Dr. Mark Haacke has requested that we share information regarding his new clinical trial held at Wayne State University in Detroit, Michigan. If you could please share this in your Facebook MS community, it would be greatly appreciated. Dr. Haacke will be studying brain perfusion and lesions in CIS and RRMS by comparing two different types of contrast agents. There will be a $200 payment for two scans. The information is below:
Imaging Multiple Sclerosis Lesions using Magnevist® and GadavistTM
Wayne State University MR Research Facility
About this project:
Dr. E. Mark Haacke, PhD, a pioneer in imaging research at Wayne State University , is conducting a magnetic resonance imaging (MRI) study comparing two MRI contrast agents in people with clinically isolated syndrome and relapsing remitting multiple sclerosis (MS).
MS is a disease that affects the white matter and gray matter in the brain. In MS clinical practice, MRI is used as a gold standard to visualize the degenerative changes in the brain and spine. The neurologist will usually order an MRI to confirm the diagnosis of MS using conventional imaging methods. These images reveal two main pieces of information regarding (a) the location of the lesions (dissemination in space) and (b) the status of the lesions (dissemination in time). While the location of the lesions directly correlates with the clinical symptoms, the information about the status of the lesions informs the neurologist whether the lesion is new (active) or old (chronic).
The use of contrast agents
This ability to differentiate new and old lesions requires the use of a contrast agent. Currently used agents (such as Magnevist®) reveal some lesions but it is unclear if they reveal the full extent of the disease. These contrast agents are injected into the blood in small amounts during the MR scan allowing us to monitor the change in blood flow throughout the whole brain including the MS lesions. Note that all subjects will be screened for proper functions of their kidneys prior to being scanned.
Once injected into the medial cubital vein, the contrast agent circulates in the vessels making them more visible and reveals any leaky vessels which can exist in and/or around new lesions, and therefore, we can see them. In healthy controls, the blood brain barrier is usually intact and this leak doesn’t happen. One open question is:
"Can contrast agent enhancement seen in lesions precede the major tissue damage that we see in the structural MRI?"
The research being performed in this study should help demonstrate if leakiness occurs prior to obvious lesion formation.
Magnevist® and GadavistTM
An FDA approved contrast agent, GadavistTM, Bayer HealthCare Pharmaceuticals, has been recently released and has enhanced characteristics in terms of T1 relaxivity or the ability to detect blood signal. Compared to Magnevist®, GadavistTM is excreted faster from the body (90% of the dose after 12 hours). Both contrast agents have no harm to the kidneys given their low injected dose. This component will strongly affect the MR signal resulting in better contrast in the image and better diagnosis of the status of the disease. Given its high relaxivity, a small amount of GadavistTM may show a better signal enhancement in the affected tissue for MS patients. We hypothesize that GadavistTM will reveal more lesions than Magnevist®, thus may present a better tool for early diagnosis of brain damage.
Our goal in this research project is to see if the newer contrast agent is able to detect changes and differentiate healthy from affected tissue in the white and gray matter earlier than current contrast agents so that detection can be possible before major damage occurs to the tissue. In this study, we will use more advanced MR techniques to assess not only the status of the lesions, but also the function of the vessels around them. The imaging protocol is expected to take a little over an hour and will include conventional imaging methods and vascular imaging methods to study the lesions and perfusion to the brain.
Each person will be scanned twice: initially with one agent and then between 8 and 30 days later with the other agent. The MR data processing results will be compared to check the efficacy of each contrast agent. Each person will receive $200 total after the second scan is completed.
The successful implementation of this study might help confirm the use of GadavistTM as an alternate contrast agent for earlier detection of tissue damage, and theretofore, initiate an earlier intervention treatment plan to reduce the progression of the disease.
What do I need to do to participate in this study? The participation in this study is only possible by a physician’s referral. Given that this brochure may initially be given to you by your physician, who has been informed about the goals and the content of this study, please let your doctor know about your interest in participating in this project. Then, your physician will contact us about your eligibility and provide us with your contact information. Please allow 2 to 3 days for your physician to inform us about your interest. After that, you can contact us to provide you more details about our study and check your schedule for possible MR scan dates for phase one and two of the study.
MS patients who wish to participate in this research study must be referred by a physician. Afterwards, please contact:
Anamika Choudhary @ 313-745-1378 Kingsley Jie Yang @ 313-993-8771 Or you can also reach us via email at chabib@med.wayne.edu
How does MRI work?
MR imaging of the body is a non-ionizing method therefore has no potential for radiation damage. Water contains Hydrogen protons which is what is used to do MR imaging. To create an image of the inside of our body, MRI needs a) a strong magnet, b) radio waves, c) a receiver coil and d) a computer to calculate and display the images.
When our body is placed in a strong magnetic field, it aligns the Hydrogen protons in our body and spin in the same direction like a synchronized ballet of spinning tops. An antenna/RF coil is used to beam radio wave signals (RF pulses) into the magnetic field to modify these spinning protons. And when this RF coil is turned off, the protons keep spinning synchronously. They interact with a receive radio frequency coil leading to a signal. This receiver coil is in turn connected to a computer which then takes this signal and uses it to calculate and display the images.