PINPOINT Feasibility Study

NCT ID: NCT05481372

Last Updated: 2022-08-01

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

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-31

Study Completion Date

2023-12-31

Brief Summary

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This feasibility study is investigating the application of magnetic resonance imaging (MRI) and transperineal ultrasound (TPUS) to visualise potential sites of relapse and surrounding normal tissue in patient having post-operative prostate cancer radiotherapy. Structure visualisation on MRI and TPUS will be compared to current standard computer tomography (CT) and cone-beam computer tomography (CBCT) imaging.

Detailed Description

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Approximately 47,000 men are diagnosed with prostate cancer yearly in the UK, 15% of which receive surgery (radical prostatectomy) as primary treatment. Of these men one third develop recurrence after prostatectomy and are offered post-operative radiotherapy.

Radiotherapy is targeted at the area where the prostate used to be, this includes potential relapse sites (PRS); vesicourethral anastomosis, bladder neck and retrovesicle space. When planning post-operative radiotherapy, the lack of a visible target means surrounding normal tissue is used to guide clinical target volume (CTV) delineation. The CTV is the area of tissue to be treated to the full radiotherapy prescription and includes PRS. Typically, the CTV is defined on a radiotherapy planning computer tomography (CT) scan.

The CTV lies adjacent to the bladder and rectum and is highly susceptible to positional changes influenced by organ filling. To identify and correct for CTV displacement during daily radiotherapy a cone-beam CT (CBCT) is acquired, this is an image similar to a CT scan but taken immediately prior to treatment delivery.

CT visualisation of PRS has been reported as inadequate, increasing the risk of missing or miss-identifying CTV structures during radiotherapy planning and delivery. To compensate for restricted visualisation on CT and CBCT an additional 1cm circumference around the CTV is treated to the prescription dose, this volume is referred to as the planning target volume (PTV). This margin reduces the risk of missing the target however its inclusion of normal tissue increases the risk of patient toxicity.

We propose that visualisation of PRS and surrounding normal tissue structures is enhanced on magnetic resonance imaging (MRI) compared to CT and on transperineal ultrasound (TPUS) compared to CBCT. This project investigates the reality of this statement by quantifying the confidence and reliability with which anatomical structures can be identified and delineated on all four image types.

Conditions

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Prostate Cancer Image Guided Radiotherapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Single centre feasibility study
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Standard radiotherapy with research image acquisition

Radiotherapy delivered as per standard of care Additional trans-perineal ultrasound (TPUS) imaging at three timepoints (1 x pre-treatment and 2 x treatment). Additional magnetic resonance imaging (MRI) pre-treatment.

Group Type EXPERIMENTAL

Imaging

Intervention Type OTHER

Trans-perineal ultrasound and Magnetic resonance image acquisition

Interventions

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Imaging

Trans-perineal ultrasound and Magnetic resonance image acquisition

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient has undergone radical prostatectomy
* Histologically confirmed prostate cancer
* Patient due to receive post-operative prostate bed +/- pelvic lymph node radiotherapy
* WHO performance status 0-1
* Age ≥ 18 years
* Written informed consent

Exclusion Criteria

* Recruitment into POPS trial
* Contraindications to MRI such as having a pacemaker or non-MRI compatible implanted device
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Royal Marsden NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Sophie Alexander

Sutton, Gastrointestinal (lower), United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Sophie Alexander

Role: CONTACT

020 8915 6053

Facility Contacts

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Sophie Alexander

Role: primary

020 8915 6053

Julia Murray

Role: backup

Other Identifiers

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CCR 5380

Identifier Type: -

Identifier Source: org_study_id

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