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RecruitingNCT03374826Updated Oct 31, 2023

PET-MRI for Axillary Staging in Node Negative Breast Cancer Patients

An interventional study of Dedicated axillary hybrid PET-MRI in Breast Cancer, Breast Neoplasms and Breast Diseases, sponsored by Maastricht University Medical Center. Recruiting at 2 sites in Netherlands. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-10-31.

Sponsored by Maastricht University Medical Center · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
125
Allocation
Not applicable
Ages
18 Years and older
Sex
Female
01

Study summary

Axillary lymph node status is an important prognostic factor for patients with breast cancer. After breast cancer diagnosis, current nodal staging consists of axillary ultrasound (US) combined with tissue sampling when deemed necessary. In case of positive axillary lymph nodes, patients will undergo axillary lymph node dissection (ALND). In case of no suspicious axillary lymph nodes (i.e. clinically node negative patients), patients will undergo sentinel lymph node biopsy (SLNB). This surgical nodal staging is accompanied by co-morbidity. In theory, if non-invasive imaging can evaluate the lymph node status accurately, a node negative patient would no longer have to undergo axillary surgery. Since MRI is suitable for soft tissue imaging and PET has the advantage of showing increased metabolic uptake in lymph node metastases, a combination of these techniques in hybrid PET/MRI would be highly desirable. If dedicated axillary hybrid PET/MRI is equally accurate to SLNB for the detection of negative axillary lymph nodes, work-up could be more efficient by bypassing SLNB. However, the accuracy of dedicated axillary hybrid PET/MRI needs to be compared with the pathological outcome of SLNB (gold standard) first.

02

Conditions studied

  • Breast Cancer
  • Breast Neoplasms
  • Breast Diseases
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  1. Female patient with histologically confirmed breast cancer and clinically confirmed negative lymph nodes in the axilla, scheduled to undergo SLNB
  2. Patients who are willing and able to undergo the study procedures
  3. The patient has provided personally written informed consent

Exclusion criteria

Exclusion Criteria:

  1. Patients treated with neoadjuvant systemic therapy prior to axillary nodal staging
  2. Patients with clinically positive axillary lymph nodes
  3. Age \< 18 years
  4. Inability to provide informed consent
  5. Pregnancy
  6. Weight >100 kg (because of the format of the PET/MRI scanner)
  7. General contraindications for MRI (such as pacemaker, aneurysm clips, metallic device in their body, severe claustrophobia) or PET (i.e. known allergy to 18F-FDG)
  8. Hyperglycaemia (> 11 mmol/L) at the time of 18F-FDG injection
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
125 participants (estimated)

Study arms

  • Experimental
    Dedicated axillary hybrid PET-MRI axilla

    Diagnostic Test: Dedicated axillary hybrid PET-MRI

Interventions

  • Diagnostic testDedicated axillary hybrid PET-MRI

    All clinically node negative patients will undergo a hybrid PET-MRI axilla preoperatively, followed by breast surgery and SLNB.

05

What researchers measure

Primary outcomes

  1. Accuracy of dedicated hybrid PET/MRI

    Accuracy (sensitivity, negative predictive value (NPV) and false negative rate (FNR)) of dedicated axillary hybrid PET/MRI to exclude axillary lymph node metastases will be calculated.

    Time frame: Participants will be followed from the moment of first outpatient clinic visit until final breast surgery, an expected average of 4 weeks

Secondary outcomes

  1. Accuracy of T2w MRI, DWI and Hybrid PET/MRI

    Accuracy (sensitivity, negative predictive value (NPV) and false negative rate (FNR)) of three MRI sequences (T2w, DWI and hybrid PET/MRI) to exclude axillary lymph node metastases will be calculated separately as well.

    Time frame: Participants will be followed from the moment of first outpatient clinic visit until final breast surgery, an expected average of 4 weeks

06

Study locations

2 of 2 sites recruiting
  • Maastricht University Medical Center
    Maastricht, Netherlands
    • Kees de Mooij, MD · Contact · c.demooij@maastrichtuniversity.nl · +31 43 388 5054
    • Marjolein Smidt, MD, PhD · Principal investigator
    • Thiemo van Nijnatten, MD, PhD · Sub investigator
    Recruiting
  • Erasmus Medical Center
    Rotterdam, 3015GD, Netherlands
    • Cécile de Monyé, MD, PhD · Contact · c.demonye@erasmusmc.nl · 0031-7040265
    • Cécile de Monyé, MD, PhD · Principal investigator
    • Linetta Koppert, MD, PhD · Sub investigator
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03374826
Lead sponsor
Maastricht University Medical Center
Collaborators
Erasmus Medical Center
Responsible party
Sponsor
First posted
Dec 15, 2017
Start date
Feb 22, 2018
Primary completion
Dec 2023 (estimated)
Completion
Dec 2023 (estimated)
Last update
Oct 31, 2023

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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