Advanced Cancer
Conditions
Keywords
IV-contrast-enhanced CT
Brief summary
This is a single-arm prospective, feasibility study evaluating the intravenous contrast-enhanced cone beam computed tomography (IV CBCT) for image guidance during radiotherapy. Patients treated with SFRT will receive IV-contrast enhanced CT and fMRI before treatment for simulation purposes. Additionally, patients will receive mpMRI just before and IV-contrast enhanced CBCT during their second and last fraction of RT, in addition to the standard of care CBCT that is acquired for daily image-guided patient positioning. Patients will undergo both IV-contrast enhanced CBCT and treatment on the TrueBeam with HyperSight imaging capability. We hypothesize IV contrast enhanced CBCT is feasible, well-tolerated by patients and improves the visibility of the target.
Interventions
DIAGNOSTIC_TESTIntravenous contrast-enhanced cone beam computed tomography
Two half-arc IV-contrast enhanced CBCT scans and mpMRI seuqences in addition to their routine standard of care CBCT that is done as part of image-guided radiotherapy. These scans will be done during the second and last fraction of treatment.
Sponsors
University Health Network, Toronto
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Primary biopsy-proven cancer * Planning to undergo spatially fractionated radiation therapy * Able to provide informed consent * Willingness to participate in follow-up * ECOG less than or equal to 3 * Normal creatinine (below 109mmol/L), normal eGF
Exclusion criteria
* Unable to understand/provide consent * History of allergic reaction to iodinated IV contrast dye (allergy to MR contrast is not an
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of IV-contrast enhanced CBCT during image-guided radiotherapy | 18 Months | Feasibility of IV-contrast enhanced CBCT in visualizing tumors, vascular structures and tumour micro-environment changes during image-guided radiotherapy. The contrast-to-noise ratio, measuring the ability of an imaging modality to differentiate between various contrasts against the background noise, will be calculated and compared between CT and CBCT, and between with and without contrast acquisition. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of dynamic-contrast-enhanced (DCE) imaging | 18 Months | Assess tumor visualization and perfusion using the HyperSight C-arm system |
| Image quality of full versus half (17 s) CBCT acquisition, with and without contrast enhancement | 18 Months | Noise-to-contrast evaluation of full and half CBCT acquisitions to ultimately assess sufficiency of scans for patient positioning and tumor visualization, and reduction of on-couch imaging time. |
| Patient preferences and comfort with the use of IV CBCT during treatment | 18 Months | All patients will be asked to complete a patient experience survey to gauge their perceptions of receiving additional IV contrast during their CBCT. All questions are answered on a 5-part Likert scale (strongly agree to strongly disagree) and grouped according to construct (knowledge, feelings and benefits). Data will be analyzed using descriptive statistics. Correlations will be examined between patient demographics (age, gender, ECOG performance status, ) and survey responses to identify any trends or specific needs. |
Countries
Canada
Contacts
CONTACTJelena Lukovic, MD FRCPC MPH MRMD
Outcome results
None listed