Contrast-enhanced Diffusion-weighted MRI to Detect Liver Metastases in Patients With Pancreatic Cancer

NCT ID: NCT03469726

Last Updated: 2021-09-21

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

465 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-22

Study Completion Date

2023-01-01

Brief Summary

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Given the dismal prognosis of pancreatic cancer, detecting liver metastases early can avoid inappropriate therapy with the associated substantial risks, long-term hospital admissions and high costs, but without survival benefit. The current standard of diagnostic workup with contrast-enhanced CT (CECT) has a poor sensitivity (38-76%) for the detection of liver metastases. As more sophisticated and expensive treatment options emerge, better staging of pancreatic cancer is needed to avoid unnecessary procedures and select the most appropriate treatment strategy. New imaging modalities are available, but their value in staging of pancreatic cancer has not been evaluated yet. Therefore prospective imaging studies are necessary.

The main aim of this study is to determine the diagnostic accuracy of contrast-enhanced diffusion-weighted MRI (CE-DW-MRI) in the detection of liver metastases in patients with pancreatic cancer compared to a reference standard of histopathology and follow up imaging.

The study is an international, multicenter prospective cohort study (inclusion of patients until 138 patients with liver metastases are included, with a total maximum of 465 patients). Patients with pancreatic cancer will undergo additional CE-DW-MRI within two weeks from the CECT. CECT and CE-DW-MRI will be read independently by two radiologists. Suspected liver lesions on CECT and/or CE-DW-MRI will be biopsied to obtain histopathology as reference standard. For liver lesions without histopathologic proof of metastases a paired follow-up CECT and CE-DW-MRI serve as a composite reference standard. Pancreatic resection will be pursued in patients without proven liver or distant metastases. Patients with locally advanced or metastatic disease will be offered palliative treatment. Follow up CECT and CE-DW-MRI will be performed in all patients at 3, 6, and 12 months.

Detailed Description

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Conditions

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Pancreatic Neoplasms

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

International multicenter prospective cohort study
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Patients with (suspected) PDAC

Patients with (suspected) pancreatic cancer will undergo additional Contrast-enhanced Diffusion-weighted MRI (CE-DW-MRI) within two weeks from the CECT.

Suspected liver lesions on CECT and/or CE-DW-MRI will be biopsied to obtain histopathology as reference standard. For liver lesions without histopathologic proof of metastases a paired follow-up CECT and CE-DW-MRI serve as a composite reference standard. Follow up CECT and CE-DW-MRI will be performed in all patients at 3, 6, and 12 months.

Group Type OTHER

Contrast-enhanced Diffusion-weighted MRI

Intervention Type DIAGNOSTIC_TEST

An MRI scan enhanced with intravenous contrast and with diffusion imaging at several B-values

Interventions

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Contrast-enhanced Diffusion-weighted MRI

An MRI scan enhanced with intravenous contrast and with diffusion imaging at several B-values

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* 18 years and older
* clinical suspicion of pancreatic cancer
* written (signed and dated) informed consent

Exclusion Criteria

* previous treatment for pancreatic cancer (e.g. chemotherapy, radiotherapy, surgery, ablation therapy)
* concomitant malignancies, except for adequately treated basocellular carcinoma of the skin or in situ carcinoma of the cervix uteri. Subjects with prior malignancies must be disease-free for at least 5 years
* contra-indications to undergo CT (due to e.g. extreme claustrophobia, untreatable contrast allergy, renal function impairment)
* contra-indications to undergo MRI (due to e.g. claustrophobia, untreatable contrast allergy, or not MRI compatible medical devices)
* insufficient command of the Dutch language to be able to understand the patient information or fill in the questionnaires
* pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dutch Cancer Society

OTHER

Sponsor Role collaborator

Radboud University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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John J. Hermans, dr. ir.

Role: PRINCIPAL_INVESTIGATOR

Radboudumc, Department of Radiology and Nuclear Medicine

Kees C.J.H.M. van Laarhoven, prof. dr.

Role: PRINCIPAL_INVESTIGATOR

Radboudumc, Department of Surgery

Locations

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Konstantopouleio general hospital

Athens, , Greece

Site Status RECRUITING

Radboudumc

Nijmegen, Gelderland, Netherlands

Site Status RECRUITING

Jeroen Bosch Ziekenhuis

's-Hertogenbosch, , Netherlands

Site Status RECRUITING

Medisch Spectrum Twente

Enschede, , Netherlands

Site Status RECRUITING

Universitair Medisch Centrum Groningen

Groningen, , Netherlands

Site Status RECRUITING

Hospital Universitario Ramón y Cajal

Madrid, , Spain

Site Status RECRUITING

Inselspital

Bern, , Switzerland

Site Status RECRUITING

Countries

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Greece Netherlands Spain Switzerland

Central Contacts

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Geke Litjens, MD

Role: CONTACT

+31243668392

Facility Contacts

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Charikleia Triantopoulou, MD, PhD

Role: primary

Geke Litjens, MD

Role: primary

+31243668392

Koop Bosscha, MD, PhD

Role: primary

Niels G Venneman, MD, PhD

Role: primary

Koert de Jong, MD, PhD

Role: primary

Julie Earl, PhD

Role: primary

Adrian Huber, MD, PhD

Role: primary

References

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Litjens G, Riviere DM, van Geenen EJM, Radema SA, Brosens LAA, Prokop M, van Laarhoven CJHM, Hermans JJ. Diagnostic accuracy of contrast-enhanced diffusion-weighted MRI for liver metastases of pancreatic cancer: towards adequate staging and follow-up of pancreatic cancer - DIA-PANC study: study protocol for an international, multicenter, diagnostic trial. BMC Cancer. 2020 Aug 10;20(1):744. doi: 10.1186/s12885-020-07226-0.

Reference Type DERIVED
PMID: 32778061 (View on PubMed)

Other Identifiers

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NL60473.091.17

Identifier Type: -

Identifier Source: org_study_id

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