Liver Function Investigation With SPECT

NCT ID: NCT02967848

Last Updated: 2023-11-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-10-19

Study Completion Date

2024-12-31

Brief Summary

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This is a Phase 1 pilot study to assess feasibility and utility of 99mTc-mebrofenin hepatobiliary scintigraphy for measurement of functional liver change due to radiotherapy.

Detailed Description

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Patients with cancers of the liver who are not suitable for surgery or chemo/radio embolisation are often treated with stereotactic ablative body radiotherapy (SABR). SABR results in high local control rates but, similar to other treatment modalities, carries risk of damage to healthy surrounding liver. This study aims to use a novel nuclear medicine imaging tracer, 99mTcMebrofenin, to evaluate liver function before and after radiotherapy.

Patients will have a 99mTcMebrofenin scan performed \< 2 weeks before radiotherapy and 1 and 6 months after radiotherapy. At the same time points, indocyanine green (ICG) and liver elasticity tests will be performed. These are global measures of liver function, whereas 99mTcMebrofenin is both global and local. From the imaging data, the Investigators will be able to correlate change in local liver function in each sub volume of the liver with the radiotherapy dose it received. The Investigators will be able to thus measure the effect of radiotherapy on global and local liver function.

Conditions

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Liver Cancer, Adult

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with Cancers in Liver

Adult patients with primary liver cancer or liver metastases from any other histology who will be measured before and after Radiotherapy by '99mTc-mebrofenin hepatobiliary scintigraphy (HBS), Indocyanine Green and Liver Elasticity.

99mTc-mebrofenin hepatobiliary scintigraphy (HBS)

Intervention Type OTHER

99mTc-mebrofenin HBS is a SPECT imaging procedure that allows evaluation of global and local liver function. Mebrofenin, bound to albumin, is taken up by hepatocytes in a similar manner to organic anions such as bilirubin. After hepatic uptake, the mebrofenin is excreted into the bile canaliculi. Dynamic imaging tools allow measurement of clearance rates for global function, and 3D SPECT imaging with corresponding CT allows visualisation of the local liver function with respect to anatomy. HBS allows direct visualisation of hepatocyte function.

Indocyanine Green

Intervention Type OTHER

ICG is a fluorescent dye injected into the patient. The dye is exclusively excreted by the liver. The ICG clearance rate is measured in the finger of the subject.

Liver Elasticity

Intervention Type OTHER

This is an Ultrasound measurement of the elasticity of the liver.

Interventions

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99mTc-mebrofenin hepatobiliary scintigraphy (HBS)

99mTc-mebrofenin HBS is a SPECT imaging procedure that allows evaluation of global and local liver function. Mebrofenin, bound to albumin, is taken up by hepatocytes in a similar manner to organic anions such as bilirubin. After hepatic uptake, the mebrofenin is excreted into the bile canaliculi. Dynamic imaging tools allow measurement of clearance rates for global function, and 3D SPECT imaging with corresponding CT allows visualisation of the local liver function with respect to anatomy. HBS allows direct visualisation of hepatocyte function.

Intervention Type OTHER

Indocyanine Green

ICG is a fluorescent dye injected into the patient. The dye is exclusively excreted by the liver. The ICG clearance rate is measured in the finger of the subject.

Intervention Type OTHER

Liver Elasticity

This is an Ultrasound measurement of the elasticity of the liver.

Intervention Type OTHER

Other Intervention Names

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ICG Liver FibroScan

Eligibility Criteria

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Inclusion Criteria

* Aged 18 or older
* Has provided written Informed Consent for participation in this trial and is willing to comply with the study
* Patients undergoing external beam radiotherapy at Northern Sydney Cancer Centre
* Histologically proven hepatocellular carcinoma or oligometastatic liver metastases (3 or less). Histological diagnosis will be obtained if clinically indicated.
* ECOG performance status 0-2

Exclusion Criteria

* Previous high-dose radiotherapy to the liver
* Previous SIRT
* Women who are pregnant or lactating
* Unwilling or unable to give informed consent
* No venous access
* Inability to lie supine and still for 30 minutes
* History of allergic reactions attributed to compounds of similar chemical or biologic composition to indocyanine green, including those patients with a history of iodide or seafood allergy (excluded from ICG testing only)
* Pacemaker (excluded from Fibroscan elasticity test only)
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Royal North Shore Hospital

OTHER

Sponsor Role lead

Responsible Party

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Professor Andrew Kneebone

Associate Professor Andrew Kneebone

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Royal North Shore Hospital

St Leonards, New South Wales, Australia

Site Status

Countries

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Australia

Other Identifiers

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RESP/16/129

Identifier Type: -

Identifier Source: org_study_id

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