The purpose of this study is to evaluate the clinical usefulness of dynamic \[18F\]FDG PET imaging in assessing brain metastasis post stereotactic radiotherapy to separate true progression from the treatment-related changes.
After being informed about the study and potential risk, all participants giving written informed consent will be screened to determine if participant being referred fits eligibility criteria for the study, under of the supervision of the radiation oncologist. If a participant agrees to participate in this study, they will receive three additional imaging sessions (the dynamic PET scan). The first session will occur prior to starting treatment; the second session will occur at about 10 weeks post treatment; the third session will occur at first concern of progression at treated lesions or 12 months post-treatment, whichever comes earlier. These scans will be scheduled in addition to the participant's regular follow-up scans and appointments.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
70
at baseline prior to stereotactic radiation, at 10 weeks after treatment, and at first concern for progression at treated lesion or 12 months post-treatment, whichever comes earlier.
Diagnostic accuracy of dynamic PET
Diagnostic accuracy will be calculated and compared based on the index lesion.
Time frame: 12-month follow-up.
Clinical outcomes
Clinical outcomes such as local recurrence.
Time frame: 24-month follow-up
Clinical outcomes
CNS progression-free survival and overall survival will be analyzed
Time frame: 24-month follow-up
Clinical outcomes
Factors impact on these outcomes will be explored.
Time frame: 24-month follow-up
Diagnostic imaging outcomes
GMR-to-perfusion ratio.
Time frame: 24-month follow-up
Diagnostic imaging outcomes
Blood-brain barrier permeability to glucose.
Time frame: 24-month follow-up
Diagnostic imaging outcomes
Glucose Metabolic Rate.
Time frame: 24-month follow-up
Diagnostic imaging outcomes
Magnetic resonance spectroscopy data.
Time frame: 24-month follow-up
Diagnostic imaging outcomes
Other ancillary clinical data will be explored.
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Time frame: 24-month follow-up
Cost-effectiveness analysis
A decision analysis model coupled with Markov model will be constructed to estimate the incremental cost-effectiveness ratio (ICER) of performing dynamic PET in this setting from the Canadian health-care system perspective.
Time frame: 24-month follow-up