Contrast Enhanced Intraoperative Ultrasound for Detection and Characterization of Renal Mass Undergoing Open Partial Nephrectomy

Study Overview
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Brief Summary
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The goal of this clinical research is to learn how effective an ultrasound contrast agent, called DEFINITY, is when used during ultrasound-guided surgery to remove part of one or both kidneys.

Detailed Description
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DEFINITY is a contrast agent that is used to create better quality ultrasound images. On the day before or the day of the standard of care surgery, women who are able to become pregnant must have a negative blood or urine pregnancy test. If it a blood pregnancy test is performed, a portion of blood will be used from routine blood draws that are collected as part of your standard of care surgery. During your standard of care surgery, the radiologist will take images and videos with an ultrasound machine before you are given the contrast agent. This is done to learn if cancer has spread around the kidney. You will then receive the DEFINITY by vein over about 1 minute. After you receive the injection of DEFINITY, the radiologist will take more images and videos of the tumor and kidney(s) to compare to those recorded earlier. Length of Study: Your active participation in this study will be over after you have completed the follow-up visit. Follow-Up Phone Call: You will have a follow-up phone call 30 days after your standard of care surgery is complete to review any side effects you may be having. This call should take about 10 minutes to complete. This is an investigational study. DEFINITY is FDA approved and commercially available for use in contrast enhanced echocardiography. It is not FDA approved or commercially available for use in radiology. Up to 11 patients will take part in this study. All will be enrolled at MD Anderson.

Official Title
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Feasibility Study of Contrast Enhanced Intraoperative Ultrasound for Detection and Characterization of Renal Mass Undergoing Open Partial Nephrectomy

Conditions
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Kidney Cancer

Intervention / Treatment
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* Procedure: Contrast Enhanced Intraoperative Ultrasound
* Drug: DEFINITY
* Behavioral: Phone Call


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients must have previous cross sectional imaging (CT or MRI) demonstrating renal mass or masses that is amenable to open partial nephrectomy. Patient is scheduled for intraoperative ultrasound guided open partial nephrectomy. Patient must sign informed consent, with risks and benefits of CEUS explained (see risks outlined on the following pages) Exclusion Criteria: Patients with known renal mass scheduled for total or laparoscopic partial nephrectomy. Patients who are hypersensitive to Definity (Perflutren Lipid Microsphere) Patients with known history of right-to-left, bidirectional or transient right-to-left cardiac shunts. Pediatric patients less than 18 years of age. Pregnant or nursing mothers.

Ages Eligible for Study
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Minimum Age: 18 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: Contrast Enhanced Intraoperative Ultrasound<br>During standard of care surgery, radiologist will take images and videos with an ultrasound machine before patient given the contrast agent. Patient then receives the DEFINITY contrast by vein over about 1 minute. After receiving the injection of DEFINITY, radiologist will take more images and videos of the tumor and kidney(s) to compare to those recorded earlier. Follow-up phone call 30 days after standard of care surgery is complete to review any side effects patient may be having. | Procedure: Contrast Enhanced Intraoperative Ultrasound<br>* During standard of care surgery, radiologist will take images and videos with an ultrasound machine before and after patient given the contrast agent.<br>Drug: DEFINITY<br>* During standard of care surgery, radiologist will take images and videos with an ultrasound machine before patient given the contrast agent. Patient then receives the DEFINITY contrast by vein over about 1 minute. After receiving the injection of DEFINITY, radiologist will take more images and videos of the tumor and kidney(s) to compare to those recorded earlier.<br>Behavioral: Phone Call<br>* Follow-up phone call 30 days after standard of care surgery is complete to review any side effects patient may be having.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Successful Capture of IO-CEUS Images | Primary objective is to determine feasibility of obtaining intraoperative (IO) contrast enhanced ultrasound (CEUS) images in participants undergoing open partial nephrectomy. Feasibility defined as the successful capture of IO-CEUS images in 8 out of 10 participants. | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assess Image Quality of the Contrast Enhanced Ultrasound (CEUS) | Number of participants that show better image quality in terms of lesion conspicuity and enhancement following contrast injection vs. baseline. | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Kidney Cancer, Renal Mass, Open partial nephrectomy, Ultrasound-guided surgery, DEFINITY, Contrast agent, Phone call