DECIMA
Research type
Research Study
Full title
Dual-Energy Computed Tomography for Improving Imaging Assessment of Multiple Myeloma
IRAS ID
274302
Contact name
Vicky Goh
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
4 years, 11 months, 1 days
Research summary
Up to 30% of patients with newly diagnosed/suspected myeloma cannot undergo or do not tolerate whole body MRI (WB-MRI). A number of factors may be contributory. First, WB-MRI protocols can take in excess of 1 hour. Patients must remain still within a narrow bore scanner with multiple MRI coils that can be claustrophobic. Second, there is significant acoustic noise that can be heard despite the use of ear protection. Third, 80% of patients will experience bone pain or fracture at some point during their illness, affecting their comfort within the scanner. Fourth, patients also have higher anxiety. One review reported up to 30% of patients experienced considerable apprehension and up to 10% severe psychological distress when undergoing MRI. Finally, myeloma is predominantly an illness of the elderly and co-morbid conditions decrease patients' ability to tolerate a long scan. When WB-MRI cannot be performed, NICE recommend whole-body computed tomography (WB-CT), which we know offers decreased diagnostic performance in terms of marrow assessment and focal lesion detection.
We believe that using a novel CT technique - dual-energy CT (DECT) - may offer better diagnostic performance over standard WB-CT in myeloma patients. What we seek to do in this study is to evaluate the sensitivity and specificity of DECT in a cohort of untreated patients; and compare the performance of DECT to simulated standard CT (data simulated from the DECT) and also to WB-MRI (reference standard alongside bone marrow biopsy results. We will assess both subjective visual analysis of DECT images as well as CT quantitative values for the bone marrow. Secondary objectives include assessment of patient experience across both imaging tests and assessment of intra & inter observer variability in subjective visual analysis.
REC name
London - Surrey Research Ethics Committee
REC reference
22/LO/0082
Date of REC Opinion
9 Feb 2022
REC opinion
Favourable Opinion