NCT04028804

Brief Summary

Background: Residual masses on follow-up surveillance imaging are frequently detected in paediatric patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma. The residual mass may consist of inflammatory, fibrous or necrotic tissue, or it could represent residual tumor. In most cases, positron emission tomography (PET) with 2-\[fluorine-18\]-fluoro-2-deoxy-D-glucose (FDG) is useful for distinguishing tumor from fibrosis. However, FDG is not tumor-specific, and increased accumulation of the tracer may be seen in a variety of benign entities which can give rise to false-positive or equivocal FDG PET findings. Alternatively, the uptake of 3'-deoxy-3'-\[fluorine-18\]-fluorothymidine (FLT) reflects cellular proliferation, and may prove to be a reliable method in resolving equivocal FDG PET findings. Indeed, several studies have demonstrated that FLT can be safely administered to children, and in some cases be more useful than FDG PET in differentiating between infection or inflammation and malignancy. This study hypothesizes that FLT PET can be used as an adjunct imaging modality in paediatric lymphoma patients with equivocal interim or post-therapy FDG PET findings, and that this technique can provide additional diagnostic information which will be useful in distinguishing fibrotic or necrotic residual mass lesions from those that may be harbouring malignancy.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
8

participants targeted

Target at below P25 for all trials

Timeline
Completed

Started Jul 2011

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 2011

Completed
2.9 years until next milestone

First Submitted

Initial submission to the registry

May 12, 2014

Completed
7 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2014

Completed
4.6 years until next milestone

First Posted

Study publicly available on registry

July 23, 2019

Completed
Last Updated

July 23, 2019

Status Verified

July 1, 2019

Enrollment Period

3.4 years

First QC Date

May 12, 2014

Last Update Submit

July 22, 2019

Conditions

Keywords

Hodgkin's LymphomaNon-Hodgkin's LymphomaPossitron Emission Therapy (PET)FDG PETFLT PETPediatrics

Outcome Measures

Primary Outcomes (1)

  • Feasibility of Performing FLT PET Imaging: SUVs values

    To assess the feasibility of performing 3'-deoxy-3'-\[fluorine-18\]-fluorothymidine positron emission tomography (FLT PET) imaging. The investigator's goals were to assess the normal tissue distribution of 18F-FLT and to provide standardized uptake values (SUVs) of lesions demonstrating equivocal uptake on 18F-FDG PET/CT and compare SUVs values of FLT and FDG

    FLT PET performed within 1-5 days of FDG PET. PET/CT image findings were compared in relation to pathology within 1 month (when tissue sampling was performed), additional cross-sectional imaging, and/or clinical follow-up for at least 3 months.

Secondary Outcomes (1)

  • Diagnostic Performance

    PET/CT image findings were compared in relation to pathology within 1 month (when tissue sampling was performed), additional cross-sectional imaging, and/or clinical follow-up for at least 3 months

Study Arms (2)

FDG PET

FDG PET imagaing

Procedure: FDG PETProcedure: FLT PET

FLT PET

FLT PET imaging

Procedure: FDG PETProcedure: FLT PET

Interventions

FDG PETPROCEDURE

Each patient will receive a single intravenous injection of FDG (5.18 MBq/kg (0.14 mCi/kg)) using a minimum dose of 37 MBq (1 mCi) up to a maximum of 370 MBq (10 mCi) with an accepted 10%-20% variation since dose variation can occur when small concentrated volumes of FDG are being drawn up or radioactive decay has reduced the amount of available.

Also known as: 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG)
FDG PETFLT PET
FLT PETPROCEDURE

The FLT PET scan will be performed 1-5 days after FDG PET in order to ensure consistency between imaging findings. Each patient will receive a single intravenous injection of FLT (5.18 MBq/kg (0.14 mCi/kg)) using a minimum dose of 37 MBq (1 mCi) up to a maximum of 370 MBq (10 mCi) with an accepted 10%-20% variation since dose variation can occur when small concentrated volumes of FLT are being drawn up or radioactive decay has reduced the amount of available.

Also known as: 3'-deoxy-3'-[fluorine-18]-fluorothymidine (FLT)
FDG PETFLT PET

Eligibility Criteria

Age1 Day - 18 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)
Sampling MethodNon-Probability Sample
Study Population

Pediatric lymphoma

You may qualify if:

  • SickKids Hospital patient of any gender or race
  • Participants who are able to undergo imaging procedures without general anaesthesia or sedation
  • Patient's or the patient's parents'/guardians' written informed consent prior to participation
  • Previous FDG PET scan with at least one documented equivocal finding (i.e. SUV ≥ 2.0, but \< 3.5) and no other finding(s) that is strongly suggestive of malignancy. The lesion(s) must have a minimum size of 1 cm in diameter by any CIM in order to address the spatial resolution limitations of the PET scanner.

You may not qualify if:

  • Patients who are pregnant or nursing
  • Medically unstable or critically ill
  • Lack of informed consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The Hospital for Sick Children

Toronto, Ontario, M5G 1X8, Canada

Location

MeSH Terms

Conditions

Hodgkin DiseaseLymphoma, Non-Hodgkin

Condition Hierarchy (Ancestors)

LymphomaNeoplasms by Histologic TypeNeoplasmsLymphoproliferative DisordersLymphatic DiseasesHemic and Lymphatic DiseasesImmunoproliferative DisordersImmune System Diseases

Study Officials

  • Amer Shammas, Md

    The Hospital for Sick Children

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Nuclear Medicine Radiologist

Study Record Dates

First Submitted

May 12, 2014

First Posted

July 23, 2019

Study Start

July 1, 2011

Primary Completion

December 1, 2014

Study Completion

December 1, 2014

Last Updated

July 23, 2019

Record last verified: 2019-07

Locations