- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04489758
4DX for the Diagnosis of Constrictive Bronchiolitis
Utility of a Novel Imaging Algorithm (4DX) for the Diagnosis of Constrictive Bronchiolitis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Constrictive (or obliterative) bronchiolitis is a rare pulmonary disease characterized by subepithelial inflammatory and fibrotic narrowing of the bronchioles on histologic analysis, which often presents with nonspecific symptoms such as progressive dyspnea on exertion and nonproductive cough over weeks to months. Constrictive bronchiolitis may be triggered by autoimmune disease, chronic allograft rejection in lung transplant recipients, graft versus host disease in stem cell transplant recipients, viral illness, or inhaled toxins. Although pulmonary function tests (PFTs) may be helpful for the diagnosis of constrictive bronchiolitis, a study performed by King and colleagues in 2009 found that many Veterans with biopsy-proven constrictive bronchiolitis had normal PFTs. Thus, for these patients, more sensitive methods of noninvasive testing are needed.
4Dx XV Ventilation Analysis is a new imaging analysis algorithm which utilizes standard fluoroscopy to quantify ventilation with sufficient fidelity to identify regional differences. Fluoroscopic images of a single tidal breath are obtained at 5 distinct angles (direct AP, +/- 36 degrees, and +/- 72 degrees). Readouts from the 4Dx XV Ventilation Analysis include absolute value of total lung ventilation, heterogeneity of lung ventilation, a frequency distribution of lung ventilation as a line plot, and a regional map of lung ventilation. In addition, an expiratory time constant (time to exhale 63% of the tidal volume), heterogeneity of the expiratory time constant, frequency distribution of expiratory time constant as a line plot, and a regional map of expiratory time constant are also calculated. Pilot studies performed by 4D Medical show data generated by the 4Dx XV Ventilation Analysis software applied to fluoroscopy is reproducible in individuals with normal lung function and the heterogeneity index increases in individuals undergoing radiation therapy.
The investigators hypothesize that the 4Dx XV Ventilation Analysis program, when applied to standard fluoroscopic images, is more sensitive for the diagnosis of constrictive bronchiolitis than PFTs in Veterans with constrictive bronchiolitis. Specific metrics that will be evaluated with the software include ventilation heterogeneity and expiratory phase constants, among other metrics. Endpoints will be compared during tidal breathing and a full exhalation to residual volume from functional residual capacity.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt University Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria
Constrictive bronchiolitis arm:
- Biopsy demonstrating constrictive bronchiolitis
- Prior CT Chest
- 18-60 years old
- < 1 pack year history of tobacco use
Control arm:
- 18-60 years old
- Prior CT Chest without evidence chronic lung disease as judged by a Pulmonologist
- No clinically significant dyspnea or functional limitations
- < 1 pack year history of tobacco use
Exclusion Criteria (for both arms)
- Pregnancy (as determined by testing on the morning prior to fluoroscopy)
- Inability to undergo PFTs or fluoroscopy
- Inability to raise arms above a 90-degree angle
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Constrictive Bronchiolitis
Veterans with surgical lung biopsy-proven constrictive bronchiolitis
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Fluoroscopy will be performed for a complete tidal breath and full exhalation at 5 angles (AP, +/- 36 degrees from AP, and +/- 72 degrees from AP) while the patient's arms are raised overhead.
4Dx XV Ventilation Analysis software will be used to analyze these images.
Both groups will also undergo pulmonary function testing and take a questionnaire regarding respiratory symptoms.
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Active Comparator: Controls
Control patients with minimal smoking history and no chronic lung disease or respiratory symptoms
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Fluoroscopy will be performed for a complete tidal breath and full exhalation at 5 angles (AP, +/- 36 degrees from AP, and +/- 72 degrees from AP) while the patient's arms are raised overhead.
4Dx XV Ventilation Analysis software will be used to analyze these images.
Both groups will also undergo pulmonary function testing and take a questionnaire regarding respiratory symptoms.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
X-ray velocimetry results
Time Frame: 1 month
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Heterogeneity of ventilation as detected by X-ray velocimetry
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1 month
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Collaborators and Investigators
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- 200473
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
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.
Clinical Trials on Constrictive Bronchiolitis
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National Heart, Lung, and Blood Institute (NHLBI)CompletedBronchiolitis Obliterans | Graft vs Host Disease | Constrictive Bronchiolitis | Bronchiolitis, Exudative | Bronchiolitis, ProliferativeUnited States
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Hal C CharlesCompletedConstrictive Bronchiolitis | Iraq-Afganistan War Lung Injury SyndromeUnited States
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Mayo ClinicWithdrawn
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Children's Healthcare of AtlantaTerminatedCongenital DisordersUnited States
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Université de SherbrookeUnknown
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Universitaire Ziekenhuizen KU LeuvenKing's College LondonCompletedPulmonary Hypertension | Cardiomyopathy, Dilated | Constrictive Pericarditis | Cardiomyopathy, Congestive
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Hillel Yaffe Medical CenterCompletedReflexology | Bronchiolitis; ChemicalIsrael
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Guy's and St Thomas' NHS Foundation TrustCompletedAcute Viral BronchiolitisUnited Kingdom
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Assistance Publique - Hôpitaux de ParisCompletedAcute Viral BronchiolitisFrance
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Ministry of Health, SpainCompleted