Novel MRI Techniques on Evaluation of Lymphedema

NCT ID: NCT05804643

Last Updated: 2023-04-19

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

RECRUITING

Total Enrollment

210 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-04-10

Study Completion Date

2026-12-31

Brief Summary

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In this project, the investigators aim to investigate the imaging approaches for breast cancer-related secondary lymphedema. The clinical study aims to optimize the conventional MRI methods for mapping lymphedema and assess the post-surgical therapeutic effects in longitudinal follow-up studies. Additionally, a normal imaging database of lymphedema MRI images will be established for future reference. For pre-clinical animal study, investigators aim to develop and integrate two novel MRI methods, including free water elimination diffusion MRI and diffusion kurtosis MRI techniques. By integrating clinical and pre-clinical studies, the investigators aim to establish a precise imaging tool for evaluating the therapeutic effects of lymphedema for following translational applications.

Detailed Description

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A total of three sub-projects will be conducted in this project. Sub-project 1 will establish a pre-clinical rat model for lymphedema and develop novel MRI methods, including diffusion kurtosis MRI and free water elimination diffusion MRI techniques, for mapping tissue characteristics of lymphedema. Sub-project 1 will be complemented with the clinical images provided by sub-project 2, yielding more information about the lymphedema. Sub-project 2 aims to optimize the clinical MRI methods for mapping lymphedema and quantitatively assess the severity of lymphedema. A normal imaging database will be established for reference. Sub-project 2 and sub-project 3 will be complementary in co-developing the image assessment of post-surgical therapeutic effect. Sub-project 3 will quantitatively evaluate the severity of lymphedema secondary to different kinds of axillary treatments by using the clinical MRI methods for establishing longitudinal monitoring and prediction approaches. It also focuses on the pre-surgical and post-surgical evaluation of lymphedema undergone supermicrosurgical technique by using the clinical MRI methods.

Conditions

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Lymphedema of Upper Limb

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Breast cancer related lymphedema

Breast cancer related lymphedema cases receive observational magnetic resonance imaging before and after lymphovenous anastomosis.

Diffusion magnetic resonance imaging

Intervention Type PROCEDURE

Free water elimination diffusion MRI and diffusion kurtosis MRI techniques

Interventions

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Diffusion magnetic resonance imaging

Free water elimination diffusion MRI and diffusion kurtosis MRI techniques

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* adults with breast cancer related lymphedema

Exclusion Criteria

* children younger than 20 years old
* pregnancy
* patients who have absolute contraindications regarding MRI scanning:

1. The cardiac implantable electronic device (CIED) such as pacemakers, implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices.
2. Metallic intraocular foreign bodies.
3. Implantable neurostimulation systems
4. Cochlear implants/ear implant: bone-anchored hearing aid (BAHA) cochlear implant type can be scanned on a 1.5-tesla scanner only after the patient removes the battery. Cochlear implant wrapping scheduling must take place before the patient's MRI appointment.
5. Drug infusion pumps (insulin delivery, analgesic drugs, or chemotherapy pumps): If possible, the patient has to remove the device.
6. Catheters with metallic components (Swan-Ganz catheter)
7. Metallic fragments such as bullets, shotgun pellets, and metal shrapnel
8. Cerebral artery aneurysm clips
9. Magnetic dental implants
10. Tissue expander
11. Artificial limb
12. Hearing aid
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Health Research Institutes, Taiwan

OTHER

Sponsor Role collaborator

National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Li-Wei Kuo, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

National Health Research Institutes, Taiwan

Locations

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National Taiwan university hospital

Taipei, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Yeefan Lee, MD

Role: CONTACT

+886-972653172

Facility Contacts

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Yeefan Lee, MD

Role: primary

+886-2-2312-3456 ext. 262570

References

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Fu MR. Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management. World J Clin Oncol. 2014 Aug 10;5(3):241-7. doi: 10.5306/wjco.v5.i3.241.

Reference Type BACKGROUND
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Garza R 3rd, Skoracki R, Hock K, Povoski SP. A comprehensive overview on the surgical management of secondary lymphedema of the upper and lower extremities related to prior oncologic therapies. BMC Cancer. 2017 Jul 5;17(1):468. doi: 10.1186/s12885-017-3444-9.

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Executive Committee. The Diagnosis and Treatment of Peripheral Lymphedema: 2016 Consensus Document of the International Society of Lymphology. Lymphology. 2016 Dec;49(4):170-84.

Reference Type BACKGROUND
PMID: 29908550 (View on PubMed)

Lohrmann C, Felmerer G, Foeldi E, Bartholoma JP, Langer M. MR lymphangiography for the assessment of the lymphatic system in patients undergoing microsurgical reconstructions of lymphatic vessels. Microvasc Res. 2008 May;76(1):42-5. doi: 10.1016/j.mvr.2008.03.003. Epub 2008 Mar 20.

Reference Type BACKGROUND
PMID: 18456290 (View on PubMed)

Notohamiprodjo M, Weiss M, Baumeister RG, Sommer WH, Helck A, Crispin A, Reiser MF, Herrmann KA. MR lymphangiography at 3.0 T: correlation with lymphoscintigraphy. Radiology. 2012 Jul;264(1):78-87. doi: 10.1148/radiol.12110229. Epub 2012 Apr 20.

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Reference Type BACKGROUND
PMID: 32057940 (View on PubMed)

Crescenzi R, Donahue PMC, Hartley KG, Desai AA, Scott AO, Braxton V, Mahany H, Lants SK, Donahue MJ. Lymphedema evaluation using noninvasive 3T MR lymphangiography. J Magn Reson Imaging. 2017 Nov;46(5):1349-1360. doi: 10.1002/jmri.25670. Epub 2017 Feb 28.

Reference Type BACKGROUND
PMID: 28245075 (View on PubMed)

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Reference Type BACKGROUND
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Reference Type BACKGROUND
PMID: 16861563 (View on PubMed)

Bae JS, Yoo RE, Choi SH, Park SO, Chang H, Suh M, Cheon GJ. Evaluation of lymphedema in upper extremities by MR lymphangiography: Comparison with lymphoscintigraphy. Magn Reson Imaging. 2018 Jun;49:63-70. doi: 10.1016/j.mri.2017.12.024. Epub 2018 Jan 3.

Reference Type BACKGROUND
PMID: 29306049 (View on PubMed)

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Reference Type BACKGROUND
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Basser PJ, Mattiello J, LeBihan D. MR diffusion tensor spectroscopy and imaging. Biophys J. 1994 Jan;66(1):259-67. doi: 10.1016/S0006-3495(94)80775-1.

Reference Type BACKGROUND
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Jensen JH, Helpern JA, Ramani A, Lu H, Kaczynski K. Diffusional kurtosis imaging: the quantification of non-gaussian water diffusion by means of magnetic resonance imaging. Magn Reson Med. 2005 Jun;53(6):1432-40. doi: 10.1002/mrm.20508.

Reference Type BACKGROUND
PMID: 15906300 (View on PubMed)

Jensen JH, Helpern JA. MRI quantification of non-Gaussian water diffusion by kurtosis analysis. NMR Biomed. 2010 Aug;23(7):698-710. doi: 10.1002/nbm.1518.

Reference Type BACKGROUND
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Chhetri A, Li X, Rispoli JV. Current and Emerging Magnetic Resonance-Based Techniques for Breast Cancer. Front Med (Lausanne). 2020 May 12;7:175. doi: 10.3389/fmed.2020.00175. eCollection 2020.

Reference Type BACKGROUND
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Tang L, Zhou XJ. Diffusion MRI of cancer: From low to high b-values. J Magn Reson Imaging. 2019 Jan;49(1):23-40. doi: 10.1002/jmri.26293. Epub 2018 Oct 12.

Reference Type BACKGROUND
PMID: 30311988 (View on PubMed)

Li Z, Li X, Peng C, Dai W, Huang H, Li X, Xie C, Liang J. The Diagnostic Performance of Diffusion Kurtosis Imaging in the Characterization of Breast Tumors: A Meta-Analysis. Front Oncol. 2020 Oct 27;10:575272. doi: 10.3389/fonc.2020.575272. eCollection 2020.

Reference Type BACKGROUND
PMID: 33194685 (View on PubMed)

Liu W, Wei C, Bai J, Gao X, Zhou L. Histogram analysis of diffusion kurtosis imaging in the differentiation of malignant from benign breast lesions. Eur J Radiol. 2019 Aug;117:156-163. doi: 10.1016/j.ejrad.2019.06.008. Epub 2019 Jun 17.

Reference Type BACKGROUND
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Rosenkrantz AB, Padhani AR, Chenevert TL, Koh DM, De Keyzer F, Taouli B, Le Bihan D. Body diffusion kurtosis imaging: Basic principles, applications, and considerations for clinical practice. J Magn Reson Imaging. 2015 Nov;42(5):1190-202. doi: 10.1002/jmri.24985. Epub 2015 Jun 26.

Reference Type BACKGROUND
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Collier Q, Veraart J, Jeurissen B, Vanhevel F, Pullens P, Parizel PM, den Dekker AJ, Sijbers J. Diffusion kurtosis imaging with free water elimination: A bayesian estimation approach. Magn Reson Med. 2018 Aug;80(2):802-813. doi: 10.1002/mrm.27075. Epub 2018 Feb 2.

Reference Type BACKGROUND
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Bergamino M, Walsh RR, Stokes AM. Free-water diffusion tensor imaging improves the accuracy and sensitivity of white matter analysis in Alzheimer's disease. Sci Rep. 2021 Mar 26;11(1):6990. doi: 10.1038/s41598-021-86505-7.

Reference Type BACKGROUND
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Other Identifiers

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202301160RINA

Identifier Type: -

Identifier Source: org_study_id

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