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WithdrawnNCT01566045Updated Apr 28, 2021

MRI/TRUS Fusion Guided Prostate Biopsy- An Improved Way to Detect and Quantify Prostate Cancer

An interventional study of Core Needle TRUS Needle biopsy (Transrectal ultrasound) and Core Needle MRI/US image fusion guided needle biopsy in Prostate Cancer, sponsored by Philips Healthcare. Withdrawn at 1 site in United States. Open to male participants aged 18 Years to 120 Years. Per ClinicalTrials.gov, last updated 2021-04-28.

Sponsored by Philips Healthcare · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
0
Allocation
Non-randomized
Ages
18 Years to 120 Years
Sex
Male
01

Study summary

This study will determine if targeted (Magnetic Resonance (MR) / Ultrasound (US) fusion biopsy) plus conventional biopsy is superior to conventional biopsy alone in diagnosing subjects with prostate cancer.

Read the detailed description

The efficacy of targeting lesions for surgery may be limited by the visibility of a target during the procedure. The successful outcome of surgical intervention depends upon accurate device placement, which may be very challenging in certain settings, such as when a kidney tumor only is visible for a brief moment during the transient arterial phase of a contrast injection, and soon disappearing on dynamic imaging.

Historically, prostate cancer was diagnosed by digitally guided trans-rectal prostate biopsies. With PSA (Prostate SPecific Antigen) screening and improvements in ultrasonography, trans-rectal ultrasound (TRUS) guided prostate biopsy have become the standard of care to screen and diagnose localized prostate cancer. Standard US 12-14 core prostate biopsy is now common practice, detecting cancer in 27% to 44% of patients.

Prostate MR imaging with the addition of an endorectal-coil probe and a 3 Tesla magnet dramatically improves diagnostic utility dramatically but biopsies are difficult, time-consuming, and require specialized equipment, which increases the cost significantly.

To meet this challenge TRUS images are overlaid on a previously obtained prostate MRI, combined with an electromagnetic tracking system. The urologist then performs directed prostate biopsies at MR-identified targets in addition to the standard 12-14 core biopsies.

This study will consist of comparison of the standard of care (TRUS guided prostate biopsy) with the protocol biopsy which consists of a TRUS guided prostate biopsy and a MR/US fusion tracked prostate biopsy. Each patient will act as their own control.

02

Conditions studied

  • Prostate Cancer

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Keywords

  • Prostate Cancer
  • Biopsy
03

Who can participate

Ages eligible
18 Years to 120 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  1. All patients must have a pre-operative MRI performed in accordance with our NSHSLIJ/NIH MR prostate imaging guidelines.
  2. Age greater than 18 years.
  3. No serious concurrent medical illness that would preclude the patient from making a rational informed decision on participation.
  4. The ability to understand and willingness to sign a written informed consent form, and to comply with the protocol. If in question, an ethics consult will be obtained.
  5. Ability to tolerate conscious sedation (if procedure to be performed with conscious sedation, and without general anesthesia).
  6. PSA > 2.5 or Abnormal digital rectal exam or current recommendations for biopsy from the American Urological Association
  7. Pre-biopsy prostate MRI as described above, showing targetable lesions within 2 months of biopsy
  8. Able to tolerate a TRUS guided biopsy

Exclusion criteria

Exclusion Criteria:

  1. Patients with an altered mental status that precludes understanding or consenting for the biopsy procedure will be excluded from this study.
  2. Patients unlikely able to hold reasonably still on a procedure table for the length of the procedure.
  3. Inability to hold breath, if procedure will be performed with conscious sedation, and without general anesthesia.
  4. Patients with pacemakers or automatic implantable cardiac defibrillators (contraindications to MRI)
  5. Patients with uncorrectable coagulopathies.
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Active comparator
    Core Needle TRUS biopsy (Transrectal ultrasound)

    Patient receiving core needle TRUS biopsy (Standard of care biopsy)

    Procedure: Core Needle TRUS Needle biopsy (Transrectal ultrasound)

  • Experimental
    Core Needle MRI/US fusion guided biopsy

    Patients receiving Standard of Care core needle TRUS biopsy will then receive the MRI / Ultrasound fusion core needle guided biopsy

    Procedure: Core Needle MRI/US image fusion guided needle biopsy

Interventions

  • ProcedureCore Needle TRUS Needle biopsy (Transrectal ultrasound)

    Standard of care 12-core TRUS sextant needle biopsy of the medial and lateral margins of the right and left apex, mid-gland and base of the prostate

    Also known as: Core Needle biopsy, TRUS needle biopsy (Transrectal ultrasound)

  • ProcedureCore Needle MRI/US image fusion guided needle biopsy

    Directed prostate needle biopsies at MR-image identified targets in addition to the standard ultrasound 12-14 core biopsies

    Also known as: Core Needle biopsy, MRI/US image fusion guided needle biopsy

05

What researchers measure

Primary outcomes

  1. Number of prostate lesions

    To determine if the number of prostate lesions identified by targeted (MR / US fusion biopsy) plus conventional biopsy is statitically greater than the number of lesions identified conventional biopsy alone. The number of positive lesions identified by both techniques will be compared.

    Time frame: Day 1

06

Study locations

1 site
  • The Arthur Smith Institute for Urology
    New Hyde Park, New York 11040, United States
07

Registry details

Key details

Study ID
NCT01566045
Lead sponsor
Philips Healthcare
Responsible party
Sponsor
First posted
Mar 29, 2012
Start date
May 2012
Primary completion
Apr 2015 (estimated)
Completion
Apr 2015 (estimated)
Last update
Apr 28, 2021

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Apr 2021. You cannot join it, but the record below documents what was studied.

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