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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT02020720
Other study ID # MC1373
Secondary ID NCI-2013-02373MC
Status Active, not recruiting
Phase Early Phase 1
First received
Last updated
Start date January 22, 2014
Est. completion date December 15, 2024

Study information

Verified date June 2023
Source Mayo Clinic
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This pilot clinical trial studies fluorine F 18 fluorodopa (18F-DOPA)-positron emission tomography (PET) in planning surgery in patients with gliomas. New imaging procedures, such as 18F-DOPA-PET scan, may help find gliomas and may help in planning surgery.


Description:

PRIMARY OBJECTIVES: I. Accurately define a standardized 18F-DOPA PET tumor/normal tissue (T/N) threshold to delineate high grade gliomas (HGG) from low grade gliomas (LGG). SECONDARY OBJECTIVES: I. Determine correlation between 18F-DOPA PET activity, magnetic resonance imaging (MRI) contrast enhancement and high- or low-grade glioma biopsies. II. Compare grade from maximum 18F-DOPA uptake samples for all resection patients against the final diagnostic grade, based on the highest grade component from all stereotactic and non-stereotactic samples acquired for open resection patients. III. Compare volume differences between 18F-DOPA PET activity, MRI contrast enhancement, perfusion MRI (pMRI), and diffusion tensor imaging (DTI) for neurosurgical planning. IV. Assess the time to progression for patients receiving resections and biopsies only. TERTIARY OBJECTIVES: I. Compare histopathology correlations with 18F-DOPA PET against correlations with perfusion MR imaging for accurate identification of the highest grade/highest density disease. II. Compare histopathology correlations with 18F-DOPA PET against correlations with diffusion tensor imaging information for accurate identification of tumor extent. III. Compare neurosurgical resection extent volume delineation with and without 18F-FDOPA-PET metabolic imaging information to determine role of metabolic imaging in neurosurgical resection planning. OUTLINE: Within 1 week of biopsy or resection, patients undergo 18F-DOPA PET/computed tomography (CT) scan and pMRI and DTI at baseline. Patients then undergo stereotactic craniotomy or image-guided biopsy. After completion of study treatment, patients are followed up yearly for 5 years.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 72
Est. completion date December 15, 2024
Est. primary completion date October 25, 2019
Accepts healthy volunteers No
Gender All
Age group 7 Years and older
Eligibility Inclusion Criteria: - MRI findings compatible with newly diagnosed or recurrent high- or low-grade malignant glioma - Planned craniotomy and resection or biopsy - Willing to sign release of information for any radiation and/or follow-up records - Provide informed written consent if >= 18 years; if < 18 years, provide informed written assent and parent or legal guardian provide informed written consent - Ability to provide tissue for mandatory correlative research component Exclusion Criteria: - Unable to undergo MRI scans with contrast (e.g. cardiac pacemaker, defibrillator, kidney failure) - Unable to undergo an 18F-DOPA PET scan (e.g. Parkinson's disease, taking anti-dopaminergic, or dopamine agonist medication or less than 6 half-lives from discontinuance of dopamine agonists; NOTE: other potentially interfering drugs: amoxapine, amphetamine, benztropine, buproprion, buspirone, cocaine, mazindol, methamphetamine, methylphenidate, norephedrine, phentermine, phenylpropanolamine, selegiline, paroxetine, citalopram, and sertraline; if a patient is on any of these drugs, list which ones on the on-study form - Any of the following: - Pregnant women - Nursing women - Men or women of childbearing potential who are unwilling to employ adequate contraception

Study Design


Intervention

Procedure:
Biopsy
Undergo image-guided biopsy
Computed Tomography
Undergo 18F-DOPA-PET/CT
Diffusion Weighted Imaging
Undergo DTI
Drug:
Fluorine F 18 Fluorodopa
Undergo 18F-DOPA-PET/CT
Other:
Laboratory Biomarker Analysis
Correlative studies
Procedure:
Perfusion Magnetic Resonance Imaging
Undergo pMRI
Positron Emission Tomography
Undergo 18F-DOPA-PET/CT
Therapeutic Conventional Surgery
Undergo stereotactic craniotomy

Locations

Country Name City State
United States Mayo Clinic Rochester Minnesota

Sponsors (2)

Lead Sponsor Collaborator
Mayo Clinic National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Accurate identification of the highest grade/highest density disease Paired t-test statistical analysis will be used to evaluate differences in volumes identified using biopsy-validated thresholds as highly aggressive disease comparing 18F-DOPA uptake and relative cerebral blood volume from pMRI. Up to 5 years
Other Accurate identification of tumor extent Paired t-test statistical analysis will be used to evaluate differences in volumes identified using biopsy-validated thresholds as disease extent comparing 18F-DOPA PET and diffusion maps from DTI. Up to 5 years
Other Role of metabolic imaging in neurosurgical resection planning Paired t-test analysis will be performed to determine the level of statistical significance between conventional MRI only and PET + MRI volumes. Up to 5 years
Primary Ratios of maximum tumor standardized uptake value (SUVmax) normalized to mean SUV (SUVmean) of T/N To determine the optimal PET threshold for distinguishing HGG from LGG brain tissue, receiver operating characteristic (ROC) analysis and the Youden's index (sum of the sensitivity and specificity - 1) will be used. The Youden's index will be calculated for each possible T/N threshold. The final ROC area under the curve (AUC) value and confidence intervals will be estimated using ROC analysis methods for clustered continuous data as described by Obychowski. Up to 5 years
Secondary Differences in volumes generated from biopsy-validated thresholds evaluated by 18F-DOPA-PET, pMRI, and DTI Paired t-test statistical analysis will be performed to determine if any differences exist and the level of statistical significance between volumes. Up to 5 years
Secondary Histologic grade of the specimen defined as HGG, LGG, or non-malignant brain tissue The relationship between these T/N values, MRI contrast enhancement values, and the histologic grade of the specimen (HGG, LGG, or non-malignant brain tissue) will be determined using multivariate linear regression. These models will also include as appropriate the specimen cellularity and necrosis values. Up to 5 years
Secondary MRI contrast enhancement values The relationship between these T/N values, MRI contrast enhancement values, and the histologic grade of the specimen (HGG, LGG, or non-malignant brain tissue) will be determined using multivariate linear regression. These models will also include as appropriate the specimen cellularity and necrosis values. Up to 5 years
Secondary Progression free survival The time from study entry to progression, assessed up to 5 years
Secondary Proportion of patients whose maximum 18F-DOPA uptake samples are in agreement with the final diagnostic grade Associated confidence intervals will be estimated based on dividing the number of patients whose samples agree by the total number of patients. Up to 5 years
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