Magnetic Resonance AngiographyNCT02155218
Improving the Concentration of MR Contrast in the Arteries
A study testing Standard Injection Rate, Patient Tailored Injection Rate and gadolinium contrast in people with Magnetic Resonance Angiography and Contrast Media, run by University of Washington at 1 site in United States.
Trial summary
In Contrast-Enhanced Magnetic Resonance Angiography (CE-MRA) a contrast agent is injected into an arm vein using a programmable medical device called a power injector. Once the contrast has circulated to the blood vessel of interest they can be imaged with MRI and distinctly separated from surrounding non-vascular… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Magnetic Resonance Angiography, Contrast Media
- What is being tested?
- Standard Injection Rate, Patient Tailored Injection Rate and gadolinium contrast
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 26 participants
- Where
- 1 siteUnited States
- Study dates
- Jun 2014to Nov 2015
- Phase
- Interventional
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 18 years of age or older;
- Scheduled at University of Washington Radiology to undergo contrast-enhanced cardiac MR.
Who cannot join
- Unable to understand the nature of the study or to consent;
- Unwilling to participate;
- Prisoner;
- Pregnant;
- Contraindications for MRI:
- Metallic or other surgical implants
Show all 21Show fewer
- History of metal work; metal pieces in your eyes or other body parts
- pacemaker
- defibrillator
- some aneurysm clips
- some artificial heart valves
- some implanted venous access device
- some cochlear/inner ear implants
- spinal stimulator
- some intrauterine devices (IUD)
- some tattoos or permanent make-up
- transdermal patch
- severe anxiety in confined spaces (claustrophobia)
- Contraindications for contrast:
- an allergic reaction to gadolinium contrast in the past that required treatment
- severe kidney or liver disease
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Contrast Dynamics of the Thoracic Vasculature and Heart
In Contrast-Enhanced Magnetic Resonance Angiography (CE-MRA) a contrast agent is injected into an arm vein using a programmable medical device called a power injector. Once the contrast has circulated to the blood vessel of interest they can be imaged with MRI and distinctly separated from surrounding non-vascular tissue.
This project is designed to find the best way to administer the contrast agent during CE-MRA to produce the best images. The clinical availability of programmable power injectors facilitates the use of variable contrast rate and volume injection protocols that are based on patient specific parameters.
Read more
CE-MRA is a valuable imaging tool for diagnosing abnormalities of the major blood vessels in the chest and abdomen. It is often used in conjunction with cardiac magnetic resonance (CMR) examinations to evaluate the blood vessels of the heart and lung. CE-MRA is attractive because 1) it does not involve radiation, and 2) the contrast agents used are not toxic to the kidneys and can be used in patients who are at greater risk for kidney dysfunction following iodinated contrast agents.
We plan to administer a small (1cc) test amount of contrast, taking pictures as the contrast passes through the blood vessels, and analyze the results. Using this information, we will administer an individually patient-tailored injection given in multiple phases (i.e., a "multi-phasic" injection) to maintain constant contrast concentration (and therefore constant signal intensity) throughout the scan. We believe this will reduce image blurring, and improve the sharpness and likely the diagnostic quality of CE-MRA.
Read the detailed description
This project will build and validate a tool designed to optimize the use of magnetic resonance (MR) contrast agents for contrast-enhanced magnetic resonance angiography (CE-MRA). As with most angiography methods, contrast agents selectively highlight a patient's arteries as compared to surrounding tissue. In CE-MRA the contrast agent is injected into an arm vein using a programmable injector and transported by the body's circulation to the arteries of interest, at which point a MR acquisition depicts the arteries distinctly from surrounding soft tissue.
At present, the clinically accepted method of injecting the contrast agent is essentially the same for every patient, and has not been systematically evaluated or optimized. For most chest and abdominal CE-MRA studies contrast is injected over 5-15 seconds, and the resultant concentration of contrast agent in the arteries over the duration of the MR acquisition is not well known. What this concentration is and how it varies over time, however, has a large impact on the quality and clarity of the resulting images. This project is designed to optimize the concentration of contrast agent in the arteries during the MR scan by using the predictive results of a small "test bolus" injection to tailor the actual contrast injection for each individual patient such that concentration remains as high and as constant as possible during the time of MR acquisition. This will be accomplished by developing algorithms and software tools to tailor the optimal, patient-specific injection parameters. The method will be validated in a preliminary clinical study.
We propose that we can predict what the contrast bolus will look like (i.e., its "concentration vs. time") by first administering a small (1cc) test bolus, taking pictures as the contrast passes through the blood vessels, and analyzing the results. Using this information, we believe that an individually patient-tailored injection given in multiple phases (i.e., a "multi-phasic" injection) can create constant contrast concentration (and therefore constant signal intensity) throughout the scan, eliminating this source of image blurring, and improving the sharpness and likely the diagnostic quality of first-pass CE-MRA. Moreover, by tailoring the contrast to the duration of the scan, the contrast agent is used most efficiently and not wasted outside the acquisition duration, potentially recouping any contrast-to-noise ratio (CNR) loss. It is important to note the results of this study are generalizable to CT Angiography (CTA) as well, where similar efficient use of the contrast will reduce cost and excessive patient exposure to iodinated contrast. We plan to compare an "optimized" multiphasic contrast administration to a standard single phase contrast administration.
- Conditions
- Magnetic Resonance Angiography, Contrast Media
- Being tested
- Standard Injection Rate, Patient Tailored Injection Rate, gadolinium contrast
- Keywords
- Magnetic Resonance Angiography, Contrast Media
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Standard Injection RateOther
Normally an IV is placed in an arm and the gadolinium contrast (30-40 cc, depending on patient size) is administered through the IV with a power injector as a single bolus. Subjects will have a test bolus and main bolus.
Patient Tailored Injection RateOther
Normally an IV is placed in an arm and the gadolinium contrast (30-40 cc, depending on patient size) is administered through the IV with a power injector as a single bolus. Subjects will have a test bolus and main bolus. We will use a mathematical algorithm to rapidly analyze the test bolus and calculate a predicted "best" way to inject the main bolus - likely slower and "multi-phasic", meaning different flow rates as the bolus injection evolves.
gadolinium contrastOther
| Study group | Role | What they receive |
|---|---|---|
| Standard Injection Rate | Active comparator | Subjects will be given a small amount of contrast (approximately 1 cc test bolus) followed by administration of the remainder of the volume of contrast they are getting for their clinical study. This will be approximately 30-40 cc, depending on patient size, given at an injection rate of 2 - 2.5 cc/second. Receives: Other: Standard Injection Rate; Other: gadolinium contrast |
| Patient Tailored Injection Rate | Experimental | Subjects will be given a small amount of contrast (approximately 1 cc test bolus) followed by administration of the remainder of the volume of contrast they are getting for their clinical study. This will be approximately 30-40 cc, depending on patient size. We will use a mathematical algorithm to rapidly analyze the test bolus and calculate a predicted "best" way to inject the contrast - likely slower and "multi-phasic", meaning different flow rates as the bolus injection evolves. The injection rate will vary from 1 to 3 cc/second. Receives: Other: Patient Tailored Injection Rate; Other: gadolinium contrast |
What is being measured
The primary outcome is the main question the study is designed to answer.
Arterial Signal Intensity Evaluation
To evaluate the performance of the bolus-tailoring method, measured signal intensity profiles will be evaluated using residual sum-of-squares (RSS) between targeted and measured responses. A smaller RSS indicates agreement with the targeted signal intensity profile. Additionally, full-width-at-half-maximum (FWHM) and start time (10% signal intensity increase over baseline) of the signal intensity profile will be measured and compared between the two groups. T-test will be used to test for significant differences between the two methods.
Measured: During the one-time contrast-enhanced cardiac MR exam lasting approximately 45 to 60 minutes, signal intensity will be evaluated continuously before, during and after administration of contrast.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Jun 2014 (estimated)
- Study startJun 2014
- Primary completionOct 2015
- Study completionNov 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Magnetic Resonance AngiographyStudies of the same condition, open and under way.
- More trials run by University of WashingtonThe 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 N/A
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 26 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Washington
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jeffrey Maki, University of Washington
- Investigators
- Jeffrey H. Maki, MD, PhD, Principal investigator, University of Washington
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02155218
- Sponsor's protocol ID
- STUDY00001892
- Status last verified
- Oct 2017
- First submitted
- 2 Jun 2014
- Last updated
- 26 Oct 2017
- Results posted
- No
- Data monitoring committee
- No
Publications
Wilson GJ, Maki JH. Evaluation of a tailored injection profile (TIP) algorithm for uniform contrast-enhanced signal intensity profiles in MR angiography. J Magn Reson Imaging. 2016 Dec;44(6):1664-1672. doi: 10.1002/jmri.25298. Epub 2016 May 5.
PubMed 27149390
Study at a glance
From the registry record, last updated by the sponsor on 26 Oct 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Contrast Dynamics of the Thoracic Vasculature and Heart
- ClinicalTrials.gov ID
- NCT02155218
- Acronym / sponsor ID
- STUDY00001892
- Conditions
- Magnetic Resonance Angiography, Contrast Media
- Keywords
- Magnetic Resonance Angiography, Contrast Media
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 26 participants (actual)
- Lead sponsor
- University of WashingtonUniversity, hospital or other
- Study start
- Jun 2014
- Primary completion
- Oct 2015 (actual)
- Study completion
- Nov 2015 (actual)
- First posted
- 4 Jun 2014 (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.
In Contrast-Enhanced Magnetic Resonance Angiography (CE-MRA) a contrast agent is injected into an arm vein using a programmable medical device called a power injector. Once the contrast has circulated to the blood vessel of interest they can be imaged with MRI and distinctly separated from surrounding non-vascular tissue.
This project is designed to find the best way to administer the contrast agent during CE-MRA to produce the best images. The clinical availability of programmable power injectors facilitates the use of variable contrast rate and volume injection protocols that are based on patient specific parameters.
CE-MRA is a valuable imaging tool for diagnosing abnormalities of the major blood vessels in the chest and abdomen. It is often used in conjunction with cardiac magnetic resonance (CMR) examinations to evaluate the blood vessels of the heart and lung. CE-MRA is attractive because 1) it does not involve radiation, and 2) the contrast agents used are not toxic to the kidneys and can be used in patients who are at greater risk for kidney dysfunction following iodinated contrast agents.
We plan to administer a small (1cc) test amount of contrast, taking pictures as the contrast passes through the blood vessels, and analyze the results. Using this information, we will administer an individually patient-tailored injection given in multiple phases (i.e., a "multi-phasic" injection) to maintain constant contrast concentration (and therefore constant signal intensity) throughout the scan. We believe this will reduce image blurring, and improve the sharpness and likely the diagnostic quality of CE-MRA.
Detailed description
This project will build and validate a tool designed to optimize the use of magnetic resonance (MR) contrast agents for contrast-enhanced magnetic resonance angiography (CE-MRA). As with most angiography methods, contrast agents selectively highlight a patient's arteries as compared to surrounding tissue. In CE-MRA the contrast agent is injected into an arm vein using a programmable injector and transported by the body's circulation to the arteries of interest, at which point a MR acquisition depicts the arteries distinctly from surrounding soft tissue.
At present, the clinically accepted method of injecting the contrast agent is essentially the same for every patient, and has not been systematically evaluated or optimized. For most chest and abdominal CE-MRA studies contrast is injected over 5-15 seconds, and the resultant concentration of contrast agent in the arteries over the duration of the MR acquisition is not well known. What this concentration is and how it varies over time, however, has a large impact on the quality and clarity of the resulting images. This project is designed to optimize the concentration of contrast agent in the arteries during the MR scan by using the predictive results of a small "test bolus" injection to tailor the actual contrast injection for each individual patient such that concentration remains as high and as constant as possible during the time of MR acquisition. This will be accomplished by developing algorithms and software tools to tailor the optimal, patient-specific injection parameters. The method will be validated in a preliminary clinical study.
We propose that we can predict what the contrast bolus will look like (i.e., its "concentration vs. time") by first administering a small (1cc) test bolus, taking pictures as the contrast passes through the blood vessels, and analyzing the results. Using this information, we believe that an individually patient-tailored injection given in multiple phases (i.e., a "multi-phasic" injection) can create constant contrast concentration (and therefore constant signal intensity) throughout the scan, eliminating this source of image blurring, and improving the sharpness and likely the diagnostic quality of first-pass CE-MRA. Moreover, by tailoring the contrast to the duration of the scan, the contrast agent is used most efficiently and not wasted outside the acquisition duration, potentially recouping any contrast-to-noise ratio (CNR) loss. It is important to note the results of this study are generalizable to CT Angiography (CTA) as well, where similar efficient use of the contrast will reduce cost and excessive patient exposure to iodinated contrast. We plan to compare an "optimized" multiphasic contrast administration to a standard single phase contrast administration.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Standard Injection Rate | Active comparator | Other: Standard Injection Rate, Other: gadolinium contrastSubjects will be given a small amount of contrast (approximately 1 cc test bolus) followed by administration of the remainder of the volume of contrast they are getting for their clinical study. This will be approximately 30-40 cc, depending on patient size, given at an injection rate of 2 - 2.5 cc/second. |
| Patient Tailored Injection Rate | Experimental | Other: Patient Tailored Injection Rate, Other: gadolinium contrastSubjects will be given a small amount of contrast (approximately 1 cc test bolus) followed by administration of the remainder of the volume of contrast they are getting for their clinical study. This will be approximately 30-40 cc, depending on patient size. We will use a mathematical algorithm to rapidly analyze the test bolus and calculate a predicted "best" way to inject the contrast - likely slower and "multi-phasic", meaning different flow rates as the bolus injection evolves. The injection rate will vary from 1 to 3 cc/second. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- 18 years of age or older;
- Scheduled at University of Washington Radiology to undergo contrast-enhanced cardiac MR.
Key exclusion criteria (21 listed)
- Unable to understand the nature of the study or to consent;
- Unwilling to participate;
- Prisoner;
- Pregnant;
- Contraindications for MRI:
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 |
|---|---|---|
| Standard Injection RateNormally an IV is placed in an arm and the gadolinium contrast (30-40 cc, depending on patient size) is administered through the IV with a power injector as a single bolus. Subjects will have a test bolus and main bolus. | Other | Standard Injection Rate |
| Patient Tailored Injection RateNormally an IV is placed in an arm and the gadolinium contrast (30-40 cc, depending on patient size) is administered through the IV with a power injector as a single bolus. Subjects will have a test bolus and main bolus. We will use a mathematical algorithm to rapidly analyze the test bolus and calculate a predicted "best" way to inject the main bolus - likely slower and "multi-phasic", meaning different flow rates as the bolus injection evolves. | Other | Patient Tailored Injection Rate |
| gadolinium contrast | Other | Patient Tailored Injection Rate, Standard Injection Rate |
Primary outcome
Arterial Signal Intensity Evaluation
Time frame: During the one-time contrast-enhanced cardiac MR exam lasting approximately 45 to 60 minutes, signal intensity will be evaluated continuously before, during and after administration of contrast.
To evaluate the performance of the bolus-tailoring method, measured signal intensity profiles will be evaluated using residual sum-of-squares (RSS) between targeted and measured responses. A smaller RSS indicates agreement with the targeted signal intensity profile. Additionally, full-width-at-half-maximum (FWHM) and start time (10% signal intensity increase over baseline) of the signal intensity profile will be measured and compared between the two groups. T-test will be used to test for significant differences between the two methods.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Oct 2017.
- Results publication: PubMed 27149390Wilson GJ, Maki JH. Evaluation of a tailored injection profile (TIP) algorithm for uniform contrast-enhanced signal intensity profiles in MR angiography. J Magn Reson Imaging. 2016 Dec;44(6):1664-1672. doi: 10.1002/jmri.25298. Epub 2016 May 5.
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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.
Jeffrey H. Maki, MD, PhD principal investigator
University of Washington
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Standard Injection Rate, Patient Tailored Injection Rate and gadolinium contrast in people with Magnetic Resonance Angiography and Contrast Media, run by University of Washington 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 2 inclusion and 21 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: finished, as of the sponsor's last update on 26 Oct 2017. 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.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Arterial Signal Intensity Evaluation (time frame: During the one-time contrast-enhanced cardiac MR exam lasting approximately 45 to 60 minutes, signal intensity will be evaluated continuously before, during and after administration of contrast.). 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 NCT02155218, which also lists 1 linked publication.
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 26 Oct 2017.