Diagnostic Validity of [18F]GP1 PET for Diagnosing Acute Deep Vein Thrombosis
Primary Purpose
Venous Thrombosis
Status
Recruiting
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
[18F]GP1 positron emission tomography/computed tomography
Sponsored by
About this trial
This is an interventional diagnostic trial for Venous Thrombosis focused on measuring Positron-Emission Tomography, Ultrasonography, Platelet Activation, Data Accuracy
Eligibility Criteria
Inclusion Criteria:
A subject will be enrolled if he/she meets all of the following inclusion criteria.
- Subject is aged between 19 and 79 years and male or female of any race/ethnicity.
- Patient has a first episode of clinically suspected acute deep vein thrombosis of the lower extremity within 14 days prior to the planned [18F]GP1 PET/CT.
- The pretest probability for deep vein thrombosis is likely by two-level Wells score (≥ 2), or the D-dimer test is positive.
- Subject underwent or is scheduled to undergo venous ultrasonography within 7 days of [18F]GP1 PET/CT:
- Patient has Eastern Cooperative Oncology Group performance status of 0-2 at time of screening.
Exclusion Criteria:
A subject is to be excluded from the study if he/she does not fulfill the inclusion criteria or display any of the following criteria.
- Subject or subject's legally acceptable representative does not provide written informed consent.
- Subject has a previous history of objectively diagnosed deep vein thrombosis or pulmonary embolism.
- Subject has symptoms of acute deep vein thrombosis lasting for longer than 4 weeks at time of screening.
- Subject is suspected to have pulmonary embolism with shock or hypotension
- Subject had pretreatment with glycoprotein IIb/IIIa inhibitors within 15 days before the administration of [18F]GP1.
- Anticancer chemotherapy is scheduled to be given to subject before or within 24 hours after administration of [18F]GP1.
- Female subject is pregnant or nursing. Exclusion of the possibility of pregnancy is made by one of the following: 1) woman is physiologically post-menopausal (cessation of menses for more than 2 years), or 2) woman is surgically sterile (has had a documented bilateral oophorectomy and/or documented hysterectomy). If the woman is of childbearing potential, a urine pregnancy test performed within 24 hours immediately prior to administration of [18F]GP1 has to be negative and the women is advised to apply contraceptive measures during her participation in this study.
- Subject has concurrent severe and/or uncontrolled and/or unstable medical disease other than cancer (e.g. congestive heart failure, acute myocardial infarction, severe pulmonary disease, chronic renal or hepatic disease) which could compromise participation in the study in the judgment of the investigator.
- Subject is a relative of the investigator, student of the investigator or otherwise dependent.
- Subject has been involved in another investigative clinical study involving administration of an investigational drug from preceding 4 weeks prior to the study enrollment or within 24 hours after administration of [18F]GP1.
- Subject has been previously included in this study.
- Subject has any other condition or personal circumstances that, in the judgment of the investigator, might make collection of complete data difficult or impossible.
- Additive-related precautions: This investigational product contains sodium bisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.
Sites / Locations
- Asan Medical CenterRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Deep vein thrombosis
Arm Description
Subjects with Deep vein thrombosis will receive a single IV injection of [18F] GP1
Outcomes
Primary Outcome Measures
Sensitivity and specificity of qualitative [18F]GP1 PET/CT interpretation for the diagnosis of patients with acute proximal deep vein thrombosis
Sensitivity = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; specificity = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100.
Secondary Outcome Measures
Area under the receiver operating characteristic curve, sensitivity and specificity of quantitative [18F]GP1 PET/CT interpretation for the diagnosis of patients with acute proximal deep vein thrombosis
Area under the receiver operating characteristic curve. Sensitivity = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; specificity = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100.
Positive and negative percent agreement between qualitative [18F]GP1 PET/CT and ultrasonography interpretation for the diagnosis of patients with acute distal deep vein thrombosis
Positive percent agreement = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; negative percent agreement = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100
Positive and negative percent agreement between quantitative [18F]GP1 PET/CT and ultrasonography interpretation for the diagnosis of patients with acute distal deep vein thrombosis
Positive percent agreement = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; negative percent agreement = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100
Intra- and inter-reader variability of qualitative [18F]GP1 PET/CT interpretation for the assessment of acute proximal and distal deep vein thrombosis
kappa statistic
Detection rate of pulmonary embolism with [18F]GP1 PET/CT
The number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; negative percent agreement = (the number of all patients who underwent [18F]GP1 PET/CT
Percent fraction of unmetabolized [18F]GP1 in plasma
Percentage
Incidence of treatment emergent adverse events
Number of participants with treatment emergent adverse events graded by the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0)
Blood pressure
mmHg
Heart rate
beats/minute
Body temperature
Celsius
Physical examination
The limited physical examination will comprise: general appearance, skin, neck, lungs, heart, abdomen, and a limited neurological examination (mental status, motor strength and sensor perception).
Blood tests for safety
The clinical laboratory safety parameters to be assessed are as follows: glutamate pyruvate transaminase, glutamate-oxaloacetate transaminase, alkaline phosphatase, total bilirubin, creatinine, potassium, sodium, total protein, blood urea nitrogen, albumin.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04156230
Brief Title
Diagnostic Validity of [18F]GP1 PET for Diagnosing Acute Deep Vein Thrombosis
Official Title
A Phase 2, Open-label, Non-randomized, Single Center Study to Assess Diagnostic Validity of [18F]GP1 Positron Emission Tomography/Computed Tomography for Acute Deep Vein Thrombosis of the Lower Extremities in Symptomatic Patients
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 13, 2020 (Actual)
Primary Completion Date
December 31, 2025 (Anticipated)
Study Completion Date
December 31, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Dae Hyuk Moon
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The first-in-human study of [18F]GP1 positron emission tomography/computed tomography (PET/CT) showed that [18F]GP1 is safe and promising novel PET tracer for imaging acute venous thromboembolism with favorable biodistribution and pharmacokinetics in patients. The goal of this phase 2 study is to evaluate whether [18F]GP1 PET/CT is sensitive and specific for the diagnosis of acute deep vein thrombosis in the appropriate patient population and clinical setting. This study will provide preliminary evidence of efficacy and expand the safety database in a larger group of patients who were suspected of having acute deep vein thrombosis. This study will further optimize image acquisition techniques, and develop methods and criteria by which [18F]GP1 PET/CT will be evaluated. Other critical questions about [18F]GP1 biodistribution including [18F]GP1 uptake in pulmonary and systemic arteries will be evaluated.
Detailed Description
This study is an open label, non-randomized, single center, intervention study. An estimated 63 symptomatic subjects with a pretest score of deep vein thrombosis likely (Wells score ≥ 2) or a positive D-dimer test will receive [18F]GP1 PET/CT to evaluate the diagnostic validity of [18F]GP1 PET/CT for detecting deep vein thrombosis foci in lower extremities.
The study comprises 3 periods: screening, treatment, and follow-up. The screening period starts with the patient's signature on the informed consent form and ends with assignment to treatment that is inclusion of the subject for treatment. The treatment period starts with baseline measurements, and ends with the last measurement/procedure on the day of intravenous injection of 250 MBq of [18F]GP1. The follow-up period contains the end-of-study interview. Key measurement is the PET/CT image acquisition about 120 minutes after the single injection of [18F]GP1 This study includes venous ultrasonography of deep vein thrombosis as a valid reference standard. [18F]GP1 PET/CT will be assessed qualitatively and quantitatively by three experienced readers.
This study will be monitored regularly by a clinical research associate from the sponsor or a designated contract research organization. Data quality and study integrity will be assessed. The investigator will document the items that are required to evaluate the study in the subject files. Data required according to this protocol are to be recorded on the case report forms provided by the sponsor as soon as possible.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Venous Thrombosis
Keywords
Positron-Emission Tomography, Ultrasonography, Platelet Activation, Data Accuracy
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Symptomatic subjects with a pretest score of deep vein thrombosis likely (Wells score ≥ 2) or a positive D-dimer test will receive [18F]GP1 PET/CT.
Masking
None (Open Label)
Allocation
N/A
Enrollment
63 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Deep vein thrombosis
Arm Type
Experimental
Arm Description
Subjects with Deep vein thrombosis will receive a single IV injection of [18F] GP1
Intervention Type
Drug
Intervention Name(s)
[18F]GP1 positron emission tomography/computed tomography
Intervention Description
A radioactive dose of 250 MBq of the study drug with a total quantity of ≤ 10 µg will be administered as slow intravenous bolus injection over up to 60 seconds. PET/CT examinations will be performed at 120 ± 15 min after the administration of [18F]GP1.
Primary Outcome Measure Information:
Title
Sensitivity and specificity of qualitative [18F]GP1 PET/CT interpretation for the diagnosis of patients with acute proximal deep vein thrombosis
Description
Sensitivity = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; specificity = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100.
Time Frame
within 7 days of [18F]GP1 PET/CT
Secondary Outcome Measure Information:
Title
Area under the receiver operating characteristic curve, sensitivity and specificity of quantitative [18F]GP1 PET/CT interpretation for the diagnosis of patients with acute proximal deep vein thrombosis
Description
Area under the receiver operating characteristic curve. Sensitivity = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; specificity = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100.
Time Frame
Within 7 days of [18F]GP1 PET/CT
Title
Positive and negative percent agreement between qualitative [18F]GP1 PET/CT and ultrasonography interpretation for the diagnosis of patients with acute distal deep vein thrombosis
Description
Positive percent agreement = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; negative percent agreement = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100
Time Frame
Within 7 days of [18F]GP1 PET/CT
Title
Positive and negative percent agreement between quantitative [18F]GP1 PET/CT and ultrasonography interpretation for the diagnosis of patients with acute distal deep vein thrombosis
Description
Positive percent agreement = (the number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; negative percent agreement = (the number of [18F]GP1 PET/CT-negative patients divided by the number of ultrasonography-negative patients) x 100
Time Frame
Within 7 days of [18F]GP1 PET/CT
Title
Intra- and inter-reader variability of qualitative [18F]GP1 PET/CT interpretation for the assessment of acute proximal and distal deep vein thrombosis
Description
kappa statistic
Time Frame
Within 1 day of [18F]GP1 PET/CT
Title
Detection rate of pulmonary embolism with [18F]GP1 PET/CT
Description
The number of [18F]GP1 PET/CT-positive patients divided by the number of ultrasonography-positive patients) x 100; negative percent agreement = (the number of all patients who underwent [18F]GP1 PET/CT
Time Frame
Within 1 day of [18F]GP1 PET/CT
Title
Percent fraction of unmetabolized [18F]GP1 in plasma
Description
Percentage
Time Frame
Within 1 day of [18F]GP1 PET/CT
Title
Incidence of treatment emergent adverse events
Description
Number of participants with treatment emergent adverse events graded by the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0)
Time Frame
From the administration of [18F]GP1 to one day after [18F]GP1 PET/CT
Title
Blood pressure
Description
mmHg
Time Frame
Pre-treatment and three hours after the administration of [18F]GP1
Title
Heart rate
Description
beats/minute
Time Frame
Pre-treatment and three hours after the administration of [18F]GP1
Title
Body temperature
Description
Celsius
Time Frame
Pre-treatment and three hours after the administration of [18F]GP1
Title
Physical examination
Description
The limited physical examination will comprise: general appearance, skin, neck, lungs, heart, abdomen, and a limited neurological examination (mental status, motor strength and sensor perception).
Time Frame
Pre-treatment and three hours after the administration of [18F]GP1
Title
Blood tests for safety
Description
The clinical laboratory safety parameters to be assessed are as follows: glutamate pyruvate transaminase, glutamate-oxaloacetate transaminase, alkaline phosphatase, total bilirubin, creatinine, potassium, sodium, total protein, blood urea nitrogen, albumin.
Time Frame
Pre-treatment and three hours after the administration of [18F]GP1
10. Eligibility
Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
A subject will be enrolled if he/she meets all of the following inclusion criteria.
Subject is aged between 19 and 79 years and male or female of any race/ethnicity.
Patient has a first episode of clinically suspected acute deep vein thrombosis of the lower extremity within 14 days prior to the planned [18F]GP1 PET/CT.
The pretest probability for deep vein thrombosis is likely by two-level Wells score (≥ 2), or the D-dimer test is positive.
Subject underwent or is scheduled to undergo venous ultrasonography within 7 days of [18F]GP1 PET/CT:
Patient has Eastern Cooperative Oncology Group performance status of 0-2 at time of screening.
Exclusion Criteria:
A subject is to be excluded from the study if he/she does not fulfill the inclusion criteria or display any of the following criteria.
Subject or subject's legally acceptable representative does not provide written informed consent.
Subject has a previous history of objectively diagnosed deep vein thrombosis or pulmonary embolism.
Subject has symptoms of acute deep vein thrombosis lasting for longer than 4 weeks at time of screening.
Subject is suspected to have pulmonary embolism with shock or hypotension
Subject had pretreatment with glycoprotein IIb/IIIa inhibitors within 15 days before the administration of [18F]GP1.
Anticancer chemotherapy is scheduled to be given to subject before or within 24 hours after administration of [18F]GP1.
Female subject is pregnant or nursing. Exclusion of the possibility of pregnancy is made by one of the following: 1) woman is physiologically post-menopausal (cessation of menses for more than 2 years), or 2) woman is surgically sterile (has had a documented bilateral oophorectomy and/or documented hysterectomy). If the woman is of childbearing potential, a urine pregnancy test performed within 24 hours immediately prior to administration of [18F]GP1 has to be negative and the women is advised to apply contraceptive measures during her participation in this study.
Subject has concurrent severe and/or uncontrolled and/or unstable medical disease other than cancer (e.g. congestive heart failure, acute myocardial infarction, severe pulmonary disease, chronic renal or hepatic disease) which could compromise participation in the study in the judgment of the investigator.
Subject is a relative of the investigator, student of the investigator or otherwise dependent.
Subject has been involved in another investigative clinical study involving administration of an investigational drug from preceding 4 weeks prior to the study enrollment or within 24 hours after administration of [18F]GP1.
Subject has been previously included in this study.
Subject has any other condition or personal circumstances that, in the judgment of the investigator, might make collection of complete data difficult or impossible.
Additive-related precautions: This investigational product contains sodium bisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jae Eun Kim, RN
Phone
+82-2-3010-4572
Email
kje0216@amc.seoul.kr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dae Hyuk Moon, MD
Organizational Affiliation
Asan Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
05505
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jae Eun Kim, RN
Phone
+82-2-3010-4572
Email
kje0216@amc.seoul.kr
First Name & Middle Initial & Last Name & Degree
Dae Hyuk Moon, MD
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
28302764
Citation
Lohrke J, Siebeneicher H, Berger M, Reinhardt M, Berndt M, Mueller A, Zerna M, Koglin N, Oden F, Bauser M, Friebe M, Dinkelborg LM, Huetter J, Stephens AW. 18F-GP1, a Novel PET Tracer Designed for High-Sensitivity, Low-Background Detection of Thrombi. J Nucl Med. 2017 Jul;58(7):1094-1099. doi: 10.2967/jnumed.116.188896. Epub 2017 Mar 16.
Results Reference
background
PubMed Identifier
29959214
Citation
Kim C, Lee JS, Han Y, Chae SY, Jin S, Sung C, Son HJ, Oh SJ, Lee SJ, Oh JS, Cho YP, Kwon TW, Lee DH, Jang S, Kim B, Koglin N, Berndt M, Stephens AW, Moon DH. Glycoprotein IIb/IIIa receptor imaging with 18F-GP1 positron emission tomography for acute venous thromboembolism: an open-label, non-randomized, first-in-human phase 1 study. J Nucl Med. 2018 Jun 29;60(2):244-9. doi: 10.2967/jnumed.118.212084. Online ahead of print.
Results Reference
background
PubMed Identifier
30617563
Citation
Chae SY, Kwon TW, Jin S, Kwon SU, Sung C, Oh SJ, Lee SJ, Oh JS, Han Y, Cho YP, Lee N, Kim JY, Koglin N, Berndt M, Stephens AW, Moon DH. A phase 1, first-in-human study of 18F-GP1 positron emission tomography for imaging acute arterial thrombosis. EJNMMI Res. 2019 Jan 7;9(1):3. doi: 10.1186/s13550-018-0471-8.
Results Reference
background
PubMed Identifier
31330411
Citation
Lee N, Oh I, Chae SY, Jin S, Oh SJ, Lee SJ, Koglin N, Berndt M, Stephens AW, Oh JS, Moon DH. Radiation dosimetry of [18F]GP1 for imaging activated glycoprotein IIb/IIIa receptors with positron emission tomography in patients with acute thromboembolism. Nucl Med Biol. 2019 May-Jun;72-73:45-48. doi: 10.1016/j.nucmedbio.2019.07.003. Epub 2019 Jul 10.
Results Reference
background
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Diagnostic Validity of [18F]GP1 PET for Diagnosing Acute Deep Vein Thrombosis
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