Gadolinium and Ferumoxytol MRI in Diagnosing Patients With Abnormalities in the Central Nervous System
The Feasibility of Steady State CBV Mapping Using Ferumoxytol Immediately After Gadolinium Enhanced MRI of the CNS
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To test if prior gadolinium administration affects vascular imaging using ferumoxytol.
II. To test signal changes of T2*w multi-echo fast field echo (mFFE) scans before and after contrast agent injection.
SECONDARY OBJECTIVES:
I. To test if ferumoxytol affects gadolinium enhanced MRI. II. To test if steady state cerebral blood volume (CBV) maps are different at various magnetic field strengths.
EXPLORATORY OBJECTIVES:
I. To explore late ferumoxytol enhancement (optional MRI) hours to days after ferumoxytol administration in various brain pathologies.
II. To evaluate the effects of ferumoxytol on malignant and non-malignant lesions in head & neck, and liver lesions
OUTLINE: Patients are randomized into 1 of 2 groups.
GROUP I: Patients receive gadolinium intravenously (IV) and then ferumoxytol IV and undergo MRI over 60 minutes on day 1.
GROUP II: Patients receive ferumoxytol IV and then gadolinium IV and undergo MRI over 60 minutes on day 1.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Amy E Huddleston, MPA:HA, CCRP
- Phone Number: 5034942910
- Email: huddlesa@ohsu.edu
Study Contact Backup
- Name: Lisa C Muir, MPA:HA, CCRP
- Phone Number: 5034942910
- Email: bennetli@ohsu.edu
Study Locations
-
-
Oregon
-
Portland, Oregon, United States, 97239
- Recruiting
- OHSU Knight Cancer Institute
-
Contact:
- Ramon Barajas, MD
- Phone Number: 503-418-0990
- Email: barajas@ohsu.edu
-
Principal Investigator:
- Ramon Barajas, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Subjects must have one of the following:
- Neurological findings (i.e. headache, loss of consciousness, paresis, cranial neuropathy, seizures, etc.)
- Radiological abnormalities in the brain (neoplastic or non-neoplastic in nature)
- Neoplastic process elsewhere in the body that may affect the brain (i.e. possible metastasis, vascular compromise, treatment related changes, etc.)
- Subjects must be able to undergo MRI imaging without anesthesia
- Subjects must be at least 10 years of age
- All subjects, or their legal guardians, must sign a written informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization in accordance with institutional guidelines
- Sexually active women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; surgical intervention i.e. tubal ligation or vasectomy; post-menopausal < 6 months; or abstinence) for at least two months after each cycle of the study; should a female become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
Exclusion Criteria:
- Subjects with clinically significant signs of uncal herniation, such as acute pupillary enlargement, rapidly developing motor changes (over hours), or rapidly decreasing level of consciousness, are not eligible
- Subjects with known allergic or hypersensitivity reactions to parenteral iron, parenteral dextran, parenteral iron-dextran, or parenteral iron-polysaccharide preparations (Ferumoxytol Investigator's Drug Brochure, 2009); subjects with significant drug or other allergies or autoimmune diseases may be enrolled at the investigator's discretion
- Subjects who are pregnant or lactating or who suspect they might be pregnant
- Subjects who have a contraindication for MRI: metal in their bodies (a cardiac pacemaker or other incompatible device), are severely agitated, or have an allergy to gadolinium containing contrast material
- Subjects with known iron overload (genetic hemochromatosis); in subjects with a family history of hemochromatosis, hemochromatosis must be ruled out prior to study entry with normal values of the following blood tests: transferrin saturation (TS) test and serum ferritin (SF) test; all associated costs will be paid by the study
- Subject who have received ferumoxytol within 3 weeks of study entry
- Subjects with three or more drug allergies from separate drug classes
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Group I (gadolinium, ferumoxytol, MRI)
Patients receive gadolinium IV and then ferumoxytol IV and undergo MRI over 60 minutes on day 1.
|
Undergo MRI
Other Names:
Given IV
Other Names:
Given IV
Other Names:
|
|
Experimental: Group II (ferumoxytol, gadolinium, MRI)
Patients receive ferumoxytol IV and then gadolinium IV and undergo MRI over 60 minutes on day 1.
|
Undergo MRI
Other Names:
Given IV
Other Names:
Given IV
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Visualization of normal vasculature
Time Frame: Up to 5 years
|
Primary analysis will use the average score of the two readers.
The mean difference and the associated 95% confidence interval (CI) between the two groups will be estimated using a linear regression model.
Equivalence will be claimed if the 95% CI does not include 0.4 on either side (equivalence margin is 0.4).
|
Up to 5 years
|
|
Visualization of abnormal vasculature
Time Frame: Up to 5 years
|
Primary analysis will use the average score of the two readers.
The mean difference and the associated 95% CI between the two groups will be estimated using a linear regression model.
Equivalence will be claimed if the 95% CI does not include 0.4 on either side (equivalence margin is 0.4).
|
Up to 5 years
|
|
Visualization of normal anatomical structures
Time Frame: Up to 5 years
|
Primary analysis will use the average score of the two readers.
The mean difference and the associated 95% CI between the two groups will be estimated using a linear regression model.
Equivalence will be claimed if the 95% CI does not include 0.4 on either side (equivalence margin is 0.4).
|
Up to 5 years
|
|
Identification of the lesion corresponding areas on cerebral blood volume (CBV) maps
Time Frame: Up to 5 years
|
Will assess the confidence in identifying the lesion corresponding areas on CBV maps as well as signal change (deltaR2*) and relative cerebral blood volume.
Primary analysis will use the average score of the two readers.
The mean difference and the associated 95% CI between the two groups will be estimated using a linear regression model.
Equivalence will be claimed if the 95% CI does not include 0.4 on either side (equivalence margin is 0.4).
|
Up to 5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Contrast enhancement
Time Frame: Up to 5 years
|
The mean difference and the associated 95% CI before versus after ferumoxytol in the three visualization variables will be estimated using a paired t-test based on the average score of the two readers.
Will use the same equivalence margin of 0.4.
To compare the two magnetic field strengths, will also use a linear regression model to analyze contrast to noise ratios, Image homogeneity and susceptibility artifacts (the latter two based on average score of the two readers).
|
Up to 5 years
|
|
Border delineation
Time Frame: Up to 5 years
|
The mean difference and the associated 95% CI before versus after ferumoxytol in the three visualization variables will be estimated using a paired t-test based on the average score of the two readers.
Will use the same equivalence margin of 0.4.
To compare the two magnetic field strengths, will also use a linear regression model to analyze contrast to noise ratios, Image homogeneity and susceptibility artifacts (the latter two based on average score of the two readers).
|
Up to 5 years
|
|
Internal morphology
Time Frame: Up to 5 years
|
The mean difference and the associated 95% CI before versus after ferumoxytol in the three visualization variables will be estimated using a paired t-test based on the average score of the two readers.
Will use the same equivalence margin of 0.4.
To compare the two magnetic field strengths, will also use a linear regression model to analyze contrast to noise ratios, Image homogeneity and susceptibility artifacts (the latter two based on average score of the two readers).
|
Up to 5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Michael F Regner, MD, OHSU Knight Cancer Institute
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Neoplasms by Site
- Neoplasms
- Nervous System Neoplasms
- Brain Neoplasms
- Central Nervous System Neoplasms
- Cranial Nerve Diseases
- Investigative Techniques
- Inorganic Chemicals
- Elements
- Metals
- Chemistry Techniques, Analytical
- Spectrum Analysis
- Ferric Compounds
- Iron Compounds
- Ferrous Compounds
- Minerals
- Lanthanoid Series Elements
- Metals, Rare Earth
- Ferrosoferric Oxide
- Magnetic Resonance Spectroscopy
- Gadolinium
Other Study ID Numbers
Other Study ID Numbers
- STUDY00017028 (Other Identifier: OHSU Knight Cancer Institute)
- NCI-2017-01460 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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