Contrast-Enhanced Cone Beam Breast CT for Diagnostic Breast Imaging

NCT ID: NCT03354611

Last Updated: 2023-03-16

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

TERMINATED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

21 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-10

Study Completion Date

2021-09-01

Brief Summary

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Up to one hundred (100) female patients will be enrolled and consented to participate in the study. These women will be enrolled from screening assigned BIRADS 0, patient complaint, or referral for second opinion. The enrolled patient will accept CE-CBBCT scans within 4 weeks of her diagnostic mammography and before breast biopsy if biopsy is needed. The final diagnostic workup outcome of these enrolled patients needs to include at least 30 confirmed cancers cases.

Detailed Description

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Conditions

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Breast Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Subjects in this group will be enrolled from screening assigned BIRADS 0, patient complaint, or referral for second opinion. The enrolled patient will accept CE-CBBCT scans within 4 weeks of her diagnostic mammography and before breast biopsy if biopsy is needed.
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Diagnostic Workup

The subjects will first have a pre-contrast CBBCT scan. Iodinated contrast will be injected intravenously, and then another CBBCT scans will be performed to capture the tumor vasculature enhancement.

Group Type EXPERIMENTAL

Contrast Enhanced Cone Beam Breast CT Scan

Intervention Type RADIATION

* Pre-contrast scan
* Begin contrast injection (and saline chaser)
* Post-contrast Scan. Start time of post-contrast CE-CBBCT scan is 90-200 seconds after start of injection, depending on method of contrast delivery (bolus vs hand injection)

Contrast Dye, Iodinated

Intervention Type DRUG

1.5-2ml/kg body weight (100 ml maximum) of a low osmolar, nonionic, 300-350 mgI/ml iodinated contrast agent, will be injected at a rate of \~2.0 ml/s, for a total injection time of 30-60 seconds (for a 50 kg subject). This will be immediately followed by a saline "chaser" from 20 to 40 ml at \~2 ml/s (20 seconds) to maximize dynamic enhancement.

Interventions

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Contrast Enhanced Cone Beam Breast CT Scan

* Pre-contrast scan
* Begin contrast injection (and saline chaser)
* Post-contrast Scan. Start time of post-contrast CE-CBBCT scan is 90-200 seconds after start of injection, depending on method of contrast delivery (bolus vs hand injection)

Intervention Type RADIATION

Contrast Dye, Iodinated

1.5-2ml/kg body weight (100 ml maximum) of a low osmolar, nonionic, 300-350 mgI/ml iodinated contrast agent, will be injected at a rate of \~2.0 ml/s, for a total injection time of 30-60 seconds (for a 50 kg subject). This will be immediately followed by a saline "chaser" from 20 to 40 ml at \~2 ml/s (20 seconds) to maximize dynamic enhancement.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Female sex
* Age 35 years or older
* Any ethnicity
* Have an abnormality detected by Breast Self Exam (BSE), or Clinical Breast Exam (CBE), or have an abnormality detected by an imaging modality.
* Will undergo study imaging within four weeks from the date of diagnostic mammography, prior to breast biopsy (if needed).
* Able to provide informed consent
* Post-menopausal, surgically sterile, or effective birth control. For women of childbearing potential, negative pregnancy test or has signed pregnancy test waiver
* If required by standard of care, eGFR \>45 within 48 hours to 6 weeks of CE-CBBCT exam

Exclusion Criteria

* Pregnancy
* Lactation
* Unknown pregnancy status AND
* has refused pregnancy testing and
* has refused to sign a pregnancy test waiver
* Women who are unable or unwilling to understand or to provide informed consent
* Women with physical limitations that may prohibit resting prone on the exam table, such as, but not limited to: frozen shoulder, recent heart surgery, pace maker.
* Women who are unable to tolerate study constraints.
* Women who have received radiation treatments to the thorax or breast area for malignant and nonmalignant conditions, such as (but not limited to):

* Treatment for enlarged thymus gland as an infant
* Irradiation for benign breast conditions, including breast inflammation after giving birth
* Treatment for Hodgkin's disease
* Women who have participated in a prior breast clinical trial that gave additional radiation dose, such as an additional mammogram.
* Women who have received large numbers of diagnostic x-ray examinations for monitoring of disease such as (but not limited to):
* Tuberculosis
* Severe scoliosis


* Allergic to iodinated contrast material
* Previous non-ionic contrast reaction
* Any conditions below regardless of eGFR

* Renal Disease
* Chronic renal dysfunction
* Renal Transplant (or waiting for a transplant)
* One kidney or other birth defect
* Polycystic Kidneys
* Renal Tumor/Renal Cancer
* History of liver failure/cirrhosis/liver transplant/pending liver transplant
* Congestive heart failure
* Multiple myeloma
* Hyperthyroidism
* Pheochromocytoma
* Sickle Cell Disease
* Patient's body weight is over the limit of the scanner table (440 lbs or 200kg)
Minimum Eligible Age

35 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Koning Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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UR Medicine Breast Imaging

Rochester, New York, United States

Site Status

Knoxville Comprehensive Breast Center

Knoxville, Tennessee, United States

Site Status

Countries

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United States

References

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O'Connell A, Conover DL, Zhang Y, Seifert P, Logan-Young W, Lin CF, Sahler L, Ning R. Cone-beam CT for breast imaging: Radiation dose, breast coverage, and image quality. AJR Am J Roentgenol. 2010 Aug;195(2):496-509. doi: 10.2214/AJR.08.1017.

Reference Type BACKGROUND
PMID: 20651210 (View on PubMed)

Pediconi F, Venditti F, Padula S, Roselli A, Moriconi E, Giacomelli L, Catalano C, Passariello R. CE-Magnetic Resonance Mammography for the evaluation of the contralateral breast in patients with diagnosed breast cancer. Radiol Med. 2005 Jul-Aug;110(1-2):61-8. English, Italian.

Reference Type BACKGROUND
PMID: 16163140 (View on PubMed)

Esserman L, Hylton N, Yassa L, Barclay J, Frankel S, Sickles E. Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol. 1999 Jan;17(1):110-9. doi: 10.1200/JCO.1999.17.1.110.

Reference Type BACKGROUND
PMID: 10458224 (View on PubMed)

Orel SG, Schnall MD. MR imaging of the breast for the detection, diagnosis, and staging of breast cancer. Radiology. 2001 Jul;220(1):13-30. doi: 10.1148/radiology.220.1.r01jl3113.

Reference Type BACKGROUND
PMID: 11425968 (View on PubMed)

Gulsun M, Demirkazik FB, Ariyurek M. Evaluation of breast microcalcifications according to Breast Imaging Reporting and Data System criteria and Le Gal's classification. Eur J Radiol. 2003 Sep;47(3):227-31. doi: 10.1016/s0720-048x(02)00181-x.

Reference Type BACKGROUND
PMID: 12927667 (View on PubMed)

McDonald RJ, McDonald JS, Kallmes DF, Jentoft ME, Murray DL, Thielen KR, Williamson EE, Eckel LJ. Intracranial Gadolinium Deposition after Contrast-enhanced MR Imaging. Radiology. 2015 Jun;275(3):772-82. doi: 10.1148/radiol.15150025. Epub 2015 Mar 5.

Reference Type BACKGROUND
PMID: 25742194 (View on PubMed)

Prionas ND, Lindfors KK, Ray S, Huang SY, Beckett LA, Monsky WL, Boone JM. Contrast-enhanced dedicated breast CT: initial clinical experience. Radiology. 2010 Sep;256(3):714-23. doi: 10.1148/radiol.10092311.

Reference Type BACKGROUND
PMID: 20720067 (View on PubMed)

Seifert P, Conover D, Zhang Y, Morgan R, Arieno A, Destounis S, Somerville P, Murphy PF. Evaluation of malignant breast lesions in the diagnostic setting with cone beam breast computed tomography (Breast CT): feasibility study. Breast J. 2014 Jul-Aug;20(4):364-74. doi: 10.1111/tbj.12285. Epub 2014 Jun 17.

Reference Type BACKGROUND
PMID: 24934253 (View on PubMed)

O'Connell AM, Kawakyu-O'Connor D. Dedicated Cone-beam Breast Computed Tomography and Diagnostic Mammography: Comparison of Radiation Dose, Patient Comfort, And Qualitative Review of Imaging Findings in BI-RADS 4 and 5 Lesions. J Clin Imaging Sci. 2012;2:7. doi: 10.4103/2156-7514.93274. Epub 2012 Feb 25.

Reference Type BACKGROUND
PMID: 22439131 (View on PubMed)

O'Connell AM, Karellas A, Vedantham S. The potential role of dedicated 3D breast CT as a diagnostic tool: review and early clinical examples. Breast J. 2014 Nov-Dec;20(6):592-605. doi: 10.1111/tbj.12327. Epub 2014 Sep 8.

Reference Type BACKGROUND
PMID: 25199995 (View on PubMed)

Fukumura D, Duda DG, Munn LL, Jain RK. Tumor microvasculature and microenvironment: novel insights through intravital imaging in pre-clinical models. Microcirculation. 2010 Apr;17(3):206-25. doi: 10.1111/j.1549-8719.2010.00029.x.

Reference Type BACKGROUND
PMID: 20374484 (View on PubMed)

Boetes C, Mus RD, Holland R, Barentsz JO, Strijk SP, Wobbes T, Hendriks JH, Ruys SH. Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology. 1995 Dec;197(3):743-7. doi: 10.1148/radiology.197.3.7480749.

Reference Type BACKGROUND
PMID: 7480749 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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16-01

Identifier Type: -

Identifier Source: org_study_id

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