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2 Phase Comparison of Pre-operative CT and PET Images for Metastatic Colorectal Cancer

Primary Purpose

Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IV A Bladder Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PET Scan
CT Scan
fludeoxyglucose F 18
computer-aided detection/diagnosis
Sponsored by
Ohio State University Comprehensive Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Recurrent Colon Cancer focused on measuring computed tomography, CT scan, positron emission tomography, PET, Metastatic Colorectal Cancer

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with histologically-confirmed colorectal carcinoma and preoperative PET scan with evidence of hypermetabolic lesions suspicious for cancer will be eligible for this study. In cases of primary cancer, there must be a tissue-confirmed diagnosis. In recurrent cases, patients must have clinical evidence by CT or MRI of disease suitable for resection.
  • Patients must be candidates for clinically indicated surgery.
  • Patients with recurrent disease may have had prior surgery and/or chemotherapy with no limit to the number of prior therapeutic procedures or chemotherapeutic regimens.
  • Patients must have a performance status of 0, 1 or 2 by ECOG(Eastern Cooperative Oncology Group)standards.
  • Patients must give written informed consent including consent to have IV line placed for FDG administration.
  • Patients must be at least 18 years of age. Children under the age of 18 are excluded from the study due to the rarity of colorectal cancer in children.
  • Because radiolabeled agents are known to be teratogenic, women of child-bearing potential and men must agree to use an acceptable form of contraception prior to study entry and for the duration of the study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  • Organ function requirements: Patients must have organ and marrow function adequate to undergo laparotomy. Specifically:
  • Serum creatinine < 2.0 mg/dl
  • Serum bilirubin < 2.0 mg/dl
  • AST(aspartate aminotransferase,serum glutamate oxaloacetate transaminase, serum glutamate oxaloacetate transaminase,serum glutamate pyruvate transaminase)[SGOT]/ALT[SGPT]<4 times institutional upper limit of normal
  • Total WBC(white blood cell)>4,000/mm3 or ANC(absolute neutrophil count)> 1,500/mm3
  • Platelets > 100,000/mm3
  • Hgb >10g/dl
  • Patient must have no clinically significant cardiac disease (New York Heart Association Class III/IV); no serious infection requiring treatment with antibiotics; no other serious ill-ness or illness requiring the use of steroids; no clinically significant pulmonary disease or other illness that would contraindicate or increase the risk of complications at surgery.
  • Fasting blood sugar less than 120 mg/dl

Exclusion Criteria:

  • Patients with active CNS (central nervous system)tumor involvement are ineligible.
  • Any patient who has retained childbearing potential will not be pregnant or lactating and must use adequate contraception to assure avoidance of conception.
  • Body size prohibits use of the diagnostic equipment (portable CT scanner).
  • Tumor burden is so great (as determined by preoperative PET scanning or intraoperative findings) that further surgery is not advised.
  • If lesions are detected with preoperative CT but not with PET scanning (in other words, all patients will have a positive PET scan as part of the inclusion criteria).

Sites / Locations

  • Ohio State University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Preoperative PET and CT Scans

Arm Description

Patients undergo preoperative whole-body PET scans and CT scans of the abdomen and pelvis. Patients then receive fluoro-deoxyglucose (FDG)IV 60-90 minutes prior to surgery and undergo intraoperative CT scans using a handheld probe and computer navigation system.

Outcomes

Primary Outcome Measures

Detection of Position Accuracy With Handheld Probe on Anatomical Location.

Secondary Outcome Measures

All Adverse Events and Complications
Tumor Detection

Full Information

First Posted
August 9, 2012
Last Updated
February 3, 2016
Sponsor
Ohio State University Comprehensive Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT01821105
Brief Title
2 Phase Comparison of Pre-operative CT and PET Images for Metastatic Colorectal Cancer
Official Title
A 2 Phase Comparison of Pre-operative CT AND PET Images in the Intraoperative Detection of Disease to a Hand-held Probe, and to an Intraoperative CT Scan in Patients Undergoing Surgery for Metastatic Colorectal Cancer.
Study Type
Interventional

2. Study Status

Record Verification Date
February 2016
Overall Recruitment Status
Completed
Study Start Date
March 2004 (undefined)
Primary Completion Date
November 2009 (Actual)
Study Completion Date
November 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ohio State University Comprehensive Cancer Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This pilot phase II studies how well computed tomography (CT) and positron emission tomography (PET) imaging works in detecting disease in patients undergoing surgery for metastatic colorectal cancer. Diagnostic procedures, such as CT and PET scans, done before and during surgery may help find colorectal cancer and help guide surgery
Detailed Description
PRIMARY OBJECTIVES: I. To determine the feasibility of rigidly (linearly) registering PET to CT images and applying this fused dataset to guide surgery with an image-guided navigation system and a handheld positron probe in order to facilitate disease detection and improve resection accuracy in advanced stage colorectal cancer. II. To complete development of software for the nonlinear registration of PET and CT datasets. OUTLINE: Patients undergo preoperative whole-body PET scans and CT scans of the abdomen and pelvis. Patients then receive 18 F fludeoxyglucose (FDG) intravenously (IV) 60-90 minutes prior to surgery and undergo intraoperative CT scans using a handheld probe and computer navigation system.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Colon Cancer, Recurrent Rectal Cancer, Stage IV A Bladder Cancer, Stage IV A Rectal Cancer, Stage IV B Colon Cancer, Stage IV B Rectal Cancer
Keywords
computed tomography, CT scan, positron emission tomography, PET, Metastatic Colorectal Cancer

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
21 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Preoperative PET and CT Scans
Arm Type
Experimental
Arm Description
Patients undergo preoperative whole-body PET scans and CT scans of the abdomen and pelvis. Patients then receive fluoro-deoxyglucose (FDG)IV 60-90 minutes prior to surgery and undergo intraoperative CT scans using a handheld probe and computer navigation system.
Intervention Type
Procedure
Intervention Name(s)
PET Scan
Intervention Description
All patients will receive whole body PET scans (chest-abdomen-pelvis).
Intervention Type
Procedure
Intervention Name(s)
CT Scan
Intervention Description
All patients will receive CT scans of the abdomen and pelvis with contrast.
Intervention Type
Radiation
Intervention Name(s)
fludeoxyglucose F 18
Other Intervention Name(s)
18FDG, FDG
Intervention Description
Given IV
Intervention Type
Procedure
Intervention Name(s)
computer-aided detection/diagnosis
Intervention Description
Undergo computer-aided detection/diagnosis during surgery
Primary Outcome Measure Information:
Title
Detection of Position Accuracy With Handheld Probe on Anatomical Location.
Time Frame
up to 12 months
Secondary Outcome Measure Information:
Title
All Adverse Events and Complications
Time Frame
up to 12 months
Title
Tumor Detection
Time Frame
At surgery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with histologically-confirmed colorectal carcinoma and preoperative PET scan with evidence of hypermetabolic lesions suspicious for cancer will be eligible for this study. In cases of primary cancer, there must be a tissue-confirmed diagnosis. In recurrent cases, patients must have clinical evidence by CT or MRI of disease suitable for resection. Patients must be candidates for clinically indicated surgery. Patients with recurrent disease may have had prior surgery and/or chemotherapy with no limit to the number of prior therapeutic procedures or chemotherapeutic regimens. Patients must have a performance status of 0, 1 or 2 by ECOG(Eastern Cooperative Oncology Group)standards. Patients must give written informed consent including consent to have IV line placed for FDG administration. Patients must be at least 18 years of age. Children under the age of 18 are excluded from the study due to the rarity of colorectal cancer in children. Because radiolabeled agents are known to be teratogenic, women of child-bearing potential and men must agree to use an acceptable form of contraception prior to study entry and for the duration of the study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Organ function requirements: Patients must have organ and marrow function adequate to undergo laparotomy. Specifically: Serum creatinine < 2.0 mg/dl Serum bilirubin < 2.0 mg/dl AST(aspartate aminotransferase,serum glutamate oxaloacetate transaminase, serum glutamate oxaloacetate transaminase,serum glutamate pyruvate transaminase)[SGOT]/ALT[SGPT]<4 times institutional upper limit of normal Total WBC(white blood cell)>4,000/mm3 or ANC(absolute neutrophil count)> 1,500/mm3 Platelets > 100,000/mm3 Hgb >10g/dl Patient must have no clinically significant cardiac disease (New York Heart Association Class III/IV); no serious infection requiring treatment with antibiotics; no other serious ill-ness or illness requiring the use of steroids; no clinically significant pulmonary disease or other illness that would contraindicate or increase the risk of complications at surgery. Fasting blood sugar less than 120 mg/dl Exclusion Criteria: Patients with active CNS (central nervous system)tumor involvement are ineligible. Any patient who has retained childbearing potential will not be pregnant or lactating and must use adequate contraception to assure avoidance of conception. Body size prohibits use of the diagnostic equipment (portable CT scanner). Tumor burden is so great (as determined by preoperative PET scanning or intraoperative findings) that further surgery is not advised. If lesions are detected with preoperative CT but not with PET scanning (in other words, all patients will have a positive PET scan as part of the inclusion criteria).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Edward Martin, MD
Organizational Affiliation
Ohio State University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
17634125
Citation
Sarikaya I, Povoski SP, Al-Saif OH, Kocak E, Bloomston M, Marsh S, Cao Z, Murrey DA, Zhang J, Hall NC, Knopp MV, Martin EW Jr. Combined use of preoperative 18F FDG-PET imaging and intraoperative gamma probe detection for accurate assessment of tumor recurrence in patients with colorectal cancer. World J Surg Oncol. 2007 Jul 16;5:80. doi: 10.1186/1477-7819-5-80.
Results Reference
result
Links:
URL
http://cancer.osu.edu
Description
Jamesline

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2 Phase Comparison of Pre-operative CT and PET Images for Metastatic Colorectal Cancer

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