Prospective Evaluation of 68Ga-DOTATATE PET/CT, Octreotide and F-DOPA PET Imaging in Ectopic Cushing Syndrome
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- To determine which imaging technique (F-DOPA PET/CT, 68Ga-DOTATATE PET/CT, CT, and/or MRI) has the best sensitivity.
研究概览
简要总结
Between 10% and 15% of patients with endogenous hypercortisolism (Cushing syndrome) have ectopic (non-pituitary) production of adrenocorticotropin hormone (ACTH) that causes cortisol excess. In approximately 50% of these patients, the tumoral source of ACTH cannot be found initially despite very detailed and extensive imaging, including studies such as computed tomography, magnetic resonance imaging, and octreotide scan (Octreoscan) using the standard dose of indium- 111 pentetreotide ([111In-DTPA-D-Phe]-pentetreotide). The sensitivity and specificity of structurally based imaging studies depends on anatomic alterations and the size of the tumor. In contrast, positron emission tomography (PET) and somatostatin ligand imaging detect pathologic tissue based on physiologic and biochemical processes within the abnormal tissue. This protocol tests the ability of [18F]-L-3,4-dihydroxyphenylalanine (18F-DOPA) PET, and the somatostatin imaging analogue, 68Ga-DOTATATE-PET, to localize the source of ectopic ACTH production.
详细描述
Study Description:
Between 10% and 15% of patients with endogenous hypercortisolism (Cushing syndrome) have ectopic (non-pituitary) production of adrenocorticotropin hormone (ACTH) that causes cortisol excess. In approximately 50% of these patients, the tumoral source of ACTH cannot be found initially despite very detailed and extensive imaging, including studies such as computed tomography, magnetic resonance imaging, and octreotide scan (Octreoscan) using the standard dose of indium- 111 pentetreotide ([111In-DTPA-D-Phe]-pentetreotide). The sensitivity and specificity of structurally based imaging studies depends on anatomic alterations and the size of the tumor. In contrast, positron emission tomography (PET) and somatostatin ligand imaging detect pathologic tissue based on physiologic and biochemical processes within the abnormal tissue.
This protocol tests the ability of [18F]-L-3,4-dihydroxyphenylalanine (18F-DOPA) PET, and the somatostatin imaging analogue, 68Ga-DOTATATE-PET, to localize the source of ectopic ACTH production.
Objectives:
Primary Objectives:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •INCLUSION CRITERIA:
- •To be eligible to participate in this study, an individual must meet all of the following criteria:
- •18 - 90 years of age
- •Medical history of ectopic Cushing syndrome or diagnosed with the possibility of ectopic Cushing syndrome
- •For females of reproductive potential: agreement to use highly effective contraception for at least 2 weeks before any PET scan
- •Ability of subject to understand and the willingness to sign a written informed consent document
- •Stated willingness to comply with all study procedures and availability for the duration of the study
排除标准
- •An individual who meets any of the following criteria will be excluded from participation in this study:
- •Pregnancy or lactation; the radiation associated with PET and CT scans may be harmful to a developing fetus. Likewise the ingestion of radionuclides in breast milk has an unknown risk to an infant.
- •Evidence of severe active infection
- •Clinically significantly impaired cardiovascular function, abnormal coagulation in the absence of medically-indicated treatment (PT and PTT elevated by 30% above the normal values), hematopoietic (hematocrit less than 30%, hemoglobin below 10 g/dl, white count below 3000 K/UL, and platelets below 100,000 K/mm^3), hepatic (liver enzymes elevated by 4-fold above normal values), or renal function (plasma creatinine level over 2.1).
- •Based on the clinical judgment of the attending physician, other medical problems may prompt exclusion.
- •Body weight over 136 kg, which is the limit for the tables used in the scanning areas.
- •Combined blood withdrawal during the six weeks preceding the study greater than 450 ml.
- •Subjects who previously underwent ten or more F-DOPA PET/CT scans and ten or more DOTATATE scans.
研究组 & 干预措施
Imaging
All subjects will be imaged
干预措施: 18F-DOPA (Drug)
Imaging
All subjects will be imaged
干预措施: F-DOPA PET CT (Radiation)
Imaging
All subjects will be imaged
干预措施: CT scan (Radiation)
Imaging
All subjects will be imaged
干预措施: Gated MRI scan (Diagnostic Test)
Imaging
All subjects will be imaged
干预措施: 68Ga-DOTATATE (Drug)
Imaging
All subjects will be imaged
干预措施: Routine MRI scan (Diagnostic Test)
Imaging
All subjects will be imaged
干预措施: DOTATATE PET-CT (Radiation)
结局指标
主要结局
To determine which imaging technique (F-DOPA PET/CT, 68Ga-DOTATATE PET/CT, CT, and/or MRI) has the best sensitivity.
时间窗: 6-12 months
Subjects will be imaged every 6-12 months until tumor is found
To determine if there is a combination of imaging tests with optimal diagnostic accuracy.
时间窗: 6-12 months
subjects will be imaged every 6-12 months until tumor is found
次要结局
- To evaluate a potential correlation between 18F-DOPA or 68Ga-DOTATATE uptake and the type of tumor, its size, SSTR expression or proliferative activity.(Ongoing)