Standardized CEUS Algorithms for Diagnosis of HCC - Prospective German Multicenter Study (ESCULAP)
Standardized Contrast-enhanced Ultrasound (CEUS) -Algorithms for the Non-invasive Diagnosis of Hepatocellular Carcinoma (HCC) in High-risk-patients - a Prospective German Multicenter Study
Aim of this prospective national multicenter study is to improve standardization of contrast-enhanced ultrasound (CEUS) in the non-invasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients.
The study is funded by the German Society for Ultrasound in Medicine (DEGUM).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
To date, CEUS criteria for non-invasive diagnosis of HCC include arterial phase hyperenhancement, followed by contrast washout in the portal venous or late phase. We would like to investigate the following points:
- whether arterial hyperenhancement alone is sufficient for the definite diagnosis of HCC in cirrhosis with CEUS
- whether a further clearly-defined point of assessment in the late phase after 4-6 minutes is of additional diagnostic value in focal liver lesions showing no contrast washout after 3 minutes
- diagnostic value of CEUS-based standardised diagnostic algorithms (ESCULAP = Erlanger Synopsis of Contrast Enhanced Ultrasound for Liver lesion Assessment in Patients at risk; CEUS LI-RADS = Contrast Enhanced Ultrasound Liver Imaging Reporting and Data System) for non-invasive diagnosis of HCC in high-risk patients (diagnostic accuracy, interobserver-variability, feasability in clinical Routine).
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
Bavaria
-
Erlangen, Bavaria, Germany, 91054
- University Hospital Erlangen, Department of Medicine 1
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- high risk for HCC
- focal liver lesion on B-mode ultrasound
Exclusion Criteria:
- pre-treated HCC lesion
- systemic therapy for HCC (sorafenib, regorafenib and others)
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Patients at risk for HCC
Patients with any of the following conditions: liver cirrhosis of any origin chronic hepatitis B infection chronic hepatitis C infection with advanced fibrosis non-alcoholic steatohepatitis (NASH) hemochromatosis Interventions: B-mode ultrasound, contrast enhanced ultrasound (CEUS); MRI / histology |
CEUS with SonoVue following standardized protocol
CE-MRI following standardized protocol
diagnostic liver biopsy
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Diagnostic value of standardised CEUS-based algorithms for the non-invasive diagnosis of HCC in high-risk patients
Time Frame: 2 years
|
Diagnostic accuracy, interobserver-variabilty and feasability in clinical routine for CEUS-based algorithms Reference Standard: histology / MRI
|
2 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Diagnostic value / dispensability of contrast washout for definite diagnosis of HCC with CEUS
Time Frame: 2 years
|
Sensitvity, specificity, positive and negative predictive value of arterial hyperenhancement only compared with arterial hyperenhancement followed by contrast washout for non-invasive diagnosis of HCC in high-risk patients Reference Standard: histology / MRI
|
2 years
|
|
Standardisation of CEUS examinations
Time Frame: 2 years
|
Diagnostic value of an additional standardised examination point in the late phase after 4-6 minutes in lesions without contrast washout after 3 minutes Reference Standard: histology / MRI
|
2 years
|
|
Diagnostic accuracy of CEUS in intrahepatic cholangiocellular carcinoma (ICC)
Time Frame: 2 years
|
Sensitvity, specificity, positive and negative predictive value of contrast-enhanced ultrasound for non-invasive diagnosis of ICC in high-risk patients / differential diagnosis of HCC versus ICC Reference Standard: histology
|
2 years
|
|
Comparison of two CEUS-based algorithms
Time Frame: 2 years
|
ESCULAP versus CEUS LI-RADS (diagnostic accuracy, interobserver agreement) Reference Standard: histology / MRI
|
2 years
|
|
Non-inferiority of CEUS versus MRI for non-invasive diagnosis of HCC
Time Frame: 2 years
|
Comparison of CEUS and MRI for non-invasive diagnosis of HCC (diagnostic accuracy, interobserver agreement) Reference Standard: histology
|
2 years
|
|
Influence of histological grading on contrast enhancement behaviour
Time Frame: 2 years
|
correlation of histological grading and contrast enhancement pattern
|
2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Barbara Schellhaas, MD, University Hospital Erlangen, Department of Medicine 1
- Principal Investigator: Deike Strobel, MD, University Hospital Erlangen, Department of Medicine 1
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- MRI
- imaging
- diagnostic accuracy
- hepatocellular carcinoma
- liver cirrhosis
- contrast-enhanced ultrasound
- non-invasive diagnosis
- focal liver lesion
- standardised diagnostic algorithm
- intrahepatic cholangiocellular carcinoma
- ESCULAP
- CEUS LI-RADS
- interobserver agreement
- Erlanger Synopsis of CEUS for Liver lesion Assessment in Patients at risk
- CEUS Liver Imaging Reporting and Data System
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- DEGUM CEUS HCC
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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