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EUS-Guided ATI and SWE in Individuals With Normal FibroScan (EUS ATI&SWE)

2026年7月15日 更新者:Mohan Ramchandani、Asian Institute of Gastroenterology, India

"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.

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

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.

研究の種類

観察的

入学 (推定)

100

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

    • Telangana
      • Hyderabad、Telangana、インド、500032
        • AIG Hospitals
        • コンタクト:
        • 主任研究者:
          • Dr. Sundeep Lakhtakia, MD, DM
        • 副調査官:
          • Dr. Anudeep Katrevula, MD, DM
        • 副調査官:
          • Dr. Jahangeer Basha, MD, DM

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

サンプリング方法

非確率サンプル

調査対象母集団

Adults aged 18 years or older undergoing clinically indicated diagnostic endoscopic ultrasound (EUS) for non-hepatobiliary indications at AIG Hospitals will be screened for eligibility. Participants with normal FibroScan findings, defined as a Controlled Attenuation Parameter (CAP) <238 dB/m and Liver Stiffness Measurement (LSM) <7.5 kPa, who meet all eligibility criteria and provide written informed consent will be enrolled in the study.

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

コホートと介入

グループ/コホート
介入・治療
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.
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.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Reference values for EUS-guided Attenuation Imaging (ATI)
時間枠:During the index EUS procedure (Day 0)
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.
During the index EUS procedure (Day 0)
Reference values for EUS-guided Shear Wave Elastography (SWE) elasticity
時間枠:During the index EUS procedure (Day 0)
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.
During the index EUS procedure (Day 0)
Reference values for EUS-guided Shear Wave Elastography (SWE) velocity
時間枠:During the index EUS procedure (Day 0)
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.
During the index EUS procedure (Day 0)

二次結果の測定

結果測定
メジャーの説明
時間枠
Technical success rate
時間枠:During the index EUS procedure (Day 0)
To determine the proportion of participants in whom acceptable EUS-guided ATI and SWE measurements are successfully acquired according to predefined quality criteria.
During the index EUS procedure (Day 0)
Measurement reliability
時間枠:During the index EUS procedure (Day 0)
To evaluate the reliability and reproducibility of EUS-guided ATI and SWE measurements using predefined quality parameters.
During the index EUS procedure (Day 0)
Agreement between right and left hepatic lobe measurements
時間枠:During the index EUS procedure (Day 0)
To assess agreement between ATI and SWE measurements obtained from the right and left hepatic lobes.
During the index EUS procedure (Day 0)
Correlation between ATI and FibroScan CAP
時間枠:During the index EUS procedure (Day 0)
To evaluate the correlation between EUS-guided ATI measurements and FibroScan Controlled Attenuation Parameter (CAP).
During the index EUS procedure (Day 0)
Correlation between SWE and FibroScan Liver Stiffness Measurement (LSM)
時間枠:During the index EUS procedure (Day 0)
To evaluate the correlation between EUS-guided SWE measurements and FibroScan Liver Stiffness Measurement (LSM).
During the index EUS procedure (Day 0)
Acquisition time
時間枠:During the index EUS procedure (Day 0)
To determine the time required to complete EUS-guided ATI and SWE measurements during the diagnostic EUS examination.
During the index EUS procedure (Day 0)

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年8月20日

一次修了 (推定)

2027年8月30日

研究の完了 (推定)

2027年9月20日

試験登録日

最初に提出

2026年7月15日

QC基準を満たした最初の提出物

2026年7月15日

最初の投稿 (実際)

2026年7月20日

学習記録の更新

投稿された最後の更新 (実際)

2026年7月20日

QC基準を満たした最後の更新が送信されました

2026年7月15日

最終確認日

2026年7月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • EUS-ATI&SWE

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いいえ

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