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.
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:David KARSENTI, MD
- 電話番号:+33 1 43 96 78 50
- メール:karsenti.paris@gmail.com
研究連絡先のバックアップ
- 名前:MORENO MAIRA, PhD
- メール:rechercheclinique@sfed.org
参加基準
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
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:診断
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的: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.
|
|
アクティブコンパレータ: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.
|
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 |
|---|---|---|
|
Percentage of positive pathological diagnoses obtained from the first four cholangioscopy-guided biopsies
時間枠: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
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Positive diagnostic yield of all eight cholangioscopy-guided biopsies
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠:Periprocedural
|
The duration required to complete the eight cholangioscopy-guided biopsies will be measured and compared between the two cholangioscopy systems.
|
Periprocedural
|
協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- SFED-160
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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