Ultrasound Biomarkers for Assessing Eligibility and Response to Resmetirom Therapy

September 30, 2026 updated by: Radnet Management, Inc.

Accuracy of Ultrasound Biomarkers for Assessing Eligibility and Response to Resmetirom Therapy Using MRI as the Reference Standard

This is a prospective, non-interventional, observational study to evaluate the accuracy of 2 US (ultrasound) biomarkers that quantify liver tissue fat and stiffness: UDFF (ultrasound-derived fat fraction) and pSWE (point shear wave elastography) for determining MRI-defined eligibility for resmetirom (REZDIFFRA®) treatment and for monitoring treatment response using MRI-PDFF (proton density fat fraction) and MRE (magnetic resonance elastography) as reference standards.

Study Centers Planned:

3 clinical practice facilities in Houston TX .

Study Rationale:

MASLD (metabolic dysfunction-associated steatotic liver disease ) is a growing global epidemic and the most common liver disease worldwide. Approximately 25% of adults in the United States alone have hepatic steatosis in the absence of significant alcohol consumption and 1 in 4 of these adults are presumed to have MASH.

MASH has a higher likelihood of progression to irreversible liver damage including cirrhosis and hepatocellular carcinoma.

Despite advancements in the field, there is still a high unmet need for technologies to accurately and reliably grade liver steatosis and stage liver fibrosis for applications related to patient identification and monitoring response to therapeutic intervention.

The association between hepatic steatosis and fibrosis progression underscores the need to have accurate and reliable noninvasive tools to aid in the assessment and monitoring of both liver steatosis and fibrosis.

The combination of 2 US (ultrasound) biomarkers that quantify liver tissue fat and stiffness (UDFF and pSWE) may aid clinicians in streamlining patient care pathways and potentially avoid unwanted and invasive medical intervention.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Detailed Description

This study will consist of 3 phases:

  1. Technologist Training: Pre-study training will be conducted for all US (ultrasound) and MRI technologists to ensure standardized image acquisition across study sites.
  2. A Pilot Study will be conducted in healthy adult participants to qualify imaging centers to participate in the Main Study.
  3. The Main Study will be conducted in adult participants suspected of MASH (metabolic dysfunction-steatohepatitis) (with moderate to advanced fibrosis consistent with F2-F3 to evaluate the diagnostic performance of the combination of 2 US (ultrasound) biomarkers (UDFF and pSWE) for determining MRI-defined eligibility for resmetirom treatment and for monitoring treatment response over time .

A Pilot Study will be conducted before the Main Study to verify image acquisition quality and data completeness, and to assess repeatability (US) and reproducibility (US and MRI). The Pilot Study will include 24 adult participants (n=8 participants/site across 3 imaging centers).

Each participant in the pilot study will undergo 4 US (ultrasound) scans (2 scans each by 2 Certified US Technologists).

All US scans will be performed on SIEMENS ACUSON Sequoia systems using the 5C1 transducer and the same software version throughout the study. Repeated US scans will be separated by ≥5 minutes, with participants repositioned between scans by the Certified US Technologists.

Each participant in the pilot study will also undergo 2 MRI scans (1 scan each by 2 Certified MRI Technologists):

MR scans will be performed using either the SIEMENS MAGNETOM Skyra 3T or GE SIGNA PIONEER 3T, depending on scheduling and site availability. The MR scanner will be running the same software version throughout the study.

Data from participants in the Pilot Study will not be included in the analysis of the Main Study.

Data Quality Verification :

All pilot data will be reviewed by Siemens to verify image acquisition quality, completeness, and adherence to the imaging protocol.

Repeatability and reproducibility will be evaluated in the Pilot Study.

Main Study

Participants will be recruited from clinical practices in the Houston, Texas area by hepatologists, gastroenterologists, and other referring clinicians. US (ultrasound) and MRI examinations will be performed across 3 Sponsor imaging centers in the Houston area. All participants will undergo Baseline US (ultrasound) biomarkers (UDFF, pSWE) and MRI biomarkers (MRI-PDFF, MRE) on the same day.

Blinding

  • Referring physicians will be blinded to US (ultrasound) (UDFF and pSWE) results, and thus decisions to prescribe resmetirom will be made based solely on MRI biomarkers (ie, MRI-PDFF and MRE) and clinical assessment.
  • US (ultrasound) operators will be blinded to results from MRI biomarkers (MRI-PDFF and MRE).
  • MRI operators will be blinded to results from US (ultrasound) biomarkers (UDFF and pSWE).

Duration of Study Participation

  • Pilot Study: 1 day, in addition to the Screening Visit
  • Main Study :
  • Participants NOT treated with resmetirom: Screening(consenting)and day 1 baseline MRI and US(2 visits total);
  • Participants treated with resmetirom (prescribed by their referring physician based on Baseline MRI results and clinical assessment): Screening (consenting), day 1 baseline MRI and US then at months 6, 12 and 24 (5 visits total).

Study Assessments

  • Record demographics
  • Record medication history since last visit
  • Record laboratory test results since last visit
  • Perform US (ultrasound)
  • Perform MRI
  • Record/report SAEs

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
524

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • United States
    • Texas
      • Houston, Texas, United States, 77055
        • HMI/Campbell
        • Contact:
        • Contact:
        • Principal Investigator:
          • Randall Stenoien, MD
      • Houston, Texas, United States, 77079
        • HMI/Energy Corridor
        • Contact:
        • Contact:
        • Principal Investigator:
          • Randall Stenoien, MD
      • Pearland, Texas, United States, 77581
        • HMI/Pearland
        • Contact:
        • Contact:
        • Principal Investigator:
          • Randall Stenoien, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Participants must be fully informed of the potential benefits of approved products and make an informed decision that they prefer to participate in a clinical study. Regulatory, ethical, and study oversight considerations are provided in the protocol.

Participants will be recruited from clinical practices in the Houston, Texas area by hepatologists, gastroenterologists, and other referring clinicians.

  • Participants in the Pilot Study will be healthy adult males or females, age ≥18 years.
  • Participants in the Main Study will be adult males or females, age ≥18 years, suspected of MASH with moderate to advanced fibrosis consistent with F2-F3.

Participants will be eligible if they meet ALL inclusion criteria and NONE of the exclusion criteria at Screening.

Description

Enrollment Criteria

Participants will be recruited from clinical practices in the Houston, Texas area by hepatologists, gastroenterologists, and other referring clinicians.

Inclusion Criteria (Pilot Study):

  • Participants must meet the following criteria:
  • Healthy adults (≥18 years) with no known liver diseases

Inclusion Criteria (Main Study):

  • Participants must meet the following criteria:
  • Adults (≥18 years) suspected of MASH with moderate to advanced fibrosis consistent with F2-F3 with no other known liver disease

Exclusion Criteria (Pilot Study, Main Study):

Participants meeting ANY of the following criteria will be excluded:

  • Use of steatogenic or hepatotoxic medications (eg, corticosteroids such as prednisone, amiodarone, methotrexate, tamoxifen)
  • Contraindications to MRI
  • Pregnancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: COHORT
  • Time Perspectives: PROSPECTIVE

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Diagnostic performance of UDFF (ultrasound-derived fat fraction)
Time Frame: Enrollment Day 1 Baseline

Ultrasound criteria associated with elevated liver fat at baseline: UDFF ≥8%
Enrollment Day 1 Baseline
Diagnostic performance of Ultrasound pSWE (point shear wave elastography)
Time Frame: Enrollment Day 1 Baseline

Ultrasound criteria consistent with MASH F2-F3 fibrosis at baseline: pSWE ≥7 and <17 kPa
Enrollment Day 1 Baseline

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
The accuracy of the Ultrasound biomarker pSWE (point shear wave elastography) for monitoring resmetirom treatment response over time.
Time Frame: 6 months to 24 months of follow-up period

Percent changes in Ultrasound pSWE from baseline to follow-up period are tested for statistical equivalence.
6 months to 24 months of follow-up period
The accuracy of the Ultrasound biomarker UDFF (ultrasound-derived fat fraction) for monitoring resmetirom treatment response over time.
Time Frame: 6 months to 24 months of follow-up period

Percent changes in UDFF from baseline to follow-up period are tested for statistical equivalence
6 months to 24 months of follow-up period
Corresponding percent changes in MRI-PDFF (proton density fat fraction) from baseline to follow- up period are tested for statistical equivalence
Time Frame: 6 months to 24 months follow-up period

MR criteria associated with elevated liver fat at baseline: PDFF ≥8%
6 months to 24 months follow-up period
Corresponding percent changes in MRE (magnetic resonance elastography) from baseline to followup period are tested for statistical equivalence
Time Frame: 6 months to 24 months follow-up period

MR criteria consistent with MASH F2-F3 fibrosis at baseline: MRE ≥3.3 and <5 kPa
6 months to 24 months follow-up period
Correlation between percent changes in imaging biomarkers for monitoring resmetirom treatment response over time.
Time Frame: 6 months to 24 months follow-up period

Percent changes in UDFF and MRI-PDFF values from baseline to follow-up period and Percent changes in pSWE and MRE values from baseline to follow-up period.
6 months to 24 months follow-up period

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
To evaluate factors influencing imaging biomarkers MRI-PDFF, MRE, UDFF and pSWE.
Time Frame: Enrollment Day 1 Baseline to 24 months follow-up period

• Assessment of the influence of GLP-1 therapy use using a subgroup analysis.
Enrollment Day 1 Baseline to 24 months follow-up period
To evaluate factors influencing imaging biomarkers MRI-PDFF, MRE, UDFF and pSWE.
Time Frame: Enrollment Day 1 Baseline to 24 months followup period

• Assessment of the influence of weight change using a subgroup analysis.
Enrollment Day 1 Baseline to 24 months followup period
To evaluate factors influencing imaging biomarkers MRI-PDFF, MRE, UDFF and pSWE.
Time Frame: Enrollment Day 1 Baseline to 24 months follow-up period

• Assessment of the association of BMI
Enrollment Day 1 Baseline to 24 months follow-up period
To evaluate factors influencing imaging biomarkers MRI-PDFF, MRE, UDFF and pSWE.
Time Frame: Enrollment Day 1 Baseline to 24 months follow-up period.

• Assessment of the association of MR-R2 (speed of signal delay)
Enrollment Day 1 Baseline to 24 months follow-up period.
To evaluate factors influencing imaging biomarkers MRI-PDFF, MRE, UDFF and pSWE.
Time Frame: Enrollment Day 1 Baseline to 24 months follow-up period

Assessment of association of laboratory findings
Enrollment Day 1 Baseline to 24 months follow-up period

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Radnet Management, Inc.

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Siemens Medical Solutions
Madrigal Pharmaceuticals, Inc.

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Randall Stenoien, MD, RadNet Research

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
October 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 1, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 1, 2030

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 31, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 30, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 6, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 6, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 30, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • MSR-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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