CT Perfusion in the Prognostication of Cerebral High Grade Glioma

NCT01923922 | Completed

• 1 other identifier: CTP GBM
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

High grade cerebral glioma is the most common primary brain tumor in adults and accounts for about 2.5% of all cancer deaths. Brain tumor affects approximately 2300 individuals per year in Canada. Noninvasive accurate and timely diagnosis is imperative. High grade glioma is an aggressive neoplasm with median survival of 12 months, irrespective of any treatment. The prognosis of these patients can only be decided based on pathology after biopsy or surgery. Conventional imaging techniques, such as routine magnetic resonance imaging(MRI), do not accurately predict the grade of malignancy of cerebral gliomas. Computed tomography(CT) perfusion allows us to study the blood supply to the tumor at the level of capillaries. This information permits determination of aggressiveness of cerebral gliomas at the time of diagnosis. In a preliminary study of 20 patients with high grade cerebral gliomas, we have shown that CT perfusion can predict survival at the time of diagnosis irrespective of the pathological grade and the treatment received. In the present study, we would like to extend our preliminary findings in larger group of patients to ensure that this technique is indeed robust. If our hypothesis was supported by our study, we will be able to subselect patients based on initial imaging for more aggressive treatment. In patients with shorter survival, the perfusion parameters may help in identifying new therapeutic targets (e.g., anti-angiogenic agents) that may help in the treatment of these patients.

Conditions

Glioblastoma Multiforme

Keywords

glioblastoma multiforme; CT Perfusion; Survival

Outcome Measures

Primary Outcomes (1)

• Survival of patients with high grade cerebral glioma based on the CT perfusion parameters irrespective of the pathological grade and irrespective of the treatment given.

  1 year

Secondary Outcomes (1)

• Number of Adverse Events as a Measure of Safety and Tolerability

  30 day

Study Arms (1)

CT Perfusion

OTHER

Participants with suspected Glioblastoma Multiforme undergo CT perfusion prior to surgery or biopsy.

Radiation: CT Perfusion

Interventions

CT Perfusion RADIATION

The CT perfusion scan will be performed on a multi-detector CT scanner at the time of routine preoperative neuronavigation imaging. A non-contrast CT head scan will be acquired to localize the tumour. Four 5 mm thick slices will be selected at the level of the tumour. Multiple images will be acquired at each levels starting 5 sec after the injection of 50 cc of non-ionic iodinated contrast media at a rate of 4 cc/sec. The acquisition parameters will be 80 kVp and 100 mA. The images will be acquired every second for a total of 110 sec. The post- processing will be performed and parameters will be calculated using regions of interest in the areas of tumour showing the highest perfusion values. Another region of interest will be placed in the contralateral normal looking white matter.

CT Perfusion

Eligibility Criteria

• Age: 15 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• All patients, presenting with a newly detected brain lesion likely to be high grade cerebral glioma either on CT or MRI of the brain

You may not qualify if:

• Pregnant patients
• those with impaired renal function

Sponsors & Collaborators

• Nova Scotia Health Authority: lead

Study Sites (1)

QE II Health Sciences Centre

Halifax, Nova Scotia, B3H 3A7, Canada

Location

Related Publications (1)

• Shankar JJ, Woulfe J, Silva VD, Nguyen TB. Evaluation of perfusion CT in grading and prognostication of high-grade gliomas at diagnosis: a pilot study. AJR Am J Roentgenol. 2013 May;200(5):W504-9. doi: 10.2214/AJR.12.8967.

  PMID: 23617517 BACKGROUND

MeSH Terms

Conditions

Glioblastoma

Interventions

Cytidine Triphosphate

Condition Hierarchy (Ancestors)

Astrocytoma; Glioma; Neoplasms, Neuroepithelial; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Glandular and Epithelial; Neoplasms, Nerve Tissue

Intervention Hierarchy (Ancestors)

Cytosine Nucleotides; Pyrimidine Nucleotides; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Nucleotides; Nucleic Acids, Nucleotides, and Nucleosides; Ribonucleotides

Study Officials

• Jai Shankar

  Capital District Health Auhtority

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 9, 2013
• First Posted: August 16, 2013
• Study Start: September 9, 2013
• Primary Completion: October 22, 2019
• Study Completion: October 22, 2019
• Last Updated: August 21, 2024

Record last verified: 2022-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)