EYEMAX® Versus SPYGLASS™ DS for Biliary Stricture Diagnosis (EYE/SPY)
Multicenter Study on the Quality of Biliary Biopsies: EYEMAX® vs SPYGLASS™ DS
Cholangiocarcinoma remains difficult to diagnose because of the limited sensitivity of currently available endobiliary sampling techniques. Cholangioscopy-guided biopsies performed with the SPYGLASS™ DS system have improved tissue acquisition compared with conventional brushing techniques, but diagnostic sensitivity remains suboptimal, partly because of the small diameter of the dedicated biopsy forceps.
The EYEMAX® cholangioscopy system has a larger working channel, potentially allowing the use of larger biopsy forceps and improved tissue acquisition. This multicenter randomized study aims to compare the diagnostic performance of EYEMAX® versus SPYGLASS™ DS for the diagnosis of malignant biliary strictures.
The primary objective is to compare the positive diagnostic yield of the first four cholangioscopy-guided biopsies obtained with each system in patients with adenocarcinomatous biliary strictures.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: David KARSENTI, MD
- Phone Number: +33 1 43 96 78 50
- Email: karsenti.paris@gmail.com
Study Contact Backup
- Name: MORENO MAIRA, PhD
- Email: rechercheclinique@sfed.org
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 1. Adult patients aged 18 to 84 years
- 2. Patients requiring ERCP with cholangioscopy-guided biopsy for biliary stricture
- 3. Absence of a mass easily accessible to EUS-guided fine needle aspiration
- 4. ASA physical status 1-3
- 5. No participation in another clinical trial
- 6. Written informed consent obtained
- 7. Patient affiliated with a social security system or equivalent
Exclusion Criteria:
- 1. Lithiasic biliary obstruction
- 2. Patients younger than 18 years
- 3. ASA 4 or ASA 5 patients
- 4. Pregnant or breastfeeding women
- 5. Coagulation disorders preventing biopsy procedures
- 6. Surgical anatomy preventing papillary access
- 7. Patients unable to provide informed consent
- 8. Upper gastrointestinal obstruction
- 9. Intolerance to endoscopy
- 10. Severe cardiopulmonary disease
- 11. Acute pancreatitis or severe cholangitis
- 12. Severe contrast agent allergy
- 13. Patients under legal protection measures
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Cholangioscopy-guided biliary biopsies performed using the EYEMAX® cholangioscope (Micro-Tech).
|
Cholangioscopy-guided biliary biopsies performed using the EYEMAX® cholangioscope (Micro-Tech) during ERCP under general anesthesia.
Following biliary cannulation and guidewire passage across the stricture, two series of four targeted biopsies are obtained using the dedicated biopsy forceps through the EYEMAX® working channel.
Additional diagnostic sampling procedures, including biliary brushing, fluoroscopy-guided biopsies, bile aspiration cytology, and EUS-guided sampling when clinically indicated, may also be performed according to local practice.
|
|
Active Comparator: Cholangioscopy-guided biliary biopsies performed using the SPYGLASS™ DS system (Boston Scientific).
|
Cholangioscopy-guided biliary biopsies performed using the SPYGLASS™ DS cholangioscopy system (Boston Scientific) during ERCP under general anesthesia.
Following biliary cannulation and guidewire passage across the stricture, two series of four targeted biopsies are obtained using the dedicated biopsy forceps through the SPYGLASS™ DS working channel.
Additional diagnostic sampling procedures, including biliary brushing, fluoroscopy-guided biopsies, bile aspiration cytology, and EUS-guided sampling when clinically indicated, may also be performed according to local practice.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percentage of positive pathological diagnoses obtained from the first four cholangioscopy-guided biopsies
Time Frame: Through study completion, an average of 1 year
|
The positive diagnostic yield will be assessed for the first four biopsies obtained under cholangioscopy in patients with adenocarcinomatous biliary strictures.
This rate will be defined as the ratio between the number of positive pathological diagnoses obtained from the first four cholangioscopy-guided biopsies and the total number of confirmed adenocarcinomatous biliary strictures.
|
Through study completion, an average of 1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Positive diagnostic yield of all eight cholangioscopy-guided biopsies
Time Frame: Through study completion, an average of 1 year
|
This rate will be defined as the proportion of positive pathological diagnoses obtained from all eight cholangioscopy-guided biopsies among all confirmed adenocarcinomatous biliary strictures.
|
Through study completion, an average of 1 year
|
|
Histological cellularity classification of cholangioscopy-guided biopsy specimens
Time Frame: Through study completion, an average of 1 year
|
Biopsy specimen cellularity will be assessed by expert gastrointestinal pathologists and classified into four predefined categories: acellular, low abundance, satisfactory abundance, or rich abundance.
|
Through study completion, an average of 1 year
|
|
False negative rate of cholangioscopy-guided biopsies
Time Frame: Through study completion, an average of 1 year
|
The false negative rate will be defined as the proportion of patients with negative biopsy results despite a final diagnosis of adenocarcinomatous biliary stricture confirmed during follow-up.
|
Through study completion, an average of 1 year
|
|
Negative predictive value of cholangioscopy-guided biopsies
Time Frame: Through study completion, an average of 1 year
|
Negative predictive value will be calculated as the proportion of patients with negative biopsy results who do not have adenocarcinomatous biliary strictures at final diagnosis.
|
Through study completion, an average of 1 year
|
|
Percentage of technical failures during cholangioscopy-guided biopsy procedures
Time Frame: Periprocedural
|
Technical failure will be defined as the inability to access the biliary stricture with the cholangioscope or the inability to obtain biopsy material using the dedicated biopsy forceps.
|
Periprocedural
|
|
Diagnostic yield of additional biliary sampling techniques
Time Frame: Through study completion, an average of 1 year
|
The diagnostic yield of additional biliary sampling techniques, including biliary brushing, fluoroscopy-guided biopsies, bile aspiration cytology, and EUS-guided sampling, will be evaluated as the proportion of positive pathological diagnoses obtained using each technique.
|
Through study completion, an average of 1 year
|
|
Number of participants with procedure-related adverse events
Time Frame: Up to Day 30
|
Procedure-related adverse events include abdominal pain, acute pancreatitis, cholangitis, cholecystitis, hepatic abscess, perforation, bleeding, and death.
|
Up to Day 30
|
|
Mean duration of cholangioscopy-guided biopsy procedures
Time Frame: Periprocedural
|
The duration required to complete the eight cholangioscopy-guided biopsies will be measured and compared between the two cholangioscopy systems.
|
Periprocedural
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SFED-160
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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