Computed Tomography (CT) Perfusion Imaging of Lung Cancer

Not Applicable

Terminated

Brief Summary: This is an experimental study of the feasibility and efficacy of CT perfusion (CTP) imaging (CT blood flow measurements) in subjects with non-small cell lung cancer.

Detailed Description: Drug/Device Information

1) Contrast

30 cc bolus of a low osmolar, iodinated CT contrast agent, which is FDA approved and used in the clinical CT Imaging procedure.

2) Scanner

The 64 row-multidetector row CT unit (LightSpeed VCT, GE Healthcare, Milwaukee, WI) is FDA approved for clinical CT imaging

Research Design and Methods

1) Primary Endpoint

1. Diagnostic yield of tumor perfusion measurements using a contrast assisted computed tomography technique.

2) Secondary Endpoints

1. Reproducibility of tumor blood flow estimates derived by CT.

2. Assessment of the association between tumor vascularity responses after two cycles of chemotherapy and subsequent best tumor response according to standard anatomic response evaluation criteria (RECIST).

3. Predictive value of tumor blood flow for patient survival, compared to the predictive power of tumor size determinations.

Recruitment & Eligibility

Inclusion Criteria

Patient with any stage non-small cell lung cancer (NSCLC) who will undergo imaging with CT of the chest with intravenous contrast as standard of care. Other imaging tests will be performed as clinically indicated.
Patient should be receiving, or planning to receive, or have received systemic therapy (chemotherapy and/or novel agents) treatment with or without radiotherapy. Patients should not be receiving adjuvant or postoperative treatment but neoadjuvant treatment is allowed.
Histologically or cytologically proven NSCLC.
At least one measurable primary or other intrathoracic/supraclavicular lesion ≥ 1 cm, according to Response Evaluation Criteria in Solid Tumors (RECIST); this lesion should be either proven to be malignant by biopsy or be considered malignant based on its evolution on previous imaging studies. A scan within 3-6 months prior to registration can be used as the baseline scan.
Age 18 years or older and ability to provide informed consent.
Subjects must use medically appropriate contraception if sexually active; women of childbearing potential must not be pregnant or breastfeeding
Subjects must have normal renal function to participate. Standard laboratory testing to evaluate renal function will be performed prior to administering IV contrast and will be available as standard of care. Renal impairment is defined as a glomerular filtration rate of less than 60 ml/min/1.73 m2 BSA, derived from the patients' serum creatinine concentration.

Exclusion Criteria

Subjects of reproductive potential, who are sexually active but unwilling and/or unable to use medically appropriate contraception, or women who are pregnant or breastfeeding;
Established allergy to iodine containing contrast media

Arm && Interventions

Group	Intervention	Description
Arm B CT Perfusion	CT Perfusion	Arm B Procedure On the first required study visit, subject will undergo one SOC CT scan followed by the research component: - CT Perfusion imaging: Single bed position CTP examination, which includes injection of 30 cc of contrast agent, over the predetermined lesion from clinical scan Procedures will be repeated at optional second study visit \~6-8 weeks later.
Arm A CT Perfusion	CT Perfusion	Arm A Procedure On the first required study visit, subject will undergo one SOC CT scan followed by the research component: * CTP imaging: Single bed position CTP examination, which includes injection of 30 cc of contrast agent, over the predetermined lesion from clinical scan * Subject will stand up and walk around, and then lay back down * CT Perfusion imaging: Second single bed position CTP examination, which includes injection of 30 cc of contrast agent, over the predetermined lesion from their clinical scan Procedures will be repeated at optional second study visit \~6-8 weeks later.

Primary Outcome Measures

Name	Time	Method
Diagnostic yield of tumor perfusion measurements using a contrast assisted computed tomography technique.	Data collected during one required study visit, and optional second study visit ~6-8 weeks later.

Secondary Outcome Measures

Name	Time	Method
Reproducibility of tumor blood flow estimates derived by CT.	Data collected during one required study visit, and optional second study visit ~6-8 weeks later.
Assessment of the association between tumor vascularity responses after two cycles of chemotherapy and subsequent best tumor response according to standard anatomic response evaluation criteria (RECIST).	Data collected during one required study visit, and optional second study visit ~6-8 weeks later.
Predictive value of tumor blood flow for patient survival, compared to the predictive power of tumor size determinations.	Data collected during one required study visit, and optional second study visit ~6-8 weeks later; and during SOC follow-up for survival.

Locations (3): Hillman Cancer Center: University of Pittsburgh Cancer Institute / UPMC Department of Radiology
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Pittsburgh, Pennsylvania, United States
University of Pittsburgh Cancer Institute - Hillman Cancer Center
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Pittsburgh, Pennsylvania, United States
University of Pittsburgh Cancer Institute
🇺🇸
Pittsburgh, Pennsylvania, United States