- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00686530
Comparison of Abnormal Cortical Development in Brain Malformations on Postmortem Imaging With Autopsy
December 2, 2013 updated by: Susan Blaser, The Hospital for Sick Children
Examination of the fetal brain at autopsy is technically challenging because of marked fragility of the brain tissue.
Studies have found postmortem fetal MR to be particularly useful in examining gross structural abnormalities in fetal brain and spine.
We have recently included postmortem MR as part of the radiological studies for fetal autopsy workup.
Using the same MR data, the development of normal layering of the brain, also called laminar organization, can also be assessed.
This laminar organization of the brain is often disturbed in congenital malformations.
Our aim is to study the disturbance in laminar organization of the postmortem brain with MR, using structural MR and a type of MR sequence called diffusion tensor imaging, which is well suited for assessing the organization of the developing brain.
The postmortem MR findings will be compared with gold standard of histopathology.
This will help us understand the abnormal development of gray and white matter in brain malformations.
Knowledge gained from studying the abnormal laminar organization in brain malformations will serve as a reference for future studies of fetal brain malformations in-utero using MRI.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
- Autopsy will be performed at Mount Sinai Hospital according to accepted current standards, based on clinical indications. Macroscopic examination of the fetus will be performed initially, followed by organ removal for tissue fixation for a period of two weeks. The brain is then scanned with MRI at the Hospital for Sick Children. The brain is transported in an air-tight container containing 10% formalin and sealed with paraffin lined tape. All brains will be anonymised and coded with a number prior to MRI examination. Following MR imaging, the tissue will be examined, sampled and reported in the usual fashion at Mount Sinai Hospital.
- Postmortem MR will be included as part of the autopsy examination in cases of suspected brain malformations. Postmortem MR will be performed at the Hospital for Sick Children due to availability of expertise in postmortem neuroimaging and imaging will be done using 1.5T GE CV/I MRI magnet (General Electric, Milwaukee, WI). Postmortem MR will be performed following dissection and tissue fixation to avoid any unnecessary delay in tissue fixation. The specimen will be scanned in an air-tight container containing formalin 10%, sealed with paraffin lined tape. Structural postmortem MR will include coronal spin-echo T1 (TR=517msec, TE=10msec, FOV=18cm, slice thickness=20-30mm, matrix=320x256), axial SPGR (TR=23msec, TE=8msec, FOV=18cm, slice thickness=1.1mm, matrix=256x256) and T2 imaging in three planes (TR=4115msec, TE=115msec, FOV=16cm, slice thickness=20-30mm, matrix=320x256). Diffusion tensor imaging (TR=8300msec, TE=99msec, FOV=180mm, slice thickness=2-3mm, b=700mm/sec2, NEX=8, matrix=128x128, 25 directions) will be performed in the coronal plane to match the histological sections of brain tissue in autopsy.
- Analysis. The laminar organization of the fetal cerebrum on structural MR and diffusion tensor imaging will be evaluated. In particular, the germinal matrix, intermediate zone, subplate and cortex will be assessed. This will be compared with the gold standard of histopathology. The presence or absence of corticospinal tracts will also be assessed and compared with macroscopic examination and histological sections.
- Statistical analysis. The sensitivity, specificity and accuracy of postmortem MR, both structural and diffusion tensor imaging, as compared to the gold standard of autopsy in assessing the abnormal laminar organization of fetal cerebrum will be evaluated.
Study Type
Observational
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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-
Ontario
-
Toronto, Ontario, Canada, M5G 1X8
- The Hospital for Sick Children
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Toronto, Ontario, Canada, M5G 1X5
- Mount Sinai Hospital
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Non-Probability Sample
Study Population
40 fetal post mortem brains, with suspected diagnosis of brain malformation
Description
Inclusion Criteria:
- suspected antenatal diagnosis of brain malformation who will undergo autopsy and MRI to further assess the malformations
- above 18 weeks gestation
Exclusion Criteria:
- significant autolysis of tissue specimens prior to tissue fixation
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
1
|
Postmortem MR will be included as part of the autopsy examination in cases of suspected brain malformations.
Imaging will be done using 1.5T GE CV/I MRI magnet.
The specimen is scanned, following fixation, using an 8-channel head coil or 8-channel knee coil, depending on the size of the brain.
Structural postmortem MR will include spin-echo T1, axial SPGR, and T2 imaging in three planes.
Diffusion tensor imaging will be performed in the coronal plane.
Autopsy will be performed according to accepted standards, based on clinical indications.
Macroscopic examination of the fetus will be performed initially , followed by organ removal for tissue fixation for a period of two weeks.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Susan Blaser, The Hospital for Sick Children
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
August 1, 2007
Primary Completion (Anticipated)
August 1, 2009
Study Completion (Anticipated)
February 1, 2010
Study Registration Dates
First Submitted
May 23, 2008
First Submitted That Met QC Criteria
May 23, 2008
First Posted (Estimate)
May 30, 2008
Study Record Updates
Last Update Posted (Estimate)
December 3, 2013
Last Update Submitted That Met QC Criteria
December 2, 2013
Last Verified
May 1, 2008
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1000011050
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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