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Multihance at 3 Tesla (3T) in Brain Tumors

A Phase IV Double-blind Multicenter Randomized Crossover Study to Compare 0.10 mmol/kg of Multihance With 0.10 mmol.kg of Magnevist in Magnetic Resonance Imaging(MRI) of the Brain at 3T

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00395863
Enrollment
46
Registered
2006-11-06
Start date
2006-11-30
Completion date
2008-03-31
Last updated
2020-11-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Brain Tumor

Brief summary

Compare the efficacy of MultiHance and Magnevist

Detailed description

The purpose of this study was to evaluate whether Multihance is superior to Magnevist in terms of qualitative and quantitative assessment of unenhanced MRI and contrast-enhanced MRI for the visualization of brain disease.

Interventions

0.5 M at a single injection

DRUGArm 2 - Magnevist

0.5 M Magnevist at a single dose injection

Sponsors

Bracco Diagnostics, Inc
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Was 18 years or older * Provided written informed consent * Scheduled for MRI * Confirmed or highly suspected to have brain tumor(s) and willing to undergo two MRI exams within 14 days

Exclusion criteria

* Pregnant or lactating females * Allergy to one or more of the ingredients in the products or hypersensitivity to any metals * Congestive heart failure, class IV * Previous stroke in the past year * Received another contrast agent within 24 hours pre and post each exam * Investigational product * Contraindications to MRI * Severe claustrophobia * Surgery with 3 weeks prior * Steroid therapy or radiosurgery between two exams

Design outcomes

Primary

MeasureTime frameDescription
Global Diagnostic Preference Between the Two ExamsPostdose Images for MultiHance Exam and for Magnevist Exam ComparedAssessed by 3 blinded Readers for each of the 41 patients who had both MultiHance and Magnevist post dose MRI exam to assess whether the image with MultiHance was preferred, both contrast agents were equal, or the image with Magnevist was preferred. Each patient's image was reviewed by 3 readers.

Secondary

MeasureTime frameDescription
Lesion Contrast Enhancement Between the Two ExamsPostdose Images for MultiHance Exam and for Magnevist Exam ComparedAssessed by 3 blinded Readers for each of the 41 patients who had both MultiHance and Magnevist post dose MRI exam to assess whether the image with MultiHance was preferred, both contrast agents were equal, or the image with Magnevist was preferred.
Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1Predose and immediately postdoseChange from predose to postdose in lesion-to-brain ratio computed. Comparison of the differences in change were analyzed.
Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2Predose and immediately postdoseChange from predose to postdose in lesion-to-brain ratio computed. Comparison of the differences in change were analyzed.
Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3Predose and immediately postdoseChange from predose to postdose in lesion-to-brain ratio computed. Comparison of the differences in change were analyzed.
Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1Predose and immediately postdoseChange from predose to postdose in contrast-to-noise ratio computed. Comparison of the differences in change were analyzed.
Lesion Border DelineationPostdose Images for MultiHance Exam and for Magnevist Exam ComparedAssessed by 3 blinded Readers for each of the 41 patients who had both MultiHance and Magnevist post dose MRI exam to assess whether the image with MultiHance was preferred, both contrast agents were equal, or the image with Magnevist was preferred.
Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3Predose and immediately postdoseChange from predose to postdose in contrast-to-noise ratio computed. Comparison of the differences in change were analyzed.
Percentage of Lesion Contrast Enhancement (LCE) - Reader 1PostdoseQuantitative parameter derived from signal intensity (SI) measurements. LCE (\[SI of lesion (postdose)-SI of lesion (predose)\]/Standard SI of lesion (predose)\]
Percentage of Contrast Enhancement of the Lesion - Reader 2PostdoseQuantitative parameter derived from signal intensity (SI) measurements. LCE (\[SI of lesion (postdose)-SI of lesion (predose)\]/Standard SI of lesion (predose)\]
Percentage of Contrast Enhancement of the Lesion - Reader 3PostdoseQuantitative parameter derived from signal intensity (SI) measurements. LCE (\[SI of lesion (postdose)-SI of lesion (predose)\]/Standard SI of lesion (predose)\]
Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2Predose and immediately postdoseChange from predose to postdose in contrast-to-noise ratio computed. Comparison of the differences in change were analyzed.

Countries

United States

Participant flow

Recruitment details

A total of 47 patients were recruited from March 2007 through February 2008 at 8 clinical trial sites. from Feb/18/2008 to Feb/22/2008, an off-site assessment of the images was performed by 3 board-certified radiologists who were blinded to which contrast agent was used, any patient's clinical information & any results from other imaging studies.

Pre-assignment details

47 patients enrolled (signed informed consent); 46 were randomized and dosed.

Participants by arm

ArmCount
MultiHance, Then Magnevist
0.1 mmol/kg injection of each product
23
Magnevist, Then MultiHance
0.1 mmol/kg injection of each product
23
Total46

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyPatients did not complete both exams23

Baseline characteristics

CharacteristicMagnevist, Then MultiHanceTotalMultiHance, Then Magnevist
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
3 Participants7 Participants4 Participants
Age, Categorical
Between 18 and 65 years
20 Participants39 Participants19 Participants
Age, Continuous48.08 years
STANDARD_DEVIATION 16.064
49.43 years
STANDARD_DEVIATION 15.667
50.79 years
STANDARD_DEVIATION 15.497
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
3 Participants3 Participants0 Participants
Race (NIH/OMB)
More than one race
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
19 Participants42 Participants23 Participants
Region of Enrollment
United States
23 participants46 participants23 participants
Sex: Female, Male
Female
9 Participants21 Participants12 Participants
Sex: Female, Male
Male
14 Participants25 Participants11 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
4 / 431 / 44
serious
Total, serious adverse events
0 / 430 / 44

Outcome results

Primary

Global Diagnostic Preference Between the Two Exams

Assessed by 3 blinded Readers for each of the 41 patients who had both MultiHance and Magnevist post dose MRI exam to assess whether the image with MultiHance was preferred, both contrast agents were equal, or the image with Magnevist was preferred. Each patient's image was reviewed by 3 readers.

Time frame: Postdose Images for MultiHance Exam and for Magnevist Exam Compared

Population: Include all intention-to-treat (ITT) population. The number of units analyzed is the total number of technically adequate postdose images assessed by the reader from the total number of participants with both MultiHance- and Magnevist-enhanced images. Patient-level analysis.

ArmMeasureGroupValue (NUMBER)
Reader 1Global Diagnostic Preference Between the Two ExamsContrast Agents Equal19 Contrast-enhanced Images
Reader 1Global Diagnostic Preference Between the Two ExamsMultiHance Preferred22 Contrast-enhanced Images
Reader 1Global Diagnostic Preference Between the Two ExamsMagnevist Preferred0 Contrast-enhanced Images
Reader 2Global Diagnostic Preference Between the Two ExamsContrast Agents Equal19 Contrast-enhanced Images
Reader 2Global Diagnostic Preference Between the Two ExamsMultiHance Preferred21 Contrast-enhanced Images
Reader 2Global Diagnostic Preference Between the Two ExamsMagnevist Preferred1 Contrast-enhanced Images
Reader 3Global Diagnostic Preference Between the Two ExamsMultiHance Preferred27 Contrast-enhanced Images
Reader 3Global Diagnostic Preference Between the Two ExamsMagnevist Preferred0 Contrast-enhanced Images
Reader 3Global Diagnostic Preference Between the Two ExamsContrast Agents Equal14 Contrast-enhanced Images
p-value: <0.0001wilcoxon signed-rank test
p-value: <0.0001wilcoxon signed-rank test
p-value: <0.0001wilcoxon signed-rank test
Secondary

Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1

Change from predose to postdose in contrast-to-noise ratio computed. Comparison of the differences in change were analyzed.

Time frame: Predose and immediately postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureGroupValue (MEAN)Dispersion
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1Predose-18.81 [ratio]Standard Deviation 19.22
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1Postdose60.76 [ratio]Standard Deviation 66.88
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1Change from Baseline79.56 [ratio]Standard Deviation 71.57
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1Predose-11.70 [ratio]Standard Deviation 20.85
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1Postdose26.87 [ratio]Standard Deviation 28.36
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 1Change from Baseline38.57 [ratio]Standard Deviation 33.7
p-value: 0.006295% CI: [20.72, 61.26]t-test, 2 sided
Secondary

Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2

Change from predose to postdose in contrast-to-noise ratio computed. Comparison of the differences in change were analyzed.

Time frame: Predose and immediately postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureGroupValue (MEAN)Dispersion
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2Change from Baseline84.26 [ratio]Standard Deviation 63.43
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2Predose-18.30 [ratio]Standard Deviation 19.11
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2Postdose65.96 [ratio]Standard Deviation 54.75
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2Postdose38.94 [ratio]Standard Deviation 40.41
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2Change from Baseline53.31 [ratio]Standard Deviation 52.46
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 2Predose-14.38 [ratio]Standard Deviation 18.92
p-value: 0.002795% CI: [16.57, 45.33]t-test, 2 sided
Secondary

Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3

Change from predose to postdose in contrast-to-noise ratio computed. Comparison of the differences in change were analyzed.

Time frame: Predose and immediately postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureGroupValue (MEAN)Dispersion
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3Postdose62.10 [ratio]Standard Deviation 42.92
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3Change from Baseline73.84 [ratio]Standard Deviation 47.6
Reader 1Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3Predose-11.75 [ratio]Standard Deviation 17.7
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3Postdose42.34 [ratio]Standard Deviation 33.49
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3Predose-6.47 [ratio]Standard Deviation 17.2
Reader 2Contrast-to-noise Ratio (CNR) for Each Lesion - Reader 3Change from Baseline48.81 [ratio]Standard Deviation 37.51
p-value: 0.0295% CI: [12.41, 37.67]t-test, 2 sided
Secondary

Lesion Border Delineation

Assessed by 3 blinded Readers for each of the 41 patients who had both MultiHance and Magnevist post dose MRI exam to assess whether the image with MultiHance was preferred, both contrast agents were equal, or the image with Magnevist was preferred.

Time frame: Postdose Images for MultiHance Exam and for Magnevist Exam Compared

Population: Include all ITT population. The number of units analyzed is the total number of technically adequate postdose images assessed by the reader from the total number of participants with both MultiHance- and Magnevist-enhanced images. Patient-level analysis.

ArmMeasureGroupValue (NUMBER)
Reader 1Lesion Border DelineationMagnevist Preferred0 Contrast-enhanced Images
Reader 1Lesion Border DelineationMultiHance Preferred14 Contrast-enhanced Images
Reader 1Lesion Border DelineationContrast Agents Equal27 Contrast-enhanced Images
Reader 2Lesion Border DelineationContrast Agents Equal30 Contrast-enhanced Images
Reader 2Lesion Border DelineationMagnevist Preferred0 Contrast-enhanced Images
Reader 2Lesion Border DelineationMultiHance Preferred11 Contrast-enhanced Images
Reader 3Lesion Border DelineationMultiHance Preferred13 Contrast-enhanced Images
Reader 3Lesion Border DelineationMagnevist Preferred0 Contrast-enhanced Images
Reader 3Lesion Border DelineationContrast Agents Equal28 Contrast-enhanced Images
p-value: 0.0001wilcoxon signed-rank test
p-value: 0.001wilcoxon signed-rank test
p-value: 0.0002wilcoxon signed-rank test
Secondary

Lesion Contrast Enhancement Between the Two Exams

Assessed by 3 blinded Readers for each of the 41 patients who had both MultiHance and Magnevist post dose MRI exam to assess whether the image with MultiHance was preferred, both contrast agents were equal, or the image with Magnevist was preferred.

Time frame: Postdose Images for MultiHance Exam and for Magnevist Exam Compared

Population: Include all ITT population. The number of units analyzed is the total number of technically adequate postdose images assessed by the reader from the total number of participants with both MultiHance- and Magnevist-enhanced images. Patient-level analysis.

ArmMeasureGroupValue (NUMBER)
Reader 1Lesion Contrast Enhancement Between the Two ExamsMultiHance Preferred22 Contrast-enhanced Images
Reader 1Lesion Contrast Enhancement Between the Two ExamsMagnevist Preferred0 Contrast-enhanced Images
Reader 1Lesion Contrast Enhancement Between the Two ExamsContrast Agents Equal19 Contrast-enhanced Images
Reader 2Lesion Contrast Enhancement Between the Two ExamsContrast Agents Equal20 Contrast-enhanced Images
Reader 2Lesion Contrast Enhancement Between the Two ExamsMagnevist Preferred1 Contrast-enhanced Images
Reader 2Lesion Contrast Enhancement Between the Two ExamsMultiHance Preferred20 Contrast-enhanced Images
Reader 3Lesion Contrast Enhancement Between the Two ExamsMagnevist Preferred1 Contrast-enhanced Images
Reader 3Lesion Contrast Enhancement Between the Two ExamsMultiHance Preferred22 Contrast-enhanced Images
Reader 3Lesion Contrast Enhancement Between the Two ExamsContrast Agents Equal18 Contrast-enhanced Images
p-value: <0.0001wilcoxon signed-rank test
p-value: <0.0001wilcoxon signed-rank test
p-value: <0.0001wilcoxon signed-rank test
Secondary

Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1

Change from predose to postdose in lesion-to-brain ratio computed. Comparison of the differences in change were analyzed.

Time frame: Predose and immediately postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureGroupValue (MEAN)Dispersion
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1Postdose1.50 [ratio]Standard Deviation 0.3
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1Predose0.82 [ratio]Standard Deviation 0.17
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1Change from Baseline0.68 [ratio]Standard Deviation 0.33
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1Predose0.85 [ratio]Standard Deviation 0.19
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1Postdose1.31 [ratio]Standard Deviation 0.21
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 1Change from Baseline0.46 [ratio]Standard Deviation 0.24
p-value: <0.000195% CI: [0.14, 0.3]t-test, 2 sided
Secondary

Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2

Change from predose to postdose in lesion-to-brain ratio computed. Comparison of the differences in change were analyzed.

Time frame: Predose and immediately postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureGroupValue (MEAN)Dispersion
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2Predose0.82 [ratio]Standard Deviation 0.18
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2Postdose1.61 [ratio]Standard Deviation 0.28
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2Change from Baseline0.79 [ratio]Standard Deviation 0.36
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2Predose0.87 [ratio]Standard Deviation 0.17
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2Postdose1.36 [ratio]Standard Deviation 0.22
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 2Change from Baseline0.49 [ratio]Standard Deviation 0.27
p-value: <0.000195% CI: [0.22, 0.38]t-test, 2 sided
Secondary

Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3

Change from predose to postdose in lesion-to-brain ratio computed. Comparison of the differences in change were analyzed.

Time frame: Predose and immediately postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureGroupValue (MEAN)Dispersion
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3Change from Baseline0.81 [ratio]Standard Deviation 0.41
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3Predose0.86 [ratio]Standard Deviation 0.17
Reader 1Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3Postdose1.67 [ratio]Standard Deviation 0.36
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3Change from Baseline0.55 [ratio]Standard Deviation 0.31
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3Predose0.91 [ratio]Standard Deviation 0.17
Reader 2Lesion-to-brain Ratio (LBR) for Each Lesion - Reader 3Postdose1.46 [ratio]Standard Deviation 0.26
p-value: <0.000195% CI: [0.18, 0.33]t-test, 2 sided
Secondary

Percentage of Contrast Enhancement of the Lesion - Reader 2

Quantitative parameter derived from signal intensity (SI) measurements. LCE (\[SI of lesion (postdose)-SI of lesion (predose)\]/Standard SI of lesion (predose)\]

Time frame: Postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureValue (MEAN)Dispersion
Reader 1Percentage of Contrast Enhancement of the Lesion - Reader 2106.42 [percent]Standard Deviation 84.97
Reader 2Percentage of Contrast Enhancement of the Lesion - Reader 272.81 [percent]Standard Deviation 65.7
p-value: 0.000895% CI: [16.75, 50.47]t-test, 2 sided
Secondary

Percentage of Contrast Enhancement of the Lesion - Reader 3

Quantitative parameter derived from signal intensity (SI) measurements. LCE (\[SI of lesion (postdose)-SI of lesion (predose)\]/Standard SI of lesion (predose)\]

Time frame: Postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureValue (MEAN)Dispersion
Reader 1Percentage of Contrast Enhancement of the Lesion - Reader 3101.85 [percent]Standard Deviation 96.89
Reader 2Percentage of Contrast Enhancement of the Lesion - Reader 368.13 [percent]Standard Deviation 60.91
p-value: 0.002695% CI: [14.63, 52.81]t-test, 2 sided
Secondary

Percentage of Lesion Contrast Enhancement (LCE) - Reader 1

Quantitative parameter derived from signal intensity (SI) measurements. LCE (\[SI of lesion (postdose)-SI of lesion (predose)\]/Standard SI of lesion (predose)\]

Time frame: Postdose

Population: Include all ITT population. The number of units analyzed are the total number of lesions assessed by the reader from the total number of participants. Lesion-level analysis.

ArmMeasureValue (MEAN)Dispersion
Reader 1Percentage of Lesion Contrast Enhancement (LCE) - Reader 1100.15 [percent]Standard Deviation 74.92
Reader 2Percentage of Lesion Contrast Enhancement (LCE) - Reader 167.38 [percent]Standard Deviation 52.18
p-value: 0.001995% CI: [14.28, 51.25]t-test, 2 sided

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026