Comparison Study of PET/CT or PET/MRI Imaging to Magnetic Resonance Imaging (MRI) Alone in Men With Prostate Cancer

Phase 2

Terminated

Interventions: Drug: PET/CT with Gallium-68 labeled PSMA-HBED-CC
Drug: Multiple PET/MRI with Gallium-68 labeled PSMA-HBED-CC
Drug: PET/MRI with Gallium-68 labeled PSMA-HBED-CC

Brief Summary: This is a study primarily comparing Magnetic Resonance Imaging (MRI) alone to Positron Emission Tomography (PET)/MRI using an experimental tracer, 68Ga-PSMA-HBED-CC, among men with prostate cancer or prostatic cancer recurrence/metastasis. It is hypothesized that this comparison will demonstrate that PET using the tracer, 68Ga-PSMA-HBED-CC, is more sensitive than MRI alone. Potential subjects who cannot undergo MRI may undergo PET/CT instead.

Detailed Description: This is a multi-reader methodological study comparing the diagnostic value of 68Ga-PSMA-HBED-CC PET/CT or 68Ga-PSMA-HBED-CC PET/MRI over MRI alone, using histologic confirmation or serial follow-up for up to 2 years as the gold standard for determination of primary prostate cancer or prostatic cancer recurrence/metastasis. It is hypothesized that this will demonstrate the superiority of 68Ga-PSMA-HBED-CC PET to MRI for sensitivity, and the non-inferiority of 68Ga-PSMA-HBED-CC PET to MRI for specificity.This is a paired, case-control design that is appropriate to statistically evaluate the difference in sensitivity and specificity between the two imaging modalities. Therefore, the estimation of population prevalence is not a study objective, and estimation of clinical utility through calculation of positive and negative predictive values is not appropriate. Imaging studies and follow up subject scans will be organized so that a panel of independent readers will evaluate the MRI and PET studies to assess the level of suspicion for prostate cancer.

Recruitment & Eligibility

Inclusion Criteria

Not provided

Exclusion Criteria

Clinical and/or technical factors that would compromise statistical analysis of the PET and/or MRI.
If part of PET/MRI cohort and patient cohort 3 or 5, subject does not plan to have a prescribed abdomen and pelvis MRI
If part of PET/MRI cohort and patient cohort 1, 2 or 4, subject does not plan to have a prescribed pelvis MRI
If part of PET/CT cohort and patient cohort 3 or 5, subject does not have previous MR imaging of abdomen and pelvis
If part of PET/CT cohort and patient cohort 1, 2 or 4, subject does not have previous MR imaging of pelvis
If part of PET/CT cohort, investigator review determines that previous MR images do not meet institutional quality standards
If part of PET/MRI cohort, contraindications to MRI
Contraindications to PSMA IV administration
Other unspecified reasons that, in the opinion of investigators, make the subject unsuitable for enrollment

Arm && Interventions

Group	Intervention	Description
PET/CT	PET/CT with Gallium-68 labeled PSMA-HBED-CC	PET/CT with Gallium-68 labeled PSMA-HBED-CC: Subjects will have one visit during which they will undergo a PET/CT after being injected with the study drug, Gallium-68 labeled PSMA-HBED-CC. PET/CT occurs if a) an MRI can't be performed concurrently; or b) the participant already had an MRI of the abdomen/pelvis or pelvis only.
Multiple PET/MRI	Multiple PET/MRI with Gallium-68 labeled PSMA-HBED-CC	Multiple PET/MRI with Gallium-68 labeled PSMA-HBED-CC: Subjects will be invited to participate in two visits within two years, the second being an optional visit. During each visit, subjects will undergo a PET/MRI after being injected with the study drug, Gallium-68 labeled PSMA-HBED-CC. This arm will be restricted to subjects who plan to undergo focal therapy.
PET/MRI	PET/MRI with Gallium-68 labeled PSMA-HBED-CC	PET/MRI with Gallium-68 labeled PSMA-HBED-CC: Subjects will have one visit during which they will undergo a PET/MRI after being injected with the study drug, Gallium-68 labeled PSMA-HBED-CC.

Primary Outcome Measures

Name	Time	Method
Number of Subjects With Pathologic Lesions Detected by PSMA PET and PET/CT Compared to MP MRI	At each visit, immediately after administration of the study drug, approximately 2-3 hours; with up to two visits within 2 years or less	A scan was considered positive if the clinical interpretation was suspicious based on the clinical judgement of the reader.
Number of Pathological Lesions Detected by PSMA PET/MRI and PET/CT Compared to MP MRI in Prostate Cancer Patients With Biochemical Recurrence by Anatomical Region Stratified by PSA Level	At each visit, immediately after administration of the study drug, approximately 2-3 hours; with up to two visits within 2 years or less	Patients were divided into subgroups based on their PSA levels and primary treatment modality. The primary treatment modality subgroups were post radical prostatectomy, post radiation therapy, and post radical prostatectomy and radiation therapy. 109 subjects out of 273 enrolled have data reported. Multiple patients sought care elsewhere and a small number of subjects had 2-year follow-up. This lead to a smaller analysis.

Secondary Outcome Measures

Name	Time	Method
Number of Pathological Lesions Detected by PSMA PET/MRI and PET/CT Compared to MP MRI in Prostate Cancer Patients With Biochemical Recurrence by Anatomical Region	At each visit, immediately after administration of the study drug, approximately 2-3 hours; with up to two visits within 2 years or less	True positive rates for detecting lesions between PSMA PET/MRI and MP MRI in various anatomical locations were compared, including prostate/prostatic bed, N1 lymph nodes, N2 lymph nodes, and osseous lesions. Other anatomical sites are other than bone, node, and prostate.

Locations (1): Weill Cornell Medical College
🇺🇸
New York, New York, United States