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Early Detection of Amyloidosis in Monoclonal Gammopathy Using Nuclear Medicine Imaging (MGUS-PET)

28. mai 2026 oppdatert av: University of Zurich

Early Detection of Light-Chain Amyloidosis in Monoclonal Gammopathy Using 18F-Florbetaben PET/MR: a Prospective, Single-Center, Observational Study

The goal of this clinical trial is to evaluate whether ¹⁸F-florbetaben PET/MR can detect systemic amyloid deposits early and noninvasively in patients with monoclonal gammopathy. The main question it aims to answer is: Can ¹⁸F-florbetaben PET/MR identify systemic amyloid deposits across clinically and histologically defined patient groups?

Participants will:

  • Be screened for eligibility and asked to sign an informed consent form
  • Have their vital signs measured
  • Receive a single intravenous injection of approximately 300 MBq ¹⁸F-florbetaben (Neuraceq®), followed by whole-body PET/MR imaging from skull base to below the kidneys. If MRI is contraindicated (e.g., pacemaker, severe claustrophobia), PET/CT will be performed instead. The scan takes approximately one hour, during which participants lie still in the scanner
  • Be monitored during and after the scan for any side effects or adverse events
  • Complete study participation at the end of the imaging session (single visit, no follow-up required)

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Aim of the Project: The overarching goal is to establish a non-invasive, sensitive method for early detection of systemic amyloid deposits, laying the foundation for earlier diagnosis and improved treatment of AL amyloidosis.

  • Primary Aim: Validate 18F-florbetaben PET for detection of systemic AL amyloidosis versus negative controls.
  • Secondary Aim: Compare the sensitivity of amyloid PET with established methods (echocardiography, MRI, serological biomarkers) for the detection of early organ involvement.
  • Tertiary Aim: Quantify and characterize systemic amyloid burden across early and manifest disease stages.

Hypotheses:

  1. Amyloid PET shows pathological tracer uptake in patients with AL amyloidosis and remains unremarkable in negative controls.
  2. Amyloid PET detects amyloid deposits at a stage in which conventional methods do not yet show structural or functional changes.
  3. Systemic amyloid burden follows a graded pattern, with intermediate values in early disease and the highest values in manifest AL amyloidosis.

Study Design and Methods Prospective, observational cohort study at the University Hospital Zurich (USZ). 50 participants will be recruited from the established COSMO-AL cohort at the Department of Hematology, which systematically captures patients with clinically significant monoclonal gammopathy and provides standardized skin biopsy data.

Participants:

  • Negative controls: monoclonal gammopathy without histologic amyloid (n = 10).
  • Early disease (study cohort): monoclonal gammopathy with local, histologically confirmed amyloid deposits (n = 20).
  • Positive controls: biopsy-confirmed systemic AL amyloidosis (n = 20). Patients with confirmed amyloid involvement will be additionally stratified by organ involvement to allow exploratory analysis of organ-specific tracer uptake.

Studietype

Intervensjonell

Registrering (Antatt)

50

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Sveits
    • Canton of Zurich
      • Zurich, Canton of Zurich, Sveits, 8091
        • University Hospital Zurich
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Dominik C Benz, PD Dr. med.

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Participation in the COSMO-AL study
  • Available biopsy test result
  • Written informed consent

Exclusion Criteria:

  • Pregnant or lactating women

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Diagnostisk
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Annen: Monoclonal Gammopathy, Amyloid-Negative
Patients with monoclonal gammopathy, biopsy-negative for amyloid (negative controls)
Legemiddel: ¹⁸F-florbetaben
Single intravenous dose of ~300 MBq ¹⁸F-florbetaben followed by PET/MR (or PET/CT, if MRI is contraindicated), from the skull base to below the kidneys
Andre navn:
  • Neuraceq
  • Florbetaben
Annen: Monoclonal Gammopathy, Amyloid-Positive
Patients with monoclonal gammopathy, biopsy-positive for amyloid (study cohort)
Legemiddel: ¹⁸F-florbetaben
Single intravenous dose of ~300 MBq ¹⁸F-florbetaben followed by PET/MR (or PET/CT, if MRI is contraindicated), from the skull base to below the kidneys
Andre navn:
  • Neuraceq
  • Florbetaben
Annen: AL Amyloidosis
Patients with biopsy-proven AL amyloidosis (positive controls, with and without cardiomyopathy)
Legemiddel: ¹⁸F-florbetaben
Single intravenous dose of ~300 MBq ¹⁸F-florbetaben followed by PET/MR (or PET/CT, if MRI is contraindicated), from the skull base to below the kidneys
Andre navn:
  • Neuraceq
  • Florbetaben

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Systemic ¹⁸F-florbetaben PET positivity rate
Tidsramme: At time of PET/MR imaging (Day 1)
Rate of positive ¹⁸F-florbetaben PET scans assessed by visual qualitative analysis across the three patient groups (monoclonal gammopathy without biopsy-proven amyloid, biopsy-positive monoclonal gammopathy, biopsy-proven systemic AL). PET positivity is defined as any tracer uptake in the myocardium or in any organ outside the liver. Imaging performed with PET/MR or PET/CT, if MRI is contraindicated.
At time of PET/MR imaging (Day 1)

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Correlation of myocardial ¹⁸F-Florbetaben uptake with cardiac biomarker and MRI parameters
Tidsramme: At time of PET/MR imaging (Day 1)
Correlation of myocardial percent injected dose (%ID) with NT-proBNP (pg/mL) and cardiac MR parameters (indexed LV mass (g/m²), left ventricular ejection fraction (LVEF, %), and extracellular volume fraction (ECV, %)
At time of PET/MR imaging (Day 1)
Association of Myocardial ¹⁸F-Florbetaben Uptake with Histological Amyloid Status
Tidsramme: At time of PET/MR imaging (Day 1)
Association of myocardial %ID with histological amyloid status (positive vs. negative) as determined by biopsy data from the parallel COSMO-AL study cohort.
At time of PET/MR imaging (Day 1)

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of Zurich

Etterforskere

  • Hovedetterforsker: Dominik C Benz, PD Dr. med., University of Zurich

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. oktober 2026

Primær fullføring (Antatt)

1. mai 2028

Studiet fullført (Antatt)

1. mai 2028

Datoer for studieregistrering

Først innsendt

28. mai 2026

Først innsendt som oppfylte QC-kriteriene

28. mai 2026

Først lagt ut (Faktiske)

3. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

3. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

28. mai 2026

Sist bekreftet

1. mai 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 2026-00173

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Individual participant data will not be shared, as this is a single-center investigator-initiated study with a small sample size (n=50). Aggregate results will be published in a peer-reviewed journal.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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