Breast Cancer Diagnosis Clinical Trial
Official title:
Clinical Study to Evaluate Diagnostic Accuracy of Low Dose Contrast Enhanced Dual Energy Mammography Imaging in Comparison to CE-MRI
Clinical study to evaluate diagnostic accuracy of low dose contrast enhanced dual energy mammography imaging (CEDEM+PRIME) in comparison with CE-MRI The primary objective of this clinical study is to assess diagnostic accuracy in breast cancer detection in Contrast Enhanced Dual Energy Mammography compared to CEMRI. Sensitivity and specificity will be compared for both modalities.
STUDY OBJECTIVES The primary objective of this clinical study is to assess the value of
low-dose CEDEM in comparison with CE-MRI. The diagnostic accuracy in breast cancer detection
of low dose CEDEM will be evaluated.
Investigator plans to explore the diagnostic quality of 4 standard view bilateral dual energy
subtracted images compared to CE-MRI in a blinded reader study. A goal is to evaluate,
whether sensitivity and specificity of low-dose CEDEM are comparable with breast MRI.
Subjects will be asked before diagnostic workup to participate in this clinical study.
Approximately 80 subjects scheduled for a diagnostic CE-MRI (i.e., based on screening
mammography classified as BI-RADS® 0, 4 or 5), will be eligible to participate in this study
and will undergo a follow up 4 view bilateral low dose contrast enhanced mammography
procedure.
Radiologically, subjects included in the study population will have even distribution of
masses, clusters of microcalcifications, and architectural distortions as given by the nature
of breast cancer development.
The study population will include all breast compositions. Diagnostic CE-MRI Examination If
eligible, subjects with a positive or incomplete screening mammogram (BI-RADS 0, 4 or 5) will
undergo a CE-MRI of the breast. MRI examinations will be performed on a 3 Tesla scanner (Tim
trio, Siemens) with a dedicated 16 channel breast coil. A combination of high temporal and
high spatial resolution imaging protocol will be used. All patients will be examined in the
prone position and contrast agent (0.2mmol / body weight, GD-DOTA) will be administered i.v.
as a bolus followed by a 20 ml saline flush.
Both exams (CEDEM and CE-MRI) will be scheduled in the second week of the menstrual cycle in
premenopausal women. Each suspicious lesion will undergo needle or surgical biopsy (after
completion of the CEDEM+PRIME procedure). Imaging findings will be compared with findings of
histology.
Diagnostic CEDEM+PRIME If eligible, subjects with a completed MRI procedure will undergo a 4
standard view (CC, MLO) bilateral CEDEM examination. Due to use of the grid-less PRIME
acquisition technology the AGD is limited and lies in the range of a standard mammogram. The
high energy images will be acquired with the titanium filter. All acquired images - including
the unprocessed images - will be collected. Recombined CEDEM images will be created offline.
Contrast agent is injected as a bolus of 2 ml/kg body weight of non-ionic iodine contrast
media with a power injector at a rate of 3.5ml/s followed by a 25ml saline flush.
The CEDEM diagnostic procedure will be performed not later than 7 days and at least 24 hours
after the CE-MRI procedure.
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