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Improving Characterization of Calcifications With Contrast-Enhanced Mammography

Primary Purpose

Mammography

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Contrast-enhanced mammography
Biopsy
Sponsored by
Washington University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Mammography

Eligibility Criteria

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

Inclusion Criteria:

  • Women with calcifications detected on screening mammogram for which biopsy is recommended following characterization on diagnostic mammography.
  • At least 30 years of age.
  • Able to understand and willing to sign an IRB-approved written informed consent document
  • GFR ≥ 30 mL/min/1.73 m2

Exclusion Criteria:

  • Pregnant
  • Prior history of allergy or hypersensitivity reaction to iodinated contrast
  • History of chronic renal disease (including dialysis, kidney transplant, single kidney, renal cancer, or renal surgery)
  • Patients with known thyroid disorders, pheochromocytoma or sickle cell anemia

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Contrast-enhanced mammography (CME)

    Arm Description

    -Patients who meet eligibility criteria and consent to participate in this study will complete a CEM examination prior to or on the day that biopsy is scheduled. CEM must occur no later than 60 days after the diagnostic mammogram. The standard of care biopsy must occur no later than 30 days after CEM.

    Outcomes

    Primary Outcome Measures

    Evaluate risk characterization of screen-detected calcifications by CEM
    -The proportion of women with abnormal enhancement (yes/no) will be compared to the pathology results from the core needle biopsy (benign versus high risk/malignant)

    Secondary Outcome Measures

    Rate of detection of additional sites of disease in the same or contralateral breast on CEM
    This will be defined as presence of abnormal enhancement in the same breast at least 2 cm away from the margin of the calcifications of interest or any presence of abnormal enhancement in the contralateral breast at the time of CEM -The reference standard in this case will also be based on pathology results from core needle biopsy (if additional biopsies are performed) or findings on surgical pathology if the patient elects for mastectomy, with the decision for core needle biopsy and lumpectomy vs mastectomy according to surgeon preference and standard of care.
    Ability of CEM to determine whether accuracy for cancer detection varies as a function of breast density
    -Breast density category is routinely reported in the screening mammography report and accepted categories include predominantly fatty, scattered fibroglandular densities, heterogeneously dense, and extremely dense.
    Ability of whether CEM accuracy for cancer detection varies as a function of the morphology of calcifications as depicted on screening and diagnostic mammography
    -Morphology of calcifications include amorphous, coarse heterogeneous, fine pleomorphic, or fine linear branching and/or based on distribution of the calcifications as either diffuse, regional, grouped, linear, or segmental, according to the descriptors in the imaging reports

    Full Information

    First Posted
    July 31, 2018
    Last Updated
    May 10, 2019
    Sponsor
    Washington University School of Medicine
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03639129
    Brief Title
    Improving Characterization of Calcifications With Contrast-Enhanced Mammography
    Official Title
    Improving Characterization of Calcifications With Contrast-Enhanced Mammography
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2019
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Insufficient funding
    Study Start Date
    May 31, 2019 (Anticipated)
    Primary Completion Date
    May 31, 2021 (Anticipated)
    Study Completion Date
    May 31, 2021 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Washington University School of Medicine

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    Yes
    Product Manufactured in and Exported from the U.S.
    Yes
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study protocol is to assess whether contrast-enhanced mammography (CEM) will increase the accuracy of characterization of microcalcifications detected on screening mammography prior to biopsy as either benign, high risk, or malignant.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Mammography

    7. Study Design

    Primary Purpose
    Diagnostic
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Contrast-enhanced mammography (CME)
    Arm Type
    Experimental
    Arm Description
    -Patients who meet eligibility criteria and consent to participate in this study will complete a CEM examination prior to or on the day that biopsy is scheduled. CEM must occur no later than 60 days after the diagnostic mammogram. The standard of care biopsy must occur no later than 30 days after CEM.
    Intervention Type
    Device
    Intervention Name(s)
    Contrast-enhanced mammography
    Other Intervention Name(s)
    CME
    Intervention Description
    Contrast-enhanced mammography was FDA approved in 2012 and is currently being used in both clinical and research settings at breast imaging centers throughout the world
    Intervention Type
    Procedure
    Intervention Name(s)
    Biopsy
    Intervention Description
    Standard of care
    Primary Outcome Measure Information:
    Title
    Evaluate risk characterization of screen-detected calcifications by CEM
    Description
    -The proportion of women with abnormal enhancement (yes/no) will be compared to the pathology results from the core needle biopsy (benign versus high risk/malignant)
    Time Frame
    Up to 30 days after the CEM
    Secondary Outcome Measure Information:
    Title
    Rate of detection of additional sites of disease in the same or contralateral breast on CEM
    Description
    This will be defined as presence of abnormal enhancement in the same breast at least 2 cm away from the margin of the calcifications of interest or any presence of abnormal enhancement in the contralateral breast at the time of CEM -The reference standard in this case will also be based on pathology results from core needle biopsy (if additional biopsies are performed) or findings on surgical pathology if the patient elects for mastectomy, with the decision for core needle biopsy and lumpectomy vs mastectomy according to surgeon preference and standard of care.
    Time Frame
    At the time of the CEM (day 1)
    Title
    Ability of CEM to determine whether accuracy for cancer detection varies as a function of breast density
    Description
    -Breast density category is routinely reported in the screening mammography report and accepted categories include predominantly fatty, scattered fibroglandular densities, heterogeneously dense, and extremely dense.
    Time Frame
    At the time of the CEM (day 1)
    Title
    Ability of whether CEM accuracy for cancer detection varies as a function of the morphology of calcifications as depicted on screening and diagnostic mammography
    Description
    -Morphology of calcifications include amorphous, coarse heterogeneous, fine pleomorphic, or fine linear branching and/or based on distribution of the calcifications as either diffuse, regional, grouped, linear, or segmental, according to the descriptors in the imaging reports
    Time Frame
    At the time of the CEM (day 1)

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    30 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Women with calcifications detected on screening mammogram for which biopsy is recommended following characterization on diagnostic mammography. At least 30 years of age. Able to understand and willing to sign an IRB-approved written informed consent document GFR ≥ 30 mL/min/1.73 m2 Exclusion Criteria: Pregnant Prior history of allergy or hypersensitivity reaction to iodinated contrast History of chronic renal disease (including dialysis, kidney transplant, single kidney, renal cancer, or renal surgery) Patients with known thyroid disorders, pheochromocytoma or sickle cell anemia
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Matthew Covington, M.D.
    Organizational Affiliation
    Washington University School of Medicine
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Links:
    URL
    http://www.siteman.wustl.edu
    Description
    Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

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