3 Tesla MRI in Patients With Bladder Cancer
- Conditions
- Bladder Cancer
- Interventions
- Procedure: Specimen Ultra-High field MRIDrug: chemotherapyProcedure: Cystectomy and Lymphadenectomy
- Registration Number
- NCT00938145
- Lead Sponsor
- University of Cincinnati
- Brief Summary
RATIONALE: New diagnostic procedures, such as 3 Tesla magnetic resonance imaging (MRI), may help find bladder cancer and learn the extent of disease.
PURPOSE: This clinical trial is studying how well 3 Tesla MRI works in finding cancer in patients with bladder cancer.
- Detailed Description
OBJECTIVES:
Primary
* To evaluate whether 3 Tesla MRI can accurately determine the primary tumor (T) stage and pelvic lymph nodes (N) stage in patients with localized bladder cancer as compared to histopathology staging.
Secondary
* To determine whether 3 Tesla MRI can determine if the primary bladder tumor is responding to neoadjuvant chemotherapy at the mid-point of the planned treatment (after 2 courses).
* To assess whether an ex-vivo ultra-high-field MRI (4.7-11.7 Tesla) tissue scan can more accurately determine clinical stage of a primary bladder tumor and local extent of the disease (i.e., involvement of contiguous organs and regional lymph nodes) as compared to histopathology staging.
OUTLINE: Patients may receive neoadjuvant chemotherapy (typically four 21-day courses of cisplatin-based therapy) followed by standard radical cystectomy and lymph node dissection.
Patients undergo a 3 Tesla MRI scan at baseline to stage the primary tumor, regional lymph nodes, and to rule out distant sites of disease. The MRI includes diagnostic high-resolution anatomical images (e.g., T1-weighted and T2-weighted images along axial or optimal directions) and experimental images including functional MRI (e.g., dynamic contrast-enhanced MRI, diffusion-weighted MRI, MR spectroscopy, and chemical exchange-dependent saturation-transfer imaging). Patients also undergo a 3 Tesla MRI scan after 2 courses of neoadjuvant chemotherapy and after completion of neoadjuvant chemotherapy. Patients not receiving neoadjuvant chemotherapy undergo a 3 Tesla MRI scan 2-4 weeks before radical cystectomy and lymph node dissection.
Specimens from the radical cystectomy and pelvic lymph node dissection are examined ex-vivo by ultra-high-field MRI and the Micro-Imaging Specimen Study Form is completed. The specimens are then examined by the pathology department as per standard routine.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 98
- Known bladder cancer
- Scheduled for radical cystectomy and lymph node dissection.
- Able and willing to give valid written informed consent.
- No contraindications to the MRI(magnetic resonance imaging).
- Not pregnant, planning to become pregnant during the study, or nursing.
- No allergy to contrast agents.
- Patient with significant renal insufficiency, i.e. an estimated glomerular filtration rate(eGRF) less than 30 mL/min/1.73m2.
- Any condition conflict based on the investigation's clinical judgment that would prevent the patient from completion all trial assessments and visits.
- Inability or unwillingness to cooperate with requirements of this trial.
- Patients who exhibit noticeable anxiety and/or claustrophobia or who exhibit severe vertigo when they are moved into the MR.
- Patients with sickle cell anemia and other hemolytic anemia.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description MRI+surgery Specimen Ultra-High field MRI 3 Tesla MRI/Cystectomy and Lymphadenectomy/Urinary Diversion/Specimen Ultra-High field MRI MRI+surgery+chemotherapy chemotherapy 3 Tesla MRI/Cystectomy and Lymphadenectomy/Urinary Diversion/Specimen Ultra-High field MRI/chemotherapy MRI+surgery Cystectomy and Lymphadenectomy 3 Tesla MRI/Cystectomy and Lymphadenectomy/Urinary Diversion/Specimen Ultra-High field MRI MRI+surgery+chemotherapy Specimen Ultra-High field MRI 3 Tesla MRI/Cystectomy and Lymphadenectomy/Urinary Diversion/Specimen Ultra-High field MRI/chemotherapy MRI+surgery+chemotherapy Cystectomy and Lymphadenectomy 3 Tesla MRI/Cystectomy and Lymphadenectomy/Urinary Diversion/Specimen Ultra-High field MRI/chemotherapy
- Primary Outcome Measures
Name Time Method Agreement in tumor staging between pathology and 3 Tesla MRI up to 24 months
- Secondary Outcome Measures
Name Time Method Agreement in lymph node staging between pathology and 3 Tesla MRI up to 24 months
Trial Locations
- Locations (1)
Ohio State University Medical Center
🇺🇸Columbus, Ohio, United States