CATCH on CBCT

Status: Open

Specialty: Radiotherapy

Date Opened: 16/11/2021

Planned Close Date: 01/08/2023

Sponsor: University College London

Principal Investigator: 

Study Title: Covid Associated Temporal CHanges (CATCH) on Cone-Beam CT in cancer patients

Cancer patients appear to be at higher risk of symptomatic COVID-19 infection, particularly patients undergoing active treatment as in- or out-patients. Additionally, cancer patients may experience higher rates of serious complications, possibly due to compromised immune function. Systematically screening of cancer patients for COVID-19 infection has been suggested, but it is challenging: cancer treatments include many visits to hospital over the course of several weeks/months. Lung cancer patients appear to be particularly vulnerable for COVID-19 related complications; either due to their disease, the impact of treatment, or underlying health problems. Lung cancer patients undergoing chemo- or radiotherapy have been identified as ‘extremely vulnerable’ during the current pandemic by NHS England. Many of these considerations also apply to patients with oesophageal cancer or lymphoma, with the former often suffering from lung or heart disease and the latter exposed to intensive chemotherapy regimens.

COVID-19 infection results in a characteristic pattern on chest imaging. These changes may even be observed before patients develop COVID symptoms. Though the role of chest imaging as a potential screening or diagnostic tool is still debated, the daily images routinely acquired during a course of radiotherapy (cone beam computed tomography scans, or CBCTs) could provide a valuable opportunity to systematically monitor for development of COVID-19 infection in an extremely high-risk patient population, and thus assist cancer department infection control.

Initial case reports have indicated that imaging changes may indeed be observed on CBCTs in infected patients. If this study confirms that CBCT changes can provide reliable information, they could be incorporate into a clinical decision support tool to refer for further investigations, particularly in pre- or asymptomatic patients, offer a low-resource complement to COVID testing, or flag the need for a retest in selected patients.