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Peritoneal CarcinomatosisDWI-HighRiskNCT05623787

Diagnostic Value of Diffusion-weighted Magnetic Resonance in High-risk Colorectal and Appendiceal Neoplasms

A study testing Whole-body diffusion-weighted magnetic resonance imaging in people with Peritoneal Carcinomatosis and Peritoneal Metastases, run by Laval University at 2 sites in Canada.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Diffusion-weighted magnetic resonance imaging (DWI/MRI) has been described in recent literature as a highly sensitive and specific modality for the detection of peritoneal metastases PM. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Whole-body diffusion-weighted magnetic resonance imaging
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
2 sitesCanada
Study dates
1 Sep 2022to Sep 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • Confirmed diagnosis of colorectal cancer or high-risk appendiceal neoplasm (High grade Appendiceal Mucinous Neoplasm (HAMN), goblet-cell carcinoma or adenocarcinoma).
  • No evidence of residual peritoneal disease based on referring surgeon operating report and preoperative imaging.
  • At least one high-risk feature for peritoneal recurrence, including:
  • Synchronous peritoneal metastases resected at index surgery;
  • Synchronous ovarian metastases resected at index surgery;
  • Perforated primary tumor.
  • No evidence of distant metastases.
  • Patient fit for cytoreductive surgery, if required (ECOG 0 or 1).

Who cannot join

  • Unresected synchronous peritoneal metastases at referral.
  • Low grade Appendiceal Mucinous Neoplasm (LAMN).
  • No high-risk feature for peritoneal recurrence.
  • Evidence of distant metastases on preoperative imaging.
  • Patient who is unable to have MRI.
  • Patient unfit for cytoreductive surgery, if required (ECOG 2 or more).

Trial locations and contacts

2 sites in 1 country.

Canada2 sites
  • CIUSSS de l'Est-de-l'Île-de-Montréal

    Montreal, Quebec, H1T 2M4

  • CHU de Québec

    Québec, Quebec, G1R 2J6

Other trials in Canada

About this study

Official title: Diagnostic Value of Diffusion-weighted Magnetic Resonance Imaging for Detection of Peritoneal Recurrence in Patients With High-risk Colorectal and Appendiceal Neoplasms : a Pilot Study

Diffusion-weighted magnetic resonance imaging (DWI/MRI) has been described in recent literature as a highly sensitive and specific modality for the detection of peritoneal metastases PM. It has been demonstrated to be superior to CT for patients with known peritoneal disease from colorectal and gynaecological malignancies as a staging tool for cytoreductive surgery. It was also demonstrated to be superior for the detection of PM for gastric cancer patients otherwise considered with a resectable tumor. However, the literature is scarce on the role of DWI/MRI in the detection of peritoneal recurrence for patients with high-risk features, either colorectal cancer (CRC) or appendiceal neoplasms (AN).

The aim of this study is to prospectively assess the added value of whole-body DWI/MRI (WB-DWI/MRI) to CT and diagnostic laparoscopy for detection of PM in the follow-up of patients presenting with CRC or AN and high-risk features for peritoneal recurrence and evaluate how it correlates with intraoperative findings.

Read the detailed description

This is a multicentric, prospective study (CHU de Québec and Hôpital Maisonneuve-Rosemont). Patients will be referred to one of six surgeons with a subspeciality in peritoneal surface oncology after their index surgery for CRC or AN. After thorough assessment, patients judged without residual peritoneal disease, but at high-risk for peritoneal recurrence, will be prospectively included in the study. Patients will be assessed with CT and WB-DWI/MRI twelve months after their index surgery. For WB-DWI/MRI, the standard protocol will include the following sequences: Patients will drink 1L of pineapple juice one hour prior to the examination in order to provide a negative intraluminal contrast. They will receive 20 mg of intravenous hyoscine butylbromide at the beginning of the MR exam in order to reduce bowel peristalsis. Sequences will include Axial et Coronal T2WI of the abdomen and pelvis, axial DWI with b values of 0, 50 and 1000 of the abdomen and pelvis, as well as Pre and post gadolinium-based contrast Axial and Coronal 3D T1WGRE. All patients included in the study will then undergo diagnostic laparoscopy, to provide correlation with imaging findings. Patients with no evidence of peritoneal recurrence on CT, WB-DWI/MRI and diagnostic laparoscopy will continue to be followed with serial CT and blood tumor markers (CEA, CA 19-9) as done on a routine basis. Patients with confirmed peritoneal disease at diagnostic laparoscopy will be further evaluated for cytoreductive surgery, with or without hyperthermic intraperitoneal chemotherapy. The study duration will be two years for all participants.

Being tested
Whole-body diffusion-weighted magnetic resonance imaging
Keywords
DWI, CRC, Carcinomatosis, Diagnostic laparoscopy
Medical subject headings
Peritoneal Neoplasms, Appendiceal Neoplasms, Colorectal Neoplasms, Carcinoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Whole-body diffusion-weighted magnetic resonance imagingDiagnostic test

    See arm description.

Study groups in NCT05623787
Study groupRoleWhat they receive
DWI-High RiskExperimentalPatients to undergo DWI-MRI (patients included in the study).
Receives: Diagnostic Test: Whole-body diffusion-weighted magnetic resonance imaging

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Peritoneal findings

    The number of cases in which peritoneal findings on MRI matched with surgical exploration.

    Measured: 24 months

  2. Early peritoneal recurrence

    The number of cases with early peritoneal recurrence after MRI.

    Measured: 36 months

Secondary outcomes (1)
  1. Early distant recurrence

    The number of cases with early distant recurrence.

    Measured: 36 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Nov 2022
  2. Study start1 Sep 2022
  3. Primary completion30 Sep 2024
  4. Study completionSep 2025 (estimated)

Resources

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
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05623787
Sponsor's protocol ID
MP-20-2022-6366
Acronym
DWI-HighRisk
Status last verified
Mar 2025
First submitted
10 Nov 2022
Last updated
20 Mar 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017 Apr;66(4):683-691. doi: 10.1136/gutjnl-2015-310912. Epub 2016 Jan 27.

    PubMed 26818619
  • Massalou D, Benizri E, Chevallier A, Duranton-Tanneur V, Pedeutour F, Benchimol D, Bereder JM. Peritoneal carcinomatosis of colorectal cancer: novel clinical and molecular outcomes. Am J Surg. 2017 Feb;213(2):377-387. doi: 10.1016/j.amjsurg.2016.03.008. Epub 2016 Aug 5.

    PubMed 27816197
  • Sugarbaker PH. Colorectal cancer: prevention and management of metastatic disease. Biomed Res Int. 2014;2014:782890. doi: 10.1155/2014/782890. Epub 2014 Mar 24.

    PubMed 24783222
  • Goere D, Glehen O, Quenet F, Guilloit JM, Bereder JM, Lorimier G, Thibaudeau E, Ghouti L, Pinto A, Tuech JJ, Kianmanesh R, Carretier M, Marchal F, Arvieux C, Brigand C, Meeus P, Rat P, Durand-Fontanier S, Mariani P, Lakkis Z, Loi V, Pirro N, Sabbagh C, Texier M, Elias D; BIG-RENAPE group. Second-look surgery plus hyperthermic intraperitoneal chemotherapy versus surveillance in patients at high risk of developing colorectal peritoneal metastases (PROPHYLOCHIP-PRODIGE 15): a randomised, phase 3 study. Lancet Oncol. 2020 Sep;21(9):1147-1154. doi: 10.1016/S1470-2045(20)30322-3. Epub 2020 Jul 24.

    PubMed 32717180
  • Klaver CEL, Wisselink DD, Punt CJA, Snaebjornsson P, Crezee J, Aalbers AGJ, Brandt A, Bremers AJA, Burger JWA, Fabry HFJ, Ferenschild F, Festen S, van Grevenstein WMU, Hemmer PHJ, de Hingh IHJT, Kok NFM, Musters GD, Schoonderwoerd L, Tuynman JB, van de Ven AWH, van Westreenen HL, Wiezer MJ, Zimmerman DDE, van Zweeden AA, Dijkgraaf MGW, Tanis PJ; COLOPEC collaborators group. Adjuvant hyperthermic intraperitoneal chemotherapy in patients with locally advanced colon cancer (COLOPEC): a multicentre, open-label, randomised trial. Lancet Gastroenterol Hepatol. 2019 Oct;4(10):761-770. doi: 10.1016/S2468-1253(19)30239-0. Epub 2019 Jul 29.

    PubMed 31371228
  • Honore C, Goere D, Souadka A, Dumont F, Elias D. Definition of patients presenting a high risk of developing peritoneal carcinomatosis after curative surgery for colorectal cancer: a systematic review. Ann Surg Oncol. 2013 Jan;20(1):183-92. doi: 10.1245/s10434-012-2473-5. Epub 2012 Oct 23.

    PubMed 23090572
  • Soucisse ML, Lansom J, Alshahrani MS, Morris DL. Mucinous appendiceal neoplasms with or without pseudomyxoma peritonei: a review. ANZ J Surg. 2020 Oct;90(10):1888-1894. doi: 10.1111/ans.16185. Epub 2020 Aug 5.

    PubMed 32761790
  • Chicago Consensus Working Group. The Chicago Consensus on Peritoneal Surface Malignancies: Management of Appendiceal Neoplasms. Ann Surg Oncol. 2020 Jun;27(6):1753-1760. doi: 10.1245/s10434-020-08316-w. Epub 2020 Apr 13.

    PubMed 32285275
  • Chua TC, Moran BJ, Sugarbaker PH, Levine EA, Glehen O, Gilly FN, Baratti D, Deraco M, Elias D, Sardi A, Liauw W, Yan TD, Barrios P, Gomez Portilla A, de Hingh IH, Ceelen WP, Pelz JO, Piso P, Gonzalez-Moreno S, Van Der Speeten K, Morris DL. Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. J Clin Oncol. 2012 Jul 10;30(20):2449-56. doi: 10.1200/JCO.2011.39.7166. Epub 2012 May 21.

    PubMed 22614976
  • Tiselius C, Kindler C, Shetye J, Letocha H, Smedh K. Computed Tomography Follow-Up Assessment of Patients with Low-Grade Appendiceal Mucinous Neoplasms: Evaluation of Risk for Pseudomyxoma Peritonei. Ann Surg Oncol. 2017 Jul;24(7):1778-1782. doi: 10.1245/s10434-016-5623-3. Epub 2017 May 4.

    PubMed 28474197
  • Hegg KS, Mack LA, Bouchard-Fortier A, Temple WJ, Gui X. Macroscopic and microscopic characteristics of low grade appendiceal mucinous neoplasms (LAMN) on appendectomy specimens and correlations with pseudomyxoma peritonei development risk. Ann Diagn Pathol. 2020 Oct;48:151606. doi: 10.1016/j.anndiagpath.2020.151606. Epub 2020 Aug 21.

    PubMed 32889392
  • Reiter S, Rog CJ, Alassas M, Ong E. Progression to pseudomyxoma peritonei in patients with low grade appendiceal mucinous neoplasms discovered at time of appendectomy. Am J Surg. 2022 Jun;223(6):1183-1186. doi: 10.1016/j.amjsurg.2021.12.003. Epub 2021 Dec 3.

    PubMed 34879923
  • Orr CE, Yantiss RK. Controversies in appendiceal pathology: mucinous and goblet cell neoplasms. Pathology. 2022 Mar;54(2):167-176. doi: 10.1016/j.pathol.2021.09.003. Epub 2021 Nov 23.

    PubMed 34836648
  • Elekonawo FMK, Starremans B, Laurens ST, Bremers AJA, de Wilt JHW, Heijmen L, de Geus-Oei LF. Can [18F]F-FDG PET/CT be used to assess the pre-operative extent of peritoneal carcinomatosis in patients with colorectal cancer? Abdom Radiol (NY). 2020 Feb;45(2):301-306. doi: 10.1007/s00261-019-02268-w.

    PubMed 31642963
  • Esquivel J, Chua TC, Stojadinovic A, Melero JT, Levine EA, Gutman M, Howard R, Piso P, Nissan A, Gomez-Portilla A, Gonzalez-Bayon L, Gonzalez-Moreno S, Shen P, Stewart JH, Sugarbaker PH, Barone RM, Hoefer R, Morris DL, Sardi A, Sticca RP. Accuracy and clinical relevance of computed tomography scan interpretation of peritoneal cancer index in colorectal cancer peritoneal carcinomatosis: a multi-institutional study. J Surg Oncol. 2010 Nov 1;102(6):565-70. doi: 10.1002/jso.21601.

    PubMed 20976729

Questions about this trial

What is this clinical trial studying?

A study testing Whole-body diffusion-weighted magnetic resonance imaging in people with Peritoneal Carcinomatosis and Peritoneal Metastases, run by Laval University at 2 sites in Canada.

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 8 inclusion and 6 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: under way, not looking for participants, as of the sponsor's last update on 20 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Canada. 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?

This study is still under way. Results are not available in the source record yet.

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?

Peritoneal findings (time frame: 24 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05623787, which also lists 25 linked publications.

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 20 Mar 2025.

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