Pragmatic RCT of AI-Assisted Reading for Malignant Hepatic Lesions on CE-CT
A Multicenter Randomized Controlled Trial of AI-Assisted Reading Compared With Standard Radiology Interpretation for Malignant Hepatic Lesions on Contrast-Enhanced CT: Diagnostic, Clinical and Workflow Outcomes
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Detaljert beskrivelse
Studietype
Studietype
Registrering (Antatt)
Registrering
Fase
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: Yu MD PhD Shi
- Telefonnummer: +86 189 4025 9980
- E-post: 18940259980@163.com
Studiesteder
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Liaoning
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Shenyang, Liaoning, Kina, 110004
- Shengjing Hospital of China Medical University
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Ta kontakt med:
- Yu Shi, MD
- Telefonnummer: +86 189 4025 9980
- E-post: 18940259980@163.com
-
Ta kontakt med:
- Yu MD PhD Shi, MD
- Telefonnummer: +86 189 4025 9980
- E-post: 18940259980@163.com
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Beskrivelse
Inclusion Criteria:
- Age range 18 years and above
- Underwent dynamic contrast-enhanced abdominal CT examination with liver coverage
- Imaging must include at least three required phases: non-contrast, arterial phase, and venous phase; a delayed phase is optional
- Complete imaging data that meet AI system and radiologist interpretation requirements.
Exclusion Criteria:
- History of recent upper-abdominal surgery (within 30 days) or major hepatobiliary-pancreatic surgery affecting liver evaluation (e.g., liver transplantation or Whipple procedure); patients with prior simple cholecystectomy or single-lesion interventional procedures are not excluded
- History of recent hepatic trauma (within 30 days)
- Poor image quality or severe noise artifacts (e.g., metal or motion artifacts)
- Missing required imaging phases (required at least non-contrast, arterial, and venous phases) or inadequate scan range (e.g., lower-abdomen CT such as pelvic or rectal scans not covering the liver)
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Diagnostisk
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
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Eksperimentell: AI-on: AI-assisted abdominal CE-CT reporting
Intervention: AI-assisted interpretation of abdominal CE-CT
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After the unaided initial assessment is saved, the locked AI system will display lesion localization, patient-level and lesion-level malignancy probabilities, prespecified lesion-class suggestions, and uncertainty or technical-failure warnings.
The first-line radiologist may revise or retain the initial assessment and must record acceptance, rejection, or uncertainty for clinically important AI suggestions.
The senior reviewer may view the initial assessment, AI output, and revision history.
AI may not autonomously authorize reports, prescribe management, or communicate diagnoses directly to participants.
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Aktiv komparator: AI-off: Standard abdominal CE-CT reporting without AI assistance
Routine interpretation of abdominal CE-CT without access to AI system (standard of care)
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Eligible multiphasic abdominal CE-CT examinations will be interpreted and reported according to the site's standard radiology workflow, including routine senior review where applicable.
AI system outputs will not be available to radiologists or clinical staff, and no AI-triggered safety-net review will be performed.
Routine report addenda, urgent communication, multidisciplinary review, additional imaging, and subsequent clinical management will remain available according to standard clinical practice.
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Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Per-participant rate of missed clinically significant liver malignancy
Tidsramme: From the index CE-CT examination through 12 months
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Proportion of all enrolled participants with at least one reference-standard-confirmed clinically significant liver malignancy, including hepatocellular carcinoma, liver metastasis, or another primary hepatic malignancy, that was not identified or appropriately characterized in the final index CE-CT report.
The reference standard will comprise histopathology when available; otherwise, 12-month imaging and clinical follow-up and relevant record linkage, adjudicated by an independent committee masked to allocation.
Non-inferiority will be assessed against a margin prespecified before enrollment.
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From the index CE-CT examination through 12 months
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Senior-review workload
Tidsramme: Up to 24 hours after the eligible CE-CT examination becomes available for interpretation
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Number of examinations requiring senior radiologist review per 100 eligible CE-CT examinations, compared between AI-assisted and standard-reporting center-days.
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Up to 24 hours after the eligible CE-CT examination becomes available for interpretation
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Final report turnaround time
Tidsramme: Up to 24 hours after the complete CE-CT examination becomes available for interpretation
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Time in minutes from availability of the complete CE-CT examination for interpretation to authorization of the final clinical report.
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Up to 24 hours after the complete CE-CT examination becomes available for interpretation
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Detection rate of clinically significant malignant liver lesions
Tidsramme: From the index CE-CT examination through 12 months
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Proportion of enrolled participants with a reference-standard-confirmed clinically significant malignant liver lesion identified in the final index CE-CT report.
Results will be reported overall and for prespecified subgroups, including confirmed HCC smaller than 2 cm, BCLC stage 0 HCC, and liver metastases stratified by primary tumor site.
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From the index CE-CT examination through 12 months
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Clinically appropriate management-change rate
Tidsramme: From the index CE-CT examination through 12 months
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Proportion of participants with an independently adjudicated change in diagnostic evaluation, referral, biopsy, treatment, or surveillance attributable to the final index CE-CT report, including avoidance of unnecessary downstream work-up.
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From the index CE-CT examination through 12 months
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Time to initiation of treatment for liver malignancy
Tidsramme: From the index CE-CT examination through 12 months
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Time in days from the index CE-CT examination to initiation of first anti-hepatic malignancy treatment (surgery, ablation, transarterial therapy, systemic therapy, or radiotherapy) among participants with reference-standard-confirmed malignant liver lesions.
Median time and interquartile range will be reported, and the proportion of participants starting treatment within clinically relevant time thresholds (e.g., 30 days, 60 days, 90 days) will be compared between groups.
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From the index CE-CT examination through 12 months
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Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Etterforskere
Etterforskere
- Hovedetterforsker: Yu Shi, MD, Shengjing Hospital
Publikasjoner og nyttige lenker
Generelle publikasjoner
- Ding W, Meng Y, Ma J, Pang C, Wu J, Tian J, Yu J, Liang P, Wang K. Contrast-enhanced ultrasound-based AI model for multi-classification of focal liver lesions. J Hepatol. 2025 Aug;83(2):426-439. doi: 10.1016/j.jhep.2025.01.011. Epub 2025 Jan 21.
- Ying H, Liu X, Zhang M, Ren Y, Zhen S, Wang X, Liu B, Hu P, Duan L, Cai M, Jiang M, Cheng X, Gong X, Jiang H, Jiang J, Zheng J, Zhu K, Zhou W, Lu B, Zhou H, Shen Y, Du J, Ying M, Hong Q, Mo J, Li J, Ye G, Zhang S, Hu H, Sun J, Liu H, Li Y, Xu X, Bai H, Wang S, Cheng X, Xu X, Jiao L, Yu R, Lau WY, Yu Y, Cai X. A multicenter clinical AI system study for detection and diagnosis of focal liver lesions. Nat Commun. 2024 Feb 7;15(1):1131. doi: 10.1038/s41467-024-45325-9.
- Elias-Cabot E, Romero-Martin S, Raya-Povedano JL, Rodriguez-Ruiz A, Alvarez-Benito M. AI-based triage and decision support in mammography and digital tomosynthesis for breast cancer screening: a paired, noninferiority trial. Nat Med. 2026 Apr;32(4):1296-1305. doi: 10.1038/s41591-026-04277-x. Epub 2026 Mar 19.
- Woznitza N, Smith L, Rawlinson J, Au-Yong I, George B, Djearaman MG, Nair A, Lee RW, Navani N, Ndwandwe S, Clarke CS, Creeden A, Newsome J, Das I, Abaokporo S, Tucker R, Hathorn J, Baldwin DR. AI-based chest X-ray prioritization in the lung cancer diagnostic pathway: the LungIMPACT randomized controlled trial. Nat Med. 2026 May;32(5):1737-1744. doi: 10.1038/s41591-026-04253-5. Epub 2026 Mar 24.
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Neoplasmer etter nettsted
- Neoplasmer
- Patologiske tilstander, anatomiske
- Neoplasmer etter histologisk type
- Neoplasmer i fordøyelsessystemet
- Sykdommer i fordøyelsessystemet
- Leversykdommer
- Neoplasmer, kjertel og epitel
- Adenokarsinom
- Neoplasmer i leveren
- Karsinom
- Patologiske tilstander, tegn og symptomer
- Karsinom, hepatocellulært
- Kolangiokarsinom
- Cyster
- Skrumplever, familiær, med pulmonal hypertensjon
- Fokal nodulær hyperplasi
Andre studie-ID-numre
Andre studie-ID-numre
- SH-Lion2RCT--Intervention
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
Legemiddel- og utstyrsinformasjon, studiedokumenter
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