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A Study of Magnetic Resonance Imaging (MRI) With Gadavist in Children

Phase 1
Completed
Conditions
Magnetic Resonance Imaging
Interventions
Registration Number
NCT00468819
Lead Sponsor
Bayer
Brief Summary

In this clinical study a contrast agent for magnetic resonance imaging (MRI), which has already been approved for application in adults, will be investigated in children and adolescents. MRI is a modern and safe examination method without delivering radiation burden using magnetic fields to produce cross-sectional images of the human body. A special computer program then puts these images together and creates a two or three-dimensional image of the inner organs thus facilitating the detection and evaluation of pathological changes. In contrast-enhanced MRI a contrast agent is injected into a peripheral vein before the examination which results in a stronger contrast in the examined area. Therefore, pathological changes can be more easily detected and evaluated compared to non-enhanced MRI. The company Bayer HealthCare Pharmaceuticals has developed a contrast agent for MRI called Gadavist 1.0 which was first approved in 1998 in Switzerland for MRI of brain and spine. Since 2003 Gadavist can also be used in magnetic resonance angiography (MRA) in adults, i.e. in the MRI examination of the blood vessels and since 2006 in MRI of liver and kidney disease. Gadavist was examined in more than 2,900 adults within the framework of clinical studies during development and has been used after its marketing authorization in meanwhile more than 600,000 patients. Yet, clinical studies investigating Gadavist have been only conducted with adults so far. Diseases requiring MRI examinations, however, often occur in children, too. Therefore, many contrast agents are already used on a regular basis in MRI examinations of children, some of these contrast agents being authorized already. Within the framework of this study the pharmacokinetic characteristics of Gadavist in children or adolescents will be investigated, i.e. how the contrast agent is distributed and behaves in the body. In addition, safety and tolerability will be evaluated in order to demonstrate that Gadavist 1.0 is a safe and well tolerated contrast agent also for children and adolescents. Furthermore, the study aims to obtain the dosage recommendation of 0.1 ml per kilogram body weight also for this population group.

Detailed Description

Please note that the present study is allocated two study phases, i.e. phase I and phase III.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
140
Inclusion Criteria
  • Patients (male/ female) of specific age groups (2-6 years, 7-11 years, 12-17 years) who are scheduled to undergo Gadolinium (Gd)-enhanced MRI of brain, spine, liver and/or kidneys or Gd-enhanced MRA (single field of view).
Exclusion Criteria
  • Clinically unstable patients (e.g. intensive care unit)
  • Renal insufficiency
  • Patients undergoing a relevant change in chemotherapy </= 48 hours prior to and up to 24 hours after the administration of Gadovist.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Gadobutrol (Gadavist, BAY86-4875) - age 2 to 6 yearsGadobutrol (Gadavist, Gadovist, BAY86-4875)Participants received Gadobutrol 0.1 mmol/kg body weight (BW) = 0.1 mL/kg BW as single intravenous bolus injection
Gadobutrol (Gadavist, BAY86-4875) - age 7 to 11 yearsGadobutrol (Gadavist, Gadovist, BAY86-4875)Participants received Gadobutrol 0.1 mmol/kg body weight (BW) = 0.1 mL/kg BW as single intravenous bolus injection
Gadobutrol (Gadavist, BAY86-4875) - age 12 to 17 yearsGadobutrol (Gadavist, Gadovist, BAY86-4875)Participants received Gadobutrol 0.1 mmol/kg body weight (BW) = 0.1 mL/kg BW as single intravenous bolus injection
Gadobutrol (Gadavist, BAY86-4875) - age 2 to 17 yearsGadobutrol (Gadavist, Gadovist, BAY86-4875)Participants received Gadobutrol 0.1 mmol/kg body weight (BW) = 0.1 mL/kg BW as single intravenous bolus injection
Primary Outcome Measures
NameTimeMethod
Plasma Clearance Estimates of Gadobutrol by Age GroupFrom injection of Gadobutrol up to 8 hours after injection.

Total body clearance of Gadobutrol in plasma in L/h after intravenous injection.

Body Weight-corrected Plasma Clearance Estimates of Gadobutrol by Age GroupFrom injection up to 8 hours after Gadobutrol injection

Total body clearance of Gadobutrol in plasma corrected for body weight (L/h/kg) after intravenous injection.

Volume Distribution at Steady State (Vss) Estimates of Gadobutrol by Age GroupFrom injection up to 8 hours after Gadobutrol injection

Apparent volume of distribution at steady state expressed in L after intravenous injection.

Body Weight-corrected Volume Distribution at Steady State (Vss) Estimates of Gadobutrol by Age GroupFrom injection to 8 hours after Gadobutrol injection

Apparent volume of distribution at steady state corrected for body weight (L/h/kg) after intravenous injection.

Area Under the Drug Concentration-time Curve of Gadobutrol by Age GroupFrom injection to 8 hours after Gadobutrol injection

Area under the concentration versus time curve from zero to infinity after intravenous injection expressed in µmol\*h/L.

Terminal Elimination Half Life Estimates of Gadobutrol by Age GroupFrom injection to 8 hours after Gadobutrol injection

Terminal elimination half-life of Gadobutrol from plasma expressed in h and derived from the terminal slope of the concentration versus time curve.

Mean Residence Time (MRT) Estimates of Gadobutrol by Age GroupFrom injection to 8 hours after Gadobutrol injection

Mean residence time of Gadobutrol in plasma expressed in h.

Secondary Outcome Measures
NameTimeMethod
Urinary Excretion of Gadolinium as Percent of Administered Doseup to 6 hours after Gadobutrol injection

Amount of gadolinium\* excreted into urine during the collection interval 0 - 6 h post dose expressed as % of administered dose. \*A metallic rare-earth element, used as a contrast medium for magnetic resonance imaging.

Number of Participants With Basic Technical Adequacy of Magnetic Resonance (MR) Images for Diagnosis by Age GroupUp to 1 hour after Gadobutrol injection

In the participants the technical adequacy (evaluability) of MR images was assessed on the following 4-point scale (1=not adequate \[compromised quality\], 2=partially adequate \[evaluation possible\], 3=adequate despite artifacts, 4=adequate with excellent quality).

Pre-Contrast Lesions by Location and by Age Groupup to 1 hour after Gadobutrol injection

Number of lesions on pre-contrast images by organ location and age group.

Number of Participants With Change in Diagnostic Confidence by Age Groupup to 1 hour after Gadobutrol injection

In the participants the change in diagnostic confidence (additional diagnostic gain by the post-contrast scan) was assessed on the following 3-point scale (1=unchanged, 2=improved, 3=worsened).

Post-Contrast Delineation of Lesion/Vessel Border by Age Groupup to 1 hour after Gadobutrol injection

In the participants post-contrast delineation of each lesion/vessel border was assessed on the following 5-point scale (no, moderate, good, excellent, not assessable).

Post-Contrast Lesion Characterization by Age Groupup to 1 hour after Gadobutrol injection

In the participants the internal morphology and structure of each post-contrast lesion was assessed on the following 4-point scale (1=poor, 2=moderate, 3=good, 4=not applicable).

Number of Participants With Overall Contrast Quality of Post Contrast Images by Age Groupup to 1 hour after Gadobutrol injection

In the participants qualitative overall contrast quality of post contrast images was assessed on the following 6-point scale (none, poor, moderate, good, excellent, not assessable).

Post-Contrast Lesions by Location and by Age Groupup to 1 hour after Gadobutrol injection

Number of lesions on post-contrast images by organ location and age group.

Pre-Contrast Delineation of Lesion/Vessel Border by Age Groupup to 1 hour after Gadobutrol injection

In the participants pre-contrast delineation of each lesion/vessel border was assessed on the following 5-point scale (no, moderate, good, excellent, not assessable).

Pre-Contrast Lesion Characterization by Age Groupup to 1 hour after Gadobutrol injection

In the participants the internal morphology and structure of each pre-contrast lesion was assessed on the following 4-point scale (1=poor, 2=moderate, 3=good, 4=not applicable).

Degree of Contrast Enhancement in Lesion/Vessel by Age Group (Given Are Total Numbers of Lesions)up to 1 hour after Gadobutrol injection

In the participants the degree of contrast enhancement in each lesion/vessel was assessed on the following 5-point scale (1=no, 2=moderate, 3=good, 4=excellent, 5=not applicable).

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