Benefit of Spectral Information in Patients Suspected for Lung Cancer
- Conditions
- Lung Neoplasm Malignant
- Interventions
- Device: Spectral CT images generated by a photon counting CT scanner
- Registration Number
- NCT06440616
- Lead Sponsor
- Copenhagen University Hospital at Herlev
- Brief Summary
Purpose The aim of the study is to investigate the utilization of photon counting CT (PCCT) and the spectral information provided to determine the impact of spectral information on follow-up examinations.
As secondary aims we will compare conventional CT, CT + 18Flouro-deoxy-glucose (18F-FDG) positron emission tomography (PET) and PCCT + 18F-FDG PET for the tumor-node-metastasis (TNM) staging of lung cancer patients.
PCCT with and without spectral information to assess the need for additional work-up,TNM classification, and sensitivity/specificity for malignant lesions. Patients will be randomized for reading with or without spectral information available within a clinical setting. The clinical readings are performed as a structured reports of all significant findings. Including both malignant and benign findings. Furthermore, in case additional follow-up/work-up is needed based on the guidelines on incidental findings by the American College of Radiology (ACR), this will be reported as well. If lesions suspicious of pulmonary malignancy is present, a provisional TNM classification is provided based on the scan findings.
After 3 months, the patient record is reviewed where additional examinations that can be attributed to the PCCT scan are recorded. The financial impact is calculated by a health economist based on the findings. PET/CT, conventional CT and PCCT combined with PET will be assessed retrospectively for comparison. Endpoints are number of supplementary examinations and cost savings. Sensitivity and specificity for any malignant finding. The T, N and M stages are assessed separately as diagnostic measures by the McNemar's test with a reference standard from the Danish Lung cancer register. The number of malignant lesions will be determined by reviewing the patient records incl. pathology assessment if available 12 months after inclusion of the last patient.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 1000
- Patients suspected of lung cancer refered to Copenhagen University Hospital as per the guidelines from the danish national health authorities from either the general practitioner or from the department of pulmonology.
- Informed consent
- Patients who cannot tolerate intravenous iodinated contrast
- Already verified lung cancer from another institution
- Comorbidities that exclude the patient from receiving treatment
- Lack of reference standard in the form of either histology or follow-up
- Known extrapulmonary malignancy
- Technical limitations within the scans/reconstructions
- other
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description CT images with spectral information available Spectral CT images generated by a photon counting CT scanner Reported with access to spectral information in a normal clinical practice. Supplemental examinations suggested as per the ACR white papers for incidental findings.
- Primary Outcome Measures
Name Time Method Number of follow up examinations Baseline Determine the number of suggested follow-up examinations based on the initial CT scan to learn the significance of spectral information in a clinical setting.
- Secondary Outcome Measures
Name Time Method T, N, and M stage 24 months Determine the accuracy of T, N, and M stage based on PCCT, conventional CT, PET/CT and PET/PCCT. Retrospective assessment 24 months after primary scan.
Number of malignant lesions 24 months Determine the number of found malignant lesions in each arm. Reference standard will be follow up or pathology within a minimum of one year of the scan. That means 12 months after the end of the inclusion period.
Trial Locations
- Locations (1)
Copenhagen University Hospital Herlev
🇩🇰Herlev, Capital Region, Denmark