MAGNIFY - Pulmonary Magnetic Resonance Imaging for Cystic Fibrosis

NHS Foundation Trust

Status: Enrolling

Conditions: Cystic Fibrosis (CF)

Study type: Observational

Funder types: Other

Identifiers

NCT07192679

STH22784

Details and patient eligibility

About

This research study is looking at new ways of measuring the function of the lungs in patients with cystic fibrosis. This study is using the most advanced methods for measuring lung function including 2 tests called hyperpolarised gas magnetic resonance imaging (HP MRI) and multiple breath washout (MBW), to better understand changes in the lungs over time.

HP MRI involves taking pictures of the air in your lungs after breathing in a harmless gas (xenon). MBW is a breathing test used to calculate something called the lung clearance index (LCI).

By measuring these tests on the same day, alongside standard lung function tests, we aim to understand lung function in greater detail than ever before.

Enrollment: 80 estimated patients

Sex: All

Ages: 1+ year old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

General Inclusion criteria

For eligibility into MAGNIFY, subjects should meet all of the following criteria:

1. A confirmed clinical diagnosis of CF, consisting of 2 confirmed disease-causing CFTR mutations along with either positive sweat chloride (>60mmol/L, measured before starting CFTR modulator therapy) or a clinical picture consistent with CF as judged by a senior CF physician. Patients will be under one of named regional CF centres above.
2. Be able to attend the local facility for scans (Royal Hallamshire Hospital, Sheffield).

For eligibility into 129Xe-MRI and lung function (cohort 1,2 and 3)

1. Aged 5 years and above
2. FEV1 >30% predicted (best in the previous 6 months) For eligibility for cohort 1

1. Previous participation in the MMAVIC study, with at least one prior visit where lung ventilation MRI was successfully measured.

For eligibility into cohort 4 for 1H MRI only:

1. Aged between 1 and 5 years of age

General Exclusion criteria

Patients who meet any of the following criteria will be excluded from the study. Further exclusions may be applied at the discretion of the principal investigators.

1. Previous lung transplant.
2. Infection with organisms of the Burkholderia cepacia complex, MRSA or Mycobacterium abscessus.
3. Pregnancy.
4. Resting SpO2 < 90% in room air.
5. Inability to comfortably lie supine for more than 60 minutes.
6. Any contraindication(s) to MRI scanning as per the MRI questionnaire used in clinical practice by the University of Sheffield MRI unit, Royal Hallamshire Hospital.

Research visit (temporary) exclusion criteria

1. Pulmonary exacerbation within 4 weeks as defined by no new treatments in that time, no clinically significant change in their symptoms or spirometry (as judged by attending physician).
2. Pregnancy. Patients who become pregnant prior to consent or during the study can remain in the study. However, no research visits will take place during pregnancy.

Trial design

80 participants in 4 patient groups

Cohort 1 - MMAVIC protocol

Description:

Twenty patients who previously participated in the MMAVIC study, eligible to be on the new regime of CF therapies. These patients will be recruited and invited to attend 4 visits over 3 years.

Cohort 2: Patients not eligible for HEMT

Description:

A combination of approximately ten children and ten adults who are either not eligible to take HEMT or have not tolerated highly effective modulator treatment (HEMT). Previous MMAVIC participants not on HEMT are also eligible for this cohort. These patients will be invited to attend 3 visits over 2 years.

Cohort 3: School-age children on standard of care treatment

Description:

Twenty children who are receiving the current standard of care treatment, including HEMT or other CFTR modulators. These patients will be invited to attend 2 visits - 1 year apart.

Cohort 4: Pre-school children on standard of care treatment

Description:

Up to 20 children under the age of 5 years, who are receiving the current standard of care, including CFTR modulator therapies. These participants will have a single visit.