Imaging of Osteonecrosis With Ferumoxytol-Enhanced MRI

NCT ID: NCT02893293

Last Updated: 2024-11-26

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-31

Study Completion Date

2023-10-31

Brief Summary

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The goal of the project is to evaluate osteonecrosis before and after decompression surgery with ferumoxytol-enhanced MRI.

Detailed Description

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The goal of the project is to evaluate osteonecrosis before and after decompression surgery with ferumoxytol-enhanced MRI.

The investigators approach relies on the FDA-approved iron supplement ferumoxytol (Feraheme), which is used off label as a contrast agent for MRI. Ferumoxytol is composed of iron oxide nanoparticles, which provide a strong T1- and T2-signal on magnetic resonance (MR) images and are taken up by cells in bone marrow.

20 patients will undergo MRI before and after decompression surgery and transplantation of bone marrow derived cells. 10 patients will receive a single intravenous injection of ferumoxytol prior to their surgery. 10 additional patients will serve as untreated controls. The investigators hypothesize that MR images after intravenous injection of ferumoxytol will improve lesion detection and allow to track transplanted bone marrow cells. MR imaging findings will be correlated with clinical outcomes.

Conditions

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Osteonecrosis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Ferumoxytol-enhanced MRI

Patients receive a ferumoxytol injection (Feraheme, AMAG, 5mg Fe/kg, single administration) prior to routine decompression surgery and autologous stem cell transplant. Follow-up imaging with magnetic resonance imaging will be conducted in regular intervals for evaluation of the response to treatment.

Group Type ACTIVE_COMPARATOR

Ferumoxytol-enhanced magnetic resonance imaging

Intervention Type DRUG

Eligible patients receive a single ferumoxytol-dose and follow-up magnetic resonance imaging to evaluate success of stem cell transplant

Magentic Resonance Imaging

Intervention Type DEVICE

Both arms will receive MRI

Non-ferumoxytol enhanced MRI

Patients scheduled for routine decompression surgery and autologous stem cell transplant will receive follow-up magnetic resonance imaging in regular intervals for evaluation of the response to treatment.

Group Type SHAM_COMPARATOR

Magentic Resonance Imaging

Intervention Type DEVICE

Both arms will receive MRI

Interventions

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Ferumoxytol-enhanced magnetic resonance imaging

Eligible patients receive a single ferumoxytol-dose and follow-up magnetic resonance imaging to evaluate success of stem cell transplant

Intervention Type DRUG

Magentic Resonance Imaging

Both arms will receive MRI

Intervention Type DEVICE

Other Intervention Names

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MRI

Eligibility Criteria

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Inclusion Criteria

* Osteonecrosis
* planned decompression surgery with autologous stem cell transplant

Exclusion Criteria

* Contraindications for magnetic resonance imaging
* Hemosiderosis/hemochromatosis ( patients can still be included in the non-ferumoxytol arm)
Minimum Eligible Age

8 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Heike E Daldrup-Link

Professor of Radiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Heike Daldrup-Link, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Lucile Packard Children's Hospital

Stanford, California, United States

Site Status

Countries

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United States

References

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Muehe AM, Feng D, von Eyben R, Luna-Fineman S, Link MP, Muthig T, Huddleston AE, Neuwelt EA, Daldrup-Link HE. Safety Report of Ferumoxytol for Magnetic Resonance Imaging in Children and Young Adults. Invest Radiol. 2016 Apr;51(4):221-227. doi: 10.1097/RLI.0000000000000230.

Reference Type BACKGROUND
PMID: 26656202 (View on PubMed)

Nejadnik H, Lenkov O, Gassert F, Fretwell D, Lam I, Daldrup-Link HE. Macrophage phagocytosis alters the MRI signal of ferumoxytol-labeled mesenchymal stromal cells in cartilage defects. Sci Rep. 2016 May 13;6:25897. doi: 10.1038/srep25897.

Reference Type BACKGROUND
PMID: 27174199 (View on PubMed)

Theruvath AJ, Nejadnik H, Muehe AM, Gassert F, Lacayo NJ, Goodman SB, Daldrup-Link HE. Tracking Cell Transplants in Femoral Osteonecrosis with Magnetic Resonance Imaging: A Proof-of-Concept Study in Patients. Clin Cancer Res. 2018 Dec 15;24(24):6223-6229. doi: 10.1158/1078-0432.CCR-18-1687. Epub 2018 Sep 17.

Reference Type RESULT
PMID: 30224340 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Related Links

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http://daldrup-link-lab.stanford.edu/

Pediatric Molecular Imaging Program

Other Identifiers

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PEDSBONE0006

Identifier Type: OTHER

Identifier Source: secondary_id

IRB-20253(osteonecrosis)

Identifier Type: -

Identifier Source: org_study_id

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