<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03264300</url>
  </required_header>
  <id_info>
    <org_study_id>PHXA-16-0235-10-08</org_study_id>
    <secondary_id>1R01CA213158-01A1</secondary_id>
    <nct_id>NCT03264300</nct_id>
  </id_info>
  <brief_title>Development and Validation of Advanced MRI Methods for Clinical Applications</brief_title>
  <official_title>Development and Validation of Advanced MRI Methods for Clinical Applications</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>St. Joseph's Hospital and Medical Center, Phoenix</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>National Cancer Institute (NCI)</agency>
      <agency_class>NIH</agency_class>
    </collaborator>
  </sponsors>
  <source>St. Joseph's Hospital and Medical Center, Phoenix</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>Yes</is_fda_regulated_device>
    <is_us_export>Yes</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      A critical aspect of brain tumor patient management is the radiographic assessment of tumor&#xD;
      status, which is used for diagnosis, localization, surgical planning and surveillance. The&#xD;
      primary goal is to develop and apply advanced, quantitative magnetic resonance imaging (MRI)&#xD;
      techniques that can supplement existing high-resolution anatomic imaging to aid clinical&#xD;
      decision-making for patients diagnosed with brain tumors. The studies proposed herein involve&#xD;
      the development of advanced imaging methods that are intrinsically sensitive to the&#xD;
      biophysical characteristics associated with tumor pathogenesis, as they are more likely to&#xD;
      improve tumor characterization and localization and may offer early and more specific&#xD;
      indicators of treatment response. These advanced methods include diffusion-weighted imaging&#xD;
      (DWI), chemical exchange saturation transfer (CEST), and dynamic susceptibility contrast&#xD;
      (DSC) perfusion MRI. A secondary objective of this study is to validate cerebral blood volume&#xD;
      (CBV) metrics acquired using a DSC acquisition and post-processing methods by comparison with&#xD;
      an intravascular reference standard contrast agent. Validated perfusion imaging techniques&#xD;
      will improve the reliability and relevancy of derived CBV metrics across a range of clinical&#xD;
      applications, including tumor localization, treatment guidance, therapy response assessment,&#xD;
      surgical and biopsy guidance, and multi-site clinical trials of conventional and targeted&#xD;
      brain tumor therapies.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The objectives of this study are to (1) Develop and optimize acquisition methods for&#xD;
      MRI-based biomarkers that are indicative of brain tumor pathophysiology. These methods&#xD;
      include, but are not limited to, DWI, CEST, and Dynamic Susceptibility Contrast (DSC) and&#xD;
      Dynamic Contrast Enhanced (DCE) MRI; and (2) Validate DSC-MRI accuracy by comparison to an&#xD;
      intravascular reference standard. Developmental studies: During the development of new&#xD;
      imaging-based biomarkers, it is critical to optimize acquisition parameters, systematically&#xD;
      characterize performance and contrast in the pathology of interest, validate with&#xD;
      histopathology and establish test-retest repeatability. Thus, the first goal of this study is&#xD;
      to develop advanced Diffusion Weighted Imaging (DWI), CEST and DSC/DCE-MRI methods for&#xD;
      application to brain tumors. Objective 1 is a single-center study of up to 60 subjects being&#xD;
      done to explore and optimize imaging signatures indicative of altered functional tumor&#xD;
      states. These advanced imaging methods will allow the investigators to probe&#xD;
      neuropathological tumor correlates, including cellular characteristics, molecular and&#xD;
      metabolic changes, and vascular characteristics. Compared to existing conventional anatomic&#xD;
      imaging, the researchers hypothesize that these experimental methods will be better able to&#xD;
      characterize brain tumors and will have the potential to serve as new biomarkers of&#xD;
      diagnostic and therapeutic importance. The researchers approach brings together biophysical&#xD;
      and physiological information obtained from MRI and correlates this with clinical diagnoses&#xD;
      and outcomes. Validation of DSC-MRI: Despite DSC-MRI's potential impact on clinical care, its&#xD;
      broad scale integration has been slow, in large part from a lack of consensus about&#xD;
      methodology and how to prevent potential CBV inaccuracies. Although DSC-MRI relies on the&#xD;
      assumption that gadolinium-based contrast agents remain within the vascular lumen, this&#xD;
      condition is often violated in vivo. If not corrected for, contrast agent leakage effects&#xD;
      lead to CBV inaccuracy, misdiagnosis, and potentially mistreatment. While there exist&#xD;
      numerous leakage correction strategies that have been shown to clearly improve DSC-MRI's&#xD;
      clinical utility (e.g., predicting therapeutic response), a key limitation has prevented the&#xD;
      standardization and wide-spread adoption of DSC-MRI methodology: To date, no study has&#xD;
      validated the accuracy of leakage corrected CBV measures in patients. So while leakage&#xD;
      corrected CBV values may be used, for example, to differentiate tumor recurrence from&#xD;
      post-treatment effects, it is unknown whether this clinical benefit is a consequence of the&#xD;
      complex combination of pulse sequence parameters, kinetics, dosing scheme, relaxivities, and&#xD;
      leakage correction strategy or if the computed CBV actually reflects the underlying vascular&#xD;
      density. This distinction is critical because it has implications for DSC-MRI&#xD;
      standardization, establishing CBV thresholds for clinic use, multi-site comparisons and&#xD;
      clinical trials. The investigators believe this limitation represents the most critical and&#xD;
      clinically relevant challenge in the field of brain tumor DSC-MRI that urgently needs to be&#xD;
      addressed. Objective 2 is a single-center study of up to 160 subjects being done to validate&#xD;
      the accuracy of DSC-MRI measures of CBV. To validate the DSC-MRI measures derived from small&#xD;
      molecular weight gadolinium-based (Gd) contrast agents, the investigators will compare rCBV&#xD;
      maps to those derived from the intravascular contrast agent, Ferumoxytol. Ferumoxytol has&#xD;
      been evaluated in humans as a potential DSC-MRI contrast agent but not for the purposes of&#xD;
      validating leakage correction techniques. Since ferumoxytol-based DSC-MRI is not influenced&#xD;
      by leakage effects, it enables the assessment of the most reliable perfusion metrics that can&#xD;
      be expected from DSC-MRI and, as such, is the most reliable reference standard by which to&#xD;
      evaluate CBV accuracy. Note that while ferumoxytol is undergoing clinical trials as a&#xD;
      potential DSC-MRI contrast agent, it is unlikely to replace Gd-based contrast agents because&#xD;
      it cannot provide the signal enhancement expected on conventional post-contrast T1-weighted&#xD;
      images and is therefore unsuitable for use with standard response criteria.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">June 26, 2017</start_date>
  <completion_date type="Anticipated">October 30, 2022</completion_date>
  <primary_completion_date type="Anticipated">June 26, 2022</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Diagnostic</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>cerebral blood volume</measure>
    <time_frame>Within 60 days of MRI</time_frame>
    <description>In patients with brain tumors we will develop and optimize advanced MRI methods to characterize blood volume.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>the contrast agent extravasation rate constant (Ktrans, 1/min)</measure>
    <time_frame>Within 60 days of MRI</time_frame>
    <description>In patients with brain tumors we will develop and optimize advanced MRI methods to characterize Ktrans</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Repeatability coefficient</measure>
    <time_frame>within 60 days of MRI</time_frame>
    <description>will assess the repeatability of MRI</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Intraclass correlation coefficient</measure>
    <time_frame>Within 60 days of MRI</time_frame>
    <description>Validate DSC-MRI accuracy by comparison to an intravascular reference standard by comparing rCBV maps to those derived from the intravascular contrast agent, Ferumoxytol</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">220</enrollment>
  <condition>Brain Tumor</condition>
  <arm_group>
    <arm_group_label>Development of advanced MRI methods</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Subjects with brain tumor. Subjects may be scanned using a single time-point to permit development and optimization of advanced MRI methods. Subjects may be scanned up to two times, with both visits occurring within one month, to permit analysis of test-retest reliability/repeatability.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Validation of rCBV accuracy</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>64 subjects with primary glioma and 96 subjects with recurrent glioma. Subjects will be scanned using a single time-point to validate rCBV accuracy.</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>MRI</intervention_name>
    <description>MRI scans to include: scout images, transmitter tuning, shimming, slice prescription - 5 min; conventional structural MRI; T1-weighted anatomic MRI scan - 7 min; and, T2-weighted anatomic MRI scan - 5 min. Advanced MRI to include: Diffusion Weighted MRI (DW-MRI) - 7 min; Chemical Exchange Saturation Transfer (CEST) - 9 min; Dynamic Susceptibility Contrast / Dynamic Contrast Enhanced MRI - 8 min; and, other advanced imaging, as needed, to be determined. Post-contrast conventional MRI to include T1-weighted anatomic MRI scan - 7 min. Repeat within 1 month.</description>
    <arm_group_label>Development of advanced MRI methods</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>MRI</intervention_name>
    <description>MRI scans to include: scout images, transmitter tuning, shimming, slice prescription - 5 min. Conventional structural MRI to include: T1-weighted anatomic MRI scan - 7 min; and, T2-weighted anatomic MRI scan - 5 min. Serial DSC-MRI: staged injections of Gd-based contrast and Ferumoxytol - 20 min. Post-contrast conventional MRI: T1-weighted anatomic MRI scan - 7 min.</description>
    <arm_group_label>Validation of rCBV accuracy</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Must have either radiological or established histological diagnosis of the following:&#xD;
             glioma / central nervous system (CNS) lymphoma / meningioma or brain metastases.&#xD;
&#xD;
          -  Willing and able to provide written informed consent in compliance with the regulatory&#xD;
             requirements. If a subject is unable to provide written informed consent, written&#xD;
             informed consent may be obtained from the subject's legal representative.&#xD;
&#xD;
          -  In the opinion of the investigator, able to fully participate in the study and&#xD;
             sufficiently proficient in English to be capable of reliably completing study&#xD;
             assessments.&#xD;
&#xD;
          -  Sexually active women of child-bearing potential (Groups 1 and 2) and men (Group 2&#xD;
             only) must agree to use adequate methods to avoid pregnancy.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Subjects who have a contraindication for MRI: presence of an incompatible bio-implants&#xD;
             (e.g., pacemakers, neurostimulators, electronic infusion pumps, etc.), metal in their&#xD;
             bodies (non-MRI compatible cerebral aneurysm clips, shrapnel, metallic fragments in or&#xD;
             near the eyes as pertains to metal workers and machinists), or noticeable anxiety&#xD;
             and/or claustrophobia and/or severe vertigo when moved into the magnet bore.&#xD;
&#xD;
          -  Subjects who are pregnant or lactating or who suspect they might be pregnant.&#xD;
&#xD;
          -  (Groups 1 and 2, subjects receiving intravenous gadolinium (Gd) contrast material).&#xD;
             Subjects with renal insufficiency or known allergy to Gd-based contrast material.&#xD;
&#xD;
          -  (Group 2 only) Subjects with known or suspected iron overload.&#xD;
&#xD;
          -  (Group 2 only) Subjects with known allergic or hypersensitivity reactions to&#xD;
             parenteral iron treatment or other intravenous iron products; subjects with&#xD;
             significant drug or other allergies or autoimmune diseases may be enrolled at the&#xD;
             investigator's discretion.&#xD;
&#xD;
          -  Unwilling or unable to comply with the requirements of this protocol, including the&#xD;
             presence of any condition (physical, mental, or social) that is likely to affect the&#xD;
             subject's ability to comply with the protocol.&#xD;
&#xD;
          -  Any other reasons that, in the opinion of the Investigator, the candidate is&#xD;
             determined to be unsuitable for entry into the study.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>C C Quarles, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>St. Joseph's Hospital and Medical Center, Phoenix</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Ashley M Stokes, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>St. Joseph's Hospital and Medical Center, Phoenix</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Lisa Arnold, BS</last_name>
    <phone>602-406-9593</phone>
    <email>Lisa.Arnold@dignityhealth.org</email>
  </overall_contact>
  <location>
    <facility>
      <name>St. Joseph's Hospital and Medical Center</name>
      <address>
        <city>Phoenix</city>
        <state>Arizona</state>
        <zip>85013</zip>
        <country>United States</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Lisa Arnold, BS</last_name>
      <phone>602-406-9593</phone>
      <email>Lisa.Arnold@dignityhealth.org</email>
    </contact>
    <investigator>
      <last_name>C C Quarles, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Ashley M Stokes, PhD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <verification_date>September 2021</verification_date>
  <study_first_submitted>July 11, 2017</study_first_submitted>
  <study_first_submitted_qc>August 24, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">August 29, 2017</study_first_posted>
  <last_update_submitted>September 20, 2021</last_update_submitted>
  <last_update_submitted_qc>September 20, 2021</last_update_submitted_qc>
  <last_update_posted type="Actual">September 21, 2021</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>St. Joseph's Hospital and Medical Center, Phoenix</investigator_affiliation>
    <investigator_full_name>Lisa Arnold</investigator_full_name>
    <investigator_title>Research Operations Manager</investigator_title>
  </responsible_party>
  <keyword>brain tumor, MRI</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Brain Neoplasms</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03264300
org study id: PHXA-16-0235-10-08
secondary id: 1R01CA213158-01A1
nct id: NCT03264300
lead sponsor: 
collaborator: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: Yes
is us export: Yes
A critical aspect of brain tumor patient management is the radiographic assessment of tumor
      status, which is used for diagnosis, localization, surgical planning and surveillance. The
      primary goal is to develop and apply advanced, quantitative magnetic resonance imaging (MRI)
      techniques that can supplement existing high-resolution anatomic imaging to aid clinical
      decision-making for patients diagnosed with brain tumors. The studies proposed herein involve
      the development of advanced imaging methods that are intrinsically sensitive to the
      biophysical characteristics associated with tumor pathogenesis, as they are more likely to
      improve tumor characterization and localization and may offer early and more specific
      indicators of treatment response. These advanced methods include diffusion-weighted imaging
      (DWI), chemical exchange saturation transfer (CEST), and dynamic susceptibility contrast
      (DSC) perfusion MRI. A secondary objective of this study is to validate cerebral blood volume
      (CBV) metrics acquired using a DSC acquisition and post-processing methods by comparison with
      an intravascular reference standard contrast agent. Validated perfusion imaging techniques
      will improve the reliability and relevancy of derived CBV metrics across a range of clinical
      applications, including tumor localization, treatment guidance, therapy response assessment,
      surgical and biopsy guidance, and multi-site clinical trials of conventional and targeted
      brain tumor therapies.
The objectives of this study are to (1) Develop and optimize acquisition methods for
      MRI-based biomarkers that are indicative of brain tumor pathophysiology. These methods
      include, but are not limited to, DWI, CEST, and Dynamic Susceptibility Contrast (DSC) and
      Dynamic Contrast Enhanced (DCE) MRI; and (2) Validate DSC-MRI accuracy by comparison to an
      intravascular reference standard. Developmental studies: During the development of new
      imaging-based biomarkers, it is critical to optimize acquisition parameters, systematically
      characterize performance and contrast in the pathology of interest, validate with
      histopathology and establish test-retest repeatability. Thus, the first goal of this study is
      to develop advanced Diffusion Weighted Imaging (DWI), CEST and DSC/DCE-MRI methods for
      application to brain tumors. Objective 1 is a single-center study of up to 60 subjects being
      done to explore and optimize imaging signatures indicative of altered functional tumor
      states. These advanced imaging methods will allow the investigators to probe
      neuropathological tumor correlates, including cellular characteristics, molecular and
      metabolic changes, and vascular characteristics. Compared to existing conventional anatomic
      imaging, the researchers hypothesize that these experimental methods will be better able to
      characterize brain tumors and will have the potential to serve as new biomarkers of
      diagnostic and therapeutic importance. The researchers approach brings together biophysical
      and physiological information obtained from MRI and correlates this with clinical diagnoses
      and outcomes. Validation of DSC-MRI: Despite DSC-MRI's potential impact on clinical care, its
      broad scale integration has been slow, in large part from a lack of consensus about
      methodology and how to prevent potential CBV inaccuracies. Although DSC-MRI relies on the
      assumption that gadolinium-based contrast agents remain within the vascular lumen, this
      condition is often violated in vivo. If not corrected for, contrast agent leakage effects
      lead to CBV inaccuracy, misdiagnosis, and potentially mistreatment. While there exist
      numerous leakage correction strategies that have been shown to clearly improve DSC-MRI's
      clinical utility (e.g., predicting therapeutic response), a key limitation has prevented the
      standardization and wide-spread adoption of DSC-MRI methodology: To date, no study has
      validated the accuracy of leakage corrected CBV measures in patients. So while leakage
      corrected CBV values may be used, for example, to differentiate tumor recurrence from
      post-treatment effects, it is unknown whether this clinical benefit is a consequence of the
      complex combination of pulse sequence parameters, kinetics, dosing scheme, relaxivities, and
      leakage correction strategy or if the computed CBV actually reflects the underlying vascular
      density. This distinction is critical because it has implications for DSC-MRI
      standardization, establishing CBV thresholds for clinic use, multi-site comparisons and
      clinical trials. The investigators believe this limitation represents the most critical and
      clinically relevant challenge in the field of brain tumor DSC-MRI that urgently needs to be
      addressed. Objective 2 is a single-center study of up to 160 subjects being done to validate
      the accuracy of DSC-MRI measures of CBV. To validate the DSC-MRI measures derived from small
      molecular weight gadolinium-based (Gd) contrast agents, the investigators will compare rCBV
      maps to those derived from the intravascular contrast agent, Ferumoxytol. Ferumoxytol has
      been evaluated in humans as a potential DSC-MRI contrast agent but not for the purposes of
      validating leakage correction techniques. Since ferumoxytol-based DSC-MRI is not influenced
      by leakage effects, it enables the assessment of the most reliable perfusion metrics that can
      be expected from DSC-MRI and, as such, is the most reliable reference standard by which to
      evaluate CBV accuracy. Note that while ferumoxytol is undergoing clinical trials as a
      potential DSC-MRI contrast agent, it is unlikely to replace Gd-based contrast agents because
      it cannot provide the signal enhancement expected on conventional post-contrast T1-weighted
      images and is therefore unsuitable for use with standard response criteria.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Diagnostic
masking: None (Open Label)
measure: cerebral blood volume
time frame: Within 60 days of MRI
description: In patients with brain tumors we will develop and optimize advanced MRI methods to characterize blood volume.
measure: the contrast agent extravasation rate constant (Ktrans, 1/min)
time frame: Within 60 days of MRI
description: In patients with brain tumors we will develop and optimize advanced MRI methods to characterize Ktrans
measure: Repeatability coefficient
time frame: within 60 days of MRI
description: will assess the repeatability of MRI
measure: Intraclass correlation coefficient
time frame: Within 60 days of MRI
description: Validate DSC-MRI accuracy by comparison to an intravascular reference standard by comparing rCBV maps to those derived from the intravascular contrast agent, Ferumoxytol
arm group label: Development of advanced MRI methods
arm group type: Active Comparator
description: Subjects with brain tumor. Subjects may be scanned using a single time-point to permit development and optimization of advanced MRI methods. Subjects may be scanned up to two times, with both visits occurring within one month, to permit analysis of test-retest reliability/repeatability.
arm group label: Validation of rCBV accuracy
arm group type: Active Comparator
description: 64 subjects with primary glioma and 96 subjects with recurrent glioma. Subjects will be scanned using a single time-point to validate rCBV accuracy.
intervention type: Other
intervention name: MRI
description: MRI scans to include: scout images, transmitter tuning, shimming, slice prescription - 5 min; conventional structural MRI; T1-weighted anatomic MRI scan - 7 min; and, T2-weighted anatomic MRI scan - 5 min. Advanced MRI to include: Diffusion Weighted MRI (DW-MRI) - 7 min; Chemical Exchange Saturation Transfer (CEST) - 9 min; Dynamic Susceptibility Contrast / Dynamic Contrast Enhanced MRI - 8 min; and, other advanced imaging, as needed, to be determined. Post-contrast conventional MRI to include T1-weighted anatomic MRI scan - 7 min. Repeat within 1 month.
arm group label: Development of advanced MRI methods
intervention type: Other
intervention name: MRI
description: MRI scans to include: scout images, transmitter tuning, shimming, slice prescription - 5 min. Conventional structural MRI to include: T1-weighted anatomic MRI scan - 7 min; and, T2-weighted anatomic MRI scan - 5 min. Serial DSC-MRI: staged injections of Gd-based contrast and Ferumoxytol - 20 min. Post-contrast conventional MRI: T1-weighted anatomic MRI scan - 7 min.
arm group label: Validation of rCBV accuracy
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: C C Quarles, PhD
role: Principal Investigator
affiliation: St. Joseph's Hospital and Medical Center, Phoenix
last name: Ashley M Stokes, PhD
role: Principal Investigator
affiliation: St. Joseph's Hospital and Medical Center, Phoenix
last name: Lisa Arnold, BS
phone: 602-406-9593
email: Lisa.Arnold@dignityhealth.org
facility: 
status: Recruiting
contact: 
investigator: 
investigator: 
country: United States
responsible party type: Principal Investigator
investigator affiliation: St. Joseph's Hospital and Medical Center, Phoenix
investigator full name: Lisa Arnold
investigator title: Research Operations Manager
mesh term: Brain Neoplasms