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Phase 2 N=232 Randomized Triple-blind Diagnostic

Myocardial Perfusion MRI

Myocardial Perfusion Imaging · Magnetic Resonance Imaging

Enrolled (actual)
232
Serious AEs
0.0%
Results posted
Jun 2012
Primary outcome: Primary: Percentage Agreement Between Gadobutrol Perfusion Magnetic Resonance Imaging (MRI) (Blinded Reading) and SPECT (Central Reading) Regarding the Diagnosis for Detection of Cardiac Perfusion Deficits Based on Myocardial Regions — 58.8; 44.1; 36.7; 40.3 Percent regional assessments

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Gadobutrol (Gadavist,Gadovist, BAY86-4875) (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Bayer
Primary completion
May 2006

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage Agreement Between Gadobutrol Perfusion Magnetic Resonance Imaging (MRI) (Blinded Reading) and SPECT (Central Reading) Regarding the Diagnosis for Detection of Cardiac Perfusion Deficits Based on Myocardial Regions
58.8; 44.1; 36.7; 40.3; 41.2; 55.9
PRIMARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and SPECT (Central Reading) Regarding the Diagnosis for Detection of Cardiac Perfusion Deficits Based on Myocardial Segments
51.1; 39.4; 34.5; 34.1; 48.9; 60.6
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding the Diagnosis for Detection of Cardiac Perfusion Deficits Based on Myocardial Regions
48.5; 39.2; 35.2; 37.7; 51.5; 60.8
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding the Diagnosis for Detection of Cardiac Perfusion Deficits Based on Myocardial Segments
39.3; 30.4; 28.7; 33.3; 60.7; 69.6
SECONDARY
Diagnosis 'Scar': Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and SPECT (Central Reading) Regarding the Diagnosis Scar Based on Myocardial Regions
81.3; 80.6; 83.3; 86.5; 18.8; 19.4
SECONDARY
Diagnosis "Scar": Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and SPECT (Central Reading) Regarding the Diagnosis "Scar" Based on Myocardial Segments
88.4; 85.7; 82.0; 90.8; 11.6; 14.3
SECONDARY
Diagnosis "Scar": Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding the Diagnosis "Scar" Based on Myocardial Regions
81.8; 76.0; 76.5; 85.7; 18.2; 24.0
SECONDARY
Diagnosis "Scar": Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding the Diagnosis "Scar" Based on Myocardial Segments
86.4; 84.8; 69.7; 88.0; 13.6; 15.2
SECONDARY
Diagnosis "Ischemia": Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and SPECT (Central Reading) Regarding the Diagnosis of Ischemia Based on Myocardial Regions
87.9; 69.3; 64.4; 60.6; 12.1; 30.7
SECONDARY
Diagnosis "Ischemia": Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and SPECT (Central Reading) Regarding the Diagnosis of Ischemia Based on Myocardial Segments
91.8; 77.5; 74.3; 68.9; 8.2; 22.5
SECONDARY
Diagnosis "Ischemia": Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding the Diagnosis of Ischemia Based on Myocardial Regions
63.5; 61.5; 48.3; 46.7; 36.5; 38.5
SECONDARY
Diagnosis "Ischemia": Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding the Diagnosis of Ischemia Based on Myocardial Segments
77.4; 66.7; 58.4; 58.2; 22.6; 33.3
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and SPECT (Central Reading) Regarding a Detailed Diagnosis of Cardiac Perfusion Deficits i.e. Scar, Ischemia or a Mixture of Both, Based on Myocardial Regions
67.4; 57.3; 46.8; 53.0; 32.6; 42.7
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and SPECT (Central Reading) Regarding a Detailed Diagnosis of Cardiac Perfusion Deficits i.e. Scar, Ischemia or a Mixture of Both Based on Myocardial Segments
53.8; 42.7; 36.8; 37.3; 46.2; 57.3
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding a Detailed Diagnosis of Cardiac Perfusion Deficits i.e. Scar, Ischemia or a Mixture of Both Based on Myocardial Regions
52.3; 49.1; 42.1; 46.5; 47.7; 50.9
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Clinical Evaluation) and SPECT (Central Reading) Regarding a Detailed Diagnosis of Cardiac Perfusion Deficits i.e. Scar, Ischemia or a Mixture of Both Based on Myocardial Segments
40.9; 33.0; 31.1; 35.6; 59.1; 67.0
SECONDARY
Percent Agreement Between Combined Gadobutrol Perfusion MRI (Perfusion Imaging and Delayed (DE) Imaging; Blinded Reading) and SPECT (Central Reading) Regarding a Detailed Diagnosis of Perfusion Deficits Based on Myocardial Regions
66.2; 53.8; 51.4; 53.5; 33.8; 46.2
SECONDARY
Percent Agreement Between Combined Gadobutrol Perfusion MRI (Perfusion Imaging and Delayed (DE) Imaging; Blinded Reading) and SPECT (Central Reading) Regarding a Detailed Diagnosis of Perfusion Deficits Based on Myocardial Segments
48.5; 41.2; 35.6; 35.3; 51.5; 58.8
SECONDARY
Percentage of Artifacts in Gadobutrol Perfusion MRI (Blinded Reading) Based on Myocardial Segments
1.8; 1.4; 2.8; 1.5; 66.3; 62.7
SECONDARY
Percentage of Artifacts in Gadobutrol Perfusion MRI (Clinical Evaluation) Based on Myocardial Segments
85.5; 85.3; 81.5; 83.5; 14.5; 14.7
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading, Based on Myocardial Regions) and Coronary Angiography (Central Reading) Regarding Detection of Significant Stenoses
50.6; 48.1; 38.8; 32.3; 49.4; 51.9
SECONDARY
Percentage Agreement Between the Semiquantitative Gadobutrol Perfusion MRI Parameter "Myocardial Perfusion Reserve Index (MPRI) " (Expert Evaluation) and Detection of Significant Stenoses by Coronary Angiography (MR Based on Myocardial Regions)
53.7; 40.7; 60.3; 56.7; 46.3; 59.3
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI (Blinded Reading) and the Truth Panel Diagnosis (SoT) Regarding Perfusion Defects Based on Regions
62.8; 51.4; 53.6; 40.7; 37.2; 48.6
SECONDARY
Percentage Agreement Between the Semiquantitative Gadobutrol Perfusion MRI Parameter "Myocardial Perfusion Reserve Index (MPRI)" (Expert Evaluation) and SPECT (Central Reading) Based on Myocardial Regions
62.1; 60.8; 59.1; 66.0; 37.9; 39.2
SECONDARY
Percentage Agreement Between the Semiquantitative Gadobutrol Perfusion MRI Parameter "Myocardial Perfusion Reserve Index (MPRI)" (Expert Evaluation) and SPECT (Central Reading) Based on Myocardial Segments
69.6; 57.0; 48.9; 49.4; 30.4; 43.0
SECONDARY
Percentage Agreement Between the Visual (Blinded Reading) and the Semiquantitative (MPRI; Expert Evaluation) Gadobutrol Perfusion MRI Diagnosis Based on Myocardial Regions
56.3; 55.2; 49.1; 58.3; 43.7; 44.8
SECONDARY
Percentage Agreement Between the Visual (Blinded Reading) and Semiquantitative (MPRI; Expert Evaluation) Gadobutrol Perfusion MRI Diagnosis Based on Myocardial Segments
53.0; 46.3; 41.8; 43.7; 47.0; 53.7
SECONDARY
Signal Intensity (SIrel) Based on Segments
0.768; 0.625; 0.708; 0.615; 0.732; 0.603
SECONDARY
Upslope Based on Segments
11.44; 18.18; 27.49; 31.31; 11.41; 17.90
SECONDARY
Time to Peak Based on Segments
12.43; 13.83; 13.87; 15.34; 12.11; 13.67
SECONDARY
Percentage Agreement Between Presence/Absence of Delayed Enhancement in MRI (Blinded Reading) and Scar in SPECT (Central Reading) Based on Myocardial Regions
0.0; 1.4; 14.3; 36.5; 0.0; 5.6
SECONDARY
Percentage Agreement Between Presence/Absence of Delayed Enhancement in MRI (Blinded Reading) and Scar in SPECT (Central Reading) Based on Myocardial Segments
0.0; 0.7; 18.9; 31.3; 0.0; 2.7
SECONDARY
Percentage Agreement Between Presence/Absence of Delayed Enhancement in MRI (Clinical Evaluation) and Scar in SPECT (Central Reading) Based on Myocardial Regions
6.3; 4.2; 21.4; 25.0; 6.3; 4.2
SECONDARY
Percentage Agreement Between Presence/Absence of Delayed Enhancement in MRI (Clinical Evaluation) and Scar in SPECT (Central Reading) Based on Myocardial Segments
4.7; 2.0; 21.6; 23.1; 7.0; 2.0
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 5 Minutes Post Injection (Blinded Reading)
5; 12; 11; 8; 0; 1
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 5 Minutes Post Injection (Clinical Evaluation) (Only Participants With DE in at Least One Segment, PPS)
1; 4; 1; 4; 0; 4
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 10 Minutes Post Injection (Blinded Reading) (Only Participants With DE in at Least One Segment, PPS)
3; 11; 14; 14; 0; 5
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 10 Minutes Post Injection (Clinical Evaluation) (Only Participants With DE in at Least One Segment, PPS)
1; 6; 2; 3; 2; 3
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 15 Minutes Post Injection (Blinded Reading) (Only Participants With DE in at Least One Segment, PPS)
3; 8; 15; 17; 0; 4
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 15 Minutes Post Injection (Clinical Evaluation) (Only Participants With DE in at Least One Segment, PPS)
2; 5; 2; 4; 2; 4
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 20 Minutes Post Injection (Blinded Reading) (Only Participants With DE in at Least One Segment, PPS)
5; 11; 15; 18; 0; 4
SECONDARY
Assessment of the Overall Confidence in the Presence of Delayed Enhancement (DE) at 20 Minutes Post Injection (Clinical Evaluation) (Only Participants With DE in at Least One Segment, PPS)
4; 3; 1; 3; 1; 5
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 5 Minutes Post Injection (Blinded Reading) (Only Participants With DE in at Least One Segment, PPS)
5; 11; 13; 8; 0; 2
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 5 Minutes Post Injection (Clinical Evaluation) (Only Participants With DE in at Least One Segment, PPS)
2; 3; 3; 4; 0; 5
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 10 Minutes Post Injection (Blinded Reading) (Only Participants With DE in at Least One Segment, PPS)
4; 13; 13; 15; 0; 5
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 10 Minutes Post Injection According to Clinical Evaluation (Only Participants With DE in at Least One Segment, PPS)
1; 5; 3; 3; 1; 5
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 15 Minutes Post Injection According to Blinded Reading (Only Participants With DE in at Least One Segment, PPS)
4; 11; 13; 15; 0; 2
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 15 Minutes Post Injection According to Clinical Evaluation (Only Participants With DE in at Least One Segment, PPS)
3; 4; 3; 4; 1; 5
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 20 Minutes Post Injection According to Blinded Reading (Only Participants With DE in at Least One Segment, PPS)
5; 12; 12; 14; 0; 4
SECONDARY
Assessment of Contrast Quality of Delayed Enhancement (DE) at 20 Minutes Post Injection According to Clinical Evaluation (Only Participants With DE in at Least One Segment, PPS)
4; 2; 2; 3; 1; 5
SECONDARY
Percent Agreement Between Gadobutrol Perfusion MRI Diagnosis (Blinded Reading) and the Presence/Absence of Delayed Enhancement (DE) at the Time Point of Highest Agreement Between SPECT (Central Reading) and DE Based on Myocardial Regions
12.1; 21.2; 27.5
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI Diagnosis (Blinded Reading) and the Presence/Absence of Delayed Enhancement (DE) at the Time Point of Highest Agreement Between SPECT (Central Reading) and DE Based on Myocardial Segments
7.3; 27.1; 23.8
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI Diagnosis (Clinical Evaluation) and the Presence/Absence of Delayed Enhancement (DE) at the Time Point of Highest Agreement Between SPECT (Central Reading) and DE Based on Myocardial Segments
41.7; 75.0; 82.4; 100.0
SECONDARY
Percentage Agreement Between Gadobutrol Perfusion MRI Diagnosis (Clinical Evaluation) and Presence/Absence of Delayed Enhancement (DE) at the Time Point of Highest Agreement Between SPECT (Central Reading) and DE Based on Myocardial Regions
20.0; 72.7; 87.5; 92.9
SECONDARY
Percentage of Segments With Artifacts on Delayed Enhancement Images (Blinded Reading)
23.9; 22.3; 26.7; 26.2; 25.3; 19.4
SECONDARY
Percentage of Segments With Artifacts on Delayed Enhancement Images (Clinical Evaluation)
26.8; 24.9; 21.3; 11.7; 23.3; 21.3
SECONDARY
Percentage of Participants With Deviation of MRI Procedure (Clinical Evaluation)
86.5; 76.7; 76.8; 85.2; 13.5; 23.3

Summary

The object of this study is to compare four different dosages of Gadavist 1.0 in cardiac Magnetic Resonance Tomography (MRT) imaging with the imaging results of a cardiac SPECT examination in terms of diagnostic quality. For this purpose Gadavist dosages of 0.01 mmol/kg, 0.025 mmol/kg, 0.05 mmol/kg or 0.1mmol/kg body weight are administered. A study participant receives the respective dose twice i.e. at rest and at stress using Adenosine (which puts circulation into a state of stress similar to that of physical exercise). The time between both injections is 10-15 min. The total imaging time is about 45 min.

Eligibility Criteria

Inclusion Criteria

  • Males or females of any ethnic group with reversible focal hypoperfusion in at least 2 adjoining segments in SPECT
  • The SPECT examination had been performed within 4 weeks prior to the MRI examination and had been performed for clinical reasons only

Exclusion Criteria

  • Generalized myocardial hypoperfusion (e.g. severe 3 vessel disease)
  • Recent myocardial infarction (MI) (within 1 week prior to the study procedure)
  • Event that significantly altered cardiac performance between SPECT and MRI imaging, e.g. myocardial infarction, unstable angina, alteration of cardiac medication
  • Non-sinus rhythm
  • Sinus node disease or symptomatic bradycardia
  • Second or third degree atrial ventricular (AV) block
  • Complete left bundle branch block (LBBB)
  • Known congenital long QT syndrome or a family history of congenital long QT syndrome
  • Known previous arrhythmias on drugs that prolong cardiac repolarization
  • Uncorrected hypokalemia
  • Uncontrolled hypertension (e.g. systolic blood pressure >185 mm Hg, diastolic blood pressure >110 mm Hg)
  • Baseline hypotension (e.g. mean arterial pressure <60 mm Hg)
  • Ejection fraction below 35%
  • Cardiomyopathy, congenital heart defect or higher degree valvular pathology
  • Coronary artery stent placement within 4 weeks prior to the MRI procedure
  • Previous heart transplantation
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01490294). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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