Imaging, Surgical Fitness
Conditions
Brief summary
This study aims to explore an alternative method for assessing a participant's readiness for surgery, specifically for those undergoing surgery for gastric, oesophageal, or pancreatic cancer. Surgery for these diseases is extremely demanding on the body and surgeons need to be confident that a patient can tolerate the procedure. Traditionally, participants undergo Cardiopulmonary Exercise Tests (CPET) to determine their fitness for surgery. This involves cycling on an exercise bike with increasing resistance until the resistance is too great to continue cycling at a constant rate. An individual's maximum rate of oxygen consumption (VO2max) and the anaerobic threshold (AT) are calculated during CPET and used by surgeons as a predictor for surgical fitness. CPET tests can be physically demanding for participants and are very resource intensive. Furthermore, some patients may not be able to tolerate exercise tests due to physical constraints. An alternative method, Magnetic Resonance Spectroscopy (MRS), could be used to measure an individual's fitness prior to surgery. Within this study, MRS will be used to determine the levels of fat within the thigh muscle, which in turn may be able to be used to predict fitness for surgery. The first phase includes recruiting participants on the surgical pathway. MRS will be performed as an additional examination, typically on the same day as the CPET. Fat levels determined from MRS will be compared with conventional CPET outcomes (VO2max and AT). This analysis aims to determine if MRS derived fat levels correlates with VO2max and AT and, if correlation is high, potentially providing an alternative to CPET for patients who cannot tolerate exercise tests. The second phase involves recruiting volunteers who will undergo repeated MRS scans to assess the reliability of MRS methods. This process allows us to understand the consistency of MRS derived fat levels over both short and long-term intervals. The potential benefits of this project include an additional pathway for assessing fitness for surgery or enhancing the presurgical pathway for patients by providing an alternative method for fitness assessment. This study aims to provide evidence that could present an alternative method of assessing a patient's fitness for surgery. The goal is to explore an alternative that may complement or refine current practices in preoperative assessments.
Interventions
DIAGNOSTIC_TESTMRS scan
Magnetic Resonance Spectroscopy scan on the thigh
DIAGNOSTIC_TESTCPET
Cardiopulmonary Exercise Test
Sponsors
University Hospitals of North Midlands NHS Trust
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria for patients (cohort 1) * Patients diagnosed oesophageal/gastric or pancreatic cancer. * Patients who have or a under consideration for a CPET investigation. * Aged ≥ 18. * Existing UHNM Patient. * Willing and able to give fully informed consent. * Willing and able to comply with the study procedures. Inclusion criteria for staff volunteers (cohort 2) * Aged ≥ 18 years. * Willing and able to give fully informed consent. * Willing and able to comply with the study procedures. * UHNM member of staff.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlations between levels | 2 years | Calculate the correlation between the intramyocellular lipid (IMCL) saturation index and Cardiopulmonary Exercise Test (CPET) derived VO2max and Anaerobic Threshold (AT). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comparisons between participants who did not suffer major morbidity | 2 years | Compare the mean Intra-Myocellular Lipid (IMCL) saturation index for patients who suffered major morbidity after oesophagectomy, gastrectomy, or pancreaticoduodenectomy and compare this to the mean IMCL saturation index of those who did not suffer major morbidity. |
| Short and long term repeatability | 2 years | Assess the short- and long-term repeatability of Magnetic Resonance Spectroscopy (MRS) of Intra-Myocellular Lipid (IMCL) saturation index measurements in healthy volunteers. . |
| Difference in IMCL composition | 2 years | Assess the difference in Intra-Myocellular Lipid (IMCL) composition between patients considered for surgery and age and gender matched volunteers |
Countries
United Kingdom
Contacts
CONTACTAviva Ogbolosingha
Outcome results
None listed