Evaluation of the Value of 18F-Fluoromisonidazole (18F-FMISO) Positron Emission Tomography Hypoxia Imaging in Idiopathic Pulmonary Fibrosis

Study Overview
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Brief Summary
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Idiopathic pulmonary fibrosis (IPF) is a rare, chronic, lethal disease of unknown etiology and with a variable course. There is currently no test in routine care that can assess both the anatomical and functional damage of the disease at an early stage. This is the first human study in IPF to evaluate the value of a non-invasive tracer, 18F-fluoromisonidazole (18F-FMISO), targeting hypoxia in IPF patients. This is a Phase I, proof-of-concept, single-center, open-label, parallel group study. It will include 2 groups: 1 group of 10 IPF patients 1 group of 10 healthy volunteers matched to IPF patients for age and gender

Official Title
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Evaluation of the Value of 18F-Fluoromisonidazole (18F-FMISO) Positron Emission Tomography Hypoxia Imaging in Idiopathic Pulmonary Fibrosis - A Non-randomized Proof-of-concept Study Comparing Patients With Idiopathic Pulmonary Fibrosis and Healthy Subjects

Conditions
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Idiopathic Pulmonary Fibrosis

Intervention / Treatment
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* Radiation: FMISO-PET Protocol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For all patients (IPF and healthy volunteers) : Person who has given written consent Age ≥ 50 years Absence of disease, comorbidity, or treatment that may interfere with the evaluation of the study objective, as decided by the investigator For patients with IPF only: Diagnosis of IPF according to the criteria of the current international recommendations (ATS/ERS/JRS/ALAT of 2011) and validated in a multi-disciplinary meeting in a Competence or Reference Center Patients who have had a high-resolution thoracic CT scan less than 1 month previously as part of the management of their disease Patients who have had a PFT less than 1 month previously as part of the management of their disease For healthy volunteers only: Absence of functional respiratory signs - absence of dyspnea on exertion and at rest and absence of chronic cough. Normal clinical examination with no crackles on pulmonary auscultation No personal history of chronic hypoxemic respiratory disease Exclusion Criteria: Person who is not covered by national health insurance Cancer or history of cancer in the past 5 years (except basal cell skin cancer) Chronic lung disease other than IPF or a history incompatible with the diagnosis of idiopathic pulmonary fibrosis (thoracic radiotherapy, pneumotoxic chemotherapy, etc.) Exacerbation of IPF during treatment Active smoking Patient requiring long-term oxygen therapy (excluding ambulatory oxygen therapy alone) Contraindication to PET or CT scan or presence of a condition disturbing the interpretation : known allergy to 18F-FMISO pregnancy or breastfeeding claustrophobia uncontrolled type I/II diabetes (HbA1c >7%) surgical intervention in the previous month Radiotherapy session in the previous 3 months concomitant granulomatous condition (sarcoidosis type) or pulmonary inflammation Moderate or severe renal insufficiency (GFR < 70 ml/min/1.73 m²) Person under legal protection (curatorship, guardianship) Adult unable to express consent SECONDARY EXCLUSION CRITERIA (AFTER SCREENING VISIT) Abnormal 6 min walk test at screening Abnormal PFT at screening with FVC ≤ 80% of predicted value and DLCO ≤ 75% of predicted value

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with idiopathic pulmonary fibrosis<br> | Radiation: FMISO-PET Protocol<br>* injection of 18F-FMISO Monitoring for 2 h PET scan (30 min) 2h post injection Monitoring for 2h PET (30min) 4h post injection Discharge of the subject with appropriate recommendations after a PET/CT<br>|
| Active Comparator: Healthy volunteers<br> | Radiation: FMISO-PET Protocol<br>* injection of 18F-FMISO Monitoring for 2 h PET scan (30 min) 2h post injection Monitoring for 2h PET (30min) 4h post injection Discharge of the subject with appropriate recommendations after a PET/CT<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lung SUVmean of 18F-FMISO measured in PET | Comparison in IPF patients and healthy volunteers | At baseline |