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PET / MR With PSMA for Diagnosis and Staging of Hepatocellular Carcinoma

Not Applicable
Recruiting
Conditions
Carcinoma, Hepatocellular
Interventions
Diagnostic Test: PET MRI with PSMA
Registration Number
NCT05580835
Lead Sponsor
University of Sao Paulo
Brief Summary

Assess the rate and degree of PSMA uptake in patients with hepatocellular carcinoma submitted to PET/MRI scans. The objective is to evaluate its value on diagnosis and staging of HCC.

Detailed Description

PET/MR - PSMA have emerged as a new method and there are few studies about its role in the evaluation of hepatocellular carcinoma (HCC).

The hypothesis in this study is that PET/MRI with PSMA might have an additional value in the assessment of hepatocellular carcinoma, contributing to the diagnosis of distant metastasis and to confirm the diagnosis in undetermined nodules by the standard exams (computed tomography and magnetic resonance imaging).

Patients with hepatocellular carcinoma diagnosed by computed tomography or magnetic resonance imaging and referred to a liver transplant or surgery by clinical decision wil be submitted to a whole-body PSMA-PET/MRI and will be included in this prospective unicentric study to be conducted at Instituto do Câncer do Estado de São Paulo (ICESP) and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP).

All cases will be evaluated to determine the presence and degree of PSMA uptake on lesions considered as definitely HCCs by CT or MRI. The sensitivity of PSMA - PET/MR for the diagnosis of HCC will be calculated.

The added value of PSMA - PET MR on systemic staging will be calculated by the number of lesions considered suspicious for malignancy that were not detected by conventional scans.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Patients with an imaging diagnosis of HCC by a previous CT or MRI, reviewed by an abdominal radiologist
  • Patients candidates to liver transplant or surgical resection
Exclusion Criteria
  • Patients with treated liver lesion without viable tumor
  • Age under 18
  • Pregnancy
  • Patients with renal insufficiency;
  • Elevated bilirubin levels (>3 mg/dL)
  • Known allergy to contrast media (gadoxetic acid) or radiotracer (PSMA);
  • Blood glucose level higher than 150 mg/dl.
  • MR contraindications (claustrophobia, cardiac pacemakers, neurostimulators, cochlear implants, and insulin pumps).

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
PET MRI - PSMAPET MRI with PSMAPatients with an imaging diagnosis of HCC and submitted to PET MRI - PSMA
Primary Outcome Measures
NameTimeMethod
Degree of PSMA uptake by HCC24 months

For all liver lesions diagnosed as HCC, the degree of PSMA on PET uptake will be measured and correlated with available pathology information

Diagnostic performance of PET MRI - PSMA for HCC24 months

Patients with a liver lesion diagnosed as hepatocellular carcinoma by MRI or CT and candidates to surgical resection or liver transplant will be submitted to PET MRI with PSMA. Based on the presence or absence of PSMA uptake, sensitivity and specificity of PET MRI for diagnosis of the liver lesion and extrahepatic disease will be calculated.

Secondary Outcome Measures
NameTimeMethod
Correlation of PSMA uptake and liver nodules histology24 months

All other non-HCC nodules simultaneously diagnosed will be also evaluated in terms of presence and degree of PSMA uptake. This results will be computed and correlated with all pathology data available

Presence of PSMA uptake on treated liver lesions24 months

Whenever a treated observation is present, the presence and degree of PSMA uptake will be evaluated and correlated to conventional imaging scans and pathology results available

Trial Locations

Locations (1)

University of Sao Paulo

🇧🇷

São Paulo, Brazil

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