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Endoscopic Ultrasound Elastography in Pancreatic Masses (EUS-EG)

11. januar 2010 oppdatert av: University of Medicine and Pharmacy Craiova

Computer-aided Diagnosis of Endoscopic Ultrasound Elastography Used in the Differentiation of Focal Pancreatic Masses

The aim of the study is to assess elastography during EUS examinations of focal pancreatic masses, and to consequently differentiate benign versus malignant pancreatic masses in a prospective multi-center design.

Studieoversikt

Detaljert beskrivelse

Ultrasound elastography is a recent ultrasound method used for the calculation of tissue elasticity distribution in real-time. The method allows the reconstruction of tissue elasticity (i.e. the elasticity modulus) and reveals directly the physical properties of the tissue, consequently showing different tissue hardness patterns that are determined by diseases. Tissue elastography can be easily performed real-time with conventional probes, including the linear EUS probes used for the examination of the pancreas. The calculation of tissue elasticity distribution is performed in real-time and the examination results are represented as transparent overlay colour images overimposed on the conventional gray-scale B-mode images.

Ultrasound elastography was previously used for the diagnosis of breast lesions, prostate cancer and thyroid nodules. However, the value of endoscopic ultrasound elastography for the diagnosis of pancreatic focal masses is not clear for the current moment, as some authors couldn't differentiate benign and malignant pancreatic tumors. Moreover, the intense fibrotic reaction and calcifications in chronic pancreatitis induce strain differences, and it is not clear if elastography is sensitive enough to detect them.

The study protocol is based on a semi-quantitative approach of EUS elastography data (movies) consisting of characterization of manually user-defined regions of interest, based on the hue histograms of the individual focal masses. Due to the inherent bias induced by selection of images from a dynamic sequence of EUS elastography, we have previously reported on the utility of using computer-aided diagnosis by averaging images from a dynamic sequence of EUS elastography. A special plugin (based on the ImageJ software, NIH, Bethesda, MD, USA) is used to compute hue histograms on average EUS elastography images, while the hue histograms values for each patient (0 to 255 values) are further used to classify the patients with benign and malignant lesions.

Ultrasound elastography will be performed during an usual EUS examination (7.5 MHz frequency), with two movies of 10 seconds recorded on the embedded HDD in order to minimize variability and to increase repeatability of acquisition. A two panel image with the usual conventional gray-scale B-mode EUS image on the right side and with the elastography image on the left side will be used. The region of interest will be preferably larger than the focal mass, in order to include the surrounding structures. In order to minimize the human bias, all the post-processing and computer analysis of digital movies will be performed within the IT Center in Craiova, with all programmers and statisticians being blinded to the clinical, pathological and imaging data, with the exception of the average hue histogram values calculated from a second region of interest manually traced around the focal mass.

The study design is prospective, blinded and multi-center, comparing endoscopic ultrasound elastography (EUS-EG) results for the detection and characterization of focal pancreatic masses by using artificial intelligence techniques, in comparison with the gold standard represented by pathology. The study will be performed with the approval of the institutional board review of each center.

Studietype

Observasjonsmessig

Registrering (Faktiske)

285

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

      • Brussels, Belgia
        • Erasme University
      • Brussels, Belgia
        • Universite Chatolique Louvain
      • Copenhagen, Danmark
        • Gentofte University Hospital
      • Odense, Danmark
        • University Hospital
      • Marseille, Frankrike
        • Institute Paoli Calmettes
      • Milan, Italia
        • Hospital San Raffaele
      • Rotterdam, Nederland
        • Erasme Medisch Centrum
      • Bergen, Norge
        • University of Haukeland
      • Craiova, Romania
        • University of Medicine and Pharmacy Craiova
      • Santiago, Spania
        • University Hospital Santiago
      • Glasgow, Storbritannia
        • Glasgow Royal Infirmary
      • Newcastle, Storbritannia
        • Newcastle Upon Tyne Hospitals
      • Bad Mergentheim, Tyskland
        • Caritas-Krankenhaus
      • Bochum, Tyskland
        • St. Josef Hospital
      • Gera, Tyskland
        • SRH Klinik
      • Mainz, Tyskland
        • University Clinic Mainz
      • Wiesbaden, Tyskland
        • Dr.Horst-Schmidt-Klinik
      • Wuppertal, Tyskland
        • HELIOS Klinikum Wuppertal, University of Witten/Herdecke

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 80 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

The diagnosis of chronic pancreatitis will be based on the clinical information (history of alcohol abuse, previous diagnosis of chronic pancreatitis or diabetes mellitus), as well as a combination of imaging methods (ultrasound, CT and EUS). At least four criteria of chronic pancreatitis during EUS will be considered for the positive diagnosis.

A positive cytological diagnosis will be taken as a final proof of malignancy of the pancreas mass. The diagnoses obtained by EUS-FNA will be further verified either by surgery or during a clinical follow-up of at least 6 months.

Beskrivelse

Inclusion criteria

  • Patients diagnosed with solid pancreatic tumor masses, with cytological / histological confirmation
  • Age 18 to 80 years old, men or women
  • Signed informed consent for EUS with elastography and FNA biopsy

Exclusion criteria

  • Prior surgical treatment with curative intent or chemo-radiotherapy
  • Patients diagnosed with mucin producing tumors, pancreatic cystic tumors, etc.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Kronisk pankreatitt
Pasienter diagnostisert med solide svulstmasser i bukspyttkjertelen med alle kriteriene oppfylt for å utelukke kreft i bukspyttkjertelen
Pancreatic adenocarcinoma
Patients diagnosed with solid pancreatic adenocarcinoma masses, with cytological / histological confirmation

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Value of endoscopic ultrasound elastography for the differential diagnoses of pancreatic masses.
Tidsramme: 18 months
18 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Hjelpsomme linker

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. juni 2008

Primær fullføring (Faktiske)

1. november 2009

Studiet fullført (Faktiske)

1. desember 2009

Datoer for studieregistrering

Først innsendt

25. mai 2009

Først innsendt som oppfylte QC-kriteriene

26. mai 2009

Først lagt ut (Anslag)

27. mai 2009

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

12. januar 2010

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. januar 2010

Sist bekreftet

1. januar 2010

Mer informasjon

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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