Breast Neoplasm Female Clinical Trial
Official title:
Role of Dedicated Breast PET in the Characterisation of Indeterminate Breast Lesions on MRI Requiring a Second-look Ultrasound - a Feasibility Study
Breast PET may be able to help in the diagnostic pathway in patients to determine which ones need to go on to have a second look ultrasound +/- biopsy and those who need to be sent for MRI guided biopsy. This may reduce the need to create more anxiety and uncertainty in this group of patients, already extremely stressed by the recent diagnosis of breast cancer.This study involves a single trial visit the Royal Free Hospital for imaging. Participants will need to lie flat for up to 30 minutes on the PET-CT camera and up to 30 minutes on the MAMMI. They will be advised not to take part in this study if they are unable to lie flat on their back and their front for this length of time or if they are claustrophobic. They will be offered the opportunity to see the PET-CT scanner and the MAMMI before deciding to consent to the trial.
This study involves a single trial visit the Royal Free Hospital for imaging. Participants
will need to lie flat for up to 30 minutes on the PET-CT camera and up to 30 minutes on the
MAMMI. They will be advised not to take part in this study if they are unable to lie flat on
their back and their front for this length of time or if they are claustrophobic. They will
be offered the opportunity to see the PET-CT scanner and the MAMMI before deciding to consent
to the trial.
Participants will be exposed to a radiation dose from the radioactive tracer F-18 FDG that is
injected into the vein before the scan and from the CT exposures during the scan. The dose
associated with the injection of about 3 MBq/kg of F-18 FDG is in the range of 4-7mSv. A CT
will be performed over the thorax to allow attenuation correction of PET images and
localisation of tracer uptake. The dose from the thorax CT will be patient dependent but the
mean dose to a patient undergoing this type of scan is 2.1mSv. A whole body CT will be
performed from the base of the skull to mid-thigh to plan the bed positions for the whole
body emission scan and to allow attenuation correction of PET images and localisation of
tracer uptake. The dose from the whole body CT will be patient dependent but the mean dose to
a patient undergoing this type of scan is 5.2mSv.The total radiation dose participants will
be exposed to is in the range of 11.3-14.3mSv. This is equivalent to 4-5.3 years of
background radiation to which individuals in the UK are regularly exposed. This would amount
to an increased lifetime risk of cancer of approximately 1 in 1250 in a standard population.
These risks are compared to a normal lifetime risk of cancer of 1 in 3.
The half-life of F-18 is 110 minutes. The duration of the scan will be up to 120 minutes post
injection. The activity within the patient will have reduced by more than 50% through
radioactive decay alone by the time they leave the department and will be further reduced by
excretion in urine. As with standard clinical administration of F-18, patients will not need
to follow any special restrictions once leaving the department.
The CT scanning protocols used in the trial PET-CT are the standard clinical protocols used
in the nuclear medicine department and have been developed with a view to minimising the dose
to the patient as far as possible. All women of childbearing potential will undergo a
pregnancy test on the day of the scan before the injection of the radioactive tracer in order
to rule out any risk to a potential foetus. Any woman of childbearing potential who is found
to be pregnant or will not consent to a pregnancy test will be excluded from the trial.
Very rarely, individuals may develop an allergic reaction to the PET tracer. No serious
adverse reactions to this tracer have been reported. Patients may experience some discomfort
from having a needle inserted into their arm/hand in order to have the tracer injected.
Occasionally the vein may become inflamed or infected, or they may experience bruising at the
insertion site. All efforts will be made to avoid or minimise any discomfort or other adverse
effects from these procedures.
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