Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43871   clinical trials with a EudraCT protocol, of which   7290   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Download PDF

    Clinical Trial Results:
    Characterization of Focal Liver Lesions with SonoVue®-Enhanced Ultrasound Imaging: A Phase III, Intrapatient Comparative Study Versus Unenhanced Ultrasound Imaging Using Histology or Combined Imaging/Clinical Data As Truth Standard

    Summary
    EudraCT number
    2010-022730-91
    Trial protocol
    DE  
    Global end of trial date
    29 Jul 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    30 Dec 2016
    First version publication date
    30 Dec 2016
    Other versions

    Trial information

    Close Top of page
    Trial identification
    Sponsor protocol code
    BR1-130
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00829413
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bracco Diagnostics, Inc.
    Sponsor organisation address
    259 Prospect Plains Rd, Cranbury, United States, 08512
    Public contact
    Maria Luigia Storto, Bracco Imaging S.p.A., (609) 514-2200, MariaLuigia.Storto@diag.bracco.com
    Scientific contact
    Maria Luigia Storto, Bracco Imaging S.p.A., (609) 514-2200, MariaLuigia.Storto@diag.bracco.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    29 Jul 2013
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Jul 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To demonstrate the sensitivity and specificity of Sonovue-enhanced ultrasound is superior to that of unenhanced ultrasound for the characterization of benign versus malignant focal liver lesions (FLLs) using final diagnosis based on histology or combiend imaging (CE-CT and/or CE-MRI)/clinical data as truth standard.
    Protection of trial subjects
    This study was conducted in compliance with Title 21, CFR Part 50, CFR Part 56, and CFR Part 312, with the ethical principles that have their origin in the Declaration of Helsinki (adopted by the 18th World Medical Assembly (WMA) in Helsinki, Finland [June 1964] and amended by the 29th WMA in Tokyo, Japan [October 1975], by the 35th WMA in Venice, Italy [October 1983], by the 41st WMA in Hong Kong [September 1989], by the 48th Assembly of the WMA in Somerset West, Republic of South Africa [October 1996], by the 52nd WMA in Edinburgh, Scotland [October 2000], with clarification by the 53rd WMA in Washington DC, United States [2002] and 55th WMA General Assembly in Tokyo, Japan [2004], and by the 59th WMA General Assembly in Seoul, Korea [October 2008]). In addition, this study was conducted in compliance with Good Clinical Practices (GCP) as outlined in International Conference on Harmonization (ICH) E6 Good Clinical Practice: Consolidated Guideline.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    15 Jun 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 43
    Country: Number of subjects enrolled
    United States: 185
    Country: Number of subjects enrolled
    Germany: 108
    Country: Number of subjects enrolled
    France: 4
    Worldwide total number of subjects
    340
    EEA total number of subjects
    112
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    238
    From 65 to 84 years
    101
    85 years and over
    1

    Subject disposition

    Close Top of page
    Recruitment
    Recruitment details
    Study Initiation Date (first subject enrolled): 15 June 2010; Study completion date (last patient completed study related activities): 18 February 2013. The study was conducted at 11 investigational sites throughout the United States (USA), 2 sites in Canada and 5 sites in Europe.

    Pre-assignment
    Screening details
    A total of 67 patients received SonoVue in the training phase and were included only in safety population. A total of 273 patients received SonoVue in the efficacy phase. A total of 340 patients received SonoVue and are included in all safety analyses.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    No

    Arm title
    UE-US (Reader 1)
    Arm description
    Unenhanced Ultrasound Image Assessment by Reader 1
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    CE-US (Reader 1)
    Arm description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 1
    Arm type
    Experimental

    Investigational medicinal product name
    SonoVue
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    SonoVue (2.4 mL bolus injection containing 8 µL/mL of sulfur hexafluoride microbubbles) was administered intravenously through an intravenous 20-guage catheter positioned into an upper extremity vein or through a central venous catheter (internal jugular vein, subclavian vein) without an IV filter Immediately following, 5 to 10 mL of saline was administered to flush the IV line of any remaining contrast agent. A maximum of 2 injections of 2.4 mL of SonoVue was allowed with an interval of 30 minutes between the administrations.

    Arm title
    UE-US (Reader 2)
    Arm description
    Unenhanced Ultrasound Image Assessment by Reader 2
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    CE-US (Reader 2)
    Arm description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 2
    Arm type
    Experimental

    Investigational medicinal product name
    SonoVue
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    SonoVue (2.4 mL bolus injection containing 8 µL/mL of sulfur hexafluoride microbubbles) was administered intravenously through an intravenous 20-guage catheter positioned into an upper extremity vein or through a central venous catheter (internal jugular vein, subclavian vein) without an IV filter Immediately following, 5 to 10 mL of saline was administered to flush the IV line of any remaining contrast agent. A maximum of 2 injections of 2.4 mL of SonoVue was allowed with an interval of 30 minutes between the administrations.

    Arm title
    UE-US (Reader 3)
    Arm description
    Unenhanced Ultrasound Image Assessment by Reader 3
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    CE-US (Reader 3)
    Arm description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 3
    Arm type
    Experimental

    Investigational medicinal product name
    SonoVue
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    SonoVue (2.4 mL bolus injection containing 8 µL/mL of sulfur hexafluoride microbubbles) was administered intravenously through an intravenous 20-guage catheter positioned into an upper extremity vein or through a central venous catheter (internal jugular vein, subclavian vein) without an IV filter Immediately following, 5 to 10 mL of saline was administered to flush the IV line of any remaining contrast agent. A maximum of 2 injections of 2.4 mL of SonoVue was allowed with an interval of 30 minutes between the administrations.

    Arm title
    UE-US
    Arm description
    UE-US Inter-reader agreement
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    CE-US
    Arm description
    CE-US Inter-reader agreement
    Arm type
    Experimental

    Investigational medicinal product name
    SonoVue
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    SonoVue (2.4 mL bolus injection containing 8 µL/mL of sulfur hexafluoride microbubbles) was administered intravenously through an intravenous 20-guage catheter positioned into an upper extremity vein or through a central venous catheter (internal jugular vein, subclavian vein) without an IV filter Immediately following, 5 to 10 mL of saline was administered to flush the IV line of any remaining contrast agent. A maximum of 2 injections of 2.4 mL of SonoVue was allowed with an interval of 30 minutes between the administrations.

    Number of subjects in period 1
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3) UE-US CE-US
    Started
    259
    259
    259
    259
    259
    259
    259
    259
    Completed
    259
    259
    259
    259
    259
    259
    259
    259

    Baseline characteristics

    Close Top of page
    Baseline characteristics reporting groups
    Reporting group title
    UE-US (Reader 1)
    Reporting group description
    Unenhanced Ultrasound Image Assessment by Reader 1

    Reporting group title
    CE-US (Reader 1)
    Reporting group description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 1

    Reporting group title
    UE-US (Reader 2)
    Reporting group description
    Unenhanced Ultrasound Image Assessment by Reader 2

    Reporting group title
    CE-US (Reader 2)
    Reporting group description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 2

    Reporting group title
    UE-US (Reader 3)
    Reporting group description
    Unenhanced Ultrasound Image Assessment by Reader 3

    Reporting group title
    CE-US (Reader 3)
    Reporting group description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 3

    Reporting group title
    UE-US
    Reporting group description
    UE-US Inter-reader agreement

    Reporting group title
    CE-US
    Reporting group description
    CE-US Inter-reader agreement

    Reporting group values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3) UE-US CE-US Total
    Number of subjects
    259 259 259 259 259 259 259 259 259
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    185 185 185 185 185 185 185 185 185
        Adults (>= 65 years)
    74 74 74 74 74 74 74 74 74
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    56.9 ± 13.4 56.9 ± 13.4 56.9 ± 13.4 56.9 ± 13.4 56.9 ± 13.4 56.9 ± 13.4 56.9 ± 13.4 56.9 ± 13.4 -
    Gender categorical
    Units: Subjects
        Female
    123 123 123 123 123 123 123 123 123
        Male
    136 136 136 136 136 136 136 136 136

    End points

    Close Top of page
    End points reporting groups
    Reporting group title
    UE-US (Reader 1)
    Reporting group description
    Unenhanced Ultrasound Image Assessment by Reader 1

    Reporting group title
    CE-US (Reader 1)
    Reporting group description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 1

    Reporting group title
    UE-US (Reader 2)
    Reporting group description
    Unenhanced Ultrasound Image Assessment by Reader 2

    Reporting group title
    CE-US (Reader 2)
    Reporting group description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 2

    Reporting group title
    UE-US (Reader 3)
    Reporting group description
    Unenhanced Ultrasound Image Assessment by Reader 3

    Reporting group title
    CE-US (Reader 3)
    Reporting group description
    SonoVue Contrast Enhanced Ultrasound Image Assessment by Reader 3

    Reporting group title
    UE-US
    Reporting group description
    UE-US Inter-reader agreement

    Reporting group title
    CE-US
    Reporting group description
    CE-US Inter-reader agreement

    Primary: Sensitivity

    Close Top of page
    End point title
    Sensitivity [1]
    End point description
    Sensitivity of SonoVue-enhanced versus unenhanced ultrasound for characterization of malignant focal liver lesions (FLLs), using the diagnosis provided by each of the 3 off-site assessors (blinded to patient data) for the ITD population Truth standard: CE-CT and /or CE-MRI examination OR tissue pathology/histology from surgical resection/biopsy OR 6-month follow up
    End point type
    Primary
    End point timeframe
    24 hours to 6 months
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to EudraCT system restrictions, an arm was created for each reader’s assessment of UE-US and Sonovue CE-US. For 3 readers, 6 arms were created to report the results of each image assessment. For this endpoint, statistical comparison between UE-US and CE-US was performed for each reader. Finally, each reader assessed the images for 259 subjects. Therefore, 259 subjects composed each statistical analysis and not the “Subjects in this analysis: 518” field computed by the EudraCT system.
    End point values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3)
    Number of subjects analysed
    259
    259
    259
    259
    259
    259
    Units: Lesions
    number (confidence interval 95%)
        Lesions
    48.7 (39.8 to 57.7)
    86.6 (80.4 to 92.7)
    35.3 (26.7 to 43.9)
    75.6 (67.9 to 83.3)
    16 (9.4 to 22.5)
    91.6 (86.6 to 96.6)
    Statistical analysis title
    Reader 1 – UE-US, Reader 1 CE-US
    Comparison groups
    UE-US (Reader 1) v CE-US (Reader 1)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [2]
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Sensitivity (%)
    Point estimate
    37.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    27.4
         upper limit
    48.2
    Notes
    [2] - 259 subjects in the analysis
    Statistical analysis title
    Reader 2 – UE-US, Reader 2 CE-US
    Comparison groups
    UE-US (Reader 2) v CE-US (Reader 2)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [3]
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Sensitivity (%)
    Point estimate
    40.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    30.4
         upper limit
    50.3
    Notes
    [3] - 259 subjects in this analysis
    Statistical analysis title
    Reader 3 – UE-US, Reader 3 CE-US
    Comparison groups
    UE-US (Reader 3) v CE-US (Reader 3)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [4]
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Sensitivity (%)
    Point estimate
    75.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    67.9
         upper limit
    83.3
    Notes
    [4] - 259 subjects in the analysis

    Primary: Specificity

    Close Top of page
    End point title
    Specificity [5]
    End point description
    Specificity of SonoVue-enhanced versus unenhanced ultrasound for characterization of benign FLLs, using the diagnosis provided by each of the 3 off-site assessors (blinded to patient data) for the ITD population Truth standard: CE-CT and /or CE-MRI examination OR tissue pathology/histology from surgical resection/biopsy OR 6-month follow-up
    End point type
    Primary
    End point timeframe
    24 hours to 6 months
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to EudraCT system restrictions, an arm was created for each reader’s assessment of UE-US and Sonovue CE-US. For 3 readers, 6 arms were created to report the results of each image assessment. For this endpoint, statistical comparison between UE-US and CE-US was performed for each reader. Finally, each reader assessed the images for 259 subjects. Therefore, 259 subjects composed each statistical analysis and not the “Subjects in this analysis: 518” field computed by the EudraCT system.
    End point values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3)
    Number of subjects analysed
    259
    259
    259
    259
    259
    259
    Units: Lesions
        number (confidence interval 95%)
    62.9 (54.9 to 70.9)
    70.7 (63.2 to 78.3)
    54.3 (46 to 62.5)
    82.9 (76.6 to 89.1)
    22.1 (15.3 to 29)
    72.9 (65.5 to 80.2)
    Statistical analysis title
    Reader 1 – UE-US, Reader 1 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 1) v CE-US (Reader 1)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.138
    Method
    Mcnemar
    Parameter type
    Difference in Specificity (%)
    Point estimate
    7.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.4
         upper limit
    18.2
    Statistical analysis title
    Reader 2 – UE-US, Reader 2 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 2) v CE-US (Reader 2)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [6]
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Specificity (%)
    Point estimate
    28.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    19.7
         upper limit
    37.5
    Notes
    [6] - 259 subjects in this analysis
    Statistical analysis title
    Reader 3 – UE-US, Reader 3 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 3) v CE-US (Reader 3)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Specificity (%)
    Point estimate
    50.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    42
         upper limit
    59.5

    Primary: Accuracy

    Close Top of page
    End point title
    Accuracy [7]
    End point description
    The Accuracy of SonoVue-enhanced versus unenhanced ultrasound for characterization of malignant and benign FLLs, using the diagnosis provided by each of the 3 off-site assessors (blinded to patient data) for the ITD population Truth standard: CE-CT and /or CE-MRI examination OR tissue pathology/histology from surgical resection/biopsy OR 6-month follow up
    End point type
    Primary
    End point timeframe
    24 hours to 6 months
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to EudraCT system restrictions, an arm was created for each reader’s assessment of UE-US and Sonovue CE-US. For 3 readers, 6 arms were created to report the results of each image assessment. For this endpoint, statistical comparison between UE-US and CE-US was performed for each reader. Finally, each reader assessed the images for 259 subjects. Therefore, 259 subjects composed each statistical analysis and not the “Subjects in this analysis: 518” field computed by the EudraCT system.
    End point values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3)
    Number of subjects analysed
    259
    259
    259
    259
    259
    259
    Units: Lesions
        number (confidence interval 95%)
    56.4 (50.3 to 62.4)
    78 (72.9 to 83)
    45.6 (39.5 to 51.6)
    79.5 (74.6 to 84.5)
    19.3 (14.5 to 24.1)
    81.5 (76.7 to 86.2)
    Statistical analysis title
    Reader 1 – UE-US, Reader 1 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 1) v CE-US (Reader 1)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [8]
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Accuracy (%)
    Point estimate
    21.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    14.1
         upper limit
    29.2
    Notes
    [8] - 259 Subjects in this analysis
    Statistical analysis title
    Reader 2 – UE-US, Reader 2 -SonoVue CE-US
    Comparison groups
    UE-US (Reader 2) v CE-US (Reader 2)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [9]
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Accuracy (%)
    Point estimate
    34
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    27.3
         upper limit
    40.7
    Notes
    [9] - 259 subjects in the analysis
    Statistical analysis title
    Reader 3 – UE-US, Reader 3 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 3) v CE-US (Reader 3)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Mcnemar
    Parameter type
    Difference in Accuracy (%)
    Point estimate
    62.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    56.1
         upper limit
    68.3

    Secondary: Positive Predictive Value [PPV]

    Close Top of page
    End point title
    Positive Predictive Value [PPV] [10]
    End point description
    Positive Predictive Value of of SonoVue-enhanced versus unenhanced ultrasound for characterization of FLLs, using the diagnosis provided by each of the 3 off-site assessors (blinded to patient data) for the ITD population Truth standard: CE-CT and /or CE-MRI examination OR tissue pathology/histology from surgical resection/biopsy OR 6-month follow up
    End point type
    Secondary
    End point timeframe
    24 hours to 6 months
    Notes
    [10] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to EudraCT system restrictions, an arm was created for each reader’s assessment of UE-US and Sonovue CE-US. For 3 readers, 6 arms were created to report the results of each image assessment. For this endpoint, statistical comparison between UE-US and CE-US was performed for each reader. Finally, each reader assessed the images for 259 subjects. Therefore, 259 subjects composed each statistical analysis and not the “Subjects in this analysis: 518” field computed by the EudraCT system.
    End point values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3)
    Number of subjects analysed
    259
    259
    259
    259
    259
    259
    Units: Lesions
        number (confidence interval 95%)
    52.7 (43.4 to 62.1)
    71.5 (64.2 to 78.9)
    39.6 (30.3 to 48.9)
    78.9 (71.5 to 86.4)
    14.8 (8.7 to 21)
    74.1 (67.1 to 81.2)
    Statistical analysis title
    Reader 1 – UE-US, Reader 1 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 1) v CE-US (Reader 1)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [11]
    P-value
    < 0.0001
    Method
    Wald Test
    Confidence interval
    Notes
    [11] - 259 Subjects in this analysis
    Statistical analysis title
    Reader 3 – UE-US, Reader 3 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 3) v CE-US (Reader 3)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [12]
    P-value
    < 0.0001
    Method
    Wald Test
    Confidence interval
    Notes
    [12] - 259 Subjects in this analysis
    Statistical analysis title
    Reader 2 – UE-US, Reader 2 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 2) v CE-US (Reader 2)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [13]
    P-value
    < 0.0001
    Method
    Wald Test
    Confidence interval
    Notes
    [13] - 259 Subjects in this analysis

    Secondary: Negative Predictive Value [NPV]

    Close Top of page
    End point title
    Negative Predictive Value [NPV] [14]
    End point description
    Negative Predictive Value of SonoVue-enhanced versus unenhanced ultrasound for characterization of FLLs, using the diagnosis provided by each of the 3 off-site assessors (blinded to patient data) for the ITD population Truth standard: CE-CT and /or CE-MRI examination OR tissue pathology/histology from surgical resection/biopsy OR 6-month follow up
    End point type
    Secondary
    End point timeframe
    24 hours to 6 months
    Notes
    [14] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to EudraCT system restrictions, an arm was created for each reader’s assessment of UE-US and Sonovue CE-US. For 3 readers, 6 arms were created to report the results of each image assessment. For this endpoint, statistical comparison between UE-US and CE-US was performed for each reader. Finally, each reader assessed the images for 259 subjects. Therefore, 259 subjects composed each statistical analysis and not the “Subjects in this analysis: 518” field computed by the EudraCT system.
    End point values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3)
    Number of subjects analysed
    259
    259
    259
    259
    259
    259
    Units: Lesions
        number (confidence interval 95%)
    59.1 (51.2 to 67)
    86.1 (79.8 to 92.4)
    49.7 (41.8 to 57.6)
    80 (73.5 to 86.5)
    23.7 (16.4 to 30.9)
    91.1 (85.8 to 96.4)
    Statistical analysis title
    Reader 1 – UE-US, Reader 1 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 1) v CE-US (Reader 1)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [15]
    P-value
    < 0.0001
    Method
    Wald Test
    Confidence interval
    Notes
    [15] - 259 subjects in this analysis
    Statistical analysis title
    Reader 3 – UE-US, Reader 3 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 3) v CE-US (Reader 3)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [16]
    P-value
    < 0.0001
    Method
    Wald Test
    Confidence interval
    Notes
    [16] - 259 Subjects in this analysis
    Statistical analysis title
    Reader 2 – UE-US, Reader 2 - SonoVue CE-US
    Comparison groups
    UE-US (Reader 2) v CE-US (Reader 2)
    Number of subjects included in analysis
    518
    Analysis specification
    Pre-specified
    Analysis type
    superiority [17]
    P-value
    < 0.0001
    Method
    Wald Test
    Confidence interval
    Notes
    [17] - 259 Subjects in this analysis

    Secondary: Specific Diagnosis of Malignant FLLs

    Close Top of page
    End point title
    Specific Diagnosis of Malignant FLLs [18]
    End point description
    SonoVue-enhanced versus unenhanced ultrasound for specific diagnosis of malignant FLLs, using the diagnosis provided by each of the 3 off-site assessors (blinded to patient data) for the ITD population Truth standard: CE-CT and /or CE-MRI examination OR tissue pathology/histology from surgical resection/biopsy OR 6-month follow up
    End point type
    Secondary
    End point timeframe
    24 hours to 6 months
    Notes
    [18] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to EudraCT system restrictions, an arm was created for each reader’s assessment of UE-US and Sonovue CE-US. For 3 readers, 6 arms were created to report the results of each image assessment. For this endpoint, no statistical comparison was performed between, UE-US and CE-US. Finally, each reader assessed the images for 259 subjects.
    End point values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3)
    Number of subjects analysed
    259
    259
    259
    259
    259
    259
    Units: Lesions
    number (not applicable)
        # of HCC by Truth Standard
    47
    47
    47
    47
    47
    47
        # HCC(Malignant) Correctly Characterized
    16
    26
    10
    29
    3
    30
        # of Metastasis by Truth Standard
    47
    47
    47
    47
    47
    47
        # Metastasis Correctly Characterized
    18
    37
    12
    31
    1
    28
    No statistical analyses for this end point

    Secondary: Specific Diagnosis of Benign FLLs

    Close Top of page
    End point title
    Specific Diagnosis of Benign FLLs [19]
    End point description
    SonoVue-enhanced versus unenhanced ultrasound for specific diagnosis of benign FLLs, using the diagnosis provided by each of the 3 off-site assessors (blinded to patient data) for the ITD population Truth standard: CE-CT and /or CE-MRI examination OR tissue pathology/histology from surgical resection/biopsy OR 6-month follow-up
    End point type
    Secondary
    End point timeframe
    24 hours to 6 months
    Notes
    [19] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to EudraCT system restrictions, an arm was created for each reader’s assessment of UE-US and Sonovue CE-US. For 3 readers, 6 arms were created to report the results of each image assessment. For this endpoint, no statistical comparison was performed between, UE-US and CE-US. Finally, each reader assessed the images for 259 subjects.
    End point values
    UE-US (Reader 1) CE-US (Reader 1) UE-US (Reader 2) CE-US (Reader 2) UE-US (Reader 3) CE-US (Reader 3)
    Number of subjects analysed
    259
    259
    259
    259
    259
    259
    Units: Lesions
    number (not applicable)
        # of Hemangioma by Truth Standard
    52
    52
    52
    52
    52
    52
        # Hemangioma Correctly Characterized
    28
    38
    30
    43
    12
    38
        # of Focal nodular hyperplasia by Truth Standard
    39
    39
    39
    39
    39
    39
        #Focal nodular hyperplasia Correctly Characterized
    15
    23
    8
    22
    2
    18
    No statistical analyses for this end point

    Secondary: Inter-reader Agreement

    Close Top of page
    End point title
    Inter-reader Agreement [20]
    End point description
    Kappa statistic based on an assessment of malignant or benign by unenhanced and SonoVue-enhanced ultrasonography separately and computation for the percentage agreement within two categories: "3 out of 3 readers agree" and "2 out of 3 readers agree".
    End point type
    Secondary
    End point timeframe
    24 hours to 6 months
    Notes
    [20] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Due to restrictions with the EudraCT system, two additional arms were created to present data for inter-reader agreement between UE-US and CE-US. For this endpoint, no statistical comparison was performed between, UE-US and CE-US. Finally, each reader assessed the images for 259 subjects.
    End point values
    UE-US CE-US
    Number of subjects analysed
    259
    259
    Units: Percentage
    number (not applicable)
        % Agreement: All 3 off-site readers agree
    28.2
    66
        % Agreement: 2 out of 3 off-site readers agree
    94.6
    99.6
        Generalized Kappa Value
    0.191
    0.553
    No statistical analyses for this end point

    Adverse events

    Close Top of page
    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were monitored from the time of signing the Informed Consent Form through 7 days after SonoVue administration.
    Adverse event reporting additional description
    All adverse events collected were categorized using MedDRA 12.1 and tabulated
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    12.1
    Reporting groups
    Reporting group title
    Safety Population
    Reporting group description
    -

    Serious adverse events
    Safety Population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    4 / 340 (1.18%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    colon cancer metastatic
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    rectal haemorrhage
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    hepatic hemorrhage
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    dehydration
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Safety Population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    44 / 340 (12.94%)
    Vascular disorders
    Flushing
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    General disorders and administration site conditions
    Chest Discomfort
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Chest pain
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Asthenia
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Injection site irritation
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Fatigue
         subjects affected / exposed
    2 / 340 (0.59%)
         occurrences all number
    2
    Injection site haemorrhage
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Injection site pain
         subjects affected / exposed
    2 / 340 (0.59%)
         occurrences all number
    2
    Malaise
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Dyspnoea
         subjects affected / exposed
    2 / 340 (0.59%)
         occurrences all number
    2
    Psychiatric disorders
    Hallucination
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Insomnia
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Investigations
    Basophil count increased
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Electrocardiogram abnormal
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Blood creatinine increased
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Procedural pain
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    3 / 340 (0.88%)
         occurrences all number
    3
    Dysgeusia
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Headache
         subjects affected / exposed
    6 / 340 (1.76%)
         occurrences all number
    6
    Paraesthesia
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Parosmia
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal tenderness
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Diarrhea
         subjects affected / exposed
    4 / 340 (1.18%)
         occurrences all number
    4
    Abdominal discomfort
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Abdominal pain upper
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Flatulence
         subjects affected / exposed
    3 / 340 (0.88%)
         occurrences all number
    3
    Dyspepsia
         subjects affected / exposed
    2 / 340 (0.59%)
         occurrences all number
    2
    Toothache
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    6 / 340 (1.76%)
         occurrences all number
    6
    Vomiting
         subjects affected / exposed
    2 / 340 (0.59%)
         occurrences all number
    2
    Hepatobiliary disorders
    Hepatic pain
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Night sweats
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Renal and urinary disorders
    Renal pain
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Groin pain
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Muscle spasms
         subjects affected / exposed
    2 / 340 (0.59%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1
    Dehydration
         subjects affected / exposed
    1 / 340 (0.29%)
         occurrences all number
    1

    More information

    Close Top of page

    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    24 Sep 2010
    Amendment 1 dated 24 September 2010 included the following major changes to the protocol • The Sponsor Medical Expert and Drug Safety Physician were changed. • The number of investigational sites was increased from approximately 10 to 15. • It was possible that, in some patients, access to an upper extremity vein could be difficult; therefore the option to inject the product through a central venous catheter was added. • The possibility of an assessment of a second lesion was deleted from the protocol because these data were not relevant to the study’s objectives. • Follow-up requirements for truth standard were modified to include histology as appropriate and <6 month confirmation for malignant lesions showing progression of disease on CE-MRI or CE-CT. • The CE-CT and CE-MR image acquisition parameters were modified to be consistent with current clinical practice for examination of the liver. • A statement that training cases were not to be part of the blinded read was added to the off-site assessment methodology section of the protocol to further clarify what was previously stated in the Overall Study Design Description and Statistical Methods. • The number of training cases was reduced from “up to 10” to “up to 4” and the number of efficacy cases was increased to 246 subjects to allow detection of smaller differences and to have higher statistical power for the study.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

    European Medicines Agency © 1995-Fri May 03 13:37:39 CEST 2024 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA