The Benefit of UHR-CT: Precision of Repeated Volume Measurements of Pulmonary Nodules

NCT ID: NCT04209972

Last Updated: 2019-12-24

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

92 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-11

Study Completion Date

2019-07-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

To assess the variability of semi-automated volume measurements of pulmonary nodules on same-day repeated scans of equal radiation dose from two different CT scanners: One high-end CT scanner with standard spatial resolution (CT1) and one UHRCT scanner (CT2), in patients with known or suspected pulmonary metastases.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Rationale: Ultra-high resolution computed tomography (UHRCT) produces radiological images with a spatial resolution of 0.25 mm in a matrix of 1024x1024. This should decrease measurement variation of nodule growth as a marker of malignancy, by making nodule delineation more precise for automatic volumetry segmentation and volume doubling time assessment than in conventional CT. If possible, this can shorten follow up of incidental pulmonary nodules to exclude malignancy, with less medicalisation and patient anxiety.

Objective: To assess the variability of semi-automated volume measurements of pulmonary nodules in patients with known or suspected pulmonary metastases on same-day repeated scans of equal radiation dose from two different CT scanners: CT scanner with standard spatial resolution (conventional CT, CT1) and UHRCT (CT2).

Study design: This is a single center prospective trial on 80 patients with known or suspected pulmonary metastases who are scheduled for chest and/or abdominal CT. Study participants will undergo two additional partial chest CT scans on either CT 1 or CT 2 for research purpose only, at similar radiation dose. Patients are equally divided across CT 1 and 2.

Study population: Patients who are 18 years or older with known solid pulmonary nodules compatible with metastases and who are willing and able to give informed consent are eligible. Patients are excluded if they have less than two eligible pulmonary nodules with a z range of 16 cm. Nodules with calcifications, surrounding opacities, or vessel- or pleural abutment will be excluded from analysis.

Main study parameters/endpoints: The main endpoint of this study is the upper limit of the 95% confidence interval of repeated semi-automated nodule volume measurements of both CT scanners.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness:

CT imaging is associated with risks related to the use of ionizing radiation. The CT protocol including the scheduled CT scan and the additional scans in this study has been carefully designed to have a total radiation dose at the same level as the achievable diagnostic reference level of chest CT in the Netherlands, which is 542 mGycm in 2013 (1). The burden associated with the two extra study CT acquisitions comprises a dose length product (DLP) of 120.4 mGy•cm for research (1.7 mSv, which is lower than the background radiation of one year in the Netherlands, with a conversion factor of 0.014 from Deak et al (2)).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Pulmonary Nodule, Solitary

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Ultra-high resolution CT volume measumerents

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

2 groups, 40 patients on one CT scanner, 40 different patients on the other CT scanner.
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Participants
Patients does not know if he is on the standard CT scanner, or on the UHR CT scanner

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Patients on CT1

Patients will undergo two pre-contrast scans, and will be in between the two scans be off and on the table at a standard CT scanner. (Aquilion One Genesis, Canon Medical Systems)

Group Type ACTIVE_COMPARATOR

Genesis high-end CT scanner

Intervention Type DEVICE

Patients will be divided on one of the two CT scanners. This group will be scanned on the Aquilion one Genesis.

Patients on CT2

Patients will undergo two pre-contrast scans, and will be in between the two scans be off and on the table at a UHRCT scanner. (Aquilion One Precision, Canon Medical Systems)

Group Type ACTIVE_COMPARATOR

Precision Ultra-High-Resolution CT scanner

Intervention Type DEVICE

Patients will be divided on one of the two CT scanners. This group will be scanned on the Precision CT scanner.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Precision Ultra-High-Resolution CT scanner

Patients will be divided on one of the two CT scanners. This group will be scanned on the Precision CT scanner.

Intervention Type DEVICE

Genesis high-end CT scanner

Patients will be divided on one of the two CT scanners. This group will be scanned on the Aquilion one Genesis.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* 18 years of age or older
* A solid primary tumour anywhere in the body and solid, noncalcified nodules in the pulmonary parenchyma on previous CT scans suspected for pulmonary metastases, according to radiological reports
* Two lung nodules that do not abut vessels or pleura with a two dimensional diameter between 5 and 10 mm within a distance of each other of 16 cm in the craniocaudal direction

Exclusion Criteria

* Immobility (not able to stand up and get off the scanner table)
* Patients who received local pulmonary treatment: Radiotherapy, Excision, Ablation
* Patients with radiologically suspected lymphangitis carcinomatosa or consolidations around the nodules.
* Patients who only have calcified pulmonary nodules or nodules that abut vessels or pleura.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Radboud University Medical Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Monique Brink, PhD, MD

Role: PRINCIPAL_INVESTIGATOR

Radboud University Medical Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Radboudumc

Nijmegen, Gelderland, Netherlands

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Netherlands

References

Explore related publications, articles, or registry entries linked to this study.

van der Molen AJ, Schilham A, Stoop P, Prokop M, Geleijns J. A national survey on radiation dose in CT in The Netherlands. Insights Imaging. 2013 Jun;4(3):383-90. doi: 10.1007/s13244-013-0253-9. Epub 2013 May 15.

Reference Type RESULT
PMID: 23673455 (View on PubMed)

Deak PD, Smal Y, Kalender WA. Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology. 2010 Oct;257(1):158-66. doi: 10.1148/radiol.10100047.

Reference Type RESULT
PMID: 20851940 (View on PubMed)

Alpert JB, Ko JP. Management of Incidental Lung Nodules: Current Strategy and Rationale. Radiol Clin North Am. 2018 May;56(3):339-351. doi: 10.1016/j.rcl.2018.01.002. Epub 2018 Mar 7.

Reference Type RESULT
PMID: 29622070 (View on PubMed)

MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Mayo JR, Mehta AC, Ohno Y, Powell CA, Prokop M, Rubin GD, Schaefer-Prokop CM, Travis WD, Van Schil PE, Bankier AA. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Radiology. 2017 Jul;284(1):228-243. doi: 10.1148/radiol.2017161659. Epub 2017 Feb 23.

Reference Type RESULT
PMID: 28240562 (View on PubMed)

Baldwin DR, Callister ME; Guideline Development Group. The British Thoracic Society guidelines on the investigation and management of pulmonary nodules. Thorax. 2015 Aug;70(8):794-8. doi: 10.1136/thoraxjnl-2015-207221. Epub 2015 Jul 1.

Reference Type RESULT
PMID: 26135833 (View on PubMed)

Devaraj A, van Ginneken B, Nair A, Baldwin D. Use of Volumetry for Lung Nodule Management: Theory and Practice. Radiology. 2017 Sep;284(3):630-644. doi: 10.1148/radiol.2017151022.

Reference Type RESULT
PMID: 28825886 (View on PubMed)

Wormanns D, Kohl G, Klotz E, Marheine A, Beyer F, Heindel W, Diederich S. Volumetric measurements of pulmonary nodules at multi-row detector CT: in vivo reproducibility. Eur Radiol. 2004 Jan;14(1):86-92. doi: 10.1007/s00330-003-2132-0. Epub 2003 Nov 13.

Reference Type RESULT
PMID: 14615902 (View on PubMed)

Gietema HA, Schaefer-Prokop CM, Mali WP, Groenewegen G, Prokop M. Pulmonary nodules: Interscan variability of semiautomated volume measurements with multisection CT-- influence of inspiration level, nodule size, and segmentation performance. Radiology. 2007 Dec;245(3):888-94. doi: 10.1148/radiol.2452061054. Epub 2007 Oct 8.

Reference Type RESULT
PMID: 17923508 (View on PubMed)

Goodman LR, Gulsun M, Washington L, Nagy PG, Piacsek KL. Inherent variability of CT lung nodule measurements in vivo using semiautomated volumetric measurements. AJR Am J Roentgenol. 2006 Apr;186(4):989-94. doi: 10.2214/AJR.04.1821.

Reference Type RESULT
PMID: 16554568 (View on PubMed)

Hein PA, Romano VC, Rogalla P, Klessen C, Lembcke A, Bornemann L, Dicken V, Hamm B, Bauknecht HC. Variability of semiautomated lung nodule volumetry on ultralow-dose CT: comparison with nodule volumetry on standard-dose CT. J Digit Imaging. 2010 Feb;23(1):8-17. doi: 10.1007/s10278-008-9157-5. Epub 2008 Sep 5.

Reference Type RESULT
PMID: 18773240 (View on PubMed)

Han D, Heuvelmans MA, Oudkerk M. Volume versus diameter assessment of small pulmonary nodules in CT lung cancer screening. Transl Lung Cancer Res. 2017 Feb;6(1):52-61. doi: 10.21037/tlcr.2017.01.05.

Reference Type RESULT
PMID: 28331824 (View on PubMed)

Tanaka R, Yoshioka K, Takagi H, Schuijf JD, Arakita K. Novel developments in non-invasive imaging of peripheral arterial disease with CT: experience with state-of-the-art, ultra-high-resolution CT and subtraction imaging. Clin Radiol. 2019 Jan;74(1):51-58. doi: 10.1016/j.crad.2018.03.002. Epub 2018 Apr 5.

Reference Type RESULT
PMID: 29627067 (View on PubMed)

Zhou W, Montoya J, Gutjahr R, Ferrero A, Halaweish A, Kappler S, McCollough C, Leng S. Lung Nodule Volume Quantification and Shape Differentiation with an Ultra-High Resolution Technique on a Photon Counting Detector CT System. Proc SPIE Int Soc Opt Eng. 2017 Feb 11;10132:101323Q. doi: 10.1117/12.2255736. Epub 2017 Mar 9.

Reference Type RESULT
PMID: 28392613 (View on PubMed)

de Hoop B, Gietema H, van Ginneken B, Zanen P, Groenewegen G, Prokop M. A comparison of six software packages for evaluation of solid lung nodules using semi-automated volumetry: what is the minimum increase in size to detect growth in repeated CT examinations. Eur Radiol. 2009 Apr;19(4):800-8. doi: 10.1007/s00330-008-1229-x. Epub 2008 Nov 19.

Reference Type RESULT
PMID: 19018537 (View on PubMed)

Leng S, Gutjahr R, Ferrero A, Kappler S, Henning A, Halaweish A, Zhou W, Montoya J, McCollough C. Ultra-High Spatial Resolution, Multi-Energy CT using Photon Counting Detector Technology. Proc SPIE Int Soc Opt Eng. 2017 Feb 11;10132:101320Y. doi: 10.1117/12.2255589. Epub 2017 Mar 9.

Reference Type RESULT
PMID: 28392615 (View on PubMed)

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307-10.

Reference Type RESULT
PMID: 2868172 (View on PubMed)

Kalra MK, Sodickson AD, Mayo-Smith WW. CT Radiation: Key Concepts for Gentle and Wise Use. Radiographics. 2015 Oct;35(6):1706-21. doi: 10.1148/rg.2015150118.

Reference Type RESULT
PMID: 26466180 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

NL67905.091.18

Identifier Type: -

Identifier Source: org_study_id