or body. Using our standard method, smaller cancers are sometimes difficult to detect in the lungs because the PET images are taken over several minutes and the patient is breathing during that time. That means the cancer may appear "blurred" on the images (like a poor photograph) or may not be identified at all. In this study, in addition to the images that were ordered by your doctor, we will take additional images of your lungs while you are following a breathing command ("breath in-hold-breath out"). We will then compare the images of your cancer during the regular PET study with those taken during the breathing commands.
The hypotheses to be tested in this pilot study are:
- Respiratory gated image acquisition reduces partial volume effects on PET image that may render lung lesions undetectable.
- Breath-hold CT may detect small lung lesions that are beyond the limit of detection in shallow-breathing CT scans, related to respiratory motion which causes blurring artifacts around smaller lung lesions.
Detailed description
Positron emission tomography is now a clinically accepted imaging modality for the evaluation of pulmonary nodules as well as for the staging of patients with lung cancer. PET imaging with the radiotracer 18 Fluoro-deoxy-glucose (FDG) has a high accuracy for the differentiation between benign and malignant lung lesions and for the detection of nodal metastases. This is because malignant tumors are characterized by an increase in glucose metabolism as compared to most normal tissues. In clinical practice, PET images are interpreted visually or semiquantitatively, using a standardized uptake value (SUV). Previous studies have shown that SUV thresholds can be used with high accuracy to distinguish between benign and malignant lesions that exhibit increased uptake of FDG. In addition, the SUV is frequently used as a surrogate marker for the evaluation of a response to chemo- or radiation therapy. Unfortunately, the accuracy of SUV measurements may be affected by lesion motion during the image acquisition. This is a particular problem in PET imaging of the lung. Normal respiratory motion, and hence lesion motion, causes a smearing effect, whereby the concentration of radiotracer within a given lesion is spread out over a larger area. For the same reason small lesions and lesions with relatively low uptake of radiotracer may become undetectable during normal breathing (partial volume effect). PET images are acquired for several minutes, image acquisition during breath hold is therefore not an option for clinical scans. However recently published work from UCLA (Auerbach et al. J Nucl Med., February 2006) shows that 3 lesions per patient on average can be missed on shallow breathing scans compared to breath-hold CT scans. These lesions did not show any FDG uptake on clinical PET scans. The goal of this pilot study is to evaluate whether respiratory gating during PET image acquisition enables the detection of those lesions which are identified during the breath-hold CT scan.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Age ≥ 18 years old
- Patients must have at least one lung lesion or lung cancer on prior chest Xray or chest CT.
- Sign informed consent. Eligible patients should give their consent at the beginning of the clinical PET scan. Following clinical CT and PET scans, breathhold CT should follow. Then, these breath-hold CT images will be reviewed by one of the investigating physicians to determine if the patient qualifies for the study. If there is a small lesion (< 5 mm) gated PET images will be acquired.
Key exclusion criteria (3 listed)
- Pregnant women are ineligible.
- Patients who are unable to follow breathing instructions either due to language difficulties or hearing impairment This will be determined by one of the consenting individuals when they approach the patient to ask for informed consent.
- Patients who are too ill to hold their breath.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PET/CTSynchronized PET/CT Imaging | Other | – |
Primary outcome
Pts w/suspected lung lesions will undergo more breath-hold CT scan & if visible lesion(s), gated-PET will be acquired plus clinical PET/CT. Scans will be used to compare how often additional lung lesions can be identified on breath-hold CT, if lesions
Time frame: 5 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Dec 2009.
- Memorial Sloan-Kettering Cancer CenterLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Heiko Schoder, MD principal investigator
Memorial Sloan Kettering Cancer Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing PET/CT in people with Lung Cancer, run by Memorial Sloan Kettering Cancer Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Dec 2009. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pts w/suspected lung lesions will undergo more breath-hold CT scan & if visible lesion(s), gated-PET will be acquired plus clinical PET/CT. Scans will be used to compare how often additional lung lesions can be identified on breath-hold CT, if lesions (time frame: 5 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Dec 2009.