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Comparison of 129Xe MRI With 19F MRI in CF Lung Disease

Primary Purpose

Cystic Fibrosis

Status
Completed
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hyperpolarized Xenon gas
PFP
Sponsored by
University of North Carolina, Chapel Hill
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Cystic Fibrosis focused on measuring imaging, hyperpolarized, perfluorinated, MRI, lung

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

Subjects with CF must meet all of the following inclusion criteria to be eligible for enrollment:

  1. Subjects must be at least 18 years of age;
  2. Non-smokers (<10 pack year history and no active smoking in the past year);
  3. Diagnosis of cystic fibrosis as via standard sweat chloride/phenotypic features/genotyping
  4. Stable lung disease as evidenced by no change in respiratory medications or change in forced expiratory volume in 1 second (FEV1) of >15% from baseline over the preceding 4 weeks prior to enrollment
  5. Baseline FEV1 >70% of predicted.
  6. No use of supplemental oxygen
  7. Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the trial
  8. Subjects must be willing and able to comply with scheduled visits and other trial procedures.

Subjects without CF must meet all of the following inclusion criteria to be eligible for enrollment:

  1. Subjects must be at least 18 years of age;
  2. Non-smokers (<10 pack year history and no active smoking in the past year);
  3. Baseline FEV1 >70% of predicted.
  4. No use of supplemental oxygen or clinically significant lung disease
  5. Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the trial
  6. Subjects must be willing and able to comply with scheduled visits and other trial procedures.

Exclusion Criteria:

  1. Active or past smokers with less than 1 years since quitting or >10 pack-year smoking history
  2. Co-existent asthma (as evidenced by either clinical diagnosis, chronic oral steroid use, or marked broncho-reactivity on pulmonary function testing)
  3. Unable to undergo a 3.0-Tesla MRI exam of the lungs and chest because of contraindications including

    • Occupation (past or present) of machinist, welder, grinder;
    • Injury to the eye involving a metallic object
    • Injury to the body by a metallic object (bullet, BB, shrapnel)
    • Presence of a cardiac pacemaker or defibrillator
    • Presence of aneurysm clips
    • Presence of carotid artery vascular clamp
    • Presence of neurostimulator
    • Presence of insulin or infusion pump
    • Presence of implanted drug infusion device that is not known to be MRI compatible (i.e., was placed outside of UNCH or is older than 10 years)
    • Bone growth or fusion simulator
    • Presence of cochlear, otologic or ear implant
    • Any type of prosthesis (eye, penile, etc.)
    • Artificial limb or joint
    • Non-removable electrodes (on body, head or brain)
    • Intravascular stents, filters or coils
    • Shunt (spinal or intraventricular)
    • Swan-ganz catheter
    • Any implant held in place by a magnet
    • Transdermal delivery system (e.g. Nitro)
    • Intrauterine Device (IUD) or diaphragm
    • Tattooed makeup (eyeliner, lips, etc.) or tattoos covering >25% of body surface area
    • Body piercings (MUST BE REMOVED BEFORE MRI)
    • Any metal fragments
    • Internal pacing wires
    • Metal or wire mesh implants
    • Hearing aid (REMOVE BEFORE MRI)
    • Dentures (REMOVE BEFORE MRI)
    • Claustrophobia
  4. Unable to tolerate inhalation of gas mixture
  5. Any changes in medications that may affect CF lung disease in the past 14 days, including any experimental therapies
  6. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with trial participation or may interfere with the interpretation of trial results and, in the judgment of the investigator, would make the subject inappropriate for entry into this trial.
  7. Pregnancy; women of childbearing potential must have a confirmed negative urine pregnancy test on the day of the MRI scan, prior to the MRI scan.

Sites / Locations

  • The University of North Carolina at Chapel Hill

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

129Xe MRI

19F MRI with PFP

Arm Description

Participants will self-administer hyperpolarized xenon gas via inhalation prior to the investigators acquiring MRI images. MRI imaging will be taken during approximately 15-second breath-holds. After the MRI is complete, participant performs spirometry maneuvers in a room outside the magnet. Once a minimum of 15 minutes has elapsed since leaving the MRI scanner, the participant will return to the MRI scanner, where the second phase of the study will occur. PFP gas will be administered using a full-face mask during the MRI. Images are acquired during 12-second breath-hold after every 3rd breath.

PFP gas will be administered using a full-face mask during the MRI. Images are acquired during 12-second breath-hold after every 3rd breath. After the MRI is complete, participant performs spirometry maneuvers in a room outside the magnet. Once a minimum of 15 minutes has elapsed since leaving the MRI scanner, the participant returns to the MRI scanner, where he/she will self-administer hyperpolarized xenon gas prior to acquiring MRI images. MRI imaging will be taken during approximately 15-second breath-holds.

Outcomes

Primary Outcome Measures

Volume of unventilated lung area after a single 129Xe inhalation and after each inhalation cycle with PFP
Primary comparison will be the VDP with Xenon (single breath) and after first PFP inhalation cycle (3 breaths of PFP)

Secondary Outcome Measures

Signal-to-noise (SNR) of each modality
Assessment of the quality of signal achieved with each modality
Rate constant describing wash-in and wash-out of PFP
change in ventilated areas of the lung over time when administered PFP
Correlation between VDP identified by each modality and spirometry and Lung Clearance Index (LCI)
Comparison of VDP to two standard metrics of lung function, spirometry and LCI

Full Information

First Posted
March 23, 2018
Last Updated
January 21, 2021
Sponsor
University of North Carolina, Chapel Hill
Collaborators
Cystic Fibrosis Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT03482960
Brief Title
Comparison of 129Xe MRI With 19F MRI in CF Lung Disease
Official Title
Comparison of 129Xe MRI With 19F MRI in CF Lung Disease
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
May 29, 2018 (Actual)
Primary Completion Date
April 9, 2019 (Actual)
Study Completion Date
April 10, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of North Carolina, Chapel Hill
Collaborators
Cystic Fibrosis Foundation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is designed to compare the capabilities of two novel imaging techniques: polarized perfluorinated gas mixed with oxygen, and hyperpolarized xenon mixed with N2 to detect changes in lung ventilation using MRI.
Detailed Description
The goal of this study is to compare the capabilities of two novel imaging techniques: conventional 'thermally' polarized perfluorinated gases (perfluoropropane, or PFP) mixed with oxygen, and hyperpolarized xenon (129Xe) mixed with N2 to detect changes in lung ventilation using magnetic resonance imaging (MRI). Although considerable work has been done internationally with hyperpolarized xenon MRI, the low availability and high cost of this technique is limiting. Perfluorinated gas MRI is an alternative that may in fact be a suitable, simpler alternative. PFP is commercially availability in large quantities, which allows multiple breath studies and thus provides the ability to analyze gas wash-in and wash-out kinetics. These endpoints may improve the investigators ability to detect ventilation abnormalities beyond the traditional "ventilation defect percentage" parameter obtained with 129Xe MRI. The commercial availability of PFP and lack of need for onsite hyperpolarization may also facilitate the transfer of this technology to other centers for the conduct of multicenter studies. The investigators hypothesize that 19F MRI will not be inferior to hyperpolarized xenon MRI in detection of ventilation defect percentages (VDP).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis
Keywords
imaging, hyperpolarized, perfluorinated, MRI, lung

7. Study Design

Primary Purpose
Other
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
129Xe MRI
Arm Type
Experimental
Arm Description
Participants will self-administer hyperpolarized xenon gas via inhalation prior to the investigators acquiring MRI images. MRI imaging will be taken during approximately 15-second breath-holds. After the MRI is complete, participant performs spirometry maneuvers in a room outside the magnet. Once a minimum of 15 minutes has elapsed since leaving the MRI scanner, the participant will return to the MRI scanner, where the second phase of the study will occur. PFP gas will be administered using a full-face mask during the MRI. Images are acquired during 12-second breath-hold after every 3rd breath.
Arm Title
19F MRI with PFP
Arm Type
Experimental
Arm Description
PFP gas will be administered using a full-face mask during the MRI. Images are acquired during 12-second breath-hold after every 3rd breath. After the MRI is complete, participant performs spirometry maneuvers in a room outside the magnet. Once a minimum of 15 minutes has elapsed since leaving the MRI scanner, the participant returns to the MRI scanner, where he/she will self-administer hyperpolarized xenon gas prior to acquiring MRI images. MRI imaging will be taken during approximately 15-second breath-holds.
Intervention Type
Drug
Intervention Name(s)
Hyperpolarized Xenon gas
Other Intervention Name(s)
129Xe
Intervention Description
Hyperpolarized Xenon gas Hyperpolarized mixture (750ml HP 129Xe and 250ml nitrogen) Administration: By mouthpiece attached to a single use Tedlar bag. Dosage: 750 mL of the 129Xe mixture up to, but not exceeding, four doses of the 129Xe. Frequency: 10-minute interval between doses.
Intervention Type
Drug
Intervention Name(s)
PFP
Other Intervention Name(s)
Perfluoropropane gas (C3F8); 19F
Intervention Description
Inhaled PFP, a gaseous contrast agent (79% PFP; 21% O2, pre-mixed, medical grade gas) Administration: Full-face disposable ventilation mask and a standard Douglas Bag system. Dosage: Two controlled breaths of the contrast gas followed by a full breath and a 12-second breath-hold and scan for image acquisition. Frequency: Repeated 5 times followed by an identical five cycles with room air to ensure PFP gas wash-out has occurred.
Primary Outcome Measure Information:
Title
Volume of unventilated lung area after a single 129Xe inhalation and after each inhalation cycle with PFP
Description
Primary comparison will be the VDP with Xenon (single breath) and after first PFP inhalation cycle (3 breaths of PFP)
Time Frame
1 hour
Secondary Outcome Measure Information:
Title
Signal-to-noise (SNR) of each modality
Description
Assessment of the quality of signal achieved with each modality
Time Frame
20 minutes
Title
Rate constant describing wash-in and wash-out of PFP
Description
change in ventilated areas of the lung over time when administered PFP
Time Frame
15 minutes
Title
Correlation between VDP identified by each modality and spirometry and Lung Clearance Index (LCI)
Description
Comparison of VDP to two standard metrics of lung function, spirometry and LCI
Time Frame
2 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subjects with CF must meet all of the following inclusion criteria to be eligible for enrollment: Subjects must be at least 18 years of age; Non-smokers (<10 pack year history and no active smoking in the past year); Diagnosis of cystic fibrosis as via standard sweat chloride/phenotypic features/genotyping Stable lung disease as evidenced by no change in respiratory medications or change in forced expiratory volume in 1 second (FEV1) of >15% from baseline over the preceding 4 weeks prior to enrollment Baseline FEV1 >70% of predicted. No use of supplemental oxygen Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the trial Subjects must be willing and able to comply with scheduled visits and other trial procedures. Subjects without CF must meet all of the following inclusion criteria to be eligible for enrollment: Subjects must be at least 18 years of age; Non-smokers (<10 pack year history and no active smoking in the past year); Baseline FEV1 >70% of predicted. No use of supplemental oxygen or clinically significant lung disease Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the trial Subjects must be willing and able to comply with scheduled visits and other trial procedures. Exclusion Criteria: Active or past smokers with less than 1 years since quitting or >10 pack-year smoking history Co-existent asthma (as evidenced by either clinical diagnosis, chronic oral steroid use, or marked broncho-reactivity on pulmonary function testing) Unable to undergo a 3.0-Tesla MRI exam of the lungs and chest because of contraindications including Occupation (past or present) of machinist, welder, grinder; Injury to the eye involving a metallic object Injury to the body by a metallic object (bullet, BB, shrapnel) Presence of a cardiac pacemaker or defibrillator Presence of aneurysm clips Presence of carotid artery vascular clamp Presence of neurostimulator Presence of insulin or infusion pump Presence of implanted drug infusion device that is not known to be MRI compatible (i.e., was placed outside of UNCH or is older than 10 years) Bone growth or fusion simulator Presence of cochlear, otologic or ear implant Any type of prosthesis (eye, penile, etc.) Artificial limb or joint Non-removable electrodes (on body, head or brain) Intravascular stents, filters or coils Shunt (spinal or intraventricular) Swan-ganz catheter Any implant held in place by a magnet Transdermal delivery system (e.g. Nitro) Intrauterine Device (IUD) or diaphragm Tattooed makeup (eyeliner, lips, etc.) or tattoos covering >25% of body surface area Body piercings (MUST BE REMOVED BEFORE MRI) Any metal fragments Internal pacing wires Metal or wire mesh implants Hearing aid (REMOVE BEFORE MRI) Dentures (REMOVE BEFORE MRI) Claustrophobia Unable to tolerate inhalation of gas mixture Any changes in medications that may affect CF lung disease in the past 14 days, including any experimental therapies Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with trial participation or may interfere with the interpretation of trial results and, in the judgment of the investigator, would make the subject inappropriate for entry into this trial. Pregnancy; women of childbearing potential must have a confirmed negative urine pregnancy test on the day of the MRI scan, prior to the MRI scan.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jennifer Goralski, MD
Organizational Affiliation
University of North Carolina, Chapel Hill
Official's Role
Principal Investigator
Facility Information:
Facility Name
The University of North Carolina at Chapel Hill
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32770779
Citation
McCallister A, Chung SH, Antonacci M, Z Powell M, Ceppe AS, Donaldson SH, Lee YZ, Branca RT, Goralski JL. Comparison of single breath hyperpolarized 129 Xe MRI with dynamic 19 F MRI in cystic fibrosis lung disease. Magn Reson Med. 2021 Feb;85(2):1028-1038. doi: 10.1002/mrm.28457. Epub 2020 Aug 8.
Results Reference
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Comparison of 129Xe MRI With 19F MRI in CF Lung Disease

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