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NCT Number: NCT06475066

Clinical Effectiveness of CEM in Diagnosis of Additional Findings at Preoperative Breast Magnetic Resonance Imaging

In order to explain the value of adding CESM into the clinical pathway, and also to obtain the relevant clinical data to support future update of clinical guideline, we plan to evaluate the detection rate of CESM for additional findings on preoperative breast MRI and the relevant clinical safety in the study.

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Key information

Age range

18 year–75 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Union Hospital of Tongji Medical College of Huazhong University of Science and Technology

Wuhan, Hubei, 430000, China

About this study

The goal of the prospective, multicenter, interventional Study is to prospectively evaluate the detection rate of preoperative contrast enhanced spectral mammography for additional suspicious findings of preoperative breast MRI in patients presenting with index breast lesions (BI-RADS ≥ 4).

The study plans to include 320 adult female patients with Index lesions of "BI-RADS≥4" in breast MRI.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 1. Adult women aged 18-75 years old
  • 2. First-time referral to the breast clinic or inpatient department of the study center for being diagnosed as presenting with suspicious breast lesions by previous procedures in 30 days
  • 3. Presenting with Index lesions of "BI-RADS≥4" and additional findings in preoperative breast MRI
  • 4. Sign the informed consent form for this study.
  • 5. Commit to follow the research procedures and cooperate with the implementation of the whole process of the study.
  • 6. In the case of women of childbearing age, have been taken contraception for at least one month prior to screening and have had a negative serum or urine pregnancy test and commit to use contraception throughout the study period

Exclusion criteria

  • 1. Patients with contraindications of intravenous administration of iodine contrast agent, such as pregnant or lactating women, patients with a history of iodine contrast agent allergy, patients with obvious hyperthyroidism
  • 2. It has been more than 14 days since the most recent preoperative breast MRI was performed for the relevant breast disease
  • 3. For the relevant breast disease, the preoperative breast MRI images and reports received within 14 days before screening are not available or do not meet the requirements of clinical diagnosis
  • 4. Patients who is receiving non-surgical interventional treatment such as neoadjuvant chemotherapy, hormone therapy or radiation therapy
  • 5. Patients who have received any breast operation for the relevant disease, such as various biopsies, therapeutic breast surgery
  • 6. Other patients assessed by the investigators as not suitable for the study, such as those who are difficult to cooperate with CESM examination due to unconsciousness, communication disorder or/and small breasts to meet the examination requirements

Treatment and study plan

contrast-enhanced spectral mammography

Diagnostic Test

After enrollment, subjects should undergo contrast-enhanced spectral mammography again within within 28 days of MRI examination.

Iopromide/contrast agent is intravenously administered two minutes prior to the first (dual-energy) image acquisition.

  • The dosage of iodine contrast agent is calculated as 1.5 mL/kg of iopromide 370 mgI/ml.
  • Injecting with high pressure syringe (Stellant, Bayer AG) at an IDR of 3ml/s, followed by 10 ml normal saline.

Other names: CEM, CESM

Primary outcomes

  1. The detection rate of preoperative contrast-enhanced spectral mammography

    Time frame: within 28 days of MRI examination

    The detection rate of preoperative contrast-enhanced spectral mammography in 28 days after breast MRI for the detection of additional MRI findings in patients with breast index lesions (BI-RADS ≥ 4).

    The efficacy analysis data set of the study included all subjects who have obtained breast MRI and CESM with adequate image quality (score ≥ 2 of the 1-5 rating scale).

Secondary outcomes

  1. detection rate

    Time frame: within 28 days of MRI examination

    • Assess detection rate of CESM on the additional findings of breast MRI
  2. Number of Participants with change of treatment plan from baseline

    Time frame: within 28 days of MRI examination

    • Once CESM result is made available, the site investigators will be asked to re-evaluate the lesions and re-discuss the management strategy with site clinicians. Subsequent clinical management decisions such as biopsy or medical therapy is rested at the discretion of the referring clinicians and patients.
  3. Number of Participants with change of biopsy plan from baseline

    Time frame: within 28 days of MRI examination

    • re-determining the treatment plan or biopsy plan and record the changes from baseline for each subject based on the clinical and radiology examination results, medical history and Breast Cancer Management Guideline (China HA 2022).
  4. diagnostic accuracy of CESM

    Time frame: within 28 days of MRI examination

    • Evaluate the accuracy of CESM when get histological examination report
    • Protocols of clinical diagnosis, biopsy or therapeutic surgery, or histopathology examination will be conducted and reported according to the clinical routine of study sites.
  5. difference by MRI and CESM

    Time frame: within 28 days of MRI examination

    • All breast MRI and CESM images will be re-evaluated in Wuhan Union Hospital (quality-control center) for image quality assessment by 2 independent radiologists (˃ 5 years' experience in diagnostic breast imaging) by Score of 5-point Likert scale and Score of 10-point Likert scale.
    • For Score of 5-point Likert scale:

    Score 1: insufficient image quality and cannot meet the diagnostic requirements Score 2: the image quality is average and basically meets the diagnostic requirements Score 3: The image quality is good and meets the diagnostic requirements Score 4: The image quality is good and meets the diagnostic requirements Score 5: The image quality is excellent and meets the diagnostic requirements

    • For Score of 10-point Likert scale: 10 subscale scores for subjective overall evaluation and selection preferences for CESM inspections. 1 is the worst, 10 is the best.

Other outcomes

  1. Safety Outcomes

    Time frame: During imaging procedure, 1 hour

    Percentage of ADR in 1 hour post Iopromide administration

  2. Safety Outcomes

    Time frame: During imaging procedure, 1 hour

    Average gland dose (AGD) of CESM

Study contacts

Contact information is provided by the study sponsor or research team.

Fan Yang, Dr.

CONTACT

[email protected]

008685726114

Juan Tao, Dr.

CONTACT

[email protected]

008685726114

Sponsors and collaborators

Lead sponsor

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Other

Registry information

Official study title

Clinical Effectiveness of cOntrast Enhanced Mammography in Diagnosis of Additional Findings at Preoperative Breast Magnetic ResOnance Imaging: A Prospective, Multicenter, Interventional Study

Acronym: COMBO-I

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Jun 26, 2024
Registry last updated
Jun 26, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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