Researchers are looking for a better way to help people with any known or suspected problems (except brain or spinal cord-related problems) scheduled for a "contrast-enhanced" Magnetic Resonance Imaging (MRI). MRI is used by doctors to create detailed images of the inside of the body to identify health problems. Sometimes doctors need to inject contrast agent into a patient's vein to perform a so called "contrast-enhanced" MRI (CE-MRI). Such CE-MRI examinations may support doctors to identify certain health problems or improve the evaluation. The contrast agents commonly used in MRI are gadolinium-based contrast agents (GBCAs). GBCAs contain a "rare earth" element called gadolinium (Gd). Gadoquatrane is a new contrast agent under development with a lower amount of Gd needed per CE-MRI. The main purpose of this study is to learn whether CE-MRI scans with gadoquatrane work better than MRI scans without the use of a contrast agent (GBCA). The researchers will compare the ability to detect known or suspected problems (except brain or spinal cord-related problems) with gadoquatrane-MRI scans to plain-MRI scans without the use of a contrast agent. The participants will undergo 2 MRI scans, one with gadoquatrane and one with currently used GBCA. Both contrast agents will be injected into the vein. Each participant will be in the study for between 6 and 42 days with up to 7 doctor visits. At the start or during the study, the doctors and their study team will: * take blood and urine samples * do physical examinations * check blood pressure and heart rate * review the MRI scans obtained in the study and decide on the diagnosis * ask the participants questions about how they are feeling and what adverse events they are having. An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events, irrespective if they think it is related or not to the study treatments.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
QUADRUPLE
Enrollment
410
0.04 mmol Gd/kg body weight, solution for intravenous injection, single dose
Approved standard of care macrocyclic GBCA, 0.1 mmol Gd/kg body weight, solution for intravenous injection, single dose
Approved standard of care macrocyclic GBCA, 0.1 mmol Gd/kg body weight, solution for intravenous injection, single dose
Approved standard of care macrocyclic GBCA, 0.1 mmol Gd/kg body weight, solution for intravenous injection, single dose
UAB Hospital - Radiology
Birmingham, Alabama, United States
Halo Diagnostics - Indian Wells
Indian Wells, California, United States
UC Irvine Medical Center
Orange, California, United States
University of Connecticut Health Center
Farmington, Connecticut, United States
Biogenix Molecular, LLC
Miami, Florida, United States
Visualization Parameter Contrast Enhancement Assessed by Separate Blinded Evaluation of Unenhanced and Combined Pre- and Post-gadoquatrane MRI, by a BICR
Contrast Enhancement was assessed on a 4-point scale (1/No: not enhanced, 2/Moderate: weakly enhanced, 3/Good: clearly enhanced, 4/Excellent: clearly and brightly enhanced). BICR = blinded independent central read / blinded independent central readers; MRI = magnetic resonance imaging
Time frame: 1 day procedure
Visualization Parameter Delineation Assessed by Separate Blinded Evaluation of Unenhanced and Combined Pre- and Post-gadoquatrane MRI, by a BICR
Delineation was assessed on a 4-point scale (1/No: no or unclear delineation, 2/Moderate: some aspects of delineation, 3/Good: almost clear but not complete, 4/Excellent: clear and complete delineation). BICR = blinded independent central read / blinded independent central readers; MRI = magnetic resonance imaging
Time frame: 1 day procedure
Visualization Parameter Morphology Assessed by Separate Blinded Evaluation of Unenhanced and Combined Pre- and Post-gadoquatrane MRI, by a BICR
Morphology was assessed on a 3-point scale (1/Poor: no or poorly evaluable, 2/Moderate: partially evaluable, 3/Good: sufficiently evaluable). BICR = blinded independent central read / blinded independent central readers; MRI = magnetic resonance imaging
Time frame: 1 day procedure
Visualization Parameter Contrast Assessed by Separate Blinded Evaluation of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs, by a BICR
Contrast Enhancement was assessed on a 4-point scale (1/No: not enhanced, 2/Moderate: weakly enhanced, 3/Good: clearly enhanced, 4/Excellent: clearly and brightly enhanced). BICR = blinded independent central read / blinded independent central readers; MRI = magnetic resonance imaging; GBCAs = gadolinium-based contrast agents
Time frame: Two MRI examinations with an interval of 3-14 days between them
Visualization Parameter Delineation Assessed by Separate Blinded Evaluation of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs, by a BICR
Delineation was assessed on a 4-point scale (1/No: no or unclear delineation, 2/Moderate: some aspects of delineation, 3/Good: almost clear but not complete, 4/Excellent: clear and complete delineation). BICR = blinded independent central read / blinded independent central readers; MRI = magnetic resonance imaging; GBCAs = gadolinium-based contrast agents
Time frame: Two MRI examinations with an interval of 3-14 days between them
Visualization Parameter Morphology Assessed by Separate Blinded Evaluation of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs, by a BICR
Morphology was assessed on a 3-point scale (1/Poor: no or poorly evaluable, 2/Moderate: partially evaluable, 3/Good: sufficiently evaluable). BICR = blinded independent central read / blinded independent central readers; MRI = magnetic resonance imaging; GBCAs = gadolinium-based contrast agents
Time frame: Two MRI examinations with an interval of 3-14 days between them
Sensitivity for the Detection of Lesions of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs, by a BICR
Sensitivity for the detection of lesions was evaluated by blinded independent central review (BICR) readers using combined pre- and post-contrast MRI image sets for gadoquatrane and comparator macrocyclic GBCAs. A lesion was defined as a localized, clinically relevant pathological change in a tissue due to injury or disease. In the context of imaging, it was defined as the localization of a pathology which might have been visualized on the MRI. The result from the BICR was then matched with the information from the composite Standard of Truth (cSoT). The cSoT was determined up to 4 weeks after second study related MRI based on the totality of the available clinical information by the referring physician.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Specificity for the Detection of Lesions of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs, by a BICR
Specificity for the detection of lesions was evaluated by blinded independent central review (BICR) readers using combined pre- and post-contrast MRI image sets for gadoquatrane and comparator macrocyclic GBCAs. A lesion was defined as a localized, clinically relevant pathological change in a tissue due to injury or disease. In the context of imaging, it was defined as the localization of a pathology which might have been visualized on the MRI. The result from the BICR was then matched with the information from the composite Standard of Truth (cSoT). The cSoT was determined up to 4 weeks after second study related MRI based on the totality of the available clinical information by the referring physician.
Time frame: Two MRI examinations with an interval of 3-14 days between them
The Overall Diagnostic Clinical Value of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs
Overall diagnostic clinical value is based on the three descriptive imaging features; enhancement location, extension and pattern and is measured on a 5 point scale: 1- no diagnostic clinical value; 2-poor diagnostic clinical value; 3- moderate diagnostic clinical value; 4- good diagnostic clinical value; 5-excellent diagnostic clinical value. BICR = Blinded independent central reviewer.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Sensitivity for the Detection of Malignant Lesions of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs Assessed by BICR and the Investigator
Sensitivity for the detection of malignant lesions was evaluated by blinded independent central review (BICR) readers and by the investigator/designee using combined pre- and post-contrast MRI image sets for gadoquatrane and comparator macrocyclic GBCAs. Lesion assessments were compared with the composite Standard of Truth (cSoT), and sensitivity with corresponding 95% confidence intervals was calculated.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Specificity for the Detection of Malignant Lesions of Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs Assessed by BICR and the Investigator
Specificity for the detection of malignant lesions was evaluated by blinded independent central review (BICR) readers and by the investigator/designee using combined pre- and post-contrast MRI image sets for gadoquatrane and comparator macrocyclic GBCAs. Lesion assessments were compared with the composite Standard of Truth (cSoT), and specificity with corresponding 95% confidence intervals was calculated.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Number of Cases With Concordance Between Final Diagnosis and MRI Diagnosis From Combined pre-and Post- Gadoquatrane MRI and Combined Pre- and Post- Comparator MRI With Macrocyclic GBCAs, as Assessed by the Investigator
The investigator or designee, who remained blinded to the contrast agent used in the image set, was asked for the diagnosis based on the combined pre- and post-contrast MRI image sets for each period, which was compared to the composite Standard of Truth (cSoT). The cSoT was determined up to 4 weeks after second study related MRI based on the totality of the available clinical information by the referring physician. Concordance between the MRI-based diagnosis and the final clinical diagnosis was evaluated, and the number of cases with matching and non-matching diagnoses was summarized.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Confidence in Diagnosis Combined Pre- and Post- Gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs by BICR and by Investigator
Confidence in diagnosis was assessed by blinded independent central review (BICR) readers and the investigator to determine the level of certainty in the assigned diagnosis based on combined pre- and post-contrast MRI image sets for gadoquatrane and comparator macrocyclic GBCAs. Confidence was scored using a 4-point scale (1 = Not confident, 2 = Somewhat confident, 3 = Confident, 4 = Very confident), and mean scores with standard deviation are reported.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Number of Lesions Seen on Unenhanced MR Image Sets and Combined Pre- and Post-gadoquatrane MRI and Combined Pre- and Post-comparator MRI With Macrocyclic GBCAs, by a BICR
Total number of lesions across all participants was counted by 3 blinded independent central readers on the unenhanced (pre-contrast) and combined pre- and post-contrast gadoquatrane and comparator MR image set.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Number of Enhancing Lesions Seen on Combined Pre- and Post- Gadoquatrane MRI and Combined pre-and Post-comparator MRI With Macrocyclic GBCAs, by a BICR
The total number of contrast-enhanced lesions for each contrast- enhanced image set (gadoquatrane and comparators-enhanced MR images) was evaluated by two of the blinded independent central readers.
Time frame: Two MRI examinations with an interval of 3-14 days between them
Number of Participants With Treatment Emergent Adverse Events, Including Number of Serious Adverse Events, After Administration of Gadoquatrane Compared to Macrocyclic GBCAs Reported by the Investigator
Treatment-emergent adverse events (TEAEs), including serious adverse events (TESAEs), are defined as events occurring from the start of study intervention until follow-up (24 ± 4 hours post-injection.
Time frame: Within 24 ± 4 hours after administration of gadoquatrane or any approved macrocyclic GBCAs
Number of Participants With Treatment Emergent Adverse Events, Including Number of Serious Adverse Events, Per Intensity After Administration of Gadoquatrane Compared to Macrocyclic GBCAs Reported by the Investigator
Treatment-emergent (serious) AEs are defined as events occurring from the start of study intervention until follow-up (24 ± 4 hours post-injection). Participants with at least one treatment-emergent adverse event are counted once and categorized according to the maximum intensity of their adverse events (mild, moderate, or severe), as assessed by the investigator.
Time frame: Within 24 ± 4 hours after administration of gadoquatrane or any approved macrocyclic GBCAs
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