An Investigational Scan (7T MRI) for the Imaging of Central Nervous System Tumors

• ClinicalTrials.gov Identifier: NCT04539574
• Recruitment Status: Recruiting
• First Posted: September 7, 2020
• Last Update Posted: February 8, 2021
• Sponsor: M.D. Anderson Cancer Center
• Collaborator: National Cancer Institute (NCI)
• Information provided by (Responsible Party): M.D. Anderson Cancer Center

Study Description

Brief Summary:

This trial investigates how well 7T MRI scan works in imaging central nervous system tumors. Diagnostic procedures, such as 7T MRI, may help find and diagnose central nervous system tumors and help measure a patient's response to earlier treatment. The goal of this trial is to learn if a new MRI system can provide better quality images than a standard MRI.

Condition or disease	Intervention/treatment	Phase
Central Nervous System Neoplasm; Glioma; Metastatic Malignant Neoplasm in the Central Nervous System; Metastatic Malignant Solid Neoplasm	Procedure: 7 Tesla Magnetic Resonance Imaging; Other: Questionnaire Administration	Not Applicable

Detailed Description:

PRIMARY OBJECTIVE:

I. To estimate the contrast-to-noise ratio (CNR) for several imaging modalities in brain malignancy as compared with normal brain parenchyma separately by type of malignancy and treatment status.

SECONDARY OBJECTIVE:

I. To assess the conspicuity of each imaging modality to differentiate radiation necrosis from progressive disease.

EXPLORATORY OBJECTIVES:

I. To assess patient experience in the 7 Tesla (7T) magnetic resonance imaging (MRI) system compared to their most recent MRI examination.

II. To assess the typical significance values seen for areas of maximal brain activity associated with each functional MRI (fMRI) test.

III. To assess the geometric distortion of a radiation planning sequence on a ultra-high field (UHF) system.

OUTLINE:

Patients undergo 7T MRI over 60 minutes.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 100 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Diagnostic
• Official Title: Validation of a Multi-Parametric Ultra-High Field MRI Protocol for Central Nervous System Malignancy
• Actual Study Start Date: September 4, 2020
• Estimated Primary Completion Date: December 31, 2021
• Estimated Study Completion Date: December 31, 2021

Arms and Interventions

Arm	Intervention/treatment
Experimental: Diagnostic (7T MRI); Patients undergo 7T MRI over 60 minutes.	Procedure: 7 Tesla Magnetic Resonance Imaging; Undergo 7T MRI; Other Names: 7 Tesla MRI; 7T MRI; Other: Questionnaire Administration; Ancillary studies

Outcome Measures

Primary Outcome Measures :

1. Contrast-to-noise ratio (CNR) [ Time Frame: 1 year ]
   For each imaging modality, will calculate the CNR separately in the largest lesion/metastasis per patient as well as in all study lesions. The CNR for each imaging method will be determined and reported along with the corresponding 95% confidence interval. If enough follow-up images are obtained, will compare the CNR in lesions that respond to treatment to those that do not by using a Wilcoxon rank-sum test. Will compare the CNR between baseline and follow-up within patient by using a Wilcoxon signed-rank test. Also, for those lesions that initially respond, some will subsequently grow in size after the initial response. Of these, some will be considered radiation necrosis and some progressive disease. The CNR will be compared between lesions with necrosis and those that are progressive disease using a Wilcoxon rank-sum test.

Secondary Outcome Measures :

1. Conspicuity of each imaging modality to differentiate radiation necrosis from progressive disease [ Time Frame: After completion of magnetic resonance imaging (MRI) ]
   The T1 sequence by MRI will be considered the gold standard, and will compare the conspicuity of each of the other methods to that of T1 sequencing by using McNemar's test. This analysis will first be performed in the largest lesion per patient, and then analyses will be repeated using all lesions.

Other Outcome Measures:

1. Functional (f)MRI paradigms [ Time Frame: After completion of MRI ]
   Will be summarized by the group mean and standard deviation.
2. Patient satisfaction [ Time Frame: 1 year ]
   Will be reported on a five-point Likert scale and compared between the 7 Tesla (7T) scan and the most recent clinical scan by using a Wilcoxon rank-sum test.

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Adult patients must meet one set of inclusion criteria:

  • Newly identified and untreated central nervous system glioma or metastasis of at least 5 mm or greater in size

    • Suspected central nervous system neoplasms will require agreement from a study neuroradiologist and a study neurosurgeon or a radiation oncology that a lesion exists that is most likely either a glioma or a metastasis
    • Patients with suspected brain metastasis must also have a history of solid organ malignancy

  • History of central nervous system glioma or metastasis treated with surgery, radiation, chemotherapy, or immunotherapy with new or increasing signal on MR imaging that is suspicious for progressive disease (treatment failure)

    • Suspected recurrent neoplasms will require agreement from a study neuroradiologist and a study neurosurgeon, radiation oncologist, or neuro-oncologist that lesion behavior is suspicious for recurrent disease

Exclusion Criteria:

• Contraindication to MR imaging

• Absolute or relative contra-indication to 3T MRI due to metallic foreign bodies and devices and/or other conditions that are not MR safe, which include implants with unknown behavior in 3T MRI as well as:

  • Electronically, magnetically, and mechanically activated implants
  • Ferromagnetic or electronically operated active devices like automatic cardioverter defibrillators and cardiac pacemakers
  • Metallic splinters in the eye
  • Ferromagnetic hemostatic clips in the central nervous system (CNS) or body
  • Cochlear implants
  • Other pacemakers, e.g., for the carotid sinus
  • Insulin pumps and nerve stimulators
  • Non-MR safe lead wires
  • Prosthetic heart valves (if dehiscence is suspected)
  • Non-ferromagnetic stapedial implants
• Pregnancy
• Claustrophobia that does not readily respond to oral medication
• Known allergy to gadolinium-based contrast agents
• Renal failure as defined by a glomerular filtration rate (GFR) less than 30 or the use of hemodialysis
• Pregnant
• Interval treatment with radiation or surgery between the diagnostic MRI lesion identification and planned study MRI

Contacts and Locations

Contacts

Contact: Jason Johnson; 713-792-8443; jjohnson12@mdanderson.org

Locations

United States, Texas

M D Anderson Cancer Center; Recruiting

Houston, Texas, United States, 77030

Contact: Jason M. Johnson 713-792-8443 jjohnson12@mdanderson.org

Principal Investigator: Jason M. Johnson

Sponsors and Collaborators

M.D. Anderson Cancer Center

National Cancer Institute (NCI)

Investigators

• Principal Investigator: Jason Johnson; M.D. Anderson Cancer Center

More Information

Additional Information:

MD Anderson Cancer Center Website 

• Responsible Party: M.D. Anderson Cancer Center
• ClinicalTrials.gov Identifier: NCT04539574
• Other Study ID Numbers: 2019-1032; NCI-2020-06374 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ); 2019-1032 ( Other Identifier: M D Anderson Cancer Center )
• First Posted: September 7, 2020
• Last Update Posted: February 8, 2021
• Last Verified: February 2021

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: Yes

Additional relevant MeSH terms:

Neoplasms; Nervous System Neoplasms; Central Nervous System Neoplasms; Nervous System Diseases; Neoplasms by Site