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Trial registered on ANZCTR
Registration number
ACTRN12623000966695
Ethics application status
Approved
Date submitted
1/08/2023
Date registered
6/09/2023
Date last updated
6/09/2023
Date data sharing statement initially provided
6/09/2023
Type of registration
Retrospectively registered
Titles & IDs
Public title
Delineating gastric emptying after major gastro-oesophageal surgery using real time MRI
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Scientific title
Delineating gastric emptying after major gastro-oesophageal surgery using real time MRI
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Secondary ID [1]
307321
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Gastric conduit dysmotility
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Gastric Conduit Emptying Failure
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Oesophagectomy
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Condition category
Condition code
Surgery
327757
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0
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Other surgery
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Oral and Gastrointestinal
327863
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Each participant (with a previous oesophagectomy) will present to the MRI department fasted for 8 hours. The MRI will take approximately 30 minutes.
Immediately prior to the MRI, the participant will consume a semi solid porridge meal, consisting of 34 grams of oats, sugar, honey, and milk powder.
An MRI will be performed by a specialised MRI radiographer, and the following sequences will be attained: T2 Volume acquisition, followed by T2 weighted true fast imaging with steady state free precession (TRUFI) free breathing sequence for 4 minutes. This block will be repeated 4 times. Then a final volume acquisition T2 Volume sequence will be completed.
A specialised radiologist or surgeon investigator will be present for the scan to ensure all sequences are adequately completed.
No IV contrast will be used. No further follow-up scans are required.
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Intervention code [1]
326644
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Diagnosis / Prognosis
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Comparator / control treatment
Subjects with normal gastric anatomy will undergo an MRI with the identical procedures to the patients with a prior oesophagectomy, outlined above.
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Control group
Active
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Outcomes
Primary outcome [1]
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Gastric Peristalsis is the primary outcome. To measure this, we will assess each TRUFI (dynamic) phase of the MRI and measure the amplitude and velocity of each peristaltic wave. We will calculate the Gastric Motility Index as a surrogate measure of peristalsis by multiplying the amplitude (mm) by the velocity (mm/sec) of the largest peristaltic wave in each block.
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Assessment method [1]
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Timepoint [1]
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Peristaltic waves will be quantified during each MRI TRUFI (dynamic) block at 5 minutes, 11 minutes, 17 minutes and 23 minutes.
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Secondary outcome [1]
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Gastric Emptying is a secondary outcome. This will be assess by calculating the conduit volume at the beginning and end of the MRI scanning period, and measuring the % of emptying.
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Assessment method [1]
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Timepoint [1]
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The first and last volume scans will be performed approximately 20 minutes apart.
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Secondary outcome [2]
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Allens Reflux and Regurgitation score
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Assessment method [2]
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Timepoint [2]
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At the time of the MRI, at least 2 years post oesophagectomy
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Secondary outcome [3]
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Dakkak Dysphagia Scores
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Assessment method [3]
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Timepoint [3]
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At the time of the MRI, at least 2 years post oesophagectomy
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Secondary outcome [4]
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Sigstad dumping scores,
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Assessment method [4]
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Timepoint [4]
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At the time of the MRI, at least 2 years post oesophagectomy
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Secondary outcome [5]
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Rand SF-35 Quality of Life scores
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Assessment method [5]
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Timepoint [5]
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At the time of the MRI, at least 2 years post oesophagectomy
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Eligibility
Key inclusion criteria
Interventional Group:
> 2 years post oesophagectomy
Control Group:
Normal gastrointestinal Anatomy
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Interventional group:
Known gastrointestinal dysmotility
Medications that may affect gastric motility
Recurrence of Cancer
Prior gastrointestinal operations (other than oesopahgectomy) that may affect intestinal transit
Control group:
Known gastrointestinal dysmotility
Medications that may affect gastric motility
Prior gastrointestinal operations (other than oesopahgectomy) that may affect intestinal transit
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
2/08/2021
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Date of last participant enrolment
Anticipated
4/11/2023
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Actual
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Date of last data collection
Anticipated
4/12/2023
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Actual
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Sample size
Target
36
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Accrual to date
34
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
40978
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3004 - St Kilda Road Melbourne
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Monash University
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Address [1]
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Central Clinical School
Monash University
Level 6, Alfred Centre
99 Commercial Rd
Melbourne, Vic
3004
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Alfred Health
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Address
The Alfred
55 Commercial road
Melbourne, Vic
3004
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
313048
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
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55 Commercial rd, Melbourne, Vic, 3004
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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12/11/2020
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Ethics approval number [1]
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Summary
Brief summary
Background:: Optimising gastric conduit emptying post oesophagectomy is key to improving morbidity outcomes in a cohort of patients with increasingly long survivorship. It is thought that peristaltic function and resultant emptying of the gastric conduit improves over time. However, the relationship between peristalsis and conduit emptying has not been precisely delineated, nor has the presumed recovery. Aims:: In this study, we aim to investigate dynamic MRI as a technique to measure gastric conduit peristalsis in the mediastinum. We will use it to quantify the degree of peristalsis in the established gastric conduit and assess its correlation with emptying. We will also use quality of life and adverse symptom questionnaires to look for a relationship between peristalsis and gastrointestinal quality of life. Hypothesis: Dynamic MRI is an accurate way to measure gastric conduit peristalsis and conduit emptying. Peristaltic activity recovers post oesophagectomy and is more effective in narrower conduits. Brief Methods: Post oesophagectomy patients will be recruited greater than 2 years post oesophagectomy. Dynamic MRI will be performed, and questionnaires and demographic data collected Patients greater than 2 years post oesophagectomy and gastric conduit reconstruction will be prospectively recruited. Static and Dynamic MRIs will be performed in the supine position post consumption of a semisolid meal. Speed, length, and amplitude of peristaltic waves will be measured at 4 time points over a 20-minute period. Gastric Motility Index mm2/s (GMI) will be calculated (velocity x amplitude of peristaltic wave). Gastric conduit volumes will be calculated at the start and end of each MRI.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Paul Burton
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Address
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Department of General Surgery, The Alfred HospitalLevel 6, 99 Commercial Road, Prahran, Victoria, 3181
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Country
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Australia
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Phone
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+613 85730000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Julie Playfair
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Address
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Centre for Obesity Research and Education, Monash UniversityLevel 6, The Alfred Centre, 99 Commercial Road, Prahran, Victoria, 3181
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Country
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Australia
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Phone
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+613 9903 0725
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Kaleb Lourensz
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Address
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Department of General Surgery, The Alfred HospitalLevel 6, 99 Commercial Road, Prahran, Victoria, 3181
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Country
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Australia
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Phone
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+613 9076 2000
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Not part of ethics approval
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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