Trial Outcomes & Findings for TOF-18F-FDG-PET/CT in Patients With Suspected Pancreatic Cancer (NCT NCT03914950)

NCT ID: NCT03914950

Last Updated: 2020-05-29

Results Overview

Quantitative measurement of regional tracer uptake by SUVmax in the TOF-PET/CT and standard PET/CT images over the FDG-accumulating lesions in the pancreas 30 and 90min p.i. The histopathological findings (malignant or benign) were assigned to the corresponding SUVmax values of the pancreatic lesions for the calculation of AUC values in ROC analysis. Then AUC values with and without TOF were compared with the DeLong-test to analyze if there is a significant difference in characterization of pancreatic lesions with TOF.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

174 participants

Primary outcome timeframe

2 hours

Results posted on

2020-05-29

Participant Flow

Participants were recruited based on physician referral at one university hospital between February 2014 and January 2019. The first participant was enrolled on February 7, 2014, and the last participant was enrolled in January 2019.

Of 174 enrolled participants, 120 participants met ALL inclusion criteria having TOF-18F-FDG PET/CT with diagnostic CT of the abdomen or upper abdomen AND biopsy or FNA or operation of the pancreas and were analyzed. Participants not completing the study were excluded and therefore not analyzed (54 participants).

Participant milestones

Participant milestones
Measure
PET/CT Results With TOF/Without TOF
Participants received TOF-18F-FDG PET/CT 30 and 90min p.i. and diagnostic CT of the abdomen or upper abdomen (in case of already performed diagnostic CT of the abdomen \< 2 weeks ago) with contrast medium in the case of normal creatinine, GFR, and TSH levels (101 participants). In the case of elevated creatinine or decreased GFR or TSH levels a diagnostic CT without contrast medium was performed (19 participants). After PET/CT examination the participants received a biopsy or FNA (fine-needle aspiration) or operation of the pancreas.
Overall Study
STARTED
174
Overall Study
COMPLETED
120
Overall Study
NOT COMPLETED
54

Reasons for withdrawal

Reasons for withdrawal
Measure
PET/CT Results With TOF/Without TOF
Participants received TOF-18F-FDG PET/CT 30 and 90min p.i. and diagnostic CT of the abdomen or upper abdomen (in case of already performed diagnostic CT of the abdomen \< 2 weeks ago) with contrast medium in the case of normal creatinine, GFR, and TSH levels (101 participants). In the case of elevated creatinine or decreased GFR or TSH levels a diagnostic CT without contrast medium was performed (19 participants). After PET/CT examination the participants received a biopsy or FNA (fine-needle aspiration) or operation of the pancreas.
Overall Study
Physician Decision
54

Baseline Characteristics

85 of 120 participants had malignant pancreatic lesions.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
PET/CT Results With TOF/Without TOF
n=120 Participants
Participants received TOF-18F-FDG PET/CT 30 and 90 min p.i. and diagnostic CT of the abdomen or upper abdomen (in case of already performed diagnostic CT of the abdomen \< 2 weeks ago) with contrast medium in case of normal creatinine, GFR, and TSH levels. In the case of elevated creatinine and decreased GFR and TSH levels a diagnostic CT without contrast medium was performed. After PET/CT examination participants received biopsy or FNA or operation of the pancreas.
Age, Continuous
64.4 years
STANDARD_DEVIATION 10.4 • n=120 Participants
Sex: Female, Male
Female
43 Participants
n=120 Participants
Sex: Female, Male
Male
77 Participants
n=120 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=120 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
120 Participants
n=120 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=120 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=120 Participants
Race (NIH/OMB)
Asian
0 Participants
n=120 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=120 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=120 Participants
Race (NIH/OMB)
White
120 Participants
n=120 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=120 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=120 Participants
Region of Enrollment
Austria
120 participants
n=120 Participants
Type of pancreatic mass
Solid
86 Participants
n=120 Participants
Type of pancreatic mass
Solid-cystic
11 Participants
n=120 Participants
Type of pancreatic mass
Cystic
23 Participants
n=120 Participants
History of pancreatitis
21 Participants
n=120 Participants
Dignity of pancreatic lesions
Malignant
85 Participants
n=120 Participants
Dignity of pancreatic lesions
Benign
35 Participants
n=120 Participants
Pathological diagnoses of malignant pancreatic lesions
Adenocarcinoma
70 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Acinuscellcarcinoma
1 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Diffuse large cell-B-cell lymphoma
1 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Follicular lymphoma
1 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Myeloid sarcoma
1 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Neuroendocrine carcinoma
1 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Moderately differentiated neuroendocrine tumor (G2
2 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
IPMN adenocarcinoma invasive
1 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
IPMN carcinoma non-invasive
2 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Pancreatic intraepithelial neoplasia III(PanINIII)
4 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of malignant pancreatic lesions
Mesenchymal neoplasia
1 Participants
n=85 Participants • 85 of 120 participants had malignant pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
Acute pancreatitis
3 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
Chronic pancreatitis
11 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
Mucinous cystic neoplasm (MCN) adenoma
2 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
IPMN borderline-lesion
2 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
Serous cyst adenoma
3 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
Benign cyst
1 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
Highly differentiated neuroendocrine tumor
1 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.
Pathological diagnoses of benign pancreatic lesions
No indication of malignancy
12 Participants
n=35 Participants • 35 of 120 participants had benign pancreatic lesions.

PRIMARY outcome

Timeframe: 2 hours

Population: 120 participants meeting ALL inclusion criteria, i.e. completed TOF-18F-FDG PET/CT AND biopsy or FNA or operation were analyzed. 54 participants had TOF-18F-FDG PET/CT but no biopsy or FNA or operation or the tumor was not in the pancreas and were therefore excluded from the study.

Quantitative measurement of regional tracer uptake by SUVmax in the TOF-PET/CT and standard PET/CT images over the FDG-accumulating lesions in the pancreas 30 and 90min p.i. The histopathological findings (malignant or benign) were assigned to the corresponding SUVmax values of the pancreatic lesions for the calculation of AUC values in ROC analysis. Then AUC values with and without TOF were compared with the DeLong-test to analyze if there is a significant difference in characterization of pancreatic lesions with TOF.

Outcome measures

Outcome measures
Measure
SUVmax TOF 30min p.i.
n=120 Participants
SUVmax values of the pancreatic lesions with TOF 30min p.i.
SUVmax Without TOF 30min p.i.
n=120 Participants
SUVmax values of the pancreatic lesions without TOF 30min p.i.
SUVmax TOF 90min p.i.
n=120 Participants
SUVmax values of the pancreatic lesions with TOF 90min p.i.
SUVmax Without TOF 90min p.i.
n=120 Participants
SUVmax values of the pancreatic lesions without TOF 90min p.i.
SUVmax (Maximal Standard Uptake Value) Measurement 30 and 90 Min p.i. (Post Injection)
0.77 SUVmax
0.78 SUVmax
0.81 SUVmax
0.8 SUVmax

PRIMARY outcome

Timeframe: 2 hours

Population: 120 participants meeting ALL inclusion criteria, i.e. completed TOF-18F-FDG PET/CT AND biopsy or FNA or operation were analyzed. 54 participants had TOF-18F-FDG PET/CT but no biopsy or FNA or operation or the tumor was not in the pancreas and were therefore excluded from the study.

The number of participants with increased tracer uptake over the pancreatic lesion, i.e. the number of pancreatic lesions with increased tracer uptake with and without TOF. One pancreatic lesion per patient was measured.

Outcome measures

Outcome measures
Measure
SUVmax TOF 30min p.i.
n=120 Participants
SUVmax values of the pancreatic lesions with TOF 30min p.i.
SUVmax Without TOF 30min p.i.
n=120 Participants
SUVmax values of the pancreatic lesions without TOF 30min p.i.
SUVmax TOF 90min p.i.
SUVmax values of the pancreatic lesions with TOF 90min p.i.
SUVmax Without TOF 90min p.i.
SUVmax values of the pancreatic lesions without TOF 90min p.i.
Participants With Increased Tracer Uptake Over the Pancreatic Lesion With and Without TOF
116 Participants
101 Participants

SECONDARY outcome

Timeframe: 2 hours

Population: 120 participants meeting ALL inclusion criteria, i.e. completed TOF-18F-FDG PET/CT AND biopsy or FNA or operation were analyzed. 54 participants had TOF-18F-FDG PET/CT but no biopsy or FNA or operation or the tumor was not in the pancreas and were therefore excluded from the study.

Lesion or tumor size in cm in the pancreas measured in the diagnostic CT of the abdomen or upper abdomen.

Outcome measures

Outcome measures
Measure
SUVmax TOF 30min p.i.
n=120 Participants
SUVmax values of the pancreatic lesions with TOF 30min p.i.
SUVmax Without TOF 30min p.i.
SUVmax values of the pancreatic lesions without TOF 30min p.i.
SUVmax TOF 90min p.i.
SUVmax values of the pancreatic lesions with TOF 90min p.i.
SUVmax Without TOF 90min p.i.
SUVmax values of the pancreatic lesions without TOF 90min p.i.
Lesion Size
3.0 cm
Standard Deviation 1.67

Adverse Events

PET/CT Results With TOF/ Without TOF

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
PET/CT Results With TOF/ Without TOF
n=101 participants at risk
101 participants received diagnostic CT of the abdomen/upper abdomen with contrast medium within the PET/CT examination and 19 participants had diagnostic CT of the abdomen or upper abdomen without contrast medium due to elevated creatine or decreased GFR (glomerular filtration rate) or TSH (thyroid-stimulating hormone) levels.
Cardiac disorders
Hypotensive shock
0.00%
0/101 • 1 day
Cardiac disorders
Cardiac arrest
0.00%
0/101 • 1 day
Respiratory, thoracic and mediastinal disorders
Respiratory arrest
0.00%
0/101 • 1 day
Nervous system disorders
Convulsion
0.00%
0/101 • 1 day

Other adverse events

Other adverse events
Measure
PET/CT Results With TOF/ Without TOF
n=101 participants at risk
101 participants received diagnostic CT of the abdomen/upper abdomen with contrast medium within the PET/CT examination and 19 participants had diagnostic CT of the abdomen or upper abdomen without contrast medium due to elevated creatine or decreased GFR (glomerular filtration rate) or TSH (thyroid-stimulating hormone) levels.
Gastrointestinal disorders
Severe vomiting
0.00%
0/101 • 1 day
Gastrointestinal disorders
Nausea, mild vomiting
0.00%
0/101 • 1 day
Skin and subcutaneous tissue disorders
Marked urticaria
0.00%
0/101 • 1 day
Skin and subcutaneous tissue disorders
Urticaria
0.00%
0/101 • 1 day
Skin and subcutaneous tissue disorders
Itching
0.00%
0/101 • 1 day
Skin and subcutaneous tissue disorders
Facial edema
0.00%
0/101 • 1 day
Respiratory, thoracic and mediastinal disorders
Bronchospasm
0.00%
0/101 • 1 day
Respiratory, thoracic and mediastinal disorders
Laryngeal edema
0.00%
0/101 • 1 day
Nervous system disorders
Vasovagal attack
0.00%
0/101 • 1 day

Additional Information

Dr. Susanne Stanzel

Medical University of Graz, Department of Radiology, Division of Nuclear Medicine

Phone: +43-316-385-81789

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place