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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT00751920
Other study ID # 1000010635
Secondary ID
Status Terminated
Phase Phase 3
First received September 10, 2008
Last updated January 4, 2016
Start date August 2008
Est. completion date December 2010

Study information

Verified date January 2016
Source The Hospital for Sick Children
Contact n/a
Is FDA regulated No
Health authority Canada: Health Canada
Study type Interventional

Clinical Trial Summary

The purpose of this study is to apply the techniques of dynamic MRI imaging enhancement to research participants with one or more pulmonary nodule to determine if meaningful information about the nature of the nodule can be obtained. This data will then be compared with follow up information about nodule growth or histology obtained by biopsy or surgical resection.


Description:

The gold standard for investigating the detection of pulmonary metastases is Multi-Detector Computed Tomography (MDCT). Computed Tomography (CT) is routinely used in the staging of pediatric patients with primary tumors which commonly metastasize to the lungs (with approximate percentage incidence of pulmonary metastases at presentation) are Ewing's sarcoma (15-20%), osteosarcoma (15-20%), Wilm's Tumor (10%), rhabdomyosarcoma (10%), and hepatoblastoma (10%). However, CT scanning has two central limitations. Firstly, it carries associated radiation risks. This risk is increased if multiple scans need to be performed during treatment and follow up. This is of particular concern in children who frequently have curable disease and may have years to live with the radiation risk. Secondly, CT is limited in its ability to distinguish between benign and malignant nodules.

Recently, Magnetic Resonance Imaging (MRI) of the lung has been shown to be a feasible alternative to CT for the detection of pulmonary metastases in adults with sensitivities and specificities of over 90% for the detection of nodules 5mm or larger. It has also shown promise in the characterization of nodules as benign or malignant. Since MRI does not involve radiation, it may prove to be a preferable imaging technique for children. We wish to evaluate the potential for MRI to complement or even replace CT in the imaging of pulmonary metastatic disease in children.


Recruitment information / eligibility

Status Terminated
Enrollment 1
Est. completion date December 2010
Est. primary completion date November 2010
Accepts healthy volunteers No
Gender Both
Age group 2 Years to 18 Years
Eligibility Inclusion Criteria:

- Patients between 2-18 years of age

- Patients who present themselves to the Department of Diagnostic Imaging at the Hospital for Sick Children for CT of the thorax

- Patients undergoing a CT of the thorax for detection of lung metastases following diagnosis of a solid tumor or suspected solid tumor

- Patients who present themselves for initial diagnosis or at follow up CT for progression

- Able to give informed consent (parents or patients)

Exclusion Criteria:

- Usual exclusion criteria for MRI (e.g. pacemaker, ocular metal, claustrophobia)

- Have any known allergy to one or more of the ingredients in the study contrast agents; have a history of hypersensitivity to any metals or chelates of gadolinium; have a history of allergies or bronchial asthma; use beta blockers, have cardiovascular disease; or have anaphylactic reactions

- Have moderate-to-severe renal impairment (defined as having a GFR/ eGFR < 60 mL/min)

- Have sickle cell anemia

- MRI of the chest requiring sedation or general anesthesia

- Known pregnancy or breast feeding

- Renal failure

- Patient uncooperative during a MRI without sedation or anesthesia (unless already receiving this for MRI of another body region)

- Children under the age of 2 will not be eligible for intravenous contrast

Study Design

Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic


Intervention

Procedure:
Enhanced MRI Scan
Following the detection of a pulmonary nodule(s) with the unenhanced MRI scan, the subjects will then be injected with the contrast agent, Magnevist, and have a dynamic enhanced MRI scan of the largest pulmonary nodule.

Locations

Country Name City State
Canada The Hospital for Sick Children Toronto Ontario

Sponsors (1)

Lead Sponsor Collaborator
The Hospital for Sick Children

Country where clinical trial is conducted

Canada, 

Outcome

Type Measure Description Time frame Safety issue
Primary MRI sensitivity for the detection of pulmonary nodule(s) greater than 3mm in size (diameter) compared to CT One hour No
Secondary How accurate MRI is at distinguishing between benign and malignant pulmonary nodules. One hour No