Imaging Techniques for Acute Myeloid Leukemia
Recruiting in Palo Alto (17 mi)
Overseen byVikas Kundra
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Phase 1
Recruiting
Sponsor: M.D. Anderson Cancer Center
Disqualifiers: Secondary AML, Relapsed AML, APL, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This pilot phase I trial studies how well positron emission tomography (PET)/magnetic resonance imaging (MRI), fludeoxyglucose F-18 (18F-FDG) PET/computed tomography (CT), and whole body MRI work in finding extramedullary myeloid leukemia in patients with newly diagnosed acute myeloid leukemia. Extramedullary myeloid leukemia is a type of cancer found outside of the bone marrow and can be hard to detect with routine bone marrow monitoring, such as bone marrow aspirations. Diagnostic procedures, such as PET/MRI, 18F-FDG PET/CT and whole body MRI, may help find and diagnose extramedullary myeloid leukemia in patients with newly diagnosed acute myeloid leukemia.
Will I have to stop taking my current medications?
The trial protocol does not specify whether you need to stop taking your current medications. However, if you are receiving more than minimal anti-leukemia treatment, you may not be eligible to participate.
What data supports the effectiveness of imaging techniques for acute myeloid leukemia treatment?
The study on 18F-FLT PET/CT suggests that this imaging technique can help assess early response to treatment in acute myeloid leukemia patients, potentially predicting clinical outcomes.
12345Is it safe to use imaging techniques like CT and MRI for leukemia?
CT scans involve exposure to radiation, which can increase cancer risk, especially in children. MRI does not use radiation and is generally considered safe, but its safety in specific conditions like leukemia needs careful evaluation.
26789How does the imaging treatment for acute myeloid leukemia differ from other treatments?
This treatment uses advanced imaging techniques like MRI and PET/CT to assess bone marrow involvement and early response to therapy in acute myeloid leukemia, offering a non-invasive way to monitor disease progression and treatment effectiveness, unlike traditional methods that rely on more invasive procedures like bone marrow biopsies.
410111213Eligibility Criteria
This trial is for patients with newly diagnosed acute myeloid leukemia (AML) or acute promyelocytic leukemia (APL). Women who can have children must show a negative pregnancy test to participate.Inclusion Criteria
I have been recently diagnosed with AML or APL.
I am a woman who can have children and have a negative pregnancy test.
Exclusion Criteria
Cognitively impaired adults or prisoners
Patients with contraindications to MR
I am under 18 years old.
+9 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Diagnostic Imaging
Patients receive gadolinium IV and undergo whole body PET/MRI and 18F-FDG PET/CT to detect extramedullary myeloid leukemia
1 week
1 visit (in-person)
Follow-up
Participants are monitored periodically for safety and effectiveness after imaging procedures
4 weeks
Participant Groups
The study tests how well PET/MRI, 18F-FDG PET/CT, and whole body MRI detect extramedullary myeloid leukemia in new AML patients. These imaging techniques may improve diagnosis of cancer outside the bone marrow.
1Treatment groups
Experimental Treatment
Group I: Diagnostic (18F-FDG PET/CT, whole body PET/MRI)Experimental Treatment7 Interventions
Patients receive gadolinium IV and undergo whole body PET/MRI comprising diffusion weighted imaging and 3D FSPGR-DE with and without fiducial markers. Patients then undergo 18F-FDG PET/CT before start treatment for acute myeloid leukemia.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
M D Anderson Cancer CenterHouston, TX
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Who Is Running the Clinical Trial?
M.D. Anderson Cancer CenterLead Sponsor
National Cancer Institute (NCI)Collaborator
References
MRI and PET/MRI in hematologic malignancies. [2022]The role of MRI differs considerably between the three main groups of hematological malignancies: lymphoma, leukemia, and myeloma. In myeloma, whole-body MRI (WB-MRI) is recognized as a highly sensitive test for the assessment of myeloma, and is also endorsed by clinical guidelines, especially for detection and staging. In lymphoma, WB-MRI is presently not recommended, and merely serves as an alternative technique to the current standard imaging test, [18 F]FDG-PET/CT, especially in pediatric patients. Even for lymphomas with variable FDG avidity, such as extranodal mucosa-associated lymphoid tissue lymphoma (MALT), contrast-enhanced computed tomography (CT), but not WB-MRI, is presently recommended, despite the high sensitivity of diffusion-weighted MRI and its ability to capture treatment response that has been reported in the literature. In leukemia, neither MRI nor any other cross-sectional imaging test (including positron emission tomography [PET]) is currently recommended outside of clinical trials. This review article discusses current clinical applications as well as the main research topics for MRI, as well as PET/MRI, in the field of hematological malignancies, with a focus on functional MRI techniques such as diffusion-weighted imaging and dynamic contrast-enhanced MRI, on the one hand, and novel, non-FDG PET imaging probes such as the CXCR4 radiotracer [68 Ga]Ga-Pentixafor and the amino acid radiotracer [11 C]methionine, on the other hand. Level of Evidence: 5 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:1325-1335.
Cranial computerized tomography in childhood leukemia. [2019]The value of computerized tomography (CT) of the head in childhood leukemia is emphasized by a striking example. The response of the leukemic infiltrate to radiation suggests that an earlier (presymptomatic) scan might have led to major improvement in management. A routine CT scan may be warranted in children with a prolonged remission in search of a CNS reservoir for leukemia cells.
Acute myeloid leukemia: lack of predictive value of sequential quantitative MR imaging during treatment. [2007]To assess the use of magnetic resonance (MR) imaging in monitoring treatment response in patients with acute myeloid leukemia (AML).
Early assessment of response to induction therapy in acute myeloid leukemia using 18F-FLT PET/CT. [2020]Label="BACKGROUND" NlmCategory="BACKGROUND">We evaluated the suitability of 18F-fluorodeoxythymidine (18F-FLT) positron emission tomography (PET)/computed tomography (CT) for assessment of the early response to induction therapy and its value for predicting clinical outcome in patients with acute myeloid leukemia (AML). Adult patients who had histologically confirmed AML and received induction therapy were enrolled. All patients underwent 18F-FLT PET/CT after completion of induction. PET/CT images were visually and quantitatively assessed. Cases with intensely increased bone marrow uptake in more than one third of the long bones and throughout the central skeleton were interpreted as PET-positive for resistant disease (RD). PET results were compared to the clinical response and outcome.
Chest low-dose computed tomography in neutropenic acute myeloid leukaemia patients. [2019]We aimed to compare chest low-dose computed tomography (LDCT) with chest radiography (CXR) in the assessment of febrile acute myeloid leukaemia neutropenic patients.
Radiation Exposure From Pediatric CT Scans and Subsequent Cancer Risk in the Netherlands. [2022]Computed tomography (CT), a strong diagnostic tool, delivers higher radiation doses than most imaging modalities. As CT use has increased rapidly, radiation protection is important, particularly among children. We evaluate leukemia and brain tumor risk following exposure to low-dose ionizing radiation from CT scans in childhood.
[Quantitative magnetic resonance (MR) imaging of bone marrow in leukemia]. [2015]There were many studies on the relationship between magnetic resonance (MR) imaging of bone marrow and clinical laboratory variables of the patients with leukemia; however, few of them had separated lymphoid leukemia (LL) from myeloid leukemia (ML). The current study was designed to investigate the role of signal intensity ratio (SIR) of MR Imaging in the characteristic diagnosis and tumor burden evaluation in leukemia by separately measurement of spinal marrow SIR in LL and ML.
[Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Evaluating Diffuse Tumor Infiltration of Bone Marrow in Patients with Acute Leukemia]. [2018]To analyze the value of dynamic contrast-enhanced magnetic resonance imaging (CEMRI) for evaluating diffuse tumor infiltration of bone marrow in patients with acute leukemia (AL).
[Cerebral computed x-ray tomography in acute lymphoblastic leukemia in children]. [2016]After analysis of the results of 142 CT brains scans performed from 1976 to 1982 on children with acute lymphoblastic leukemia, we can propose indications for this exam in relation with the different clinical stages and evolution of the disease. An exam is carried out as soon as possible at the start of the disease without injection of contrast media for use as a reference point. Excepting complications or neurological localisations, a scan will be performed at the end of the third year of treatment, without injection of contrast media, in screening for possible iatrogenic lesions. Neurological complications of unknown origin and leucoblastic meningitis seems to require a scan with injection of contrast media firstly as a mean of diagnosis, and secondly, in case of a cerebro meningeal localisation, in order to judge the efficiency of treatment and to screen for early complications. Computerized tomography however has its limits, particularly in case of purely meningeal leucoblastic infiltration.
Detection of bone marrow involvement in patients with cancer. [2022]Current methods for the study of bone marrow to evaluate possible primary or metastatic cancers are reviewed. Bone marrow biopsy, radionuclide scan, computed tomography and magnetic resonance imaging (MRI) are analyzed with regard to their clinical usefulness at the time of diagnosis and during the course of the disease. Bone marrow biopsy is still the examination of choice not only in hematologic malignancies but also for tumors that metastasize into the marrow. Radionuclide scans are indicated for screening for skeletal metastases, except for those from thyroid carcinoma and multiple myeloma. Computed tomography is useful for cortical bone evaluation. MRI shows a high sensitivity in finding occult sites of disease in the marrow but its use has been restricted by high cost and limited availability. However, the future of MRI in bone marrow evaluation seems assured. MRI is already the method of choice for diagnosis of multiple myeloma, when radiography is negative, and for quantitative evaluation of lymphoma when a crucial therapeutic decision (i.e. bone marrow transplantation) must be made. Finally, methods are being developed that will enhance the sensitivity and specificity of MRI studies of bone marrow.
3 Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: initial results in comparison to HRCT. [2019]To evaluate the diagnostic accuracy of 3 Tesla proton MRI for the assessment of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia.
Bone marrow in leukemia and aplastic anemia: MR imaging before, during, and after treatment. [2015]Serial magnetic resonance (MR) studies of the cervical bone marrow were performed in five patients undergoing bone marrow transplantation for chronic granulocytic leukemia and in four patients with aplastic anemia who were treated with antilymphocytic globulin. Findings were compared with those from a group of healthy volunteers. Chemical shift imaging techniques were used to exploit the presence of protons in fat and water in the red marrow. Characteristic changes were seen in aplastic anemia before treatment, but derivation of images representing fat and water fractions was necessary to distinguish leukemic marrow. Acute changes during the treatment of leukemia may reflect the effects of chemotherapy and radiation therapy, whereas changes in the chronic phase of both diseases may prove useful in predicting treatment outcome. MR studies are likely to be useful in the assessment and treatment of hematologic disorders.
Whole-body MR imaging of bone marrow. [2005]In clinical routine, multimodality algorithms, including X-ray, computed tomography, scintigraphy and MRI, are used in case of suspected bone marrow malignancy. Skeletal scintigraphy is widely used to asses metastatic disease to the bone, CT is the technique of choice to assess criteria of osseous destruction and bone stability. MRI is the only imaging technique that allows direct visualization of bone marrow and its components with high spatial resolution. The combination of unenhanced T1-weighted-spin echo- and turbo-STIR-sequences have shown to be most useful for the detection of bone marrow abnormalities and are able to discriminate benign from malignant bone marrow changes. Originally, whole-body MRI bone marrow screening was performed in sequential scanning techniques of five body levels with time consuming coil rearrangement and repositioning of the patient. The introduction of a rolling platform mounted on top of a conventional MRI examination table facilitated whole-body MR imaging and, with the use of fast gradient echo, T1-weighted and STIR-imaging techniques, for the first time allowed whole-body imaging within less than one hour. With the development of parallel imaging techniques (PAT) in combination with global matrix coil concepts, acquisition time could be reduced substantially without compromises in spatial resolution, enabling the implementation of more complex and flexible examination protocols. Whole-body MRI represents a new alternative to the stepwise multimodality concept for the detection of metastatic disease, multiple myeloma and lymphoma of the bone with high diagnostic accuracy.