Is the 3D-PANC MSP Model Superior to CT for Assessing Response to Neoadjuvant Treatment in PCA Patients?

NCT ID: NCT06582342

Last Updated: 2025-08-06

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

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-03-21

Study Completion Date

2025-12-30

Brief Summary

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Prospective multicenter study in which all patients with borderline or locally advanced pancreatic adenocarcioma undergoing neoadjuvant chemotherapy and surgical exploration with curative intent will be included for one year. Preoperative images by traditional CT and 3D-MSP technology will be evaluated, comparing the accuracy variables (sensitivity, specificity, predictive values, area under the curve, concordance index) of both techniques with the gold standard (results of surgery and histopathological analysis).

Detailed Description

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Neoadjuvant chemotherapy followed by surgery represents the treatment of choice for patients with borderline and locally advanced pancreatic adenocarcinoma (PAC). Despite being the diagnostic technique of choice for PAC staging, computed tomography (CT) has a very low accuracy in detecting those patients who may benefit from surgical resection after neoadjuvant chemotherapy. Consequently, the study of computerized image processing technologies is gaining importance. However, there are no prospective validation studies of these technologies to determine their usefulness in the preoperative evaluation of PCA patients undergoing neoadjuvant therapy.

A prospective multicenter study in which all patients with borderline or locally advanced PAC undergoing neoadjuvant chemotherapy and surgical exploration with curative intent will be included for one year. Preoperative images by traditional CT and 3D-MSP technology will be evaluated, comparing the accuracy variables (sensitivity, specificity, predictive values, area under the curve, concordance index) of both techniques with the gold standard (results of surgery and histopathological analysis).

A prospective, multicenter study with control group will be performed. Since this is the evaluation of a diagnostic test, it will not be necessary to randomize the patients included, since each patient will be evaluated by means of both techniques under study, thus serving as his or her own control.

Conditions

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Adenocarcinoma of the Pancreas

Study Design

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Observational Model Type

CASE_CROSSOVER

Study Time Perspective

PROSPECTIVE

Study Groups

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Case-crossover group

All patients included in the study will undergo preoperative CT (conventional protocol) and 3D-MSP reconstruction. These results will be compared with the results of the surgery and the anatomopathological study. Each patient will be evaluated by both techniques of the study, thus serving as his or her own control.

Three dimensional imaging technology (3D-PANC MSP model)

Intervention Type PROCEDURE

The processing of the CT images obtained in each center for the creation of the 3D model will be performed centrally by the team of radiologists and computer scientists of the company Cella Medical Solutions. This team will be blinded to the reports of the CT scans.For each patient 4 NCCN check-lists will be filled in without knowing the result of the surgery or the AP study: 2 based on the conventional CT and two based on the 3D-MSP study.

Computerized tomography group (conventional CT)

Intervention Type PROCEDURE

A multiphase CT (venous phase and pancreatographic phase) with 1mm thick slices and series of images in coronal, axial and sagittal reconstructions will be performed. This CT model will be performed at disease diagnosis and after completion of neoadjuvant chemotherapy treatment. Both CT scans will be independently reported by a radiologist from the hospital of origin. The preoperative CT scan will also be evaluated a posteriori by a radiologist from the sponsoring center with expertise in PAC. Both reports (the one from the radiologist of the center and the one from the radiologist of the sponsoring center) will be used to fill out the imaging study variables sheet based on the latest version of the NCCN 2022 guidelines. The radiologists will not know the outcome of the surgery or the anatomic pathology study at the time of the completion of the report.

Interventions

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Three dimensional imaging technology (3D-PANC MSP model)

The processing of the CT images obtained in each center for the creation of the 3D model will be performed centrally by the team of radiologists and computer scientists of the company Cella Medical Solutions. This team will be blinded to the reports of the CT scans.For each patient 4 NCCN check-lists will be filled in without knowing the result of the surgery or the AP study: 2 based on the conventional CT and two based on the 3D-MSP study.

Intervention Type PROCEDURE

Computerized tomography group (conventional CT)

A multiphase CT (venous phase and pancreatographic phase) with 1mm thick slices and series of images in coronal, axial and sagittal reconstructions will be performed. This CT model will be performed at disease diagnosis and after completion of neoadjuvant chemotherapy treatment. Both CT scans will be independently reported by a radiologist from the hospital of origin. The preoperative CT scan will also be evaluated a posteriori by a radiologist from the sponsoring center with expertise in PAC. Both reports (the one from the radiologist of the center and the one from the radiologist of the sponsoring center) will be used to fill out the imaging study variables sheet based on the latest version of the NCCN 2022 guidelines. The radiologists will not know the outcome of the surgery or the anatomic pathology study at the time of the completion of the report.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

\- Patients with a diagnosis of borderline or locally advanced PAC of the head of the pancreas, as defined by the National Comprehensive Cancer Network (NCCN), who have received neoadjuvant treatment and who undergo surgical exploration with resective intent.

Exclusion Criteria

* Patients younger than 18 years of age.
* Patients under 18 years of age.
* Disease progression during neoadjuvant treatment.
* No preoperative CT scan.
* Refusal to participate in the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundación para la Investigación del Hospital Clínico de Valencia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hospital General de Alicante

Alicante, , Spain

Site Status RECRUITING

Hospital Universitario de Badajoz

Badajoz, , Spain

Site Status RECRUITING

Hospital del Mar (Barcelona)

Barcelona, , Spain

Site Status RECRUITING

Hospital Clínic de Barcelona

Barcelona, , Spain

Site Status RECRUITING

Hospital de Bellvitge

Barcelona, , Spain

Site Status RECRUITING

Hospital German Trias y Puyol

Barcelona, , Spain

Site Status RECRUITING

Hospital Nuestra señora de la Candelaria

Candelaria, , Spain

Site Status RECRUITING

Hospital General de Castellón

Castellon, , Spain

Site Status RECRUITING

Hospital Carlos Haya

Málaga, , Spain

Site Status RECRUITING

Hospital Virgen de la Victoria

Málaga, , Spain

Site Status RECRUITING

Hospital Virgen de la Arrixaca

Murcia, , Spain

Site Status RECRUITING

Hospital Son Espases Palma de Mallorca

Palma de Mallorca, , Spain

Site Status RECRUITING

Hospital Virgen del Rocío

Seville, , Spain

Site Status RECRUITING

Hospital Juan XXIII Tarragona

Tarragona, , Spain

Site Status RECRUITING

Hospital Clínico Universitario de Valencia

Valencia, , Spain

Site Status RECRUITING

Hospital Dr Peset

Valencia, , Spain

Site Status RECRUITING

Hospital La Fe

Valencia, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Dimitri Dorcaratto

Role: CONTACT

675441388

Marina Garcés

Role: CONTACT

Facility Contacts

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Celia Villodre Tudela

Role: primary

Gerardo Blanco

Role: primary

Fernando Burdío

Role: primary

Fabio Ausania

Role: primary

Juli Busquets

Role: primary

Esteban Cugat

Role: primary

Betsabé Reyes Correa

Role: primary

Laura Granell

Role: primary

Julio Santoyo

Role: primary

Miguel Ágel Suárez

Role: primary

Francisco Sánchez-Bueno

Role: primary

Rafael Morales Soriano

Role: primary

Javier Padillo

Role: primary

Laia Estalella Mercadé

Role: primary

Dimitri Dorcaratto

Role: primary

Marina Garcés

Role: backup

Manuel Bellver

Role: primary

Cristina Ballester Ibáñez

Role: primary

Other Identifiers

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3D-PANC

Identifier Type: -

Identifier Source: org_study_id

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