Multi-center, Double-blind, Randomized, Controlled, Parallel Group, Dose Comparison Study With Corresponding Blinded Image Evaluation Following a Single Intravenous Injection of Three Different Doses of Gadobutrol 1.0 Molar (Gadavist) in Patients With Known or Suspected Focal Blood Brain Barrier Disturbances and/or Abnormal Vascularity of the Central Nervous System
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- Bayer
- 入组人数
- 237
- 试验地点
- 27
- 主要终点
- Categorical Visualization Score (CVS)
研究概览
简要总结
The purpose of this study is to look at the safety (what are the side effects) and efficacy (how well does it work) of Gadavist when used for taking images of the brain and spine. The results of the MRI with Gadavist Injection will be compared to the results of MR images taken without contrast and with the results of the MR images taken with OptiMARK.
详细描述
Safety issues are addressed in the Adverse Events section
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with either known or highly suspected focal areas of disruption of the blood brain barrier (BBB) (eg, primary and secondary tumors, focal inflammatory or demyelinating disorders) and/or abnormal vascularity in the CNS, who are scheduled to undergo a routine contrast-enhanced MRI of the CNS.
- •Patients with untreated brain tumors should constitute a minimum of 50% of the study population and patients with treated brain tumors will be limited to a maximum of 20% of the study population
排除标准
- •Is a female patient who is pregnant or nursing.
- •Is a female of childbearing potential and did not have a negative urine pregnancy test the same day as the administration of gadobutrol or comparator treatment.
- •Has received any investigational product within 30 days prior to enrolling in this study.
- •Has been previously enrolled in this study or any other study using gadobutrol.
- •Has any contraindication to the MRI examinations.
- •Has a history of severe allergic or anaphylactoid reaction to any allergen including drugs and contrast agents.
- •Has received any contrast agent within 24 hours prior to gadobutrol contrast administration, or is scheduled to receive any contrast agent within 72 hours after the gadobutrol study.
- •Is considered to be clinically unstable or his/her clinical course during the study period is unpredictable (eg, due to previous surgery, acute renal failure).
- •Has been treated with high dose (>55 cobalt Gy equivalent) photon radiation or global radiotherapy for CNS lesions at any time before entering the study.
- •Is scheduled to receive chemotherapy or radiotherapy during the study period.
- •Is expected or scheduled to have a change in any treatment or procedure between the comparator and gadobutrol MRIs that may alter their interpretation.
- •Is scheduled or is likely to require a biopsy or surgery within the 72 hours after the gadobutrol MRI procedure, or is scheduled for or has undergone such interventions between the comparator and gadobutrol studies.
- •Has severe cardiovascular disease.
- •Has any contraindication to OptiMARK according to the package insert.
- •Has more than 30 brain lesions detected by any prior imaging examination.
研究组 & 干预措施
Gadobutrol~0.03 mmol/kg BW (Gadavist, BAY86-4875)
Participant received one dose of 0.03 mmol/kg BW of Gadobutrol and one dose of 0.1 mmol/kg body weight (BW) of OptiMARK. The order in which the participants received Gadobutrol and OptiMARK was randomized. Gadobutrol was administered via a power injector at a rate of 5 mL/s followed by a 20 mL 0.9% saline flush at the same rate.
干预措施: Gadobutrol~0.03 mmol/kg BW (Gadavist, Gadovist, BAY86-4875) (Drug)
Gadobutrol~0.03 mmol/kg BW (Gadavist, BAY86-4875)
Participant received one dose of 0.03 mmol/kg BW of Gadobutrol and one dose of 0.1 mmol/kg body weight (BW) of OptiMARK. The order in which the participants received Gadobutrol and OptiMARK was randomized. Gadobutrol was administered via a power injector at a rate of 5 mL/s followed by a 20 mL 0.9% saline flush at the same rate.
干预措施: OptiMARK~0.1 mmol/kg BW (Drug)
Gadobutrol~0.1 mmol/kg BW (Gadavist, BAY86-4875)
Participant received one dose of 0.1 mmol/kg BW of Gadobutrol and one dose of 0.1 mmol/kg BW of OptiMARK. The order in which the participants received Gadobutrol and OptiMARK was randomized. Gadobutrol was administered via a power injector at a rate of 5 mL/s followed by a 20 mL 0.9% saline flush at the same rate.
干预措施: Gadobutrol~0.1 mmol/kg BW (Gadavist, Gadovist, BAY86-4875) (Drug)
Gadobutrol~0.1 mmol/kg BW (Gadavist, BAY86-4875)
Participant received one dose of 0.1 mmol/kg BW of Gadobutrol and one dose of 0.1 mmol/kg BW of OptiMARK. The order in which the participants received Gadobutrol and OptiMARK was randomized. Gadobutrol was administered via a power injector at a rate of 5 mL/s followed by a 20 mL 0.9% saline flush at the same rate.
干预措施: OptiMARK~0.1 mmol/kg BW (Drug)
Gadobutrol~0.3 mmol/kg BW (Gadavist, BAY86-4875)
Participant received one dose of 0.3 mmol/kg BW of Gadobutrol and one dose of 0.1 mmol/kg BW of OptiMARK. The order in which the participants received Gadobutrol and OptiMARK was randomized. Gadobutrol was administered via a power injector at a rate of 5 mL/s followed by a 20 mL 0.9% saline flush at the same rate.
干预措施: Gadobutrol~0.3 mmol/kg BW (Gadavist, Gadovist, BAY86-4875) (Drug)
Gadobutrol~0.3 mmol/kg BW (Gadavist, BAY86-4875)
Participant received one dose of 0.3 mmol/kg BW of Gadobutrol and one dose of 0.1 mmol/kg BW of OptiMARK. The order in which the participants received Gadobutrol and OptiMARK was randomized. Gadobutrol was administered via a power injector at a rate of 5 mL/s followed by a 20 mL 0.9% saline flush at the same rate.
干预措施: OptiMARK~0.1 mmol/kg BW (Drug)
结局指标
主要结局
Categorical Visualization Score (CVS)
时间窗: up to 2 hours after the injection of study medication
The primary visualization variables (number \[no.\] of lesions detected, border delineation, contrast enhancement, internal morphology) were condensed to a composite score (CVS). Each variable was considered a category; the CVS was calculated as: CVS=(No. of categories with increase over precontrast)-(No. of categories with decrease over precontrast). The possible outcomes of the CVS for a participant and each reader were in the range of - 3 to +4. The CVS was averaged across the 3 blinded readers, producing 1 mean CVS per participant. The higher the CVS, the more effective the treatment.
Difference in Number of Lesions Detected in Pre-contrast and Combined Pre-/Post-contrast MRI.
时间窗: up to 2 hours after the injection of study medication
Three blinded readers evaluated the unenhanced MRI sets and the combined unenhanced/gadobutrol-enhanced MRI sets to evaluate the number of lesions, which was then averaged to produce an average reader value.
Assessment of Lesion Contrast Enhancement
时间窗: up to 2 hours after the injection of study medication
The blinded readers assessed the degree of contrast enhancement for each lesion on a 4-point scale where 1 = no enhancement and 4 = excellent enhancement, which was then averaged to produce an average reader score.
Assessment of Border Delineation
时间窗: up to 2 hours after the injection of study medication
The blinded readers assessed the delineation for each lesion on a 4-point scale where 1 = none and 4 = excellent, which was then averaged to produce an average reader score.
Assessment of Internal Morphology
时间窗: up to 2 hours after the injection of study medication
The blinded readers assessed the degree of information available about internal morphology and structure for each lesion on a 3-point scale where 1 = poor and 3 = good, which was then averaged to produce an average reader score.
Contrast to Noise Ratio (CNR) Between White and Gray Matter With Gadobutrol Perfusion MRI
时间窗: up to 2 hours after the injection of study medication
CNR between white and gray matter in the perfusion imaging was defined as the signal intensity (SI) difference between white and gray matter divided by the standard deviation of the SI of white matter. An independent radiologist evaluated the gadobutrol-enhanced perfusion MRI for signal intensity.
次要结局
- Accuracy Comparison of Gadobutrol Doses - Detection of Matched Lesions: Blinded Reader 1(up to 2 hours after the injection of study medication)
- Accuracy Comparison of Gadobutrol Doses - Detection of Matched Lesions: Blinded Reader 2(up to 2 hours after the injection of study medication)
- Accuracy Comparison of Gadobutrol Doses - Detection of Matched Lesions: Blinded Reader 3(up to 2 hours after the injection of study medication)
- Accuracy Comparison of Gadobutrol Doses - Detection of Matched Enhanced Lesions: Blinded Reader 1(up to 2 hours after the injection of study medication)
- Accuracy Comparison of Gadobutrol Doses - Detection of Matched Enhanced Lesions: Blinded Reader 3(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Uncorrected Cerebral Blood Volume (CBV)) - Blinded Reader 2(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Corrected Cerebral Blood Volume (CBV)) - Blinded Reader 1(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Corrected Cerebral Blood Volume (CBV)) - Blinded Reader 2(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Corrected Cerebral Blood Volume (CBV)) - Blinded Reader 3(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Cerebral Blood Flow (CBF)) - Blinded Reader 1(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Cerebral Blood Flow (CBF)) - Blinded Reader 2(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Time to Peak (TTP)) - Blinded Reader 1(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Time to Peak (TTP)) - Blinded Reader 3(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Mean Transit Time (MTT)) - Blinded Reader 2(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Artifacts (Permeability Factor (PF)) - Blinded Reader(up to 2 hours after the injection of study medication)
- Evaluation of MRI Tumor Grade Agreement With Biopsy Results by Dose Group(up to 2 hours after the injection of study medication)
- Contrast to Noise Ratio (CNR) of Lesion/Gray Matter and Lesion/White Matter(up to 2 hours after the injection of study medication)
- Accuracy Comparison of Gadobutrol Doses - Detection of Matched Enhanced Lesions: Blinded Reader 2(up to 2 hours after the injection of study medication)
- Evaluation of the Diagnostic Confidence Based on Unenhanced MRI and Combined Unenhanced and Enhanced MRI(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Uncorrected Cerebral Blood Volume [CBV]) - Blinded Reader 1(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Uncorrected Cerebral Blood Volume (CBV)) - Blinded Reader 3(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Mean Transit Time (MTT)) - Blinded Reader 3(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Permeability Factor (PF) - Blinded Reader 1(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Permeability Factor (PF) - Blinded Reader 2(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Permeability Factor (PF)) - Blinded Reader 3(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Parameter Value (Uncorrected Cerebral Blood Volume (CBV)) - Independent Radiologist(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Parameter Value (Corrected Cerebral Blood Volume (CBV)) - Independent Radiologist(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Parameter Value (Cerebral Blood Flow (CBF)) - Independent Radiologist(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Parameter Value (Time to Peak (TTP)) - Independent Radiologist(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Parameter Value (Mean Transit Time (MTT)) - Independent Radiologist(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Parameter Value (Permeability Factor (PF)) - Independent Radiologist(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Artifacts (Uncorrected Cerebral Blood Volume (CBV)) - Blinded Reader(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Artifacts (Corrected Cerebral Blood Volume (CBV)) - Blinded Reader(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Artifacts (Cerebral Blood Flow (CBF)) - Blinded Reader(up to 2 hours after the injection of study medication)
- Evaluation of the Correct Diagnosis Following Gadobutrol-enhanced and Unenhanced MRI(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Cerebral Blood Flow (CBF)) - Blinded Reader 3(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Time to Peak (TTP)) - Blinded Reader 2(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Quality (Mean Transit Time (MTT)) - Blinded Reader 1(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Artifacts (Time to Peak (TTP)) - Blinded Reader(up to 2 hours after the injection of study medication)
- Evaluation of Perfusion Map Artifacts (Mean Transit Time (MTT)) - Blinded Reader(up to 2 hours after the injection of study medication)
