Using Positron Emission Tomography Scan (PET scan) to improve diagnosis of pulmonary embolism.

In patients with malignancy, is V/Q PET/CT as accurate as CTPA for diagnosing acute pulmonary embolism?

Status

Recruiting

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12614001170617

Acronym

PECAN study

Enrollment

Registered

2014-11-06

Start date

2014-11-17

Completion date

2016-03-31

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

The study is comparing two different techniques to diagnose acute pulmonary embolism in patients referred to the Peter MacCallum Cancer Institute. Who is it for? You may be eligible to join this study if you are aged 18 years or above and have been referred to the Peter MacCallum Cancer Institute for suspicion of acute pulmonary embolism. What is the purpose of this research? Lung scan (also known as lung scintigraphy, ventilation/perfusion scan or V/Q scan) and CT pulmonary angiogram (called CTPA) are imaging tests that are used to diagnose pulmonary embolism (clots in the blood vessels supplying the lungs). This research project is assessing the diagnostic value of a new imaging test called lung PET/CT. PET/CT stands for Positron Emission Tomography/Computed Tomography. The conventional lung scan uses a different technology called SPECT/CT (Single Photon Emission Tomography/Computed Tomography). PET/CT produces images of better quality than the conventional SPECT/CT scan, which may improve diagnosis of pulmonary embolism. The research project is designed to compare the diagnostic value of lung PET/CT and CTPA for the diagnosis of pulmonary embolism. Our hypotheses are that V/Q PET/CT is an alternative modality to CTPA for diagnosis of PE and that the combination of both imaging may improve PE diagnosis. What does participation in this research involve? You will undergo both CTPA and lung PET/CT scans. For the lung PET/CT scan, a small quantity of a substance called Galligas, which are particles labelled with a radioactive substance called Ga-68, is breathed in and thereby deposited into your lungs. After this, you will be required to lay still on the PET/CT camera bed for about 10 minutes whilst images are obtained. Whilst you are in the PET/CT scanner, you are then injected with a substance called Ga-MAA via the intravenous catheter. Ga-MAA stands for Ga-68 macroaggregated albumin (MAA) and is radioactive substance that localises in your lungs’ blood vessels. You will then be imaged again for a further 10 minutes. Lung PET/CT is a diagnostic procedure only, not a treatment. Lung PET/CT and CTPA will be initially interpreted separately. CTPA and V/Q PET/CT images will then be interpreted together by a consensus reading. It is anticipated that 50 patients will participate in this project.

Interventions

All patients will undergo both - Ga-68 Ventilation/Perfusion (V/Q) PET/CT: a small quantity of a substance called Galligas, which are particles labelled with a radioactive substance called Ga-68, is breathed in and thereby deposited into your lungs. After this, you will be required to lay still on the PET/CT camera bed for about 10 minutes whilst images are obtained. Whilst you are in the PET/CT scanner, you are then injected with a substance called Ga-MAA via the intravenous catheter. Ga-MAA stands for Ga-68 macroaggregated albumin (MAA) and is radioactive substance that localises in your lungs’ blood vessels. You will then be imaged again for a further 10 minutes. - CT Pulmonary angiography (CTPA) : an intravenous catheter (small plastic tube) will be put into a vein in your arm. Intravenous contrast agent will be injected into a vein in your arm, and CT scan performed. You will be imaged with the CT camera for 1 minute. Whenever it will be possible, both lung PET/CT and CTPA will be performed in the same evaluation on a PET/CT camera in the PET Centre. If it is not possible for practical considerations, lung PET/CT and CTPA will be performed separately within 24 hours.

Study design

Allocation

Non-randomised trial

Primary purpose

Diagnosis

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

Patient with suspected acute pulmonary embolism Patient has diagnosis of malignancy Age greater than or equal to 18 years; Written informed consent has been provided.

Exclusion criteria

Contraindication to contrast media (including renal insufficiency with eGFR<50) Participant is not able to tolerate supine position for PET/CT acquisition, is not cooperative, or needs continuous nursing (e.g. patient from Intensive Care Unit). Inability to perform CTPA and V/Q PET/CT within the 24 hours following the suspicion of PE. Deep vein thrombosis or PE diagnosed within the previous 3 months Use of therapeutic doses of parenteral anticoagulants for greater than 48 hours Pregnancy Breast-feeding

Outcome results