Development of Radiation Free Whole Body Magnetic Resonance (MR) Imaging Technique for Staging Children With Cancer

Study Overview
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Brief Summary
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A research study on the diagnosis of spread of disease for children who have been diagnosed with solid tumors using a new whole body imaging technique and a new MR contrast agent (ferumoxytol). Standard tests that are used to determine the extent and possible spread of a child's disease include magnetic resonance (MR) imaging, computed tomography (CT), Positron Emission Tomography (PET) as well as bone scanning, and metaiodobenzylguanidine (MIBG) scanning. The purpose of this study is to determine if newer imaging tests referred to as whole body diffusion-weighted MR and whole body PET/MR can detect the extent and spread of the disease as accurately or even better as the standard tests (CT, MR and/or PET/CT). The advantage of the new imaging test is that it is associated with no or significantly reduced radiation exposure compared to standard CT and PET/CT imaging tests. The results of whole body MR and PET/MR will be compared with that of the conventional, standard imaging studies for tumor detecting.

Detailed Description
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Primary Objective: To compare the sensitivity, specificity and accuracy of WB-DW-MR scans (new technique) with 18F- FDG PET or 18F- FDG PET/CT or 18F- FDG PET/MR scans.

Official Title
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Development of Radiation Free Whole Body MR Imaging Technique for Staging of Children With Cancer.

Conditions
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Cancer

Intervention / Treatment
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* Procedure: WB-DW-MR scan
* Procedure: 18-F-FDG PET scan
* Drug: Ferumoxytol
* Procedure: 18-F-FDG PET/MR scan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of a solid extra-cranial tumor like malignant lymphoma or malignant sarcoma and Scheduled for or completed a 18F-FDG-PET or 18F-FDG-PET/CT tumor staging procedure. There will be no restrictions on prior treatment. Very young children who need sedation or anesthesia will be excluded from the study. In this pediatric & adult study, the participant or parent/guardian is consented, and the patient when a minor is given an assent form and involved in the discussion as appropriate. Exclusion Criteria: MR-incompatible metal implants, need of sedation or claustrophobia. Hemosiderosis/hemochromatosis (patients can still be included in 2nd branch without ferumoxytol) There will be restrictions regarding use of other Investigational Agents: Pt with iron-overload will not receive Ferumoxytol History of allergic reactions to similar compounds will be obtained and patients with a positive history of allergic reaction to iron compounds or other severe allergic reactions.will be excluded from the study. Pregnant women and fetuses.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: WB-DW-MR scan<br>simultaneous WB-DW-MR scan and 18-F FDG PET scan | Procedure: WB-DW-MR scan<br>* WB-DW-MR scans will be obtained on a 3T PET-MR system<br>* Other names: Whole Body Diffusion Weighted MR scan;Procedure: 18-F-FDG PET scan<br> <br> * Other names: Fludeoxyglucose PET scan;Drug: Ferumoxytol<br> <br> * Other names: feraheme;Procedure: 18-F-FDG PET/MR scan<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of sensitivity, specificity and accuracy of WB-DW-MR scans to 18-F FDG PET scans. |  | The outcome will be measured after image acquisition | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of sensitivity, specificity and accuracy of Ferumoxytol-enhanced whole-body 18-F FDG PET/MR-scans versus standard clinical Gadolinium-enhanced whole-body 18-F FDG PET/MR-scans. |  | 2 years |