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Comparing Restriction Spectrum Imaging (RSI) to Conventional and Abbreviated Breast MRI for Breast Cancer Screening

Primary Purpose

Breast Cancer

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
MRI
RSI
Sponsored by
Beth Israel Deaconess Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for Breast Cancer focused on measuring Breast Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Group 1 will consist of women who present for screening breast MRI:

    • Age >= 18
    • Female
    • Asymptomatic for breast disease
    • Presenting for routine breast cancer screening with MRI
  • Group 2 will consist of women who presented for a screening mammogram (2D or 3D tomosynthesis) AND who have had a biopsy recommended after diagnostic workup:

    • Age >= 18
    • Female
    • Asymptomatic for breast disease
    • Presenting for routine breast cancer screening with mammogram (2D or 3D tomosynthesis) and/or ultrasound
    • Biopsy recommended after subsequent diagnostic workup (BI-RADS 4 or 5)

Radiologist Reader Participant

Inclusion Criteria

  • Must have clinical experience in interpreting breast MRI.
  • Must have interpreted at least 10 breast MRI exams with RSI interpretation.

Exclusion Criteria:

-Known or suspected renal insufficiency, rendering the participant unable to safely receive intravenous contrast based on institutional clinical protocol.

Renal insufficiency for the purposes of exclusion includes any of the following:

  • Failed Chokye questionnaire
  • Known history of end stage renal disease with EGFR<30 mL/min/1.73m2
  • Point of care (POC) measure of creatinine clearance (eGFR) prior to obtaining the MRI <35. We will perform this POC test as needed per institutional policy for routine MRI if: (a) no creatinine result is available in the OMR within 30 days of the MRI exam, (b) the patient is > 60 years old, or (c) the patient is on hydroxyurea.

    • History of adverse or allergic-like reaction to gadolinium MRI intravenous contrast, rendering the participant unable to safely receive intravenous contrast based on institutional clinical protocol.
    • Presence of MRI unsafe devices or objects which would make having an MRI unsafe, as per institutional clinical protocol. MRI unsafe devices or objects for the purposes of exclusion include but are not limited to certain intracranial aneurysm clips, cardiac pacemaker, and implantable defibrillator devices, metallic heart valve, or coronary artery stents, breast tissue expanders, bio or neurostimulators, pellets and bullets, ocular implants and devices, otologic and cochlear implants. Other devices or metallic objects may be deemed unsafe for MRI at the radiologist's discretion.
    • Unable to tolerate exam (i.e., secondary to untreatable claustrophobia, positioning constraints/unable to lie prone).
    • Body weight exceeds that allowable by the MRI table.
    • Breast biopsy or surgical intervention planned before the test RSI-MRI in this study.
    • Breast implants (silicone or saline).

      8. Nursing or thinks she may be or is pregnant, as gadolinium contrast-enhanced MRI is unsafe. We will perform a pregnancy test as needed per institutional policy for routine breast MRI. Per institutional clinical protocol, all females of childbearing potential who are uncertain if they are pregnant or think they are pregnant must have a blood test or urine study within 2 weeks prior to the MRI exam to rule out pregnancy. A female of childbearing potential is any woman, regardless of sexual orientation or prior tubal ligation, who:

    • Has not had a hysterectomy or bilateral oophorectomy OR
    • Has not been naturally post-menopausal for at least 2 years (i.e., has had menses at any time in the preceding 2 years

Radiologist Reader Participant

-None.

Sites / Locations

  • Beth Israel Deaconess Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

SCREENING MRI

SCREENING MG BI-RADS 4/5

Arm Description

Standard MRI procedure will be used.

RSI is a DWI sequence with a built in distortion-correction technique that can be applied to any diffusion technique using echo planar imaging acquisition. RSI will be performed using pulsed-field gradient, spin-echo, echo planar imaging with "multi-shell" diffusion data . The b0 images will be collected in both the forward and reverse phase encoding directions to allow for post-processing correction of spatial distortion from magnetic field.

Outcomes

Primary Outcome Measures

Diagnostic accuracy of breast restriction spectrum imaging (RSI) in comparison to conventional breast MRI
We will test the non-inferiority of RSI compared to DCE-MRI using ROC curves created for the BI-RADS score, based on the reader study.

Secondary Outcome Measures

Diagnostic accuracy of RSI compared to that of abbreviated MRI (Ab-MRI) in breast cancer screening
We will test the non-inferiority of RSI compared to Ab-MRI using ROC curves created for the BI-RADS score, based on the reader study.

Full Information

First Posted
April 4, 2018
Last Updated
June 9, 2023
Sponsor
Beth Israel Deaconess Medical Center
Collaborators
Radiological Society of North America, Dana-Farber Cancer Institute
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1. Study Identification

Unique Protocol Identification Number
NCT03495115
Brief Title
Comparing Restriction Spectrum Imaging (RSI) to Conventional and Abbreviated Breast MRI for Breast Cancer Screening
Official Title
Comparing Restriction Spectrum Imaging (RSI) to Conventional and Abbreviated Breast MRI for Breast Cancer Screening
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 18, 2018 (Actual)
Primary Completion Date
December 30, 2023 (Anticipated)
Study Completion Date
December 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Beth Israel Deaconess Medical Center
Collaborators
Radiological Society of North America, Dana-Farber Cancer Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is looking at a breast cancer screening technique, restriction spectrum imaging (RSI), as a possible alternative to the breast Magnetic Resonance Imaging (MRI) used by most healthcare professionals. The technique involved in this study is: -Restriction Spectrum Imaging (RSI)
Detailed Description
The primary purpose of this research study is to measure RSI's ability to diagnose breast cancer in comparison to standard breast MRIs. RSI is a technique that has been shown to address the limitations of certain types of MRI exams used to make images of the prostate and brain. RSI is not a FDA-approved technique for screening, but is a type of advanced diffusion technique and diffusion weighted imaging is used as a part of the standard breast MRI. RSI has been shown to improve tumor detection in prostate and brain. For example, a recent pilot study in prostate showed that adding RSI improved the ability to find a certain stage of prostate cancer in comparison to an MRI without the use of the RSI technique. By comparing RSI's ability to diagnose breast cancer, future clinical testing can determine whether RSI is a more efficient way to screen for breast cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
Breast Cancer

7. Study Design

Primary Purpose
Screening
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
910 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SCREENING MRI
Arm Type
Active Comparator
Arm Description
Standard MRI procedure will be used.
Arm Title
SCREENING MG BI-RADS 4/5
Arm Type
Experimental
Arm Description
RSI is a DWI sequence with a built in distortion-correction technique that can be applied to any diffusion technique using echo planar imaging acquisition. RSI will be performed using pulsed-field gradient, spin-echo, echo planar imaging with "multi-shell" diffusion data . The b0 images will be collected in both the forward and reverse phase encoding directions to allow for post-processing correction of spatial distortion from magnetic field.
Intervention Type
Device
Intervention Name(s)
MRI
Intervention Description
A MRI uses a strong magnet to produce detailed pictures of the inside of your body.
Intervention Type
Device
Intervention Name(s)
RSI
Intervention Description
RSI is a technique that aims to improve the pictures produced during a MRI exam.
Primary Outcome Measure Information:
Title
Diagnostic accuracy of breast restriction spectrum imaging (RSI) in comparison to conventional breast MRI
Description
We will test the non-inferiority of RSI compared to DCE-MRI using ROC curves created for the BI-RADS score, based on the reader study.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Diagnostic accuracy of RSI compared to that of abbreviated MRI (Ab-MRI) in breast cancer screening
Description
We will test the non-inferiority of RSI compared to Ab-MRI using ROC curves created for the BI-RADS score, based on the reader study.
Time Frame
2 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Group 1 will consist of women who present for screening breast MRI: Age >= 18 Female Asymptomatic for breast disease Presenting for routine breast cancer screening with MRI Group 2 will consist of women who presented for a screening mammogram (2D or 3D tomosynthesis) AND who have had a biopsy recommended after diagnostic workup: Age >= 18 Female Asymptomatic for breast disease Presenting for routine breast cancer screening with mammogram (2D or 3D tomosynthesis) and/or ultrasound Biopsy recommended after subsequent diagnostic workup (BI-RADS 4 or 5) Radiologist Reader Participant Inclusion Criteria Must have clinical experience in interpreting breast MRI. Must have interpreted at least 10 breast MRI exams with RSI interpretation. Exclusion Criteria: -Known or suspected renal insufficiency, rendering the participant unable to safely receive intravenous contrast based on institutional clinical protocol. Renal insufficiency for the purposes of exclusion includes any of the following: Failed Chokye questionnaire Known history of end stage renal disease with EGFR<30 mL/min/1.73m2 Point of care (POC) measure of creatinine clearance (eGFR) prior to obtaining the MRI <35. We will perform this POC test as needed per institutional policy for routine MRI if: (a) no creatinine result is available in the OMR within 30 days of the MRI exam, (b) the patient is > 60 years old, or (c) the patient is on hydroxyurea. History of adverse or allergic-like reaction to gadolinium MRI intravenous contrast, rendering the participant unable to safely receive intravenous contrast based on institutional clinical protocol. Presence of MRI unsafe devices or objects which would make having an MRI unsafe, as per institutional clinical protocol. MRI unsafe devices or objects for the purposes of exclusion include but are not limited to certain intracranial aneurysm clips, cardiac pacemaker, and implantable defibrillator devices, metallic heart valve, or coronary artery stents, breast tissue expanders, bio or neurostimulators, pellets and bullets, ocular implants and devices, otologic and cochlear implants. Other devices or metallic objects may be deemed unsafe for MRI at the radiologist's discretion. Unable to tolerate exam (i.e., secondary to untreatable claustrophobia, positioning constraints/unable to lie prone). Body weight exceeds that allowable by the MRI table. Breast biopsy or surgical intervention planned before the test RSI-MRI in this study. Breast implants (silicone or saline). 8. Nursing or thinks she may be or is pregnant, as gadolinium contrast-enhanced MRI is unsafe. We will perform a pregnancy test as needed per institutional policy for routine breast MRI. Per institutional clinical protocol, all females of childbearing potential who are uncertain if they are pregnant or think they are pregnant must have a blood test or urine study within 2 weeks prior to the MRI exam to rule out pregnancy. A female of childbearing potential is any woman, regardless of sexual orientation or prior tubal ligation, who: Has not had a hysterectomy or bilateral oophorectomy OR Has not been naturally post-menopausal for at least 2 years (i.e., has had menses at any time in the preceding 2 years Radiologist Reader Participant -None.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Vandana Dialani, MD
Organizational Affiliation
Beth Israel Deaconess Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Comparing Restriction Spectrum Imaging (RSI) to Conventional and Abbreviated Breast MRI for Breast Cancer Screening

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