Randomised controlled trial to compare the diagnostic yield of Positron Emission Tomography Computed Tomography (PET-CT) TARGETed pleural biopsy versus CT-guided pleural biopsy in suspected pleural malignancy.
Many patients with a history of asbestos exposure can develop irregular thickening of the lung lining (the pleura). Although in many cases the pleural thickening is not serious, a small proportion of patients can develop cancer of the lung lining (mesothelioma). Chest X-rays and CT (computed tomography) scans of these patients can indicate a suspicion of cancer but the only way to confirm the diagnosis is by obtaining a sample (biopsy) from the lung lining and examining the cells.
Sometimes the biopsy does not give us the answer, so a second biopsy may be needed. Unfortunately, it is common that this second biopsy also does not give a clear answer either. If it is possible to target the biopsy to the right part of the lung lining more accurately, it may be possible to give a more definite diagnosis.
A scan called Positron Emission Tomography Computed Tomography (or PET-CT) highlights areas where the cells are more active. Cancer cells are usually more active than normal cells. Therefore a PET-CT scan may show us the best place to take the biopsy in order to establish if there are cancer cells. PET scanners are expensive and in high demand so high-quality evidence is required before they can be used routinely for this purpose.
The TARGET study will investigate how effective PET-scan targeted tissue sampling is compared to the conventional CT targeted sampling in patients requiring a second biopsy for suspected mesothelioma. The study will aim to recruit 78 patients in total across a number of UK hospitals and will compare the results in two groups of patients who have been randomly allocated to one or the other method.
The study is funded by the National Institute for Health and Research (NIHR) Research for patient benefit (RFPB) funding stream.