Hepatic FibrosisPhase 4NCT01783314
Development of an Imaging Biomarker for Hepatic Fibrosis Using Gadoxetate Disodium
A Phase 4 study testing MRI of liver in people with Hepatic Fibrosis, run by Weill Medical College of Cornell University at 1 site in United States.
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. Read more about this study
- Who is it for?
- Ages 21 years and olderHealthy volunteers can take part
- Conditions the study is for
- Hepatic Fibrosis
- What is being tested?
- MRI of liver
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteUnited States
- Study dates
- Dec 2010to Dec 2014
- Phase
- Phase 4
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- 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.
Who cannot join
- 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.
Trial locations and contacts
1 site in 1 country.
United States1 site, 1 recruiting
- Recruiting
Weill Cornell Medical College
New York, New York, 10065
Ame Ng, 212-746-2194, ameng@med.cornell.edu
Krishna Juluru, MD
About this study
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.
Read the detailed 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.
- Conditions
- Hepatic Fibrosis
- Being tested
- MRI of liver
- Keywords
- hepatic fibrosis, Eovist, gadoxetate disodium, biomarker, liver biopsy, liver function, MRI, Hepatitis C
- Medical subject headings
- Liver Cirrhosis, Hepatitis C
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MRI of liverProcedure or surgery
MRI of liver with intravenous gadoxetate disodium
| Study group | Role | What they receive |
|---|---|---|
| Normal liver function | Active comparator | Control group. Subjects will obtain MRI of liver. Receives: Procedure: MRI of liver |
| Hepatitis C | Experimental | Subjects with hepatitis C. Subjects will obtain both MRI of liver and limited CT of liver. Receives: Procedure: MRI of liver |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: up to 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Feb 2013 (estimated)
- Study startDec 2010
- Primary completionDec 2013 (estimated)
- Study completionDec 2014 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (36)Papers the sponsor has linked to this study.
- Other trials for Hepatic FibrosisStudies of the same condition, open and under way.
- More trials run by Weill Medical College of Cornell UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Weill Medical College of Cornell University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Krishna Juluru, MD, Principal investigator, Weill Medical College of Cornell University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01783314
- Sponsor's protocol ID
- 1009011259
- Other IDs
- DI-2010-18
- Status last verified
- Jan 2013
- First submitted
- 18 Nov 2011
- Last updated
- 4 Feb 2013
- Results posted
- No
- Data monitoring committee
- No
Publications
Maharaj B, Maharaj RJ, Leary WP, Cooppan RM, Naran AD, Pirie D, Pudifin DJ. Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver. Lancet. 1986 Mar 8;1(8480):523-5. doi: 10.1016/s0140-6736(86)90883-4.
PubMed 2869260Pagliaro L, Rinaldi F, Craxi 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. doi: 10.1007/BF01393359.
PubMed 6217961Tsuda 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. doi: 10.1097/01.rli.0000258058.44876.a5.
PubMed 17351431Berg CL, Steffick DE, Edwards EB, Heimbach JK, Magee JC, Washburn WK, Mazariegos GV. Liver and intestine transplantation in the United States 1998-2007. Am J Transplant. 2009 Apr;9(4 Pt 2):907-31. doi: 10.1111/j.1600-6143.2009.02567.x.
PubMed 19341415Chen 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.
PubMed 21879400Olsson R, Hagerstrand I, Broome U, Danielsson A, Jarnerot G, Loof L, Prytz H, Ryden BO, Wallerstedt S. Sampling variability of percutaneous liver biopsy in primary sclerosing cholangitis. J Clin Pathol. 1995 Oct;48(10):933-5. doi: 10.1136/jcp.48.10.933.
PubMed 8537493Poniachik 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. doi: 10.1016/s0016-5107(96)70192-x.
PubMed 8781934Taouli 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. doi: 10.2214/AJR.07.2086.
PubMed 17885048Bedossa P, Dargere D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003 Dec;38(6):1449-57. doi: 10.1016/j.hep.2003.09.022.
PubMed 14647056Regev 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. doi: 10.1111/j.1572-0241.2002.06038.x.
PubMed 12385448Kovalev VA, Kruggel F, Gertz HJ, von Cramon DY. Three-dimensional texture analysis of MRI brain datasets. IEEE Trans Med Imaging. 2001 May;20(5):424-33. doi: 10.1109/42.925295.
PubMed 11403201Segers J, Le Duc G, Laumonier C, Tropres 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. doi: 10.1097/01.rli.0000174474.43772.58.
PubMed 16118550Kim 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. doi: 10.1002/jmri.1880070413.
PubMed 9243389Romero-Gomez M, Gomez-Gonzalez E, Madrazo A, Vera-Valencia M, Rodrigo L, Perez-Alvarez R, Perez-Lopez R, Castellano-Megias VM, Nevado-Santos M, Alcon JC, Sola R, Perez-Moreno JM, Navarro JM, Andrade RJ, Salmeron J, Fernandez-Lopez 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. doi: 10.1002/hep.22112.
PubMed 18098299Asbach P, Klatt D, Hamhaber U, Braun J, Somasundaram R, Hamm B, Sack I. Assessment of liver viscoelasticity using multifrequency MR elastography. Magn Reson Med. 2008 Aug;60(2):373-9. doi: 10.1002/mrm.21636.
PubMed 18666132
Study at a glance
From the registry record, last updated by the sponsor on 4 Feb 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Development of an Imaging Biomarker for Hepatic Fibrosis Using Gadoxetate Disodium
- ClinicalTrials.gov ID
- NCT01783314
- Acronym / sponsor ID
- 1009011259
- Conditions
- Hepatic Fibrosis
- Keywords
- hepatic fibrosis, Eovist, gadoxetate disodium, biomarker, liver biopsy, liver function, MRI, Hepatitis C
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Weill Medical College of Cornell UniversityUniversity, hospital or other
- Study start
- Dec 2010
- Primary completion
- Dec 2013 (estimated)
- Study completion
- Dec 2014 (estimated)
- First posted
- 4 Feb 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed 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.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Normal liver function | Active comparator | Procedure: MRI of liverControl group. Subjects will obtain MRI of liver. |
| Hepatitis C | Experimental | Procedure: MRI of liverSubjects with hepatitis C. Subjects will obtain both MRI of liver and limited CT of liver. |
Who may qualify
- Ages
- 21 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- 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.
Key exclusion criteria (3 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| MRI of liverMRI of liver with intravenous gadoxetate disodium | Procedure or surgery | Hepatitis C, Normal liver function |
Primary outcome
The transfer constant, Ktrans, between intravascular and interstitial compartments.
Time frame: up to 3 years
Ktrans is a transfer constant obtained following analysis of all images in the MRI exam, and is a measure of the permeability of tissue.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Feb 2013.
- Background: PubMed 2869260Maharaj B, Maharaj RJ, Leary WP, Cooppan RM, Naran AD, Pirie D, Pudifin DJ. Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver. Lancet. 1986 Mar 8;1(8480):523-5. doi: 10.1016/s0140-6736(86)90883-4.
- Background: PubMed 6217961Pagliaro L, Rinaldi F, Craxi 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. doi: 10.1007/BF01393359.
- Background: PubMed 17351431Tsuda 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. doi: 10.1097/01.rli.0000258058.44876.a5.
- Background: PubMed 19341415Berg CL, Steffick DE, Edwards EB, Heimbach JK, Magee JC, Washburn WK, Mazariegos GV. Liver and intestine transplantation in the United States 1998-2007. Am J Transplant. 2009 Apr;9(4 Pt 2):907-31. doi: 10.1111/j.1600-6143.2009.02567.x.
- Background: PubMed 21879400Chen 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.
- Background: PubMed 8537493Olsson R, Hagerstrand I, Broome U, Danielsson A, Jarnerot G, Loof L, Prytz H, Ryden BO, Wallerstedt S. Sampling variability of percutaneous liver biopsy in primary sclerosing cholangitis. J Clin Pathol. 1995 Oct;48(10):933-5. doi: 10.1136/jcp.48.10.933.
- Background: PubMed 8781934Poniachik 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. doi: 10.1016/s0016-5107(96)70192-x.
- Background: PubMed 17885048Taouli 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. doi: 10.2214/AJR.07.2086.
- Background: PubMed 14647056Bedossa P, Dargere D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003 Dec;38(6):1449-57. doi: 10.1016/j.hep.2003.09.022.
- Background: PubMed 12385448Regev 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. doi: 10.1111/j.1572-0241.2002.06038.x.
- Background: PubMed 11403201Kovalev VA, Kruggel F, Gertz HJ, von Cramon DY. Three-dimensional texture analysis of MRI brain datasets. IEEE Trans Med Imaging. 2001 May;20(5):424-33. doi: 10.1109/42.925295.
- Background: PubMed 16118550Segers J, Le Duc G, Laumonier C, Tropres 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. doi: 10.1097/01.rli.0000174474.43772.58.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Krishna Juluru, MD principal investigator
Weill Medical College of Cornell University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing MRI of liver in people with Hepatic Fibrosis, run by Weill Medical College of Cornell University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 4 Feb 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Ame Ng, BSN, CCRP (212-746-2194, ameng@med.cornell.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The transfer constant, Ktrans, between intravascular and interstitial compartments. (time frame: up to 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01783314, which also lists 36 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2013.