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CompletedNCT02613390Updated Jan 10, 2019

Safety Evaluation of Intra-Operative MRI-Based Guidance for Laser Ablation of Epidural Metastasis

An interventional study of Magnetic Resonance Imaging (MRI) and Questionnaires in Spinal Tumor, sponsored by M.D. Anderson Cancer Center. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-01-10.

Sponsored by M.D. Anderson Cancer Center · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
11
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical research study is to learn about the safety and accuracy of using MRI as a guidance system during laser ablation surgery of tumors that have spread to the spine.

Read the detailed description

Study Visits:

If you agree to take part in this study, before your surgery:

  • You will have a physical exam.
  • You will have a neurological exam (tests to check the functioning of your nerves, including tests of your balance and reflexes).
  • You will complete questionnaires about pain and other symptoms that should take about 10-15 minutes.
  • You will sign a separate consent for your spinal surgery that explains the risks.

During the Surgery:

You will be positioned lying face down on your stomach during surgery. While you are under anesthesia, an MRI will be used to take images of your spine. This is an intraoperative MRI, meaning that it is performed in a special magnet located inside a specifically designed operating room. These images will be loaded into a computer navigation program and will be used to help the doctor perform surgery.

Markers will also be attached to the skin of your back. These markers are used together with the navigation program and MRI images to record the location of where on your spine the doctor should cut. This recording will be compared to the MRI images.

Your doctor will check the accuracy of this recording in 2 ways:

  • Placing the tip of the navigation probe on your skin and comparing it with the computer calculation in the computer navigation program. This is a standard navigation probe commonly used in spinal surgeries.
  • Inserting the navigation probe through a small cut on your skin along the surgical area and taking an x-ray image of its location.

If there is a difference in the result of these 2 measurements, your doctor will use the result of the first step to check the accuracy of the MRI image.

If there is more than 2 millimeter difference between the visual inspection position and the computer model position, your doctor may decide to do one of the following steps:

  • Restart the recording process by getting a new MRI image
  • Use only the x-ray images to complete the procedure
  • Stop the surgery

On the Day After Surgery:

  • You will have a physical exam.
  • You will have a neurological exam.
  • You will complete the same questionnaires as before.

Follow-Up Visits:

The research staff will call you 3 weeks after surgery to ask about your recovery and you will be asked to answer the same questionnaires as before.

You will return for a follow-up visit after surgery:

  • You will have a physical exam.
  • You will have a neurological exam.
  • You will complete the same questionnaires as before.

Length of Study Participation:

Your participation in the study will be over after your follow-up visit.

You will be taken off study if during surgery the doctor thinks the navigation is not accurate, you are injured related to an inaccurate image guidance, or your surgery is stopped.

This is an investigational study. The MRIs and x-rays on this study are performed using FDA-approved and commercially available methods. The use of MRI as image guidance for spinal surgery is investigational.

Up to 10 participants will be enrolled in this study. All will take part at MD Anderson.

02

Conditions studied

  • Spinal Tumor

Keywords

  • Epidural metastasis
  • Magnetic resonance imaging
  • MRI
  • Guidance system
  • Spinal surgery
  • Questionnaires
  • Surveys
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age =/> 18 years old.
  2. Must have epidural metastasis to be treated with MRI-guided laser ablation.
  3. Vertebral body site to be treated is located from C3 to L5.
  4. Signed informed consent.

Exclusion criteria

Exclusion Criteria:

  1. Requires open spinal procedure or a percutaneous procedure without the use of image guidance.
  2. Unable to tolerate general anesthesia and prone position.
  3. Unable to undergo MRI of the spine.
  4. Pregnant female.
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
11 participants (actual)

Study arms

  • Experimental
    MRI-Based Image Guidance

    MRI images of the spine taken of anesthetized participant in the operative prone position. These images are exported into a computer navigation program, and used to help the doctor perform surgery. Pain and symptom questionnaires completed at baseline and at follow up.

    Procedure: Magnetic Resonance Imaging (MRI) · Behavioral: Questionnaires

Interventions

  • ProcedureMagnetic Resonance Imaging (MRI)

    MRI images of the spine taken of anesthetized participant in the operative prone position.

    Also known as: MRI

  • BehavioralQuestionnaires

    Pain and symptom questionnaires completed at baseline and at follow up.

    Also known as: Surveys

05

What researchers measure

Primary outcomes

  1. Safety determined by 0% frequency of intraoperative and perioperative adverse events

    Safety of Intraoperative MRI-Based Image Guidance to Perform Laser Ablation of Epidural Metastasis

    Time frame: 3 weeks

Secondary outcomes

  1. Accuracy of MRI-Based Image Guidance to Perform Laser Ablation of Epidural Metastasis

    Navigation considered inaccurate if there is a discrepancy of more than 2mm between the real position of the probe confirmed by direct visual inspection, and the computer model displayed on the navigation screen.

    Time frame: 1 day

06

Study locations

1 site
  • University of Texas MD Anderson Cancer Center
    Houston, Texas 77030, United States
07

References and documents

08

Registry details

Key details

Study ID
NCT02613390
Lead sponsor
M.D. Anderson Cancer Center
Responsible party
Sponsor
First posted
Nov 24, 2015
Start date
Dec 18, 2015
Primary completion
Oct 17, 2018
Completion
Oct 17, 2018
Last update
Jan 10, 2019

Study contacts

Claudio E. Tatsui, MD
principal investigator · M.D. Anderson Cancer Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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