Combined PET-MRI in the Diagnostics of Chronic Inflammatory Bowel Diseases (IBD)- a Feasibility Study

March 31, 2021 updated by: Turku University Hospital
The main purpose of the present study is to examine the diagnostic performance of combined PET-MRI in detecting colonic and small bowel wall inflammatory processes caused by ulcerative colitis and Crohn's disease.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

COMBINED PET-MRI IN THE DIAGNOSTICS OF CHRONIC INFLAMMATORY BOWEL DISEASES (IBD)- A FEASIBILITY STUDY (RESEARCH CODE T31/2014)

  1. Background

    Ulcerative colitis and Crohn's disease are chronic inflammatory bowel diseases (IBD) with relapsing and remitting course. The incidence of IBD is highest in teenagers and young adults, but IBD may also affect children and old people. The diagnosis of IBD is based on clinical symptoms, endoscopy and histology of the bowel wall.

    Aims of the study

    The main purpose of the present study is to examine the diagnostic performance of combined PET-MRI in detecting colonic and small bowel wall inflammatory processes caused by ulcerative colitis and Crohn's disease.

    The hypothesis of the study is a) IBD-related inflammatory changes are detected by PET-MRI (18 F-FDG) and correlate with the endoscopic and histologic activity of colitis and ileitis.

    Study design

    A total of 45 IBD patients (ulcerative colitis or Crohn's disease) aged over 15 years will be recruited from the patients visiting outpatient gastroenterology clinic of Turku University Hospital. Every patient undergoes colonoscopy with biopsy specimens, endoscopic and histologic data are recorded via structured forms. Laboratory specimens with samples for biobank are obtained. Then the patients are examined by abdominal MRI and PET.

    Inclusion criteria:

    • informed consent obtained
    • age over 18 years
    • diagnosis of ulcerative colitis or Crohn's colitis based on endoscopy and histology
    • the activity of colitis confirmed by histology and/or elevated fecal calprotectin concentration
    • fertile women have contraception
    • no previous abdominal surgery
    • no X-ray investtigations during preceding year
  2. Investigators

    Principal investigator Markku Voutilainen, MD, Department of Gastroenterology

    Other investigators Hannu Aronen, Sami Kajander, Johanna Virtanen, Virva Saunavaara, Department of Radiology and PET center.

    Mervi Tenhami, Saila Kauhanen, Department of surgery

    Pirjo Nuutila, Department of Endocrinology and PET center

    Jukka Kemppainen, physicist, PET center

    Olli Carpen, Department of pathology

    Ville Aalto, statistician, University of Turku,

  3. PET tracer is 18 F-FDG, dose 280 megabequerel (MBq, bowel imaging)
  4. Data of scans and details of scanning time (including positioning and transmission) by tracer, blood sampling (activity, metabolites)

    • Before scanning: oral contrast intake (Mannitol dilution) 65 min
    • Magnetic resonance imaging (MRI) positioning (prone position) 5min
    • Abdominal MRI Scanning: 50min
    • Region: from diaphragma to symphysis
    • During the scan: i.v. Buscopan and +Gadolinium
    • Sequences (fast gradient echo, predominantly breath-hold imaging):

      1. T2 (field echo type) cor and ax
      2. T2
      3. T1 fs cor and ax +Gd
      4. T1 fs repeated (start at 40 seconds after injection)
      5. Diffusion
      6. T2 or T1 cor +aks
    • PET, FDG tracer: 15 min

      • Total scanning time including positioning, MRI and PET: 70 min

    Scanning code JN5JS (= Large scale PET-MRI of the body)

  5. Number of study subjects 45
  6. Scanner PET/MRI
  7. The radiation dose will be calculated by physicist after the tracer, it's amount and detector are determined. The permission from ethical committee was obtained in August 2014..
  8. No quality issues (QA), routine radiological quality control
  9. The study has been accepted by the Ethical committee of Turku University Hospital
  10. Present study is academic study and all data relating to the study belongs to the investigators.
  11. The test patients are to undergo the study in September 2014. The study is to be started October 2014.
  12. For the financing of the study, VTR-/EVO-funding (Funding from the Finnish government) will be applied. At present, 6000€ have been obtained from research funding of Department of internal medicine.

Study Type

Observational

Enrollment (Actual)

20

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

      • Turku, Finland, 20521
        • Turku University Hospital

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

14 years to 66 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

IBD patients living in the Turku University Hospital referral area

Description

Inclusion Criteria

  • age over 18 years
  • IBD (ulcerative colitis or Crohn's disease diagnosed by endoscopy and/or radiology
  • no previous abdominal surgery
  • no biological therapy for IBD

Exclusion Criteria:

  • pregnancy
  • diabetes
  • the patient is unable to give informed consent

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

  • Observational Models: Case-Only
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
PET-MRI
Patients with chronic inflammatory bowel disease who are treated at Turku University hospital outpatient clinic or ward
The study patients undergo positron emission tomography (PET) after informed consent is obtained

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The percentage of patients with active inflammation detected by PET-MRI
Time Frame: 3 YEARS
COMBINED PET-MRI IN THE DIAGNOSTICS AND FOLLOW-UP OF CHRONIC INFLAMMATORY BOWEL DISEASES
3 YEARS

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Markku Voutilainen, MD, Turku University Hospital

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 (Actual)

November 1, 2014

Primary Completion (Actual)

December 1, 2019

Study Completion (Actual)

August 1, 2020

Study Registration Dates

First Submitted

December 3, 2014

First Submitted That Met QC Criteria

February 10, 2015

First Posted (Estimate)

February 18, 2015

Study Record Updates

Last Update Posted (Actual)

April 1, 2021

Last Update Submitted That Met QC Criteria

March 31, 2021

Last Verified

March 1, 2021

More Information

Terms related to this study

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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