Streamlining Staging of Lung cancer with Whole Body MRI

Conditions

Non small cell lung cancer Cancer Malignant neoplasm of bronchus and lung

Stuart A. Taylor, Susan Mallett, Anne Miles, Stephen Morris, Laura Quinn et al. (18 authors)

Health Technology Assessment2019-12-0169 citations

Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed non-small-cell lung cancer: the prospective Streamline L trial.

Taylor SA, Mallett S, Ball S, Beare S, Bhatnagar G, Bhowmik A, Boavida P, Bridgewater J, Clarke CS, Duggan M, Ellis S, Glynne-Jones R, Goh V, Groves AM, Hameeduddin A, Janes SM, Johnston EW, Koh DM, Lock S, Miles A, Morris S, Morton A, Navani N, Oliver A, O'Shaughnessy T, Padhani AR, Prezzi D, Punwani S, Quinn L, Rafiee H, Reczko K, Rockall AG, Russell P, Sidhu HS, Strickland N, Tarver K, Teague J, Halligan S, Streamline investigators.

2019-05-0946 citations

10.1016/s2213-2600(19)30090-6

Patient experience and perceived acceptability of whole-body magnetic resonance imaging for staging colorectal and lung cancer compared with current staging scans: a qualitative study

Ruth Evans, Stuart A. Taylor, Sam M. Janes, Steve Halligan, Alison J. Morton et al. (10 authors)

BMJ Open2017-09-0147 citations

10.1136/bmjopen-2017-016391

Streamlining staging of lung and colorectal cancer with whole body MRI; study protocols for two multicentre, non-randomised, single-arm, prospective diagnostic accuracy studies (Streamline C and Streamline L).

Taylor SA, Mallett S, Miles A, Beare S, Bhatnagar G, Bridgewater J, Glynne-Jones R, Goh V, Groves AM, Janes SM, Koh DM, Morris S, Morton A, Navani N, Oliver A, Padhani AR, Punwani S, Rockall AG, Halligan S.

2017-05-0223 citations

10.1186/s12885-017-3281-x

Interventions

There are no treatment arms, every patient will receive a whole body MRI as part of the trial which takes about an hour. Aside from attending for the WB-MRI scan, patients shouldn?t have to attend for

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Adult patients (18 or over) with histologically proven or clinically diagnosed primary non small cell lung cancer with potentially radically treatable disease 2. Clinically diagnosed non small cell lung cancer defined as radiological diagnosis of lung cancer on chest CT with sufficient confidence to trigger staging investigations 3. Potentially radically treatable disease defined as stage IIIb or less on diagnostic CT (ie T14, N02, M0) 4. Performance status 02 (fit to undergo surgery if indicated) 5. Patient must have given written informed consent and be willing to comply with the protocol intervention and follow up.

Exclusion criteria

Exclusion criteria: 1. Any psychiatric or other disorder likely to impact on informed consent 2. Evidence of severe or uncontrolled systemic disease which make it undesirable the for the patient to participate in the trial 3. Pregnancy 4. Contraindications to MRI (e.g. cardiac pacemaker, severe claustrophobia, inability to lie flat) 5. Unequivocal metastatic or N3 disease on diagnostic CT chest and abdomen (including M1a disease; malignant pleural effusion) 6. Further staging work up not indicated in the opinion of the MDT due to poor performance status or patient choice. 7. Histologies other than non small cell lung cancer

Design outcomes

Primary

Measure	Time frame
Per patient sensitivity for metastasis detection by whole body MRI (WB-MRI) compared to standard staging pathways in newly diagnosed non small cell lung cancer	—

Secondary

Measure	Time frame
1. The time and test number taken to reach, and the nature of, the first major treatment decision based on WB-MRI in comparison to standard staging pathways. 2. Diagnostic accuracy of WB-MRI and conventional staging pathways for local tumour staging and detection of metastasis in comparison to an expert derived consensus reference standard. 3. Lifetime incremental cost and cost-effectiveness of staging using WB-MRI compared to standard diagnostic pathways. 4. Patient experience of staging using WB-MRI in comparison to standard diagnostic pathways and priorities placed by patients on differing attributes related to competing staging pathways. 5. Inter-observer variability in WB-MRI analysis and affect of diagnostic confidence on staging accuracy. 6. Diagnostic accuracy of limited T1 and diffusion weighted sequences compared to full multi-sequence WB-MRI protocols.	—

Measure

Time frame

1. The time and test number taken to reach, and the nature of, the first major treatment decision based on WB-MRI in comparison to standard staging pathways. 2. Diagnostic accuracy of WB-MRI and conventional staging pathways for local tumour staging and detection of metastasis in comparison to an expert derived consensus reference standard. 3. Lifetime incremental cost and cost-effectiveness of staging using WB-MRI compared to standard diagnostic pathways. 4. Patient experience of staging using WB-MRI in comparison to standard diagnostic pathways and priorities placed by patients on differing attributes related to competing staging pathways. 5. Inter-observer variability in WB-MRI analysis and affect of diagnostic confidence on staging accuracy. 6. Diagnostic accuracy of limited T1 and diffusion weighted sequences compared to full multi-sequence WB-MRI protocols.

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Countries

United Kingdom

Outcome results

None listed