Magnetic Resonance Diagnosis of Pulmonary Embolism (IRM-EP)
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Purpose
- The purpose of this study is to evaluate the diagnostic accuracy of thoracic magnetic resonance imaging with gadolinium-enhanced, unenhanced and perfusion sequences in patients with clinically suspected acute pulmonary embolism
- Thoracic CT angiography (CTA) will serve as reference standard
- Result of MRI will not interfere with patients' management
- Untreated patients with negative CTA will have 3-month follow-up to verify they were free of thrombose-embolic disease
| Condition | Intervention |
|---|---|
|
Lung Diseases Pulmonary Embolism |
Procedure: Gadolinium-enhanced Magnetic Resonance Imaging |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Magnetic Resonance Diagnosis of Pulmonary Embolism: Prospective Evaluation in 280 Patients, With Comparison to Multi-slice CT Angiography |
- MRI studies will be interpreted at the end of the inclusion process. CTA results will serve as reference standard to evaluate MRI sensitivity, specificity, positive and negative predictive values. Inter-observer agreement will be evaluated [ Time Frame: 17 months after the first inclusion ] [ Designated as safety issue: No ]
- 3 months clinical follow-up will be performed in patients with negative CTA results who did not receive anticoagulation. This is to verify there were no false negatives on CTA [ Time Frame: 3 months afer CTA ] [ Designated as safety issue: No ]
| Enrollment: | 300 |
| Study Start Date: | March 2007 |
| Estimated Study Completion Date: | February 2010 |
| Primary Completion Date: | September 2007 (Final data collection date for primary outcome measure) |
-
Procedure: Gadolinium-enhanced Magnetic Resonance Imaging
Background In patients with clinically suspected pulmonary embolism (PE)°with a contraindication to thoracic CT angiography, there is a need for an alternative diagnostic procedure. MRI has not been fully evaluated in this field; moreover, recent technological advances make it necessary to re-evaluate its performance for PE diagnosis.
Design Prospective monocentric study
- Patients with clinically suspected acute pulmonary embolism will undergo thoracic magnetic resonance imaging if inclusion criteria are fulfilled.
- A non-inclusion register will be establish for patients fulfilling the inclusion criteria , not included because MRI was not available (off-hours presentation , another patients already included in the protocol on the same day )
Estimated enrolment : 280 (based on a 25% prevalence of PE in our institution and an expected 80% sensitivity of MRI) Study start date: June 2007 Estimated study completion date: 17 months later (40 to 50 presentations for PE suspicion each month, 20 inclusions expected per month)
Magnetic Resonance imaging: performed on a 1.5 Tesla unit with 3 different sequences
- Unenhanced Steady State Free Precession (SSFP) sequences
- Perfusion imaging following Gadolinium injection at a rate of 5 c/s and a dose of 0.1mmol/kg
- Magnetic resonance angiography following an injection of 0.1mmol/kg of gadolinium at 3ml/s MRI studies will be interpreted secondarily by 2 independent radiologists, blinded to CTA results and clinical probability.
Two different readings will be performed, one global reading and one reading of each sequence separately, displayed in a random order (access base)
Objectives
- to evaluate MRI performance for PE diagnosis globally
- to evaluate the diagnostic value for each sequence (especially the negative predictive value of a normal perfusion sequence)
- to evaluate inter-observer agreement
MRI and CTA have to be performed within 24 hours
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
patients with acute pulmonary embolism suspicion who fulfil the inclusion criteria
Inclusion Criteria:
- Clinically suspected acute pulmonary embolism
- 18 years old or more
- D-dimers more than 500 or high clinical probability of pulmonary embolism according to the revised Geneva score
- Thoracic CT angiography performed within 24 hours
- Informed consent
Exclusion Criteria:
- - Contraindication to MRI (pace maker, claustrophobia, any implanted ferromagnetic foreign body)
- Obese patients too large to fit in MRI unit
- Allergy to gadolinium-containing contrast agent or to iodinated contrast media
- Renal insufficiency (clearance less than 30 ml/mn)
- Anticoagulation at a curative dose started more than 48 hours prior to MRI
- Life expectancy less than 3 months
- Pregnancy
Contacts and Locations| France | |
| Hopital George Pompidou | |
| Paris, France, 75015 | |
| Principal Investigator: | Marie-pierre Revel, PH | Assistance Publique - Hôpitaux de Paris |
More Information
Publications:
| Responsible Party: | Aurélie Guimfack, Department Clinical Research of Developpement |
| ClinicalTrials.gov Identifier: | NCT01077778 History of Changes |
| Other Study ID Numbers: | P051068 |
| Study First Received: | February 26, 2010 |
| Last Updated: | February 26, 2010 |
| Health Authority: | France: Ministry of Health |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
Magnetic Resonance Imaging/methods Magnetic Resonance Angiography Perfusion Imaging Pulmonary Embolism/diagnosis |
Additional relevant MeSH terms:
|
Embolism Lung Diseases Pulmonary Embolism Embolism and Thrombosis |
Vascular Diseases Cardiovascular Diseases Respiratory Tract Diseases |
ClinicalTrials.gov processed this record on May 16, 2013