Comparison of Spectral Photon Counting CT (SPCCT) With Dual Energy CT (DECT) and Magnetic Resonance Imaging (MRI) for Plaque and Lumen Carotid Arteries Evaluation (CAPL)
Comparison of Spectral Photon Counting CT (SPCCT) With Dual Energy CT (DECT) and Magnetic Resonance Imaging (MRI) for Plaque and Lumen Carotid Arteries Evaluation.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Philippe DOUEK, Pr
- Phone Number: +33 4 72 07 18 83
- Email: douek@creatis.insa-lyon.fr
Study Contact Backup
- Name: Adeline MANSUY
- Phone Number: +33 4 72 11 51 70
- Email: adeline.mansuy@chu-lyon.fr
Study Locations
-
-
-
Bron, France
- Louis Pradel cardiovascular Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female subjects of any ethnic background, aged > 18 years
- Any of the following known or suspected supra-aortic arterial disease based on : Prior stroke; Transient Ischemic Attack; Amaurosis Fugax; Referred for evaluation of any supra-aortic vessel; Follow-up for a stent in a supra-aortic vessel; Prior imaging ultrasounds study showing > ou = 50 % stenosis of a supra-aortic vessel segment (within 60 days before consent)
- Patient undergoing surgery within one month of carotid plaque evaluation
- Willingness and ability to follow directions and complete all study procedures specified in the protocol
- Pre-menopausal women only : Negative urinary pregnancy test on the day of imaging before the administration of study drug
- Patient has accepted to participate to the study and has signed the written consent
- Patient is affiliated to social security
Exclusion Criteria:
- Contraindication to MRI examinations (e.g. inability to hold breath, severe arrhythmias, very low cardiac output, severe claustrophobia, metallic devices not approved for MRI such as defibrillators, pacemaker, heart valve prostheses, cochlear implants, neuro-stimulators, implanted automated injection device, intraocular metallic foreign bodies, neurosurgical and vascular clips);
- Contraindication to the use of iodine and gadolinium containing contrast media (including subjects with suspicion for/or known to have NSF);- History of severe allergic or anaphylactic reaction to any allergen including drugs and contrast agents (as judged by the investigator, taking into account the intensity of the event);
- Estimated Glomerular Filtration Rate (eGFR) value < 30 mL/min/1.73 m2 derived from a serum creatinine result within 1 month before the imaging;
- Any subject on hemodialysis or peritoneal dialysis (Note: If there are multiple creatinine values, the values obtained prior to and closest to the time of the examination should be used);
- Acute renal insufficiency of any intensity, either due to hepato-renal syndrome or occurring in the per-operative liver transplantation period;
- Known subject history of severe cardiovascular disease (e.g. acute myocardial infarction [< 14 days], unstable angina, congestive heart failure New York Heart Association class IV) or known long QT syndrome;
- Suspected clinical instability or unpredictability of the clinical course during the study period (e.g. due to previous surgery);
- Scheduled or potentially expected for the period between the SPCCT or DECT and MRI: Any procedure that may alter the MRI or CT interpretation; Any interventional or surgical procedure involving the supra-aortic vessels.
- Pregnant or nursing (including pumping for storage and feeding); 11. Patient under guardianship, curators or safeguard of justice.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Spectral Photon Counting Computed Tomography (SPCCT)
The randomized SPCCT patient will have this CT scan and an MRI before surgery.
The plaque carotid will be collected for histological analysis
|
The acquisition for the assessment of the brain parenchyma and for the evaluation of the cervical and intracranial arteries will be performed without and with iodine based contrast media, respectively. The same parameters will be used for both conditions but for a large volume, from the aortic arch to the top of the head. The iodinate contrast agent's injection (Iomeron 400, Bracco Imaging France) will be performed at 5mL/s into an 18G catheter, followed by a 20 mL saline flush that will be injected at the same rate. The bolus volume will be determined according to the patient's body weight : 70 mL for patients < 80 kg and 1 mL/kg for patients > 80 kg, with a maximum of 90 mL. The SPCCT scanner is a prototype spectral photon-counting computed tomography system derived from a modified clinical CT system with a field of View (FOV) of 168 mm in-plane, and a z-coverage of 2 mm. |
|
Active Comparator: Dual Energy CT (DECT)
The randomized DECT patient will have this CT scan and an MRI before surgery.
The plaque carotid will be collected for histological analysis
|
The acquisition for the assessment of the brain parenchyma and for the evaluation of the cervical and intracranial arteries will be performed without and with iodine based contrast media, respectively. The same parameters will be used for both conditions but for a large volume, from the aortic arch to the top of the head. The iodinate contrast agent's injection (Iomeron 400, Bracco Imaging France) will be performed at 5mL/s into an 18G catheter, followed by a 20 mL saline flush that will be injected at the same rate. The bolus volume will be determined according to the patient's body weight : 70 mL for patients < 80 kg and 1 mL/kg for patients > 80 kg, with a maximum of 90 mL. DECT : IQon, Philips |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Lipid Necrotic Core (LNC) in mm² identified with SPCCT
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Lipid Necrotic Core (LNC) in mm² identified with DECT
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Lipid Necrotic Core (LNC) in mm² identified with histology
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Intra Plaque Hemorrhage (IPH) in mm² identified with SPCCT
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Intra Plaque Hemorrhage (IPH) in mm² identified with DECT
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Intra Plaque Hemorrhage (IPH) identified with histology
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Fibrous Cap Ulceration (FCU) in mm² identified with SPCCT
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Fibrous Cap Ulceration (FCU) in mm² identified with DECT
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
|
Fibrous Cap Ulceration (FCU) in mm² identified with histology
Time Frame: 1 month
|
measurement of the height and thickness of surface of the plaque's components
|
1 month
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of irregularities identified with SPCCT
Time Frame: 1 month
|
- Irregularities as defined by < 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
|
1 month
|
|
Number of irregularities identified with DECT
Time Frame: 1 month
|
- Irregularities as defined by < 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
|
1 month
|
|
Number of irregularities identified with MRI
Time Frame: 1 month
|
- Irregularities as defined by < 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
|
1 month
|
|
Number of ulcerations identified with SPCCT
Time Frame: 1 month
|
- Ulceration as defined by > 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
|
1 month
|
|
Number of ulcerations identified with DECT
Time Frame: 1 month
|
- Ulceration as defined by > 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
|
1 month
|
|
Number of ulcerations identified with MRI
Time Frame: 1 month
|
- Ulceration as defined by > 2 mm indentation, fissure, or erosion on the luminal surface of a plaque, exposing a portion of the inner plaque to direct contact with circulating blood.
|
1 month
|
|
Assessable vascular segments with lack of image artifacts
Time Frame: 1 month
|
It will be assessed by estimating the image quality on scale from 1 to 4 (1 = poor, 2 = moderate, 3 = good, and 4 = excellent)
|
1 month
|
|
radiation dose received during SPCCT
Time Frame: 1 month
|
1 month
|
|
|
radiation dose received during DECT
Time Frame: 1 month
|
1 month
|
|
|
Tolerance to SPCCT assessed by a tolerance survey
Time Frame: 1 month
|
1 to 10, 1= very bad, 10= very good.
Survey adapted from Sparrow et al., Journal of magnetic resonance imaging 19:410-416, 2004
|
1 month
|
|
Tolerance to DECT assessed by a tolerance survey
Time Frame: 1 month
|
1 to 10, 1= very bad, 10= very good.
Survey adapted from Sparrow et al., Journal of magnetic resonance imaging 19:410-416, 2004
|
1 month
|
|
Tolerance to MRI assessed by a tolerance survey
Time Frame: 1 month
|
1 to 10, 1= very bad, 10= very good.
Survey adapted from Sparrow et al., Journal of magnetic resonance imaging 19:410-416, 2004
|
1 month
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Philippe DOUEK, Pr, Hospices Civils de Lyon
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
Other Study ID Numbers
Other Study ID Numbers
- 69HCL18_0412
- 2018-A02696-49 (Other Identifier: IDRCB)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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