AzTrials
AzTrials

NeoplasmsNCT03553368

Chest Imaging of Lung Nodule(s) Under High-frequency Non-invasive Ventilation (HF-NIV)

A study testing HF-NIV-MR, HF-NIV-PET and MR in people with Neoplasms, run by University of Lausanne Hospitals at 1 site in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Imaging of chest disorders is mainly achieved by using computed tomography. This is especially the case for detection, morphologic assessment and followup of pulmonary nodules. A positron emission tomography (PET) /CT may be additionally required for lung nodule management in some conditions including a size greater… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Neoplasms
What is being tested?
HF-NIV-MR, HF-NIV-PET and MR
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteSwitzerland
Study dates
14 Jun 2018to 16 Mar 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Validated Informed Consent as documented by signature (Appendix Informed Consent Form)
  • Depending on study arm:
  • Good health (step 1 and 1 bis only) or
  • Patients with at least 1 non calcified pulmonary nodule of at least 4 mm, whatever its texture (solid, sub-solid) and nature (benign, indeterminate or malignant), just discovered or in a follow-up context (step 2 only)
  • Age ≥ 18 years

Who cannot join

  • Previous or current disorder that might interfere with performance or safety of study procedures
  • Age <18 years
  • Any contraindication to MRI (pace makers, neuro-stimulators, some implantable devices, some metallic implants, claustrophobia)
  • Any contraindication to a positive airway pressure therapy (claustrophobia, fracture of the skull, right heart failure), (step 1 bis)
  • Children, adolescents and adults with incapacities
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant
Show all 17Show fewer
  • Pregnant or breastfeeding women
  • Chronic obstructive pulmonary disease (COPD) or asthma with severe obstruction
  • Severe obstructive patients (FEV1<50% of predicted value)
  • Hypoxemia (SaO2<94% AA)
  • History or physical signs of right heart failure
  • History or physical signs of right or left cardiac failure
  • History or physical signs of pulmonary hypertension
  • History or physical signs of active coronary artery disease
  • Pulmonary graft
  • Immunocompromized patients
  • Enrollment of the investigator, his/her family members, employees and other dependent persons

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • University Hospitals

    Lausanne, 1011

Other trials in Switzerland

About this study

Imaging of chest disorders is mainly achieved by using computed tomography. This is especially the case for detection, morphologic assessment and followup of pulmonary nodules. A positron emission tomography (PET) /CT may be additionally required for lung nodule management in some conditions including a size greater than 8 mm with morphologic or growing characteristics suspicious of malignancy. Magnetic Resonance Imaging (MRI) represents however an interesting alternative diagnostic radiation-free method, in particular owing to the recent development of sequences dedicated to lung parenchyma analysis. A major limitation remains the control of respiratory artefacts.

High Frequency non-invasive ventilation, HF-NIV, has the potential to allow chest stabilization and is currently used in the department of radio-oncology at the Lausanne University Hospital. It has been recently applied to perform MRI and PET examinations at end inspiration during an "apnea " generated by the system. Continuous periods of respiratory stabilization of several minutes at end-inspiration are thus obtained, allowing prolonged MR and PET acquisitions with improvement of image quality as observed in our preliminary studies (Beigelman-Aubry et al., Prior et al.). Interestingly, the lung volume explored by using this ventilation technique is similar to that of CT studies, conversely to respiratory gated MR sequences which are currently performed at end-expiration, this potentially generating underevaluation of lung disorders especially at lung bases.

Read more

The present project aims to determine the impact of HF-NIV in the management of patients with pulmonary nodule(s). After a first step of optimization of acquisition parameters of HF-NIV-MR in healthy volunteers, the performances of MRI and PET/CT (when required) under this ventilation technique will be compared to the current method(s) of reference in cases of pulmonary nodule(s) (CT scan and PET when required) and histological data when available. All MRI and PET/CT (when required) acquisitions will be performed without the ventilation technique, as used in current practice, and with it.

The project was completed with an amendment to investigate MRI under continuous positive airway pressure (CPAP). The MR-CPAP combination will be evaluated with optimized parameters in healthy volunteers and compared to free-breathing acquisitions without any device.

Conditions
Neoplasms
Being tested
HF-NIV-MR, HF-NIV-PET, MR, PET/CT breath hold, CPAP-MR
Keywords
lung nodules
Medical subject headings
Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • HF-NIV-MRDiagnostic test

    MRI data will be acquired with the use of HF-NIV.

  • HF-NIV-PETDiagnostic test

    PET data will be acquired with the use of HF-NIV.

  • MRDiagnostic test

    MRI data will be acquired without the use of any device as a reference.

  • PET/CT breath holdDiagnostic test

    PET/CT data will be acquired in inspiratory breath hold without the use of HF-NIV.

  • CPAP-MRDiagnostic test

    MRI data will be acquired with the use of CPAP.

Study groups in NCT03553368
Study groupRoleWhat they receive
Step 1: Healthy volunteersExperimentalExperimental intervention: MRI data will be acquired with the use of HF-NIV (HF-NIV-MR). Control intervention: MRI data will be acquired without the use of HF-NIV, as a reference (MR).
Receives: Diagnostic Test: HF-NIV-MR; Diagnostic Test: MR
Step 2: Patients (arm A)ExperimentalExperimental intervention: MRI data will be acquired with the use of HF-NIV (HF-NIV-MR). Control intervention: MRI data will also be acquired without the use of HF-NIV, as a reference (MR). The clinically prescribed CT will be the gold standard.
Receives: Diagnostic Test: HF-NIV-MR; Diagnostic Test: MR
Step 2: Patients (arm B)ExperimentalExperimental intervention: PET/CT data will be acquired with the use of HF-NIV (HF-NIV-PET). MRI data will be acquired with the use of HF-NIV (HF-NIV-MR). PET/CT data will be acquired in inspiratory breath hold without the use of HF-NIV (PET/CT breath hold). Control intervention: Data from the clinically indicated PET/CT acquisition will be used as reference. MRI data will also be acquired without the use of HF-NIV, as a reference (MR). Histological data will be used when available.
Receives: Diagnostic Test: HF-NIV-MR; Diagnostic Test: HF-NIV-PET; Diagnostic Test: MR; Diagnostic Test: PET/CT breath hold
Step 1 bis: Healthy volunteersExperimentalExperimental intervention: MRI data will be acquired with the use of CPAP (CPAP-MR). Control intervention: MRI data will be acquired without the use of CPAP, as a reference (MR).
Receives: Diagnostic Test: MR; Diagnostic Test: CPAP-MR

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Image quality, step 1: Healthy volunteers, sharpness of vessels

    Sharpness of interfaces of vessels will be scored on a discrete scale as 1=blurred; 2=intermediate; 3=sharp. This will determine the adequate choice of MR sequences and parameters.

    Measured: day 1

  2. Sensitivity for nodule detection, step 2: Patients (arm A)

    Determine whether HF-NIV-MR allows a better detection (higher sensitivity) of the presence of pulmonary nodules compared with conventional MR. CT will be used as gold standard.

    Measured: day 1

  3. Sensitivity for nodule characterization, step 2: Patients (arm B)

    Determine whether sensitivity of the apparent diffusion coefficient (ADC) value obtained with HF-NIV-MR (diffusion sequence) to characterize nodules is higher than the sensitivity obtained with conventional MRI. Histological data will be used as gold standard when available.

    Measured: day 1

  4. Assessment of CPAP-MR, step 1 bis: Healthy volunteers

    Determine whether CPAP-MR has an additional value compared with MR. Image quality of the CPAP-MR acquisition will be evaluated similarly to the methodology of step 1 and compared to the gold standard MR acquisition (free-breathing without any device).

    Measured: day 1

Secondary outcomes (11)
  1. Image quality, step 1: Healthy volunteers, sharpness of bronchi

    Sharpness of interfaces of bronchi will be scored on a discrete scale as 1=blurred; 2=intermediate; 3=sharp.

    Measured: day 1

  2. Image quality, step 1: Healthy volunteers, sharpness of fissures

    Sharpness of interfaces of fissures will be scored on a discrete scale as 1=blurred; 2=intermediate; 3=sharp.

    Measured: day 1

  3. Image quality, step 1: Healthy volunteers, visibility of vessels

    Modified criteria of Ohno (Ohno et al.) will be used and vessels will be scored as follows 0=non visible; 1=depicted at a lobar level; 2=depicted at a segmental level; 3=depicted at a sub-segmental level; 4=depicted at a sub-sub segmental level; 5=depicted beyond the sub-subsegmental level.

    Measured: day 1

  4. Image quality, step 1: Healthy volunteers, visibility of bronchi

    Modified criteria of Ohno (Ohno et al.) will be used and bronchi will be scored as follows 0=non visible; 1=depicted at a lobar level; 2=depicted at a segmental level; 3=depicted at a sub-segmental level; 4=depicted at a sub-sub segmental level; 5=depicted beyond the sub-subsegmental level.

    Measured: day 1

  5. Image quality, step 1: Healthy volunteers, visibility of fissures

    Fissures will be scored as follows 0=non visible; 1=visible.

    Measured: day 1

  6. Nodule dimensions

    The variable of interest will be the volumetry of each nodule detected which will be evaluated by using dedicated software. This will be compared with volumetric assessment by using CT performed less than 1 month before the MR examination, at best the same day.

    Two-Dimensional measurements (long axis, mean of the long and short diameter) will also be used, in accordance with usual recommendations [MacMahon et al.].

    Measured: day 1

  7. MR-PET fusion

    Fusion of MR acquisitions and PET under HF-NIV should be obtained with a good accuracy. The correspondence will be evaluated with a fiducial anatomical structures technique, as if acquisitions were done on a PET-MR scanner.

    Measured: day 1

  8. Correlation of diffusion MRI with metabolic activity

    The correlation between ADC (diffusion coefficient) and metabolic activity in HF-NIV-PET/CT, will be compared to the one obtained without HF-NIV.

    Measured: day 1

  9. PET/CT stabilization assessment

    The PET/CT image stabilization methods will compared and the best one will be determined (electronic respiratory-gating during the normal free-breathing PET/CT, a single short PET/CT apnea (<30 seconds) and the HF-NIV-PET/CT acquisition.

    Measured: day 1

  10. Correlation with ex-vivo nodule volume

    When applicable, the volume of lesions measured on imaging studies will be compared to the volume measured ex-vivo following surgical resection.

    Measured: day 1

  11. Tolerance CPAP-MR, step 1 bis: Healthy volunteers

    Subject subjective tolerance to CPAP-MR will be scored on a 5 points discrete scale as follows: 0=no additional discomfort, 1=minor discomfort, 2=moderate discomfort, 3=high discomfort, 4=extreme discomfort (same methodology as for steps 1 and 2).

    Measured: day 1

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jun 2018
  2. Study start14 Jun 2018
  3. Primary completion16 Mar 2020
  4. Study completion16 Mar 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Non-randomised
Intervention model
Crossover
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03553368
Sponsor's protocol ID
HF-NIV-MR-PET
Status last verified
Oct 2020
First submitted
15 May 2018
Last updated
19 Oct 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Beigelman-Aubry C, Peguret N, Stuber M, Delacoste J, Belmondo B, Lovis A, Simons J, Long O, Grant K, Berchier G, Rohner C, Bonanno G, Coppo S, Schwitter J, Ozsahin M, Qanadli S, Meuli R, Bourhis J. Chest-MRI under pulsatile flow ventilation: A new promising technique. PLoS One. 2017 Jun 12;12(6):e0178807. doi: 10.1371/journal.pone.0178807. eCollection 2017.

    PubMed 28604833
  • Prior JO, Peguret N, Pomoni A, Pappon M, Zeverino M, Belmondo B, Lovis A, Ozsahin M, Vienne M, Bourhis J. Reduction of Respiratory Motion During PET/CT by Pulsatile-Flow Ventilation: A First Clinical Evaluation. J Nucl Med. 2016 Mar;57(3):416-9. doi: 10.2967/jnumed.115.163386. Epub 2015 Dec 3.

    PubMed 26635339
  • MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Mayo JR, Mehta AC, Ohno Y, Powell CA, Prokop M, Rubin GD, Schaefer-Prokop CM, Travis WD, Van Schil PE, Bankier AA. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Radiology. 2017 Jul;284(1):228-243. doi: 10.1148/radiol.2017161659. Epub 2017 Feb 23.

    PubMed 28240562
  • Ohno Y, Koyama H, Yoshikawa T, Seki S, Takenaka D, Yui M, Lu A, Miyazaki M, Sugimura K. Pulmonary high-resolution ultrashort TE MR imaging: Comparison with thin-section standard- and low-dose computed tomography for the assessment of pulmonary parenchyma diseases. J Magn Reson Imaging. 2016 Feb;43(2):512-32. doi: 10.1002/jmri.25008. Epub 2015 Jul 30.

    PubMed 26223818
  • Darcot E, Delacoste J, Dunet V, Dournes G, Rotzinger D, Bernasconi M, Vremaroiu P, Simons J, Long O, Rohner C, Ledoux JB, Stuber M, Lovis A, Beigelman-Aubry C. Lung MRI assessment with high-frequency noninvasive ventilation at 3 T. Magn Reson Imaging. 2020 Dec;74:64-73. doi: 10.1016/j.mri.2020.09.006. Epub 2020 Sep 6.

    PubMed 32898653

Questions about this trial

What is this clinical trial studying?

A study testing HF-NIV-MR, HF-NIV-PET and MR in people with Neoplasms, run by University of Lausanne Hospitals at 1 site in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Image quality, step 1: Healthy volunteers, sharpness of vessels (time frame: day 1). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03553368, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Oct 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in