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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT01783314
Other study ID # 1009011259
Secondary ID DI-2010-18
Status Recruiting
Phase Phase 4
First received November 18, 2011
Last updated January 31, 2013
Start date December 2010
Est. completion date December 2014

Study information

Verified date January 2013
Source Weill Medical College of Cornell University
Contact Ame Ng, BSN, CCRP
Phone 212-746-2194
Email ameng@med.cornell.edu
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Interventional

Clinical Trial Summary

When someone has hepatitis C or some other condition that causes liver injury, he or she can develop a condition called liver fibrosis that over time, can cause the liver to stop working normally. Currently, the best way to determine the degree of fibrosis is to do a liver biopsy. The investigators hope to show that measuring the degree of liver fibrosis using an MRI with gadoxetate disodium is as good as or better than obtaining this information by performing a liver biopsy. Gadoxetate disodium is a contrast solution given through the veins that is considered safe, is approved for use by the Food and Drug Administration, and is already routinely given to patients with various forms of liver disease, including fibrosis.


Description:

Liver damage, from a variety of causes, leads to a condition called liver fibrosis. Common causes are chronic alcohol use and hepatitis C infection. The condition can progress to cirrhosis and liver failure, and is the seventh leading cause of death in the United States. Presently, biopsy remains the only reliable way to test whether the various treatments that have been proposed are working, but the risks of biopsy preclude frequent re-assessment. Hence, truly personalized treatments are hampered by the lack of a non-invasive, low-risk, but appropriately qualified test by which periodic assessments may be made.

In July of 2008, the FDA approved a new drug called Eovist that is absorbed by liver cells and can be seen in the liver when performing an MRI. The amount and time course of Eovist absorption will be different between health and fibrotic liver tissue. We believe that these parameters, in combination with hematological and immunological blood tests, can predict the degree of liver fibrosis without the need for biopsy. This would allow improved assessment of potentially important interventions that might alter the course of the underlying disease. Thus development of this non-invasive biomarker might not only obviate the need for biopsy, but might in addition allow more intensive periodic assessments that are not possible currently.


Recruitment information / eligibility

Status Recruiting
Enrollment 40
Est. completion date December 2014
Est. primary completion date December 2013
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Both
Age group 21 Years and older
Eligibility Inclusion criteria:

- subjects with Hepatitis C who are scheduled to obtain a liver biopsy in the future or have obtained a liver biopsy in the 6 months prior to planned MR imaging or

- subjects who are healthy, without liver disease (used for normal controls)

All subpopulations regarding gender, race and ethnicity will have equal opportunity for inclusion in the study protocol. The study protocol only includes adult population consistent with the age (>21 years old) at presentation.

Exclusion criteria:

- subjects with any contraindication to obtaining an MRI with intravenous contrast including: metal in body, severe renal impairment, pregnancy, or breast feeding. Contraindications will be identified using the same screening questionnaire as is provided for routine clinical examinations.

- Subjects with history of allergy to MRI contrast dye

Severe renal impairment is defined as a glomerular filtration rate (GFR) < 30 mL/min/1.73 m2. All subjects will be screened with a questionnaire. The GFR will be calculated in any subject who reports kidney problems or a history of kidney problems using blood chemistries performed within 6 weeks of the planned date of the MRI examination. These blood chemistries would need to have been performed as part of routine clinical care. A potential subject who reports kidney problems or a history of kidney problems who does not have blood chemistries available within 6 weeks of the MRI examination will be excluded from participation in this study.

Study Design

Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic


Related Conditions & MeSH terms


Intervention

Procedure:
MRI of liver
MRI of liver with intravenous gadoxetate disodium

Locations

Country Name City State
United States Weill Cornell Medical College New York New York

Sponsors (1)

Lead Sponsor Collaborator
Weill Medical College of Cornell University

Country where clinical trial is conducted

United States, 

References & Publications (36)

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Chen BB, Hsu CY, Yu CW, Wei SY, Kao JH, Lee HS, Shih TT. Dynamic contrast-enhanced magnetic resonance imaging with Gd-EOB-DTPA for the evaluation of liver fibrosis in chronic hepatitis patients. Eur Radiol. 2012 Jan;22(1):171-80. doi: 10.1007/s00330-011-2249-5. Epub 2011 Aug 31. — View Citation

Christensen C, Bruden D, Livingston S, Deubner H, Homan C, Smith K, Oh E, Gretch D, Williams J, McMahon B. Diagnostic accuracy of a fibrosis serum panel (FIBROSpect II) compared with Knodell and Ishak liver biopsy scores in chronic hepatitis C patients. J Viral Hepat. 2006 Oct;13(10):652-8. — View Citation

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Hamm B, Staks T, Mühler A, Bollow M, Taupitz M, Frenzel T, Wolf KJ, Weinmann HJ, Lange L. Phase I clinical evaluation of Gd-EOB-DTPA as a hepatobiliary MR contrast agent: safety, pharmacokinetics, and MR imaging. Radiology. 1995 Jun;195(3):785-92. — View Citation

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Kim T, Murakami T, Hasuike Y, Gotoh M, Kato N, Takahashi M, Miyazawa T, Narumi Y, Monden M, Nakamura H. Experimental hepatic dysfunction: evaluation by MRI with Gd-EOB-DTPA. J Magn Reson Imaging. 1997 Jul-Aug;7(4):683-8. — View Citation

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Mendoza J, Gómez-Domínguez E, Moreno-Otero R. [Transient elastography (Fibroscan), a new non-invasive method to evaluate hepatic fibrosis]. Med Clin (Barc). 2006 Feb 18;126(6):220-2. Review. Spanish. — View Citation

Moreno S, García-Samaniego J, Moreno A, Ortega E, Pineda JA, del Romero J, Tural C, von Wichmann MA, Berenguer J, Castro A, Espacio R. Noninvasive diagnosis of liver fibrosis in patients with HIV infection and HCV/HBV co-infection. J Viral Hepat. 2009 Apr;16(4):249-58. doi: 10.1111/j.1365-2893.2009.01088.x. Epub 2009 Feb 7. Review. — View Citation

Motosugi U, Ichikawa T, Oguri M, Sano K, Sou H, Muhi A, Matsuda M, Fujii H, Enomoto N, Araki T. Staging liver fibrosis by using liver-enhancement ratio of gadoxetic acid-enhanced MR imaging: comparison with aspartate aminotransferase-to-platelet ratio index. Magn Reson Imaging. 2011 Oct;29(8):1047-52. doi: 10.1016/j.mri.2011.05.007. Epub 2011 Jul 19. — View Citation

Murakami T, Kim T, Gotoh M, Hasuike Y, Kato N, Miyazawa T, Monden M, Nakamura H. Experimental hepatic dysfunction: evaluation by MR imaging with Gd-EOB-DTPA. Acad Radiol. 1998 Apr;5 Suppl 1:S80-2. — View Citation

Murtagh J, Foerster V. Transient elastography (FibroScan) for non-invasive assessment of liver fibrosis. Issues Emerg Health Technol. 2006 Sep;(90):1-4. — View Citation

Olsson R, Hägerstrand I, Broomé U, Danielsson A, Järnerot G, Lööf L, Prytz H, Rydén BO, Wallerstedt S. Sampling variability of percutaneous liver biopsy in primary sclerosing cholangitis. J Clin Pathol. 1995 Oct;48(10):933-5. — View Citation

Pagliaro L, Rinaldi F, Craxì A, Di Piazza S, Filippazzo G, Gatto G, Genova G, Magrin S, Maringhini A, Orsini S, Palazzo U, Spinello M, Vinci M. Percutaneous blind biopsy versus laparoscopy with guided biopsy in diagnosis of cirrhosis. A prospective, randomized trial. Dig Dis Sci. 1983 Jan;28(1):39-43. — View Citation

Poniachik J, Bernstein DE, Reddy KR, Jeffers LJ, Coelho-Little ME, Civantos F, Schiff ER. The role of laparoscopy in the diagnosis of cirrhosis. Gastrointest Endosc. 1996 Jun;43(6):568-71. — View Citation

Regev A, Berho M, Jeffers LJ, Milikowski C, Molina EG, Pyrsopoulos NT, Feng ZZ, Reddy KR, Schiff ER. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol. 2002 Oct;97(10):2614-8. — View Citation

Romero-Gómez M, Gómez-González E, Madrazo A, Vera-Valencia M, Rodrigo L, Pérez-Alvarez R, Pérez-López R, Castellano-Megias VM, Nevado-Santos M, Alcón JC, Solá R, Pérez-Moreno JM, Navarro JM, Andrade RJ, Salmerón J, Fernández-López M, Aznar R, Diago M. Optical analysis of computed tomography images of the liver predicts fibrosis stage and distribution in chronic hepatitis C. Hepatology. 2008 Mar;47(3):810-6. — View Citation

Ryeom HK, Kim SH, Kim JY, Kim HJ, Lee JM, Chang YM, Kim YS, Kang DS. Quantitative evaluation of liver function with MRI Using Gd-EOB-DTPA. Korean J Radiol. 2004 Oct-Dec;5(4):231-9. — View Citation

Schuster DP. The opportunities and challenges of developing imaging biomarkers to study lung function and disease. Am J Respir Crit Care Med. 2007 Aug 1;176(3):224-30. Epub 2007 May 3. Review. — View Citation

Segers J, Le Duc G, Laumonier C, Troprès I, Elst LV, Muller RN. Evaluation of Gd-EOB-DTPA uptake in a perfused and isolated mouse liver model: correlation between magnetic resonance imaging and monochromatic quantitative computed tomography. Invest Radiol. 2005 Sep;40(9):574-82. — View Citation

Shimizu J, Dono K, Gotoh M, Hasuike Y, Kim T, Murakami T, Sakon M, Umeshita K, Nagano H, Nakamori S, Kato N, Miyazawa T, Nakamura H, Monden M. Evaluation of regional liver function by gadolinium-EOB-DTPA-enhanced MR imaging. Dig Dis Sci. 1999 Jul;44(7):1330-7. — View Citation

Taouli B, Tolia AJ, Losada M, Babb JS, Chan ES, Bannan MA, Tobias H. Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience. AJR Am J Roentgenol. 2007 Oct;189(4):799-806. — View Citation

Tsuda N, Okada M, Murakami T. New proposal for the staging of nonalcoholic steatohepatitis: evaluation of liver fibrosis on Gd-EOB-DTPA-enhanced MRI. Eur J Radiol. 2010 Jan;73(1):137-42. doi: 10.1016/j.ejrad.2008.09.036. Epub 2008 Nov 20. — View Citation

Tsuda N, Okada M, Murakami T. Potential of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for differential diagnosis of nonalcoholic steatohepatitis and fatty liver in rats using magnetic resonance imaging. Invest Radiol. 2007 Apr;42(4):242-7. — View Citation

Zeremski M, Talal AH. Noninvasive markers of hepatic fibrosis: are they ready for prime time in the management of HIV/HCV co-infected patients? J Hepatol. 2005 Jul;43(1):2-5. Review. — View Citation

* Note: There are 36 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary The transfer constant, Ktrans, between intravascular and interstitial compartments. Ktrans is a transfer constant obtained following analysis of all images in the MRI exam, and is a measure of the permeability of tissue. up to 3 years No
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