Prediction of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage Using Dynamic 18F-FDG PET/CT (PREDISP)
Prediction and Unraveling of Delayed Cerebral Ischemia in Patients With Subarachnoid Hemorrhage Using Early Dynamic 18F-FDG PET/CT Assessment of Cerebral Glucose Uptake (PREDISP)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Kevin CHALARD, M.D.
- Phone Number: +33 788 014 588
- Email: k-chalard@chu-montpellier.fr
Study Contact Backup
- Name: Pierre-Francois PERRIGAULT, M.D.
- Email: pf-perrigault@chu-montpellier.fr
Study Locations
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-
Montpellier
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Montpellier, Montpellier, France, 34295
- Département d'Anesthésie-Réanimation Gui de Chauliac 80 Av Augustin.Fliche
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- written informed consent to participate in the study must be obtained from the subject or proxy/legal representative prior to enrollment.
- males and females aged 18 years and older.
- SAH proven by computed tomography (CT) and that has occurred within the last 72 hours.
- ruptured saccular aneurysm angiographically confirmed by digital subtraction angiogram or CT angiogram, which has been successfully secured by surgical clipping or endovascular coiling.
- high-risk subjects for DCI: "thick clot" on the hospital admission CT (grade 3 or grade 4 on the modified Fisher Scale).
- a woman of childbearing potential is eligible only if the serum pregnancy test performed during the screening period is negative.
Exclusion Criteria:
- PET/CT contradications
- MRI contradications
- gadolinium or meglumine hypersensitivity
- glomerular filtration rate <30mL/min
- SAH due to other causes than ruptured saccular aneurysm.
- post-HSA cardiac arrest.
- high sustained ICP ( >20mmHg lasting >20min) despite optimal treatment.
- significant and concomitant organ failure amongst the following: hypotension with systolic blood pressure <90mmHg refractory to treatment; unresolved pulmonary edema or pneumonia with severe hypoxia defined as PaO2/FiO2 <150; severe cardiac failure requiring inotropic support.
- patients with "do-not-resuscitate" orders, withdrawal of care situation, dying patient.
- vulnerable patient populations (minor, legal vulnerability, prisoner)
- pregnant and nursing mothers.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention Group
All participants will receive study intervention
|
The intervention will consist in a dynamic cerebral 18F-FDG PET study performed at D2+/-1.
Kinetic modeling will be performed using in-house software at the global, regional, and voxel level.
In addition, cerebral perfusion and blood-brain-barrier permeability will be assessed at D4+/- 1 using perfusion MRI and permeability MRI.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Quantification of K1 parameter.
Time Frame: Day 2 +/- 1 day after the initial bleeding
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A kinetic modeling for cerebral glucose uptake will be performed using in-house software in order to provide the K1 parameter (in min-1) in every voxel reflecting the cerebral blood flow (in mL/min).
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Day 2 +/- 1 day after the initial bleeding
|
|
Quantification of Ki parameter.
Time Frame: Day 2 +/- 1 day after the initial bleeding
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A kinetic modeling for cerebral glucose uptake will be performed using in-house software in order to provide the Ki parameter (in min-1) in every voxel reflecting the cerebral metabolic rate of glucose in µmol/100g/min.
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Day 2 +/- 1 day after the initial bleeding
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Delayed cerebral ischemic regions.
Time Frame: From day 2 to day 21 +/- 3 days after the initial bleeding
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Delayed cerebral ischemic lesions will be ascertained by routine MRI scans until the end of the period of time in which the subject may present DCI (D21+/-3).
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From day 2 to day 21 +/- 3 days after the initial bleeding
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Delayed spasmed arteries territories.
Time Frame: From day 2 to day 21 +/- 3 days after the initial bleeding
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Occurence of vasospasm will be determined on routine angiograms until the end of the period of time in which the subject may present vasospasm (D21+/-3).
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From day 2 to day 21 +/- 3 days after the initial bleeding
|
|
Quantification of cerebral blood flow using DSC-MRI
Time Frame: At day 4 +/- 1 day after the initial bleeding
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Cerebral blood flow in mL/100g/min will be measured using DSC-MRI (Dynamic Susceptibility Contrast Magnetic Resonance Imaging)
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At day 4 +/- 1 day after the initial bleeding
|
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Quantification of cerebral blood flow using ASL-MRI
Time Frame: At day 4 +/- 1 day after the initial bleeding
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Cerebral blood flow in mL/100g/min will be measured using ASL-MRI (Arterial Spin Labelling Magnetic Resonance Imaging)
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At day 4 +/- 1 day after the initial bleeding
|
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Quantification of blood-brain-barrier permeability using DSC-MRI
Time Frame: At day 4 +/- 1 day after the initial bleeding
|
The blood-brain barrier permeability will be measured using DSC-MRI.
A kinetic modeling will be performed in order to provide the leakage parameter K2 (in min-1) in every voxel.
|
At day 4 +/- 1 day after the initial bleeding
|
|
Quantification of blood-brain-barrier permeability using DCE-MRI
Time Frame: At day 4 +/- 1 day after the initial bleeding
|
The blood-brain barrier permeability will be measured using DCE-MRI (Dynamic Contrast-Enhanced Magnetic Resonance Imaging).
A kinetic modeling will be performed in order to provide the leakage parameter Ktrans (in min-1) in every voxel.
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At day 4 +/- 1 day after the initial bleeding
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Kévin CHALARD, M.D., Uh Montpellier
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
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
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Necrosis
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Infarction
- Stroke
- Brain Infarction
- Intracranial Hemorrhages
- Brain Ischemia
- Ischemia
- Hemorrhage
- Cerebral Infarction
- Subarachnoid Hemorrhage
- Molecular Mechanisms of Pharmacological Action
- Radiopharmaceuticals
- Fluorodeoxyglucose F18
Other Study ID Numbers
Other Study ID Numbers
- RECHMPL19_0408
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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