Intraoperative Sonographically Versus Fluorescence-guided Resection of Contrast-enhancing Gliomas and Brain Metastases (SONOFLUO)
Intraoperative Sonographically Guided Versus 5-Aminolevulinic Acid Fluorescence Guided Resection of Gliomas and Brain Metastases Enhancing Contrast Agent in Magnetic Resonance Imaging: a Randomised, Controlled, Noninferiority Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Fluorescence with 5-aminolevulinic acid, fluorescein and intraoperative magnetic resonance imaging (MRI) are the most common modalities used to intraoperatively rate extent of brain tumor resection. Intraoperative sonography is another promising method of intraoperative visualization. It's advantages include possibility of real-time estimation of tumor remnants without disturbing of surgical workflow, opportunity to discover residual tumor under normal brain tissue and chipper cost. At this time there are no published results of randomized control trials comparing ultrasound and fluorescence-guided brain tumor resection.
Objective of this study is to determine whether intraoperative ultrasound guided resection of gliomas with contrast enhancement in magnetic resonance imaging and brain metastases can achieve as high rate of gross total resection as 5-aminolevulinic acid fluorescence-guided surgery.
Participants of the study will be randomly operated using intraoperative ultrasound or fluorescence with 5-aminolevulinic acid. Extent of resection will be assessed in postoperative MRI by blinded radiologists
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Alexander Dmitriev, MD
- Phone Number: +7 (916) 423-54-08
- Email: dmitriev@neurosklif.ru
Study Locations
-
-
-
Moscow, Russian Federation, 129090
- Sklifosovsky Institute of Emergency Care
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- single gliomas with contrast enhancement in preoperative magnetic resonance imaging (presumed high-grade gliomas)
- one or several brain metastases
- newly diagnosed
- Karnofsky Performance Status 60-100%
- age 18-79 years
- performed magnetic resonance imaging with contrast enhancement
Exclusion Criteria:
- tumor spreading to corpus callosum or brainstem
- previously performed brain radiotherapy
- planned supratotal tumor resection until neurophysiologically revealed eloquent areas
- known hypersensibility to 5-aminolevulinic or to porphyrin
- hepatic or renal insufficiency
- porphyria
- pregnancy
- breast feeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Ultrasound
Intraoperative extent of tumor resection will be assessed using sonography
|
Surgeon intraoperatively assesses extent of tumor resection using ultrasound
|
|
Active Comparator: Fluorescence
Intraoperative extent of tumor resection will be assessed using fluorescence with 5-aminolevulinic acid
|
Surgeon intraoperatively assesses extent of tumor resection observing it's fluorescence in microscope
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Gross total resection (Yes or No)
Time Frame: within 48 hours after surgery
|
No residual contrast enhancement in postoperative T1-weighted magnetic resonance imaging
|
within 48 hours after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Extent of resection (in percents)
Time Frame: within 48 hours after surgery
|
Extent of resection = (preoperative tumor volume - postoperative tumor volume) / preoperative tumor volume x 100
|
within 48 hours after surgery
|
|
Motor function (in grades)
Time Frame: within 10 days after surgery
|
Motor function is assessed in Medical Research Council scale
|
within 10 days after surgery
|
|
Speech function (in grades)
Time Frame: within 10 days after surgery
|
Speech function is assessed in Hendrix scale (2017)
|
within 10 days after surgery
|
|
Karnofsky performance status (in percents)
Time Frame: within 10 days after surgery
|
Assesses patients' possibilities to self-service in Karnofsky Performance Status scale
|
within 10 days after surgery
|
|
Cerebral complications
Time Frame: From admission to intensive care unit after surgery till hospital discharge, up to 365 days
|
Which cerebral complications arose after surgery
|
From admission to intensive care unit after surgery till hospital discharge, up to 365 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Alexander Dmitriev, MD, Sklifosovsky Institute of Emergency Care
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
Keywords
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Pathologic Processes
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Neoplasms, Glandular and Epithelial
- Neoplastic Processes
- Neoplasms, Neuroepithelial
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Nervous System Neoplasms
- Central Nervous System Neoplasms
- Neoplasm Metastasis
- Glioma
- Brain Neoplasms
- Dermatologic Agents
- Photosensitizing Agents
- Aminolevulinic Acid
Other Study ID Numbers
Other Study ID Numbers
- 9b
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
product manufactured in and exported from the U.S.
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