Quantitative Margin Assessment Using High-resolution Positron Emission Tomography - Computed Tomograhy

NCT ID: NCT06726512

Last Updated: 2024-12-10

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-31

Study Completion Date

2026-04-30

Brief Summary

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The primary endpoint is the assessment of the clinical value of a novel high-resolution mobile PET-CT scanner for intraoperative margin assessment in oral squamous cell carcinoma, soft tissue sarcoma and osteosarcoma surgery. The predicted margin status will be correlated with the margin status determined with histopathology.

Detailed Description

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The ideal outcome in oncological surgery is resection of all tumor tissue with a margin of healthy tissue. However, positive surgical margins (PSMs) occur in up to 35% of the cases, depending on tumor type. The final margin status is only available five to seven days after surgery so that in case of a PSM, intensive adjuvant radiotherapy or chemotherapy is necessary. Despite adjuvant treatment, patients still have a significantly reduced overall survival. Therefore, the intraoperative identification of PSMs is paramount to enable surgical corrections and obtain a complete resection.

The investigators propose a dedicated intraoperative high-resolution PET-CT (positron emission tomography - computed tomography) imaging system for margin assessment of the excised specimen. The proposed specimen imaging system would combine the proven functional imaging capabilities of PET with the anatomical imaging info of CT, providing multi-modal information to determine whether tumor cells are present at the excision edges of the specimen. The tomographic images obtained can precisely demonstrate tumor extension along the x, y, and z axis, and the PET signal is not distorted by bone tissue. PET is the most sensitive medical imaging modality capable of detecting the picomolar concentrations of radiotracer, allowing to assess the presence of tumor cells within the specimen margins with high precision. Current standard PET-CT scanners have a spatial resolution between 3mm and 6mm, which is insufficient to accurately assess the excision margins of tumors. A specimen imaging system ideally should have a sub-millimeter resolution. The specimen PET system which will be used in this study is capable of this. The potential of intraoperative PET-CT has been shown in several tumor types, enabling the intraoperative identification of PSMs in prostatectomy and lumpectomy specimens.

Conditions

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Oral Cancer Osteosarcoma Soft Tissue Sarcoma Oral Squamous Cell Carcinoma (OSCC)

Keywords

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margin assessment image-guided surgery PET-CT

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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2 MBq 18F-FDG

Subjects are intravenously administered with 2.0 MBq/kg 18F-FDG, standard tracer used to diagnose and stage the malignancy. After standard of care excision of the primary tumor, a high-resolution PET-CT imaging of the fresh surgical specimen will be performed.

Group Type OTHER

XEOS AURA 10

Intervention Type DEVICE

Surgery is performed according to standard of care. Directly after surgery, the surgical specimen is taken outside the operation theatre in a dedicated imaging room at the Department of Nuclear Medicine where high-resolution PET-CT imaging of the surgical specimen is performed.

Interventions

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XEOS AURA 10

Surgery is performed according to standard of care. Directly after surgery, the surgical specimen is taken outside the operation theatre in a dedicated imaging room at the Department of Nuclear Medicine where high-resolution PET-CT imaging of the surgical specimen is performed.

Intervention Type DEVICE

Other Intervention Names

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PET PET/CT High resolution PET/CT Margin detection Margin status

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years.
* Patient is confirmed with oral squamous cell carcinoma, soft tissue sarcoma or osteosarcoma.
* Patient is indicated to undergo curative surgery of the primary tumor.
* Patient is estimated compliant for study participation by the investigator.
* Written informed consent.

Exclusion Criteria

* Medical or psychiatric conditions that compromise the patient's ability to give informed consent;
* Patient has previously received radiotherapy of the primary tumor region;
* Patient has participated in other clinical studies with radiation exposure of more than 1 mSv in the past 12 months;
* A blood glucose level over 200 mg/dL on the day of surgery.
* Pregnancy or lactation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Medical Center Groningen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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University Medical Center Groningen

Groningen, , Netherlands

Site Status

Countries

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Netherlands

Central Contacts

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Jasper Vonk, Dr.

Role: CONTACT

Phone: +31 50 36162029

Email: [email protected]

Facility Contacts

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Jasper Vonk, Dr

Role: primary

Rik de Jong

Role: backup

Other Identifiers

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NL86142.042.24

Identifier Type: -

Identifier Source: org_study_id