EUS-Guided ATI and SWE in Individuals With Normal FibroScan (EUS ATI&SWE)
"EUS-Guided Attenuation Imaging and Shear Wave Elastography in Individuals With Normal FibroScan: Establishing Preliminary Reference Values in a Pilot Feasibility Study".
The goal of this observational study is to establish preliminary reference values for Endoscopic Ultrasound (EUS)-guided Attenuation Imaging (ATI) and Shear Wave Elastography (SWE) in adults undergoing diagnostic EUS for non-hepatobiliary indications who have normal FibroScan findings. The main questions it aims to answer are:
What are the preliminary normal reference values for EUS-guided ATI in the right and left hepatic lobes? What are the preliminary normal reference values for EUS-guided SWE elasticity (kPa) and velocity (m/s) in the right and left hepatic lobes?
Participants will:
Undergo same-day FibroScan assessment to confirm normal liver stiffness and steatosis parameters.
Undergo EUS-guided ATI and SWE measurements of both the right and left hepatic lobes during their clinically indicated diagnostic EUS examination.
Have demographic, clinical, and laboratory information recorded for analysis.
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
Vibration-controlled transient elastography (FibroScan) with Liver Stiffness Measurement (LSM) and Controlled Attenuation Parameter (CAP) is widely used for the non-invasive assessment of liver fibrosis and steatosis. Although these techniques have demonstrated good diagnostic performance, they have several limitations, including technical failure in obese individuals, reduced accuracy in the presence of ascites or narrow intercostal spaces, and the inability to obtain real-time image-guided measurements from specific areas of the liver.
Endoscopic ultrasound (EUS) provides high-resolution imaging of both hepatic lobes through the stomach and duodenum, allowing quantitative assessment of liver tissue under direct visualization. Recent advances have enabled the integration of Attenuation Imaging (ATI), which quantifies hepatic steatosis, and Shear Wave Elastography (SWE), which measures liver stiffness by estimating tissue elasticity and shear wave velocity, into EUS platforms. These techniques may overcome several limitations of conventional transabdominal elastography and have the potential to provide more reliable liver tissue characterization.
Before EUS-guided ATI and SWE can be evaluated as diagnostic tools for liver disease, normal reference values in individuals without liver disease must be established. Currently, there are limited data regarding normal EUS-guided ATI and SWE measurements, particularly in healthy adults with normal FibroScan findings. Establishing these reference ranges is essential for interpreting future studies involving patients with hepatic steatosis and chronic liver disease.
This prospective, single-center, observational pilot feasibility study aims to establish preliminary reference values for EUS-guided ATI and SWE in adults undergoing diagnostic EUS for non-hepatobiliary indications who have normal FibroScan examinations. A total of 100 participants will be enrolled after confirming normal liver stiffness (LSM <7.5 kPa) and steatosis (CAP <238 dB/m), along with adequate FibroScan quality criteria.
During the clinically indicated EUS examination, quantitative liver assessment will be performed without introducing additional invasive procedures beyond standard EUS. Attenuation Imaging will be obtained from both the right and left hepatic lobes, with five valid measurements acquired per lobe. Shear Wave Elastography will also be performed in both lobes, with ten valid measurements obtained per lobe. Measurements will be accepted only if predefined quality criteria are met, including acceptable correlation coefficients, propagation maps, and reliability indices. Acquisition time, technical success, and measurement reproducibility will also be recorded.
The primary outcome of the study is to establish preliminary reference values for EUS-guided ATI, SWE elasticity (kPa), and SWE velocity (m/s) for both hepatic lobes. Secondary objectives include evaluating the technical feasibility and reliability of EUS-guided quantitative liver assessment, assessing agreement between right and left hepatic lobe measurements, determining correlations between ATI and FibroScan CAP, evaluating correlations between SWE and FibroScan LSM, and documenting acquisition times for both techniques.
The findings from this pilot study will provide foundational reference data for EUS-guided quantitative liver imaging and support the design of larger validation studies investigating the role of EUS-guided ATI and SWE in the diagnosis and monitoring of hepatic steatosis and fibrosis.
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Aig research
- Número de teléfono: +919182645727
- Correo electrónico: aigresearch7@gmail.com
Ubicaciones de estudio
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Telangana
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Hyderabad, Telangana, India, 500032
- AIG Hospitals
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Contacto:
- Aig research, MD, DM
- Número de teléfono: 09182645727
- Correo electrónico: aigresearch7@gmail.com
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Investigador principal:
- Dr. Sundeep Lakhtakia, MD, DM
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Sub-Investigador:
- Dr. Anudeep Katrevula, MD, DM
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Sub-Investigador:
- Dr. Jahangeer Basha, MD, DM
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Método de muestreo
Población de estudio
Descripción
Inclusion Criteria:
- Adults aged 18 years or older.
- Undergoing clinically indicated diagnostic endoscopic ultrasound (EUS).
- Same-day FibroScan examination available.
- Controlled Attenuation Parameter (CAP) <238 dB/m.
- Liver Stiffness Measurement (LSM) <7.5 kPa.
- At least 10 valid FibroScan measurements.
- FibroScan interquartile range (IQR)/median ≤30%.
- Able and willing to provide written informed consent.
Exclusion Criteria:
- Known chronic liver disease.
- Hepatitis B or Hepatitis C infection.
- Significant alcohol consumption.
- Decompensated cirrhosis.
- Portal vein thrombosis.
- Ascites.
- Focal liver lesion.
- Previous liver surgery.
- Pregnancy.
- Inadequate FibroScan examination.
- Poor-quality EUS-guided Attenuation Imaging (ATI) or Shear Wave Elastography (SWE) acquisition.
- Incomplete study data or withdrawal of informed consent.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
Número de grupos/cohortes
Cohortes e Intervenciones
Grupo / CohorteGrupo / Cohorte |
Intervención / TratamientoIntervención / Tratamiento |
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Normal FibroScan Cohort
Adults aged 18 years or older undergoing clinically indicated diagnostic endoscopic ultrasound (EUS) for non-hepatobiliary indications who have normal FibroScan findings (Controlled Attenuation Parameter [CAP] <238 dB/m and Liver Stiffness Measurement [LSM] <7.5 kPa).
Participants will undergo EUS-guided Attenuation Imaging (ATI) and Shear Wave Elastography (SWE) of the right and left hepatic lobes during the same EUS procedure to establish preliminary reference values and assess the feasibility and reliability of these quantitative imaging techniques.
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A clinically indicated diagnostic endoscopic ultrasound will be performed according to standard institutional practice.
During the examination, the liver will be visualized from the stomach and duodenum to allow quantitative liver assessment.
Attenuation Imaging (ATI) will be performed during the diagnostic EUS to quantitatively assess hepatic steatosis.
Five valid ATI measurements will be obtained from both the right and left hepatic lobes under direct EUS visualization.
Measurements meeting predefined quality criteria will be used for analysis.
Shear Wave Elastography (SWE) will be performed during the diagnostic EUS to assess liver stiffness.
Ten valid measurements will be obtained from both the right and left hepatic lobes.
Shear wave velocity (m/s) and tissue elasticity (kPa) will be recorded, and only measurements meeting predefined quality criteria will be included in the analysis.
Participants will undergo same-day FibroScan examination before EUS to confirm normal liver stiffness and steatosis.
Controlled Attenuation Parameter (CAP) and Liver Stiffness Measurement (LSM) will be recorded, with at least 10 valid measurements and acceptable quality metrics required for study eligibility.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Reference values for EUS-guided Attenuation Imaging (ATI)
Periodo de tiempo: During the index EUS procedure (Day 0)
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To establish preliminary reference values for EUS-guided Attenuation Imaging (ATI) in the right and left hepatic lobes of adults with normal FibroScan findings.
ATI values will be reported as mean ± standard deviation (SD), median (interquartile range [IQR]), and 95% reference intervals.
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During the index EUS procedure (Day 0)
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Reference values for EUS-guided Shear Wave Elastography (SWE) elasticity
Periodo de tiempo: During the index EUS procedure (Day 0)
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To establish preliminary reference values for EUS-guided SWE elasticity (kPa) in the right and left hepatic lobes.
Results will be reported as mean ± SD, median (IQR), and 95% reference intervals.
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During the index EUS procedure (Day 0)
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Reference values for EUS-guided Shear Wave Elastography (SWE) velocity
Periodo de tiempo: During the index EUS procedure (Day 0)
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To establish preliminary reference values for EUS-guided SWE shear wave velocity (m/s) in the right and left hepatic lobes.
Results will be reported as mean ± SD, median (IQR), and 95% reference intervals.
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During the index EUS procedure (Day 0)
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Technical success rate
Periodo de tiempo: During the index EUS procedure (Day 0)
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To determine the proportion of participants in whom acceptable EUS-guided ATI and SWE measurements are successfully acquired according to predefined quality criteria.
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During the index EUS procedure (Day 0)
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Measurement reliability
Periodo de tiempo: During the index EUS procedure (Day 0)
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To evaluate the reliability and reproducibility of EUS-guided ATI and SWE measurements using predefined quality parameters.
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During the index EUS procedure (Day 0)
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Agreement between right and left hepatic lobe measurements
Periodo de tiempo: During the index EUS procedure (Day 0)
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To assess agreement between ATI and SWE measurements obtained from the right and left hepatic lobes.
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During the index EUS procedure (Day 0)
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Correlation between ATI and FibroScan CAP
Periodo de tiempo: During the index EUS procedure (Day 0)
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To evaluate the correlation between EUS-guided ATI measurements and FibroScan Controlled Attenuation Parameter (CAP).
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During the index EUS procedure (Day 0)
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Correlation between SWE and FibroScan Liver Stiffness Measurement (LSM)
Periodo de tiempo: During the index EUS procedure (Day 0)
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To evaluate the correlation between EUS-guided SWE measurements and FibroScan Liver Stiffness Measurement (LSM).
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During the index EUS procedure (Day 0)
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Acquisition time
Periodo de tiempo: During the index EUS procedure (Day 0)
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To determine the time required to complete EUS-guided ATI and SWE measurements during the diagnostic EUS examination.
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During the index EUS procedure (Day 0)
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Procesos Patológicos
- Enfermedades del Sistema Digestivo
- Enfermedades del HIGADO
- Fibrosis
- Condiciones Patológicas, Signos y Síntomas
- Cirrosis hepática
- Técnicas de investigación
- Manejo de muestras
- Técnicas de laboratorio clínico
- Técnicas y procedimientos de diagnóstico
- Diagnóstico
- Procedimientos quirúrgicos, operativo
- Procedimientos quirúrgicos mínimamente invasivos
- Técnicas citológicas
- Biopsia
- Citodiagnóstico
- Técnicas de diagnóstico, quirúrgico
- Imágenes de diagnóstico
- Ultrasonografía
- Biopsia, aguja fina
- Biopsia, aguja
- Biopsia guiada por imágenes
- Ultrasonografía, intervención
- Aspiración endoscópica de aguja fina guiada por ultrasonido
Otros números de identificación del estudio
Otros números de identificación del estudio
- EUS-ATI&SWE
Plan de datos de participantes individuales (IPD)
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Información sobre medicamentos y dispositivos, documentos del estudio
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