Contrast-enhanced Ultrasound as a Screening Tool for Kidney Cancer in Patients With Von-Hippel Lindau
Condition: Von-Hippel Lindau; Kidney Disease, Chronic
MeSH terms: Kidney Neoplasms; Von Hippel-Lindau Disease; Kidney Diseases; Renal Insufficiency, Chronic
Study type: Interventional
Phase: Phase 2

Summary: 
      The purpose of this study is to determine if contrast-enhanced ultrasound can detect abnormal
      features of kidney lesions in patients with Von-Hippel Lindau with the same accuracy as
      conventional ultrasound and contrast-enhanced magnetic resonance imaging (MRI)
    

Detailed description: 
      This is a pilot cross-sectional study that compares contrast enhanced ultrasound to
      conventional ultrasound and contrasted MRI. Any patient undergoing annual imaging screening
      is eligible, but the investigators will target inclusion of at least 10 subjects who have at
      least 1 kidney lesion. Therefore, up to 5 subjects may have no current kidney lesions.
      Subject participation will be only for the day of CEUS study. There will be no follow-up
      period for this study. However, if results are encouraging, a longitudinal observational
      study may follow, and these same subjects would be eligible for enrollment. Eligible subjects
      will undergo a contrast enhanced ultrasound.

      Following completion of imaging, all CEUS, MRI (within 4 months) and B-mode (at time of CEUS)
      US studies will be de-identified. Blinded radiologists will interpret images and provide an
      overall assessment of risk of malignancy to each kidney using the Bosniak criteria for each
      kidney lesion present. The Bosniak criteria places cystic lesions into one of 5 categories
      (I, II, IIF, III and IV) based on lesion characteristics. CEUS based diagnosis will be
      compared to the diagnoses on routine B-mode US and contrast-enhanced MRI.
    

Intervention name(s): Perflutren lipid microsphere; Sulfur hexafluoride lipid microspheres
Intervention type(s): Drug; Drug
Intervention description(s): Baseline B-mode US will be performed to confirm the lesions being imaged (unless it is a subject with no lesions, then a basic B-mode US will be performed. Perflutren is a diagnostic drug that is intended to be used for contrast enhancement. The vial contains a clear, colorless, sterile, non-pyrogenic, hypertonic solution which is activated by mechanical agitation with Vialmix®.It will be dispensed in inactivated form to a study team member. The contrast agent will be activated just prior to administration (ideally to be used within 5 minutes of activation). Contrast agent Definity (or Lumason) will be activated according to package insert instructions, including use of VialMix®, the device used to activate Definity. Administration will occur IV in coordination with sonography staff trained specifically in contrast ultrasound imaging.The total imaging time is anticipated to be less than 30 minutes.; Baseline B-mode US will be performed to confirm the lesions being imaged (unless it is a subject with no lesions, then a basic B-mode US will be performed. Lumason will be used as a secondary contrast agent only if Definity(perflutren) is unavailable.This drug will be administered using the dosing range and administration type within the Lumason prescribing information. The contrast agent will be activated just prior to administration (ideally to be used within 5 minutes of activation). Contrast agent Definity (or Lumason) will be activated according to package insert instructions, including use of VialMix®, the device used to activate Definity. Administration will occur IV in coordination with sonography staff trained specifically in contrast ultrasound imaging.The total imaging time is anticipated to be less than 30 minutes.
Other intervention name(s): • Definity®; • Microbubble contrast agent; Lumason
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic