- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02651090
Evaluation of Suspected Liver Pathology in Patients With Contraindications for Contrast Enhanced CT and/or MRI
Evaluation of Suspected Liver Pathology in Patients With Contraindications for Contrast Enhanced Computed Tomography and/or Magnetic Resonance Imaging Using Sonazoid
Study Overview
Detailed Description
Patients with a diagnosis of cancer or high probability of cancer (any primary) who have contraindications for a contrast enhanced Computed Tomography or Magnetic Resonance Image will be asked to participate in this study. Patients will be both male and female and be >18 years old. Contraindications for computer tomography (CT) or magnetic resonance imaging (MRI) would include, but not limited to:
- Creatinine clearance of <60 mg/dl
- Allergy to iodinated contrast or gadolinium based contrast agents
- History of adverse event with CT or MRI contrast
Up to 100 patients will be enrolled over a two year period.
Statistical justification for sample size Assuming that a non-enhanced CT will detect and characterize metastatic disease correctly 60% of the time (2) and that Contrast enhanced ultrasound (CEUS) will detect and characterize metastatic disease correctly 90% of the time (3,4), there will be a 100% chance of a significant difference at a one-sided 0.05 significance level using the Fisher Exact Test.
CT and MRI Patient will receive the non-contrast CT or MRI that would be ordered as routine stating or follow-up of the patient. At a minimum 5mm contiguous axial slices will be obtained with CT and T1-weighted, T2-weighted, in-phase and out of phase imaging will be performed on MRI with a minimum slice thickness of 5mm. Each lesion noted within the liver will be measured in two dimensions and recorded. The lesion will be classified on a scale of 1 - 5 regarding the probability of benignity or malignancy of the lesion. If a diagnosis can be made the diagnosis will be documented The location of the lesion will be documented on a Couinaud diagram.
CEUS-Contrast specific software optimized for Sonazoid will be used or both vascular and Kupffer phase imaging. The focus will be set below the lesion of interest for vascular phase imaging and at 4-8 cm for the left lobe and 8-10 cm for the right lobe for Kupffer phase imaging. The lesion of interest was imaged from 15 seconds before injection to 1 minute after injection (vascular phase imaging). No further scanning will be performed until the Kupffer phase imaging, which will begun 10 minutes after the injection.
The patient will receive the following ultrasound imaging:
- Standard B-mode and color-Doppler imaging. Elastography may be added at PI's discretion.
- A 20g IV will be placed in an antecubital vein
- Low MI scan will be used in the vascular phase.
- An intermediate MI scan will be used after at least a 10 minute delay to perform the Kupffer scan
- If a lesion is identified on the Kupffer scan which is not characterized by the without exam the patient will have a complete evaluation of the vascular phase a second injection may be used.
Each lesion noted within the liver will be measured in two dimensions and recorded. The lesion will be classified on a scale of 1 - 5 regarding the probability of benignity or malignancy of the lesion. If a diagnosis can be made the diagnosis will be documented. The location of the lesion will be documented on a Couinaud Diagram.
The gold standard will be either
- characteristic enhancement pattern (hemangioma, benign)
- lesion biopsy
- growth of the lesion over a 6 month period of time (malignant)
Data Analysis
For assessment of characterization efficacy the McNemar test will be used to compare the rates of correct diagnosis for lesions on unenhanced ultrasound, CEUS and unenhanced CT or MRI. For assessment of detection efficacy, Wilcoxon's signed rank test will be used to compare the lesion detection rates obtained with unenhanced ultrasound, CEUS, and unenhanced CT or MRI. For all tests, p<0.05 will be considered a statistically significant difference.
Study Type
Phase
- Phase 3
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with a diagnosis of cancer or a high probability of having cancer but not yet diagnosed who have a contraindication to a contrast CT or MRI
- Age >18 years
- No know allergies to Sonozoid
- Ability to give informed consent
Exclusion Criteria:
- No IV access
- Inability to give informed consent
- Pregnancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: sonazoid
treatment arm with sonazoid
|
Comparison of Sonazoid enhanced ultrasound to non enhanced CT
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The detection rate of Sonozoid enhanced US for focal liver lesions in patients unable to have a contrast enhanced CT or MRI compared to unenhanced CT or MRI
Time Frame: 2 years
|
Determination of the liver lesion detection rate of Sonozoid
|
2 years
|
Focal liver characterization as benign, Indeterminate, or malignant by Sonozoid enhanced ultrasound in compared to unenhanced CT or MRI.
Time Frame: 2 years
|
Determine the accuracy of liver lesion characterization by Sonozoid
|
2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Title: Number of Patients With Grade 3 Through Grade 5 Adverse Events That Are Related to Study Drug, Graded According to NCI CTCAE Version 3.0
Time Frame: 2 years
|
Evaluate the Adverse event rate using Sonozoid
|
2 years
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- SONA1
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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