TARGET Trial

  • Research type

    Research Study

  • Full title

    Randomised controlled trial to compare the diagnostic yield of Positron Emission Tomography Computerised Tomography (PET-CT) targeted pleural biopsy versus CT-guided pleural biopsy in suspected pleural malignancy.

  • IRAS ID

    167123

  • Contact name

    Nick Maskell

  • Contact email

    Nick.Maskell@bristol.ac.uk

  • Sponsor organisation

    Research and Innovation at North Bristol NHS Trust

  • Duration of Study in the UK

    2 years, 11 months, 31 days

  • Research summary

    Patients with thickening of the lung lining suspicious for underlying malignancy would usually have a biopsy of the lung lining. This maybe via a camera test to look at the lung lining and take samples from abnormal areas or via radiology guidance with a computed tomography (CT) scan identifying areas of thickened lung which can be biopsied.
    In a large proportion of patients this first biopsy would be diagnostic. In a small number of cases however, the first biopsy maybe non-diagnostic requiring a further biopsy to confirm the suspicion of pleural malignancy. Usually in this situation patients would have a CT guided biopsy.
    Unfortunately those who have had one non-diagnostic biopsy are quite likely to have further non-diagnostic biopsies on subsequent CT guided biopsies.
    If areas of cancer on the thickened lung lining can be highlighted somehow, the subsequent biopsy can be targeted to the highlighted area.
    Positron Emission Tomography - computed tomography (PET-CT) scans are able to highlight areas of increased metabolic activity such as that would occur in cancer by increasing the uptake of contrast in these areas.
    We propose a trial to investigate if PET-CT targeted biopsies are more likely to give a diagnostic biopsy compared to a second CT guided biopsy in patients who are suspected of having pleural malignancy who have already had one non-diagnostic biopsy.
    Magnetic resonance imaging (MRI) is another form of imaging which is cheaper, easily accessible and with no ionisation radiation. Currently there is a paucity of evidence in the usefulness of MRI in pleural malignancy. We would like to conduct a sub-study looking at the role of MRI in targeting biopsies by offering MRI to a sub-group of patients within the main study.

  • REC name

    South West - Cornwall & Plymouth Research Ethics Committee

  • REC reference

    15/SW/0156

  • Date of REC Opinion

    15 Jul 2015

  • REC opinion

    Further Information Favourable Opinion