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First-in-human Navigation Endoscopic Ultrasound (EUS) System Clinical Study (APEUS-Nav1)

Primary Purpose

Pancreatic Disease

Status
Recruiting
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
EUS navigation system
Sponsored by
IHU Strasbourg
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Pancreatic Disease focused on measuring Endoscopic ultrasound, EUS, Biliopancreatic, Pancreatic cancer, PDAC, EUS navigation, Education, Training, Learning curve, Quality indicators

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Man or woman over the age of 18 years old
  • Patient having a EUS procedure for pancreas study planned within the frame of his or her clinical care.
  • Patient whom pre-operative imaging indicates one lesion with a good definition on the triphasic CT scan done within the 60 days prior to the EUS.
  • Patient able to receive and understand information related to the study and give his or her written consent
  • Patient affiliated to the French social security system

Exclusion Criteria:

  • Patient unable to give informed consent
  • Patient with altered anatomy of the upper digestive tract due to previous surgery
  • Patient with known abnormal anatomy of the upper digestive tract
  • Patient wearing a metal implantable device (pacemaker, etc.)
  • Patient presenting, according to the investigator's judgment, a disease which may prevent participation in the procedures provided for by the study
  • Patient with an ASA (American Society of Anesthesiologists) score >2
  • Patient with multiple pancreatic lesions.
  • Patient unable to tolerate general anaesthesia
  • Patient with a body mass index (BMI) < 23 and > 40
  • Patient with weight variations of >10% between the date on which the CT scan was performed and the date of the procedure.
  • Pregnant or lactating patient
  • Patient in exclusion period (determined by a previous or a current study)
  • Patient under guardianship or trusteeship
  • Patient under the protection of justice of deprives of liberty
  • Patient in situation of emergency

Sites / Locations

  • Pôle Hépato-Digestif, NHCRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

No Intervention

Arm Label

EUS-NS +

EUS-NS -

EUS group

Arm Description

EUS with the navigation system first on, then off

EUS with the navigation system first off, then on

EUS alone

Outcomes

Primary Outcome Measures

Evaluation of the EUS navigation system's procedure duration compared to standard procedure times
Collect of peroperative duration for registration, insertion, navigation to cardia, navigation from the cardia to the pancreas, pancreas examination, therapeutic step and overall duration of the procedure (quantitative). Results will be compared between cases with (Groups EUS-NS) and without (Group EUS alone) use of the navigation system

Secondary Outcome Measures

Assessment of the EUS navigation system in terms of reliability and safety
Rate of intraoperative undesirable events and of any event related to the tested system (probe breaking, software crashing, etc.)
Comparison of the EUS navigation system's procedure duration depending on the order the EUS-GPS is used
Collect of peroperative duration for registration, insertion, navigation to cardia, navigation from the cardia to the pancreas, pancreas examination, therapeutic step and overall duration of the procedure (quantitative). Results will be compared between cases with use of the navigation system first (Subgroup EUS-NS +) or in a second time (Subgroup EUS-NS -)
Assessment of the system's ease-of-use (integration in the standard-of-care workflow) compared to the standard procedure by the mean of a questionnaire
Questionnaire to assess the ease-of-use (integration in the standard-of-care workflow) of the EUS navigation system, filled by the EUS endoscopist (qualitative).
Assessment of the system's stressfulness compared to the standard procedure by the mean of a questionnaire
Questionnaire to assess the stressfulness of the EUS navigation system, filled by the EUS endoscopist (qualitative).
Collect adverse events, adverse device effects and device deficiencies
Collect adverse events, adverse device effects and device deficiencies during the procedure and up to 1 month after the EUS
Assessment of registration method by the mean of video recording analysis
A complete video recording of the procedure (endoscopic camera, ultrasound probe, pre-operative data real-time display and external camera) will be performed to assess the precision of the registration, using as anatomical points landmarks detectable in both CT and US images
Collection of EUS data
Videos of the EUS procedure for further use in Artificial Intelligence-driven EUS research projects will be collected if the patient specifically consents to it. Recorded material will include the electromagnetic (EM) coordinates provided by the sensor. EUS video data associated with EM coordinates will be used to build databases for AI-driven EUS research projects
Assessment of technological maturity and ergonomics
Questionnaire to evaluate the ergonomics and technological readiness, filled by the EUS endoscopist (qualitative).

Full Information

First Posted
August 23, 2022
Last Updated
February 27, 2023
Sponsor
IHU Strasbourg
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1. Study Identification

Unique Protocol Identification Number
NCT05515705
Brief Title
First-in-human Navigation Endoscopic Ultrasound (EUS) System Clinical Study
Acronym
APEUS-Nav1
Official Title
First-in-human Navigation Endoscopic Ultrasound (EUS) System Clinical Study
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 10, 2023 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
February 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
IHU Strasbourg

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The implementation of Echo-endoscopy (or EUS for: Endoscopic UltraSound) is limited by the difficulty of obtaining quality EUS procedures, since the accuracy of the method relies on the endoscopist's abilities. Indeed, both cognitive and technical skills are required for endoscopic manipulation and image interpretation, as well as a thorough knowledge of intra-abdominal anatomy. The "EUS-GPS" system aims to assist the operator in understanding the orientation and location of the probe tip within the patient. For that, a Global Positioning System (GPS) for EUS procedures is intraoperatively provided, using a 3D-based model based on recorded preoperative data. In this clinical investigation, the EUS GPS system is intended to help EUS operators to correctly navigate towards the pancreatic gland, perform a comprehensive assessment of the area of interest, and aid in the detection and identification of lesions.
Detailed Description
Since its emergence in the 1980s, endoscopic ultrasound (EUS) is considered as one of the most accurate tools for the evaluation of the pancreatic gland and other gastrointestinal (GI) disorders. Despite its utility, the practice of EUS is still far from being part of every endoscopy suite due to its high set-up cost and the relative scarcity of credentialed experts. EUS implementation worldwide has been limited by the difficulty of achieving quality EUS procedures, since the accuracy of the method relies on the endoscopist's abilities. Both cognitive and technical competencies are required for endoscopic manipulation and image interpretation, as well as extensive knowledge of intraabdominal anatomy. The aim of the APEUS (Augmented Pancreatic Endoscopic UltraSound) project is to overcome these two main difficulties by providing a Global Positioning System (GPS)-like intraoperative navigation for EUS procedures, using a 3D-based model on registered preoperative data. The hypothesis is that, thanks to this tool, the procedures time would be shortened, and the pancreas and its lesions would be completely imaged. This would reduce the demand for experts guiding trainees and shorten the EUS learning curve. This first-in-human clinical study will enable the assessment of safety and qualitative performance of the EUS-GPS solution. The primary objective is to evaluate the EUS navigation system's procedure duration compared to standard procedure times (patient group with the EUS-GPS system vs control group without).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Disease
Keywords
Endoscopic ultrasound, EUS, Biliopancreatic, Pancreatic cancer, PDAC, EUS navigation, Education, Training, Learning curve, Quality indicators

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
96 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
EUS-NS +
Arm Type
Experimental
Arm Description
EUS with the navigation system first on, then off
Arm Title
EUS-NS -
Arm Type
Experimental
Arm Description
EUS with the navigation system first off, then on
Arm Title
EUS group
Arm Type
No Intervention
Arm Description
EUS alone
Intervention Type
Device
Intervention Name(s)
EUS navigation system
Intervention Description
Incorporation of the EUS navigation system to the EUS scope
Primary Outcome Measure Information:
Title
Evaluation of the EUS navigation system's procedure duration compared to standard procedure times
Description
Collect of peroperative duration for registration, insertion, navigation to cardia, navigation from the cardia to the pancreas, pancreas examination, therapeutic step and overall duration of the procedure (quantitative). Results will be compared between cases with (Groups EUS-NS) and without (Group EUS alone) use of the navigation system
Time Frame
1 day
Secondary Outcome Measure Information:
Title
Assessment of the EUS navigation system in terms of reliability and safety
Description
Rate of intraoperative undesirable events and of any event related to the tested system (probe breaking, software crashing, etc.)
Time Frame
1 day
Title
Comparison of the EUS navigation system's procedure duration depending on the order the EUS-GPS is used
Description
Collect of peroperative duration for registration, insertion, navigation to cardia, navigation from the cardia to the pancreas, pancreas examination, therapeutic step and overall duration of the procedure (quantitative). Results will be compared between cases with use of the navigation system first (Subgroup EUS-NS +) or in a second time (Subgroup EUS-NS -)
Time Frame
1 day
Title
Assessment of the system's ease-of-use (integration in the standard-of-care workflow) compared to the standard procedure by the mean of a questionnaire
Description
Questionnaire to assess the ease-of-use (integration in the standard-of-care workflow) of the EUS navigation system, filled by the EUS endoscopist (qualitative).
Time Frame
1 day
Title
Assessment of the system's stressfulness compared to the standard procedure by the mean of a questionnaire
Description
Questionnaire to assess the stressfulness of the EUS navigation system, filled by the EUS endoscopist (qualitative).
Time Frame
1 day
Title
Collect adverse events, adverse device effects and device deficiencies
Description
Collect adverse events, adverse device effects and device deficiencies during the procedure and up to 1 month after the EUS
Time Frame
1 month
Title
Assessment of registration method by the mean of video recording analysis
Description
A complete video recording of the procedure (endoscopic camera, ultrasound probe, pre-operative data real-time display and external camera) will be performed to assess the precision of the registration, using as anatomical points landmarks detectable in both CT and US images
Time Frame
1 day
Title
Collection of EUS data
Description
Videos of the EUS procedure for further use in Artificial Intelligence-driven EUS research projects will be collected if the patient specifically consents to it. Recorded material will include the electromagnetic (EM) coordinates provided by the sensor. EUS video data associated with EM coordinates will be used to build databases for AI-driven EUS research projects
Time Frame
1 day
Title
Assessment of technological maturity and ergonomics
Description
Questionnaire to evaluate the ergonomics and technological readiness, filled by the EUS endoscopist (qualitative).
Time Frame
1 day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Man or woman over the age of 18 years old Patient having a EUS procedure for pancreas study planned within the frame of his or her clinical care. Patient whom pre-operative imaging indicates one lesion with a good definition on the triphasic CT scan done within the 60 days prior to the EUS. Patient able to receive and understand information related to the study and give his or her written consent Patient affiliated to the French social security system Exclusion Criteria: Patient unable to give informed consent Patient with altered anatomy of the upper digestive tract due to previous surgery Patient with known abnormal anatomy of the upper digestive tract Patient wearing a metal implantable device (pacemaker, etc.) Patient presenting, according to the investigator's judgment, a disease which may prevent participation in the procedures provided for by the study Patient with an ASA (American Society of Anesthesiologists) score >2 Patient with multiple pancreatic lesions. Patient unable to tolerate general anaesthesia Patient with a body mass index (BMI) < 23 and > 40 Patient with weight variations of >10% between the date on which the CT scan was performed and the date of the procedure. Pregnant or lactating patient Patient in exclusion period (determined by a previous or a current study) Patient under guardianship or trusteeship Patient under the protection of justice of deprives of liberty Patient in situation of emergency
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Armelle TAKEDA, PhD
Phone
0390413608
Email
armelle.takeda@ihu-strasbourg.eu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Leonardo SOSA VALENCIA, MD
Organizational Affiliation
IHU Strasbourg
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pôle Hépato-Digestif, NHC
City
Strasbourg
ZIP/Postal Code
67000
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Leonardo SOSA VALENCIA, MD
Email
leonardo.sosa-valencia@ihu-strasbourg.eu

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

First-in-human Navigation Endoscopic Ultrasound (EUS) System Clinical Study

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