CClinicalTrials.gg
Status unknownNCT03469726DIA-PANCUpdated Sep 21, 2021

Contrast-enhanced Diffusion-weighted MRI to Detect Liver Metastases in Patients With Pancreatic Cancer

An interventional study of Contrast-enhanced Diffusion-weighted MRI in Pancreatic Neoplasms, sponsored by Radboud University Medical Center. Status unknown at 7 sites in 4 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-09-21.

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

The sponsor has not verified this record recently (last verified Oct 2020), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
465
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Given the dismal prognosis of pancreatic cancer, detecting liver metastases early can avoid inappropriate therapy with the associated substantial risks, long-term hospital admissions and high costs, but without survival benefit. The current standard of diagnostic workup with contrast-enhanced CT (CECT) has a poor sensitivity (38-76%) for the detection of liver metastases. As more sophisticated and expensive treatment options emerge, better staging of pancreatic cancer is needed to avoid unnecessary procedures and select the most appropriate treatment strategy. New imaging modalities are available, but their value in staging of pancreatic cancer has not been evaluated yet. Therefore prospective imaging studies are necessary.

The main aim of this study is to determine the diagnostic accuracy of contrast-enhanced diffusion-weighted MRI (CE-DW-MRI) in the detection of liver metastases in patients with pancreatic cancer compared to a reference standard of histopathology and follow up imaging.

The study is an international, multicenter prospective cohort study (inclusion of patients until 138 patients with liver metastases are included, with a total maximum of 465 patients). Patients with pancreatic cancer will undergo additional CE-DW-MRI within two weeks from the CECT. CECT and CE-DW-MRI will be read independently by two radiologists. Suspected liver lesions on CECT and/or CE-DW-MRI will be biopsied to obtain histopathology as reference standard. For liver lesions without histopathologic proof of metastases a paired follow-up CECT and CE-DW-MRI serve as a composite reference standard. Pancreatic resection will be pursued in patients without proven liver or distant metastases. Patients with locally advanced or metastatic disease will be offered palliative treatment. Follow up CECT and CE-DW-MRI will be performed in all patients at 3, 6, and 12 months.

02

Conditions studied

  • Pancreatic Neoplasms

Keywords

  • Liver metastases
  • Diffusion weighted MRI
03

Who can participate

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

Inclusion criteria

  • 18 years and older
  • clinical suspicion of pancreatic cancer
  • written (signed and dated) informed consent

Exclusion criteria

Exclusion Criteria:

  • previous treatment for pancreatic cancer (e.g. chemotherapy, radiotherapy, surgery, ablation therapy)
  • concomitant malignancies, except for adequately treated basocellular carcinoma of the skin or in situ carcinoma of the cervix uteri. Subjects with prior malignancies must be disease-free for at least 5 years
  • contra-indications to undergo CT (due to e.g. extreme claustrophobia, untreatable contrast allergy, renal function impairment)
  • contra-indications to undergo MRI (due to e.g. claustrophobia, untreatable contrast allergy, or not MRI compatible medical devices)
  • insufficient command of the Dutch language to be able to understand the patient information or fill in the questionnaires
  • pregnancy
04

Study design

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

Study arms

  • Other
    Patients with (suspected) PDAC

    Patients with (suspected) pancreatic cancer will undergo additional Contrast-enhanced Diffusion-weighted MRI (CE-DW-MRI) within two weeks from the CECT. Suspected liver lesions on CECT and/or CE-DW-MRI will be biopsied to obtain histopathology as reference standard. For liver lesions without histopathologic proof of metastases a paired follow-up CECT and CE-DW-MRI serve as a composite reference standard. Follow up CECT and CE-DW-MRI will be performed in all patients at 3, 6, and 12 months.

    Diagnostic Test: Contrast-enhanced Diffusion-weighted MRI

Interventions

  • Diagnostic testContrast-enhanced Diffusion-weighted MRI

    An MRI scan enhanced with intravenous contrast and with diffusion imaging at several B-values

05

What researchers measure

Primary outcomes

  1. Diagnostic accuracy of CE-DW-MRI

    Sensitivity and Specificity of CE-DW-MRI for the detection of liver metastases in patients with pancreatic cancer compared to CECT.

    Time frame: Baseline

Secondary outcomes

  1. Detection of metastasis on CE-DW-MRI in follow-up (3, 6 and 12 months after baseline)

    Detection of metastasis with CE-DW-MRI, compared to CECT, in follow-up (3, 6 and 12 months after baseline) of patients with pancreatic cancer, after or during therapy

    Time frame: 3, 6 and 12 months

  2. Assess local resectability

    Sensitivity and specificity for CT and MRI to assess local resectability for all patients that underwent surgery

    Time frame: Baseline

Other outcomes

  1. One year survival

    Survival rate after 1 year of follow-up

    Time frame: Maximum 1 year

  2. Median survival

    Median survival time

    Time frame: Maximum 1 year

  3. Disease free survival

    Time without (local) recurrence of cancer in patients that underwent resection

    Time frame: Maximum 1 year

  4. Progression free survival

    Time without progression of cancer

    Time frame: Maximum 1 year

06

Study locations

7 of 7 sites recruiting
  • Konstantopouleio general hospital
    Athens, Greece
    • Charikleia Triantopoulou, MD, PhD · Contact
    Recruiting
  • Radboudumc
    Nijmegen, Gelderland 6525GA, Netherlands
    Recruiting
  • Jeroen Bosch Ziekenhuis
    Den Bosch, 5223 GZ, Netherlands
    • Koop Bosscha, MD, PhD · Contact
    Recruiting
  • Medisch Spectrum Twente
    Enschede, 7512KZ, Netherlands
    • Niels G Venneman, MD, PhD · Contact
    Recruiting
  • Universitair Medisch Centrum Groningen
    Groningen, Netherlands
    • Koert de Jong, MD, PhD · Contact
    Recruiting
  • Hospital Universitario Ramón y Cajal
    Madrid, Spain
    • Julie Earl, PhD · Contact
    Recruiting
  • Inselspital
    Bern, Switzerland
    • Adrian Huber, MD, PhD · Contact
    Recruiting
07

References and documents

Publications

  • Litjens G, Riviere DM, van Geenen EJM, Radema SA, Brosens LAA, Prokop M, van Laarhoven CJHM, Hermans JJ. Diagnostic accuracy of contrast-enhanced diffusion-weighted MRI for liver metastases of pancreatic cancer: towards adequate staging and follow-up of pancreatic cancer - DIA-PANC study: study protocol for an international, multicenter, diagnostic trial. BMC Cancer. 2020 Aug 10;20(1):744. doi: 10.1186/s12885-020-07226-0. PubMed 32778061 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT03469726
Lead sponsor
Radboud University Medical Center
Collaborators
Dutch Cancer Society
Responsible party
Sponsor
First posted
Mar 19, 2018
Start date
Dec 22, 2017
Primary completion
Jan 1, 2022 (estimated)
Completion
Jan 1, 2023 (estimated)
Last update
Sep 21, 2021

Study contacts

Geke Litjens, MD
Contact
g.litjens@radboudumc.nl
+31243668392
John J. Hermans, dr. ir.
principal investigator · Radboudumc, Department of Radiology and Nuclear Medicine
Kees C.J.H.M. van Laarhoven, prof. dr.
principal investigator · Radboudumc, Department of Surgery

Oversight

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

Not currently enrolling

This study is status unknown, as verified in Oct 2020. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion