AI-Assisted Non-Contrast CT for Multi-Cancer Screening

NCT ID: NCT06632886

Last Updated: 2024-10-09

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

Clinical Phase

NA

Total Enrollment

1000000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-07

Study Completion Date

2027-10-07

Brief Summary

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Cancer poses a major public health challenge in China. Early detection can improve treatment outcomes and survival rates. In this study, we will conduct a large-scale, prospective, multi-center cohort study to evaluate the utility of AI-assisted non-contrast CT for multi-cancer screening.

The study aims to enroll 1 million asymptomatic participants undergoing routine health examinations, using an AI imaging model based on non-contrast CT to detect seven cancers such as lung, liver, gastric, colorectal, esophageal, pancreatic, and breast cancers. Positive cases will be required to be referred to Shanghai Changhai Hospital for further imaging and care based on National Comprehensive Cancer Network (NCCN) and American College of Radiology (ACR) guidelines. The goal is to assess the AI model's diagnostic performance for seven cancer types, especially for early-stage, resectable tumors.

Detailed Description

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Cancer has become a major public health issue in China, seriously affecting population health, the economy, and social development. In 2022, there were an estimated 4.82 million new cancer cases and 2.57 million cancer-related deaths. Lung cancer, liver cancer, gastric cancer, colorectal cancer, esophageal cancer, pancreatic cancer, and breast cancer are the seven leading causes of cancer-related mortality. A successful earlier detection strategy would allow patients to receive timely interventions, improve treatment outcomes, enhance overall survival, and reduce the complexity and cost of treatment.

In this study, we will conduct a large-scale, prospective, multi-center cohort study, aiming to evaluate the utility of AI-assisted non-contrast CT for multi-cancer screening. The population consists of individuals who have undergone non-contrast abdominal or chest CT scans at Meinian Onehealth Health Examination Center or Shanghai Changhai Health Examination Center, with an expected enrollment of 1 million participants. A multi-cancer screening model via non-contrast CT, developed by Alibaba DAMO Academy, will be integrated into the PACS system of health examination centers. The imaging AI model will be used to automatically detect various cancerous lesions, including lung cancer, liver cancer, gastric cancer, colorectal cancer, esophageal cancer, pancreatic cancer, and breast cancer. Subjects identified with positive lesions by the AI model will be required to be referred to Shanghai Changhai Hospital for further imaging examinations (such as contrast-enhanced CT, MRI, Endoscopy, etc.) to confirm the final disease status and formulate a treatment plan. Additionally, the medical team should follow care pathways developed based on guidelines from NCCN and ACR, and if necessary, patients will be directed to the multidisciplinary team (MDT) clinic for specific cancer types to determine the diagnostic procedures. The ultimate goal of this study is to comprehensively assess the diagnostic performance metrics of the AI model for each of the seven cancer types individually. These metrics include, but are not limited to, sensitivity, specificity, and positive/negative predictive value. Particular emphasis will be placed on evaluating the model's efficacy in detecting early-stage, resectable tumors. The overarching aim is to determine whether the implementation of this AI-assisted screening approach could potentially lead to improved overall survival rates through earlier detection and intervention.

Conditions

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Lung Cancers Liver Cancer Gastric Cancers Colorectal, Cancer Esophageal Cancer Pancreatic Cancer Breast Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Health Examination Cohort

Asymptomatic participants in routine health examinations receive abdominal or chest non-contrast CT scans, categorized as follows:

1. Meinian cohort
2. Changhai cohort

Group Type EXPERIMENTAL

AI-Assisted Non-Contrast CT for Multi-Cancer Screening

Intervention Type DIAGNOSTIC_TEST

Participants identified by the AI model as having potential cancerous lesions, including those suspected of lung, liver, gastric, colorectal, esophageal, pancreatic, and breast cancer, will be required to undergo blood tests (for tumor markers) and additional imaging studies (such as contrast-enhanced CT, MRI, Endoscopy, etc.) to confirm the diagnosis of cancerous lesions.

Interventions

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AI-Assisted Non-Contrast CT for Multi-Cancer Screening

Participants identified by the AI model as having potential cancerous lesions, including those suspected of lung, liver, gastric, colorectal, esophageal, pancreatic, and breast cancer, will be required to undergo blood tests (for tumor markers) and additional imaging studies (such as contrast-enhanced CT, MRI, Endoscopy, etc.) to confirm the diagnosis of cancerous lesions.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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AI-MCScreen

Eligibility Criteria

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Inclusion Criteria

1. Subject is able and willing to provide informed consent and sign an informed consent form.
2. Subject has undergone an abdominal or chest non-contrast CT scan.

Exclusion Criteria

1. Subject has been diagnosed with one of the following cancers within the last five years: lung, liver, stomach, colon, esophageal, pancreatic, or breast cancer;
2. Subject has any medical condition that contraindicates high-resolution MRI/CT/Endoscopy;
3. Subject cannot be followed up or is participating in other clinical trials.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Guo ShiWei

OTHER

Sponsor Role lead

Responsible Party

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Guo ShiWei

Associated Professor at the Clinical Research Center

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Jin Gang, M.D.

Role: STUDY_CHAIR

Department of general surgery, Changhai Hospital

Locations

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Changhai Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Wang Beilei, M.D.

Role: CONTACT

86-13774238083

Guo Shiwei, M.D.

Role: CONTACT

86-18621500666

Facility Contacts

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Wang Beilei, M.D.

Role: primary

86-13774238083

Jin Gang, M.D.

Role: backup

References

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Han B, Zheng R, Zeng H, Wang S, Sun K, Chen R, Li L, Wei W, He J. Cancer incidence and mortality in China, 2022. J Natl Cancer Cent. 2024 Feb 2;4(1):47-53. doi: 10.1016/j.jncc.2024.01.006. eCollection 2024 Mar.

Reference Type BACKGROUND
PMID: 39036382 (View on PubMed)

Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024 Jan-Feb;74(1):12-49. doi: 10.3322/caac.21820. Epub 2024 Jan 17.

Reference Type BACKGROUND
PMID: 38230766 (View on PubMed)

Cao K, Xia Y, Yao J, Han X, Lambert L, Zhang T, Tang W, Jin G, Jiang H, Fang X, Nogues I, Li X, Guo W, Wang Y, Fang W, Qiu M, Hou Y, Kovarnik T, Vocka M, Lu Y, Chen Y, Chen X, Liu Z, Zhou J, Xie C, Zhang R, Lu H, Hager GD, Yuille AL, Lu L, Shao C, Shi Y, Zhang Q, Liang T, Zhang L, Lu J. Large-scale pancreatic cancer detection via non-contrast CT and deep learning. Nat Med. 2023 Dec;29(12):3033-3043. doi: 10.1038/s41591-023-02640-w. Epub 2023 Nov 20.

Reference Type BACKGROUND
PMID: 37985692 (View on PubMed)

Schrag D, Beer TM, McDonnell CH 3rd, Nadauld L, Dilaveri CA, Reid R, Marinac CR, Chung KC, Lopatin M, Fung ET, Klein EA. Blood-based tests for multicancer early detection (PATHFINDER): a prospective cohort study. Lancet. 2023 Oct 7;402(10409):1251-1260. doi: 10.1016/S0140-6736(23)01700-2.

Reference Type BACKGROUND
PMID: 37805216 (View on PubMed)

Gao Q, Lin YP, Li BS, Wang GQ, Dong LQ, Shen BY, Lou WH, Wu WC, Ge D, Zhu QL, Xu Y, Xu JM, Chang WJ, Lan P, Zhou PH, He MJ, Qiao GB, Chuai SK, Zang RY, Shi TY, Tan LJ, Yin J, Zeng Q, Su XF, Wang ZD, Zhao XQ, Nian WQ, Zhang S, Zhou J, Cai SL, Zhang ZH, Fan J. Unintrusive multi-cancer detection by circulating cell-free DNA methylation sequencing (THUNDER): development and independent validation studies. Ann Oncol. 2023 May;34(5):486-495. doi: 10.1016/j.annonc.2023.02.010. Epub 2023 Feb 26.

Reference Type BACKGROUND
PMID: 36849097 (View on PubMed)

Klein EA, Richards D, Cohn A, Tummala M, Lapham R, Cosgrove D, Chung G, Clement J, Gao J, Hunkapiller N, Jamshidi A, Kurtzman KN, Seiden MV, Swanton C, Liu MC. Clinical validation of a targeted methylation-based multi-cancer early detection test using an independent validation set. Ann Oncol. 2021 Sep;32(9):1167-1177. doi: 10.1016/j.annonc.2021.05.806. Epub 2021 Jun 24.

Reference Type BACKGROUND
PMID: 34176681 (View on PubMed)

Hackshaw A, Clarke CA, Hartman AR. New genomic technologies for multi-cancer early detection: Rethinking the scope of cancer screening. Cancer Cell. 2022 Feb 14;40(2):109-113. doi: 10.1016/j.ccell.2022.01.012. Epub 2022 Feb 3.

Reference Type BACKGROUND
PMID: 35120599 (View on PubMed)

Other Identifiers

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AI-MCScreen

Identifier Type: -

Identifier Source: org_study_id

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