Tc99m-MAA Imaging for Radiation Therapy Planning in Patients with Lung Cancer or Lung Metastases

Status: complete

This phase I trial studies how well Tc99m-MAA imaging works for radiation therapy planning in patients with lung cancer or cancer that has spread to the lungs (lung metastases). Arterial administration of radiation to lung tumors may represent an alternative method of radiation therapy, with dose directly administered to the tumor. The potential radiation dose to the tumor and adjacent structures is not known. Tc99m-MAA is a type of radiotracer that is used to assess blood flow and has a similar size to the particles that are utilized for arterial delivery of radiation therapy. Giving Tc99m-MAA, followed by scans called single photon emission computed tomography (SPECT) and planar imaging, may allow doctors to estimate radiation dose to tumors and adjacent structures in the setting of intra-arterial radiation therapy.

Inclusion Criteria

Patients with known active lung cancer or pulmonary metastases with a history of hemoptysis presenting for standard of care bronchial artery embolization will be considered
Patients must be presenting for secondary prophylaxis of hemoptysis
If female, not of childbearing potential or negative serum beta-human chorionic gonadotropin (hCG) pregnancy test prior to computed tomography angiogram (CTA) chest and radiotracer injection
If female, not nursing
Willing and able to understand and sign a written informed consent document
Willing and able to undergo all study procedures

Exclusion Criteria

Patients with current active hemoptysis
Any acute or chronic inflammatory disease or medical conditions that in the investigator’s opinion may interfere with the study procedures or the interpretation of the study results
Subjects who have exclusion criteria that would prevent them from receiving a CT scan or fluoroscopy, or administration of contrast
History of allergic reactions or hypersensitivity attributed to compounds of similar chemical or biologic composition to macro-aggregated albumin
Patients with severe pulmonary hypertension
Glomerular filtration rate < 30
Platelets < 30
International normalized ratio (INR) > 3.0

PRIMARY OBJECTIVES:

I. To determine dosimetry to tumor and critical structures from target embolization (bronchi, mediastinum, esophagus, spine) that would occur following Y90 radioembolization of the bronchial artery.

II. To determine any off-target administration of tracer to distant organs.

III. Assess for immediate post-procedural adverse events associated with bronchial artery administration of technetium Tc-99m albumin aggregated (Tc99m-MAA).

OUTLINE:

Patients receive Tc99m-MAA via arterial injection over 30-240 seconds and then undergo SPECT and planar imaging over 1 hour.

After completion of study, patients are followed up within 24 hours.

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Tc99m-MAA Imaging for Radiation Therapy Planning in Patients with Lung Cancer or Lung Metastases

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