Usefulness of 18F-FDG PET/CT in the Initial Staging and Surveillance of Endometrial Cancer Patients

NCT ID: NCT05056259

Last Updated: 2021-10-25

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

Total Enrollment

42 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-01-01

Study Completion Date

2023-10-31

Brief Summary

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1. To assess the value of 18F-FDG PET/CT in the initial staging and detection of recurrent cases of endometrial cancer.
2. To determine correlation between PET/CT derived parameters including SUVmax, TLG and MTV and clinic-pathological patient characteristics.
3. To detect local and distant recurrence after therapy.

Detailed Description

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Endometrial cancer (EC) is one of the most common gynaecological malignancies worldwide.The incidence rate of uterine cancer in Egypt was 4.1 per 100,000.

The standard surgery consists of laparotomy, hysterectomy, and bilateral salpingo-oophorectomy. Maximal surgical cytoreduction is recommended for advanced EC. Prognostic impact of complete lymphadenectomy remains controversial, especially in early- stage disease.

With the aim of predicting extrauterine disease pre-operatively and optimizing surgical planning, several techniques have been evaluated, including 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). PET /CT can be used to effectively and accurately diagnose EC pelvic lymph node metastasis and distant metastasis. It has great value in clinical staging, judging prognosis, diagnosing recurrence.

Radiomics analysis of the uterine primary tumor on pre-operative 18F-FDG PET images may help predict the presence of metastatic nodes, thus reducing false-negative results and increasing the sensitivity of the technique. The maximum standard uptake value (SUVmax), metabolic tumor volume (MTV) and total glycolysis (TLG) of primary lesions are significantly correlated with pathological tissue grading. Previous studies on metabolic parameters of primary lesions examined by 18F-FDG PET/CT for endometrial cancer mainly focused on SUVmax, However, SUVmax can only reflect the functional metabolic degree of the point. It cannot assess the overall metabolic situation of tumor. MTV and TLG can more comprehensively measure the glucose metabolic activity of tumor cells with more clinical value in reflecting the malignancy degree of tumor.

Conditions

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Endometrial Cancer

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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newly diagnosed endometrial cancer

18F-FDG PET/CT

Intervention Type DEVICE

The PET/CT procedure will be performed according to the institutional standard with 18F-FDG (0.8-1.2 mCi /kg) injection following 6 h fasting. Blood glucose was controlled to be \<150 mg/dl. PET/CT from the vertex to the middle femur will be obtained 60 min after FDG injection.

MDCT examination without IV contrast will be done for attenuation correction and anatomic localization followed by PET images from the skull vault to the mid-thigh region.

Images of CT and corresponding functional PET images are displayed in axial, coronal and sagittal planes.

PET/CT data will include tumor size and extension, LN invasion\& distant metastasis SUVmax will be calculated for all positive lesions, Metabolic parameters including SUVmax, SUVmean, TLG \& MTV will be calculated for primary tumor.

Data of PET will be compared with other diagnostic imaging and postoperative pathologic data.

Recurrent cases of endometrial cancer

18F-FDG PET/CT

Intervention Type DEVICE

The PET/CT procedure will be performed according to the institutional standard with 18F-FDG (0.8-1.2 mCi /kg) injection following 6 h fasting. Blood glucose was controlled to be \<150 mg/dl. PET/CT from the vertex to the middle femur will be obtained 60 min after FDG injection.

MDCT examination without IV contrast will be done for attenuation correction and anatomic localization followed by PET images from the skull vault to the mid-thigh region.

Images of CT and corresponding functional PET images are displayed in axial, coronal and sagittal planes.

PET/CT data will include tumor size and extension, LN invasion\& distant metastasis SUVmax will be calculated for all positive lesions, Metabolic parameters including SUVmax, SUVmean, TLG \& MTV will be calculated for primary tumor.

Data of PET will be compared with other diagnostic imaging and postoperative pathologic data.

Interventions

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18F-FDG PET/CT

The PET/CT procedure will be performed according to the institutional standard with 18F-FDG (0.8-1.2 mCi /kg) injection following 6 h fasting. Blood glucose was controlled to be \<150 mg/dl. PET/CT from the vertex to the middle femur will be obtained 60 min after FDG injection.

MDCT examination without IV contrast will be done for attenuation correction and anatomic localization followed by PET images from the skull vault to the mid-thigh region.

Images of CT and corresponding functional PET images are displayed in axial, coronal and sagittal planes.

PET/CT data will include tumor size and extension, LN invasion\& distant metastasis SUVmax will be calculated for all positive lesions, Metabolic parameters including SUVmax, SUVmean, TLG \& MTV will be calculated for primary tumor.

Data of PET will be compared with other diagnostic imaging and postoperative pathologic data.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients proved to have endometrial cancer by curettage or hysteroscopy.
* Patients accepted surgery treatment, without anti-tumor and hormone therapy before surgery.
* Ability to stay still for the duration of the PET/CT scan (\~15 minutes).
* Ability of the patient (or his/her guardian) to sign informed consent.

Exclusion Criteria

* Patients who recieved neoadjuvant therapy before PET/CT.
* Patients with tumors other than endometrial cancer.
* Pregnancy.
* Inability to give informed consent.
* Inability to stay still for the duration of the scan.
* Claustrophobia
Minimum Eligible Age

30 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Aya Abdel-Baset Ahmed Ali Alsanory

Resident in nuclear medicine departement (South Egypt Cancer institute)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hanan Gamaleldin Mostafa, M.D

Role: STUDY_CHAIR

Professor

Esraa Roshdey Hassan, M.D

Role: STUDY_DIRECTOR

Doctor

Central Contacts

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Aya Abdelbaset Ahmed Alsanory, Master

Role: CONTACT

01063490867

Hemat Abdelsamea Mahmoud, M.D

Role: CONTACT

+201007532268

References

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Gai QZ, Lv YB, Li GY, Zhang DQ, Gao Z, Fang XH. Value of metabolic parameters of primary lesions examined by 18F-FDG PET/CT for endometrial cancer in preoperative evaluation. Eur Rev Med Pharmacol Sci. 2021 Mar;25(6):2493-2502. doi: 10.26355/eurrev_202103_25412.

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De Bernardi E, Buda A, Guerra L, Vicini D, Elisei F, Landoni C, Fruscio R, Messa C, Crivellaro C. Radiomics of the primary tumour as a tool to improve 18F-FDG-PET sensitivity in detecting nodal metastases in endometrial cancer. EJNMMI Res. 2018 Aug 22;8(1):86. doi: 10.1186/s13550-018-0441-1.

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Other Identifiers

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18F-FDG PET/CT

Identifier Type: -

Identifier Source: org_study_id