Improving Ultrasound Images in Brain Tumour Surgery With the Use of an Acoustic Coupling Fluid Mimicking Brain Tissue.

NCT ID: NCT03181581

Last Updated: 2019-04-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

5 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-01

Study Completion Date

2018-12-31

Brief Summary

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Tools for improving brain tumor surgery, in particular for gliomas, are increasing. There seems to be an agreement that achieving extensive resections, when done safely without jeopardizing neurological function, improves survival.

Ultrasound is currently used as a tool for providing 2D or 3D images for tumor localization and resection control. For the use in resection control the resection cavity is filled with saline to provide acoustic coupling between the ultrasound transducer and tissue. However, attenuation of acoustic waves is very low in saline compared to the brain and this difference in attenuation is the cause of artifacts that may severely degrade the ultrasound images. Such artifacts are seen as high-intensity signal at the resection cavity wall and beyond. The artificial signal enhancement can potentially mask small tumor remnants and is generally making the interpretation of images more difficult.

This research group has developed an acoustic coupling fluid intended for use in the resection cavity instead of saline. Tests in laboratory measurements have shown that the fluid reduces artifacts and has the potential to enhance ultrasound image quality in brain tumor surgery. Three different concentrations of the acoustic coupling fluid have been tested in a phase 1 study that included 15 patients with glioblastoma. The concentration that provided the optimal ultrasound images, from qualitative and quantitative inspection, is used in the current phase II study. This study is a randomized controlled trial aiming to include 82 patients with glial brain tumours. Its purpose is to test the fluid during surgery of glial brain tumours to further investigate safety and efficacy.

Detailed Description

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Conditions

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Brain Neoplasms Glioma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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High grade gliomas stage 1 ACF

In the first stage 12-15 patients with high-grade gliomas will be included in the trial (acoustic coupling fluid) group.

Group Type EXPERIMENTAL

acoustic coupling fluid

Intervention Type BIOLOGICAL

ultrasound images obtained with both ACF and Ringer's acetate

Low-high grade gliomas stage 2 ACF

If the interim safety assessments validate that the study can continue, the second stage involves inclusion in the trial (acoustic coupling fluid) group of 22-25 patients with both low-grade and high-grade glioma

Group Type EXPERIMENTAL

acoustic coupling fluid

Intervention Type BIOLOGICAL

ultrasound images obtained with both ACF and Ringer's acetate

High grade gliomas stage 1 control

In the first stage 12-15 patients with high-grade gliomas will be included in the Ringer's acetate (control) group.

Group Type ACTIVE_COMPARATOR

Ringer's acetate

Intervention Type BIOLOGICAL

ultrasound images obtained with Ringer's acetate only

Low-high grade gliomas stage 2 control

If the interim safety assessments validate that the study can continue, the second stage involves inclusion in the Ringer's acetate (control) group of 22-25 patients with both low-grade and high-grade glioma

Group Type ACTIVE_COMPARATOR

Ringer's acetate

Intervention Type BIOLOGICAL

ultrasound images obtained with Ringer's acetate only

Interventions

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acoustic coupling fluid

ultrasound images obtained with both ACF and Ringer's acetate

Intervention Type BIOLOGICAL

Ringer's acetate

ultrasound images obtained with Ringer's acetate only

Intervention Type BIOLOGICAL

Other Intervention Names

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ACF

Eligibility Criteria

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Inclusion Criteria

* A diffuse glial tumour (high-grade (stage 1), low-grade or high-grade (stage 2)) is suspected from the diagnostic magnetic resonance images (MRI).
* In cases where histopathology is not known from previous biopsy or resection (i.e. diagnosis is suspected based on MRI findings and not from previous surgery) a tissue sample for frozen section is necessary to confirm the diagnosis.
* Karnofsky performance status \>=70

Exclusion Criteria

* Not able to consent (e.g. severe cognitive impairment)
* Intended biopsy only (meaning: cases not suitable for resection)
* Hypersensitivity to egg protein
* Hypersensitivity to soya or peanut protein
* Hypersensitivity to glycerol
* Pregnancy of breast-feeding
* Intention to become pregnant during the time of the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Norwegian National Advisory Unit for Ultrasound and Image-guided Therapy

UNKNOWN

Sponsor Role collaborator

SINTEF Health Research

OTHER

Sponsor Role collaborator

St. Olavs Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Petter Aadahl, phd md

Role: STUDY_DIRECTOR

St. Olavs Hospital

Locations

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Department of Neurosurgery, St Olavs Hospital

Trondheim, , Norway

Site Status

Countries

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Norway

Other Identifiers

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2016-003025-42

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

ACF-02

Identifier Type: -

Identifier Source: org_study_id

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