Abstract 272TiP
Background
Current imaging diagnostic assessments of locally advanced breast cancer before and during neoadjuvant therapy are of variable precision and limited reliability. Dual-layer spectral detector computed tomography (SDCT) of the breast is a novel and feasible imaging modality with high spatial and temporal resolution which improves lesion conspicuity and characterization. The potential clinical indications are vast, including patients with absolute MRI contraindications, extent of disease evaluation for surgical and radiotherapy planning and monitoring tumour response. SDCT has the potential to improve diagnostic performance and to allow quantitative comparisons of the intra-tumour effects of aromatase inhibitors with clinical and pathological evaluations. The aim of this study is to advocate the feasibility of SDCT scanning. The research hypothesis is that SDCT could have equal value compared to MRI, as a tool for extent of disease evaluation, characterization of the malignant lesion, and monitoring of therapeutic effects in patients with MRI contraindications.
Trial design
Prospective analysis of 40 postmenopausal patients with biopsy-proven locally advanced breast cancer suitable for neoadjuvant endocrine therapy have been eligible for this sub-study of the Neoletexe trial. Tumours will be scanned prior to and after four months of therapy. A specific table pad was designed for prone positioning. Dynamic breast imaging from the lung apex to lung basis are obtained with the following scan parameters: dose right index: 8, tube voltage: 120 kVp, tube current: 118 mA, slice thickness: 0,9 mm, slice increment: 0,45 mm, and monoenergetic level of 40 KeV automatically reconstructed. SDCT involves a four-phase breast CT scan prior to and after intravenous injection of contrast media (35, 90, and 360 seconds). The tumour staging based on TNM system will be compared with clinical and pathologic results for diagnostic accuracy. This substudy has been open for patient enrolment since December 2019 at the Akershus University Hospital, Norway. Accrual is planned to be completed by December 2021.
Clinical trial identification
Neoletexe trial 2015/84, obtained from Regional committees for medical and health research ethics, Norway, data: March 19th, 2015.
Editorial acknowledgement
Legal entity responsible for the study
Akershus University Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.