Compare Technegas Ventilation-Perfusion SPECT and Xenon Ventilation-Perfusion Planar Imaging for Pulmonary Embolism

Phase 3

Terminated

• Conditions: Pulmonary Embolism
• Interventions: Drug: Technegas V SPECT imaging; Drug: Xenon-133 Ventilation Planar imaging

• Registration Number: NCT01458639
• Lead Sponsor: Cyclomedica Australia PTY Limited

Brief Summary

Phase 3 within-subject trial of Technegas V/Q SPECT and Tc-99m macro-aggregated albumin (MAA) imaging compared to Xenon-133 V/Q planar and Tc-99m macroaggregate of albumin (MAA) imaging for the diagnosis of Pulmonary Embolism (PE).

Detailed Description

This is a Phase 3 within-subject trial of Technegas Ventilation SPECT and Tc-99m MAA perfusion imaging compared to xenon (Xe-133) Ventilation Planar and Tc-99m MAA perfusion imaging for the diagnosis of PE. Diagnosis of PE provided by review of the subjects' documented clinical information after 30 days of follow-up. Primary assessments of efficacy will be based on an independent blind reads of the Technegas V/Q SPECT images by three different readers and the independent blind reads of Xe 133 V/Q planar images by three different readers.

Study Timeline

• Study First Submitted: 2011-10-19
• Study First Submitted QC: 2011-10-24
• Study First Posted: 2011-10-25
• Study Start: 2012-08
• Primary Completion: 2015-06
• Study Completion: 2015-06
• Results First Submitted: 2015-07-20
• Status Verified: 2015-10
• Results First Submitted QC: 2015-10-13
• Last Update Submitted: 2015-10-13
• Results First Posted: 2015-11-10
• Last Update Posted: 2015-11-10

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 18

Inclusion Criteria

Subjects will be enrolled in Cohort 1 if they meet the following requirements:

1. Male or female, at least 18 years of age.
2. Suspected of having PE and be a candidate for Xe-133 V/Q imaging.
3. Willing and able to provide informed consent.
4. Stable and able to undergo Xe-133 planar imaging, Technegas SPECT imaging, and planar/SPECT perfusion imaging and complete follow-up procedures.
5. Willing and agree to complete study procedures, including follow-up safety assessments.
6. Using adequate birth control, if female and fertile.
7. If female, has a negative urine or serum pregnancy test.
8. Agrees to return for a 24-hour and 30 day follow-up safety assessment.

Subjects will be enrolled in Cohort 2 if they meet the above criteria AND subject is likely to have pulmonary embolism based on one or more of the following:

1. Wells Score of 7 or greater. Subjects with a Wells Score less than 7 may be enrolled in Cohort 2 if there is agreement between the investigator and the medical monitor that the subject is at high risk for PE.
2. An abnormal D-dimer test.
3. Positive Doppler ultrasound for DVT.
4. CTA is positive for PE within 24 hours of this imaging study.

Exclusion Criteria

Subject

1. Has undergone imaging with Iodine-131 (I-131) within 30 days, Thallium-201 (Tl-201) or Indium-111 (In-111) within 10 days, Fluorine 18 (F-18) within 24 hours, or any other radiopharmaceutical not otherwise specified within 72 hours of this imaging study.
2. Has previously undergone an imaging study with a Tc-99m agent, within 48 hours of this imaging study.
3. Is a pregnant or lactating female.
4. Has received Technegas in the past.
5. Was previously enrolled in another investigational study or received an investigational drug within 30 days prior to dosing.
6. Is hemodynamically unstable.
7. Has received therapeutic dose of low molecular weight or unfractionated heparin within 24 hours prior to dosing or Tissue Plasminogen Activator (tPA) within 4 hours prior to dosing or has received treatment for PE between the time of a positive CTA, if performed, and Technegas V/Q SPECT imaging.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Technegas	Technegas V SPECT imaging	Technegas V SPECT imaging with Technetium-99m (Tc-99m) labeled carbon particles; approximately 1.1 milliCuries of Technegas, compared with the results of Xenon-133 ventilation scan
Xenon-133	Xenon-133 Ventilation Planar imaging	Xenon-133 ventilation Planar imaging compared with the results of the Technegas scan.

Primary Outcome Measures

Name	Time	Method
Specificity of Technegas V/Q SPECT for the Diagnosis of PE.	Prospective, 30 days follow-up	Compared to the specificity of Xenon V/Q Planar imaging. "Truth" based on blinded reader's assessments of V/Q SPECT images compared with subject's final diagnosis resulting from clinical information at 30 days follow-up.
Sensitivity of Technegas V/Q SPECT for the Diagnosis of PE	Prospective, 30 days follow-up	Compared to the sensitivity of Xenon V/Q Planar imaging. "Truth" based on blinded reader's assessments of V/Q SPECT images compared with subject's final diagnosis resulting from clinical information at 30 days follow-up.

Secondary Outcome Measures

Name	Time	Method
Positive Predictive Value (PPV) of Imaging for Diagnosis of PE	Prospective, 30 days follow-up	PPV of V/Q imaging for diagnosis of PE is determined by the results of blind-read assessment of images compared with truth using a subject's final clinical diagnosis following 30-day follow-up of occurence of PE or death, whichever occurs first.
Likelihood Ratio for Diagnosis of PE	Prospective, 30 days follow-up	Likelihood ratios of V/Q imaging for diagnosis of PE is determined by the results of blind-read assessment of images compared with truth using a subject's final clinical diagnosis following 30-day follow-up of occurence of PE or death, whichever occurs first.
Negative Predictive Value (NPV) of Imaging for Diagnosis of PE	Prospective, 30 days follow-up	NPV of V/Q imaging for diagnosis of PE is determined by the results of blind-read assessment of images compared with truth using a subject's final clinical diagnosis following 30-day follow-up of occurence of PE or death, whichever occurs first.
Safety of Technegas in Patients With Possible PE	Prospective, from enrollment through 30 days follow-up	Safety will be assessed by the incidence of treatment emergence adverse events and changes in clinical laboratory measurements, blood pressure, oxygen saturation, physical examination and pulmonary examination before and after treatment.
Accuracy of Technegas V/Q SPECT and Xenon V/Q Planar Imaging for Diagnosis of PE	prospective, 30 days follow-up.	Accuracy of V/Q imaging for diagnosis of PE is determined by the results of blind-read assessment of images compared with truth using a subject's final clinical diagnosis following 30-day follow-up of occurence of PE or death, whichever occurs first.

Trial Locations

Locations (2)

Columbia University Medical Center; 🇺🇸 New York, New York, United States

Barnes-Jewish Hospital, Washington University; 🇺🇸 St. Louis, Missouri, United States