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| Name | Class |
|---|---|
| Summit Medical Center | OTHER |
| Center for Diagnostic Imaging | OTHER |
| Loma Linda University | OTHER |
| University of Texas Southwestern Medical Center |
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The study's purpose is to validate STAGE images and, when applicable, their equivalence to conventional MRI through an assessment by a trained certified neuroradiologist in a clinical setting. For STAGE images without conventional equivalent, the neuroradiologist will determine if their contrasts, intensities, and quality are sufficient and meet expectations for images used in radiological reads of the brain. The study is a multi-center study in which STAGE can be assessed at sites with different MRI manufacturers and field strengths. Site names will be made available to the collaborators and participants. The sponsor is based out of Michigan, while participating sites may be located in other states. Any funding for the study will come from an industry source, SpinTech, Inc.
The scope of the study includes the acquisition of MR images from a specified MR manufacturer, the installation of the STAGE device at the clinical site, the subsequent processing of the acquired MR images, and their evaluation by neuroradiologists. The follow section will summarize the key procedures which are involved in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| STrategically Acquired Gradient Echo (STAGE) | Experimental | STAGE Inputs are flow compensated 3D gradient echo MR images acquired at optimal parameters which are used to calculate multiple contrasts for brain imaging. All subjects within the study are imaged using both a conventional MR protocol and STAGE protocol. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| STrategically Acquired Gradient Echo (STAGE) | Device | The STAGE package uses conventional 3D gradient echo MR, its magnitude and phase, collected at set parameters which allow for the reconstruction of multiple MR datasets which results in decreased acquisition time, equivalency to conventional MR, and the decrease in scan time allows for a higher standard of wealth within the data acquired. |
| Measure | Description | Time Frame |
|---|---|---|
| Numeric Rating Scale of Clinical Usability Assessment of STAGE Outputs | Reading radiologists responses on the clinical usability of STAGE Outputs based on image quality using a numeric rating scale of 1 to 5 with: 1=unacceptable, 2=poor, 3=acceptable, 4=good, 5=excellent. Scores of 3 or greater are considered clinically usable. | Baseline Only |
| Review of STAGE Outputs for Artifact and Image Contrast | Reading radiologist and image analyst responses on the clinical usability of STAGE Outputs based on image quality using a yes/no criteria for presence of novel or accentuated imaging artifact. Hardware or participant artifact contributions (i.e. coil sensitivity and motion) were not considered unless noted as increased due to the STAGE method. Each image series was evaluated for the presence of artifact. The total count of the artifacts reported across series evaluated in the study is reported. | Baseline Only |
| Review of STAGE Outputs for Expected Brain Structural Appearance | Reading radiologists responses on the clinical usability of STAGE Outputs based on image appearance of specified brain structures using pass/fail criteria. Expected brain contrast between tissue types will vary depending on the output reviewed (i.e. T1W, PDW, SWI). The behavior of tissue contrasts (i.e. white matter vs gray matter) should also demonstrate standard anatomic contrast (T1W, PDW, SWI) as well quantitative ratio for maps (T2*MAP, R2*MAP, SWIM, T1MAP, PDMAP). For artery/vein appearance, STAGE T1W, T1MAP and PD MAP were not evaluated due to artery/vein not appearing in the image contrasts. For GM/WM/CSF, the MRA, pSWIM and mpSWIM were not evaluated due to the anatomic contrast not appearing in the image contrasts. For calcium/iron appearance, T1WE, T1MAP, PDMAP, MRA, and DIR were not evaluated due to the calcium/iron not appearing in the image contrasts. | Baseline Only |
| Evaluation of STAGE Image Processing Times | Review of the recorded processing times for the STAGE module to accept and process STAGE inputs and to export them back to the PACS as STAGE outputs. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Douglas P Beall, MD | Summit Medical Center | Principal Investigator |
| Murray A Solomon, MD | Center for Diagnostic Imaging | Principal Investigator |
| Vincent Magnotta, MD | University of Iowa | Principal Investigator |
| Karen Tong, MD | Loma Linda University Health | Principal Investigator |
| Frank Yu, MD | University of Texas | Principal Investigator |
| Letterio Politi, MD | University of Massachusetts, Worcester | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Loma Linda University Health | Loma Linda | California | 92354 | United States | ||
| Insight Imaging - Center for Diagnostic Imaging |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31629075 | Background | Haacke EM, Chen Y, Utriainen D, Wu B, Wang Y, Xia S, He N, Zhang C, Wang X, Lagana MM, Luo Y, Fatemi A, Liu S, Gharabaghi S, Wu D, Sethi SK, Huang F, Sun T, Qu F, Yadav BK, Ma X, Bai Y, Wang M, Cheng J, Yan F. STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging method. Magn Reson Imaging. 2020 Jan;65:15-26. doi: 10.1016/j.mri.2019.09.006. Epub 2019 Oct 16. | |
| 29061370 |
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Subject recruitment took place across three sites and resulted in a total of 92 participant enrollment with 89 participants remaining after attrition. Recruitment took place between July 2020 and December 2020.
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| ID | Title | Description |
|---|---|---|
| FG000 | STrategically Acquired Gradient Echo (STAGE) | STAGE Inputs are flow compensated 3D gradient echo MR images acquired at optimal parameters which are used to calculate multiple contrasts for brain imaging. All subjects within the study are imaged using both a conventional MR protocol and STAGE protocol. STrategically Acquired Gradient Echo (STAGE): The STAGE package uses conventional 3D gradient echo MR, its magnitude and phase, collected at set parameters which allow for the reconstruction of multiple MR datasets which results in decreased acquisition time, equivalency to conventional MR, and the decrease in scan time allows for a higher standard of wealth within the data acquired. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
92 participants were imaged using STAGE and conventional MR protocols. 89 participants were included in the final analysis after an attrition of 3 participants data due to image artifact due to excessive patient motion or acquisition hardware error.
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| ID | Title | Description |
|---|---|---|
| BG000 | STrategically Acquired Gradient Echo (STAGE) | STAGE Inputs are flow compensated 3D gradient echo MR images acquired at optimal parameters which are used to calculate multiple contrasts for brain imaging. All subjects within the study are imaged using both a conventional MR protocol and STAGE protocol. STrategically Acquired Gradient Echo (STAGE): The STAGE package uses conventional 3D gradient echo MR, its magnitude and phase, collected at set parameters which allow for the reconstruction of multiple MR datasets which results in decreased acquisition time, equivalency to conventional MR, and the decrease in scan time allows for a higher standard of wealth within the data acquired. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Numeric Rating Scale of Clinical Usability Assessment of STAGE Outputs | Reading radiologists responses on the clinical usability of STAGE Outputs based on image quality using a numeric rating scale of 1 to 5 with: 1=unacceptable, 2=poor, 3=acceptable, 4=good, 5=excellent. Scores of 3 or greater are considered clinically usable. | Scores of 3 or greater are considered clinically acceptable. The count of participants is presented for each score and for each STAGE output series. | Posted | Count of Participants | Participants | Baseline Only |
|
Adverse event data collected per MRI routine examination, approximately up to 90 minutes. Participants were observed during the MRI scan. No follow-up data were recorded.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | STrategically Acquired Gradient Echo (STAGE) | STAGE Inputs are flow compensated 3D gradient echo MR images acquired at optimal parameters which are used to calculate multiple contrasts for brain imaging. All subjects within the study are imaged using both a conventional MR protocol and STAGE protocol. STrategically Acquired Gradient Echo (STAGE): The STAGE package uses conventional 3D gradient echo MR, its magnitude and phase, collected at set parameters which allow for the reconstruction of multiple MR datasets which results in decreased acquisition time, equivalency to conventional MR, and the decrease in scan time allows for a higher standard of wealth within the data acquired. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Rana El Hachem | SpinTech MRI | 2487126789 | rana@spintechmri.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Nov 10, 2020 | Jan 11, 2021 | Prot_SAP_002.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jan 13, 2020 | Feb 24, 2020 | ICF_001.pdf |
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| OTHER |
| University of Iowa | OTHER |
| University of Massachusetts, Worcester | OTHER |
All human participants in the study will be imaged using MRI under the same acquisition protocol. The STAGE protocol is collected alongside conventional MR.
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Study does not involve masking.
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|
| Baseline Only |
| Los Gatos |
| California |
| 95032 |
| United States |
| University of Iowa | Iowa City | Iowa | 52242 | United States |
| Summit Medical Center | Edmond | Oklahoma | 73013 | United States |
| University of Texas Southwestern Medical Center | Dallas | Texas | 75390 | United States |
| Background |
| Wang Y, Chen Y, Wu D, Wang Y, Sethi SK, Yang G, Xie H, Xia S, Haacke EM. STrategically Acquired Gradient Echo (STAGE) imaging, part II: Correcting for RF inhomogeneities in estimating T1 and proton density. Magn Reson Imaging. 2018 Feb;46:140-150. doi: 10.1016/j.mri.2017.10.006. Epub 2017 Oct 20. |
| 29056394 | Background | Chen Y, Liu S, Wang Y, Kang Y, Haacke EM. STrategically Acquired Gradient Echo (STAGE) imaging, part I: Creating enhanced T1 contrast and standardized susceptibility weighted imaging and quantitative susceptibility mapping. Magn Reson Imaging. 2018 Feb;46:130-139. doi: 10.1016/j.mri.2017.10.005. Epub 2017 Oct 19. |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Primary | Review of STAGE Outputs for Artifact and Image Contrast | Reading radiologist and image analyst responses on the clinical usability of STAGE Outputs based on image quality using a yes/no criteria for presence of novel or accentuated imaging artifact. Hardware or participant artifact contributions (i.e. coil sensitivity and motion) were not considered unless noted as increased due to the STAGE method. Each image series was evaluated for the presence of artifact. The total count of the artifacts reported across series evaluated in the study is reported. | Reported number of observed artifacts within image series are shown as a count. | Posted | Number | Artifact Count | Baseline Only | Image Series | Image Series |
|
|
|
| Primary | Review of STAGE Outputs for Expected Brain Structural Appearance | Reading radiologists responses on the clinical usability of STAGE Outputs based on image appearance of specified brain structures using pass/fail criteria. Expected brain contrast between tissue types will vary depending on the output reviewed (i.e. T1W, PDW, SWI). The behavior of tissue contrasts (i.e. white matter vs gray matter) should also demonstrate standard anatomic contrast (T1W, PDW, SWI) as well quantitative ratio for maps (T2*MAP, R2*MAP, SWIM, T1MAP, PDMAP). For artery/vein appearance, STAGE T1W, T1MAP and PD MAP were not evaluated due to artery/vein not appearing in the image contrasts. For GM/WM/CSF, the MRA, pSWIM and mpSWIM were not evaluated due to the anatomic contrast not appearing in the image contrasts. For calcium/iron appearance, T1WE, T1MAP, PDMAP, MRA, and DIR were not evaluated due to the calcium/iron not appearing in the image contrasts. | Image series were evaluated for 1) correct artery/vein appearance, 2) calcium/iron appearance, and 3) contrast between gray matter, white matter, and cerebrospinal fluid. Data were evaluated across all STAGE output images based on these structures appearance. The count of image series units is shown as either meeting criteria or not. | Posted | Count of Units | Image Series | Baseline Only | Image Series | Image Series |
|
|
|
| Primary | Evaluation of STAGE Image Processing Times | Review of the recorded processing times for the STAGE module to accept and process STAGE inputs and to export them back to the PACS as STAGE outputs. | The average and minimum/maximum processing times for STAGE were evaluated across scanners, resolutions, and field strengths. | Posted | Mean | Standard Deviation | Time (minutes) | Baseline Only |
|
|
|
| 0 |
| 92 |
| 0 |
| 92 |
| 0 |
| 92 |
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| Title | Measurements |
|---|---|
|
| STAGE T1W |
|
| STAGE PDW |
|
| STAGE T1WE |
|
| STAGE T1MAP |
|
| STAGE PDMAP |
|
| STAGE SWI |
|
| STAGE tSWI |
|
| STAGE iSWIM |
|
| STAGE R2*MAP |
|
| STAGE T2*MAP |
|
| STAGE MRA |
|
| STAGE pSWIM |
|
| STAGE mpSWIM |
|
| STAGE DIR |
|
| Conventional T1W Criteria Not Met |
|
| Conventional PDW Criteria Met |
|
| Conventional PDW Criteria Not Met |
|
| STAGE T1W Criteria Met |
|
| STAGE T1W Criteria Not Met |
|
| STAGE PDW Criteria Met |
|
| STAGE PDW Criteria Not Met |
|
| STAGE SWI Criteria Met |
|
| STAGE SWI Criteria Not Met |
|
| STAGE tSWI Criteria Met |
|
| STAGE tSWI Criteria Not Met |
|
| STAGE iSWIM Criteria Met |
|
| STAGE iSWIM Criteria Not Met |
|
| STAGE R2*MAP Criteria Met |
|
| STAGE R2*MAP Criteria Not Met |
|
| STAGE T2*MAP Criteria Met |
|
| STAGE T2*MAP Criteria Not Met |
|
| STAGE MRA Criteria Met |
|
| STAGE MRA Criteria Not Met |
|
| STAGE pSWIM Criteria Met |
|
| STAGE pSWIM Criteria Not Met |
|
| STAGE mpSWIM Criteria Met |
|
| STAGE mpSWIM Criteria Not Met |
|
| STAGE T1WE Criteria Met |
|
| STAGE T1WE Criteria Not Met |
|
| STAGE T1MAP Criteria Met |
|
| STAGE T1MAP Criteria Not Met |
|
| STAGE PDMAP Criteria Met |
|
| STAGE PDMAP Criteria Not Met |
|
| STAGE DIR Criteria Met |
|
| STAGE DIR Criteria Not Met |
|
| Calcium and Iron |
|
| Gray Matter / White Matter / Cerebrospinal Fluid |
|
|
| 3T Siemens Skyra |
|
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| 3T Siemens Prisma |
|
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