Point-of-care Ultrasound Screening and Assessment of Chronic Liver Diseases and NASH (POCUS-NASH)
Primary Purpose
Liver Diseases, Liver Cirrhosis, NASH - Nonalcoholic Steatohepatitis
Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Ultrasound liver assessment
Sponsored by
About this trial
This is an interventional diagnostic trial for Liver Diseases focused on measuring Elastography, Ultrasound attenuation, Sound speed, Ultrasound
Eligibility Criteria
Inclusion Criteria:
Any of the following criteria:
- Patients with known chronic liver diseases referred to liver-specific exams by their referring physician as part of the routine practice, including a VCTE exam, with or without a blood test, a MRI/MRE exam, a liver biopsy,
- Patients screened for fibrotic NASH in the context of NASH pharmaceutical trials, for which a data sharing agreement has been signed between E-Scopics and the pharmaceutical trial promoter,
- Patients who consent in written to participate in the Clinical Investigation after being orally informed on the objectives and methods of the Clinical Investigation,
- European patients covered by a social security program
Exclusion Criteria:
- Patients under 18 years of age or over 80 years of age,
- Patients with active implants such as pacemakers, defibrillators, pumps, etc.
- Patients presenting wounds at the location where the ES1 probe shall be placed on patients' skin,
- Adult patients under social tutorship, or unable to provide informed consent when not subject to tutorship measures,
- Pregnant and breastfeeding women,
- People deprived of their freedom rights
- People who have been hospitalized without giving informed consent or under emergency situation,
- People admitted in a social or sanitary institution for other reasons than the Clinical Investigation,
- Patients included in another research study that could interfere with the present Clinical Investigation.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Main arm
Arm Description
Main study arm
Outcomes
Primary Outcome Measures
Elastography diagnostic performance
Differences between areas under ROC curves for the ES1 liver stiffness measurement, used as a diagnostic measure of liver fibrosis severity, and other methods, in NASH patients.
Diagnostic performance estimates
Estimates of diagnostic performances at a defined cutoff, for binary diagnostic objectives (detect ≥ F2, ≥ F3, or F4):
Sensitivity, specificity, and diagnostic accuracy
Positive and negative predictive values
Secondary Outcome Measures
Liver stiffness robustness indicators
Dispersion and standard deviation of measurements
Intra-class Correlation Coefficients (ICC) and 95% confidence intervals for intra-operator repeatability
Intra-class Correlation Coefficients (ICC) and 95% confidence intervals for inter-operator reproducibility
Intra-subject variance
Intra-operator variance
Standard error on measurements
Equivalence with other methods
R² correlation coefficient and p-value between ES1 and VCTE liver stiffness measurements
R² correlation coefficient and p-value between ES1 and MRE liver stiffness measurements
Average of quadratic errors between 2 equipment
Concordance Correlation Coefficients (CCC) and 95% confidence intervals
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05120557
Brief Title
Point-of-care Ultrasound Screening and Assessment of Chronic Liver Diseases and NASH
Acronym
POCUS-NASH
Official Title
Evaluation of Diagnostic Performances of a New Point-of-care Ultrasound System for the Detection of Fibrotic NASH and the Assessment of Liver Disease Severity in Patients With Known or Suspected Chronic Liver Disease
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 2022 (Anticipated)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
September 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
E-Scopics
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The main objective of the study is to determine the diagnostic performances of an ultraportable diagnostic ultrasound system for the assessment of liver fibrosis severity in patients with NASH, and to compare them to other non-invasive tests.
Detailed Description
This is a prospective cross-sectional study that will recruit approximately 1000 patients across 30 clinical sites in Europe and the USA.
The target recruited population will include adult patients at risk of, or with known chronic liver diseases, whether or not screened for inclusion in NASH pharmaceutical trials.
After being informed about the study objectives and potential risks, patients who consent to participate will undergo an non-invasive external ultrasound exam of their liver using an ultraportable diagnostic ultrasound system. The system will derive quantitative information related to physical and acoustic properties of the liver tissue, which are known to correlate with the severity of chronic diffuse liver diseases such as fibrosis and steatosis.
The study will also assess the repeatability, reproducibility and robustness of quantitative parameters. Collected data will also enable exploring ultrasound-based liver tissue characterization correlated to NASH-specific histological lesions such as intra-hepatic inflammation and hepatic cell ballooning.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Liver Diseases, Liver Cirrhosis, NASH - Nonalcoholic Steatohepatitis, Non-Alcoholic Fatty Liver Disease, Fibrosis, Liver, Steatosis of Liver
Keywords
Elastography, Ultrasound attenuation, Sound speed, Ultrasound
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
All patients recruited will receive routine care for liver assessment followed by an exam using the device subject of the research.
Masking
None (Open Label)
Allocation
N/A
Enrollment
1000 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Main arm
Arm Type
Experimental
Arm Description
Main study arm
Intervention Type
Device
Intervention Name(s)
Ultrasound liver assessment
Other Intervention Name(s)
Elastography, Ultrasound attenuation, Sound speed
Intervention Description
The intervention consists in an ultrasound exam performed with the ultrasound medical device subject of the research.
Primary Outcome Measure Information:
Title
Elastography diagnostic performance
Description
Differences between areas under ROC curves for the ES1 liver stiffness measurement, used as a diagnostic measure of liver fibrosis severity, and other methods, in NASH patients.
Time Frame
At study completion, 1 year
Title
Diagnostic performance estimates
Description
Estimates of diagnostic performances at a defined cutoff, for binary diagnostic objectives (detect ≥ F2, ≥ F3, or F4):
Sensitivity, specificity, and diagnostic accuracy
Positive and negative predictive values
Time Frame
At study completion, 1 year
Secondary Outcome Measure Information:
Title
Liver stiffness robustness indicators
Description
Dispersion and standard deviation of measurements
Intra-class Correlation Coefficients (ICC) and 95% confidence intervals for intra-operator repeatability
Intra-class Correlation Coefficients (ICC) and 95% confidence intervals for inter-operator reproducibility
Intra-subject variance
Intra-operator variance
Standard error on measurements
Time Frame
At study completion, 1 year
Title
Equivalence with other methods
Description
R² correlation coefficient and p-value between ES1 and VCTE liver stiffness measurements
R² correlation coefficient and p-value between ES1 and MRE liver stiffness measurements
Average of quadratic errors between 2 equipment
Concordance Correlation Coefficients (CCC) and 95% confidence intervals
Time Frame
At study completion, 1 year
Other Pre-specified Outcome Measures:
Title
Exploratory outcome 1: Liver steatosis
Description
R² correlation coefficient and p-value between ES1 ultrasound attenuation measurements and MRI PDFF
Concordance Correlation Coefficients (CCC) and 95% confidence intervals, and Bland-Altman graphs between ultrasound attenuation measurements and MRI PDFF
R² correlation coefficient and p-value between ES1 speed of sound measurements and MRI PDFF
Concordance Correlation Coefficients (CCC) and 95% confidence intervals, and Bland-Altman graphs between speed of sound measurements and MRI PDFF
Time Frame
At study completion, 1 year
Title
Exploratory outcome 2: Intra-hepatic inflammation and/or hepatocytes ballooning
Description
Correlation coefficients between ES1 parameters or combinations of parameters and histological scoring for lobular inflammation (A0 to A3) and/or ballooning.
If relevant, area under the ROC curve for combinations of ES1 parameters or combinations of parameters used as a diagnostic measures of liver inflammation severity using histological scoring for lobular inflammation (A0 to A3)
If relevant for given binary diagnostic objectives (detect ≥ A1, ≥ A2, or A3), calculate optimal diagnostic cutoffs and estimate diagnostic performances
Time Frame
At study completion, 1 year
Title
Exploratory outcome 3: Liver NAS Score
Description
Correlation coefficients between ES1 parameters or combinations of parameters and histological NAS score (NAS 0 to NAS 8).
If relevant, area under the ROC curve for combinations of ES1 parameters or combinations of parameters used as a diagnostic measure of NAFLD-related activity using the histological NAS score (0 to 8)
If relevant, for given binary diagnostic objectives (detect < NAS 3, ≥ NAS 3, ≥ NAS 5), calculate optimal diagnostic cutoffs and estimate diagnostic performances
Time Frame
At study completion, 1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Any of the following criteria:
Patients with known chronic liver diseases referred to liver-specific exams by their referring physician as part of the routine practice, including a VCTE exam, with or without a blood test, a MRI/MRE exam, a liver biopsy,
Patients screened for fibrotic NASH in the context of NASH pharmaceutical trials, for which a data sharing agreement has been signed between E-Scopics and the pharmaceutical trial promoter,
Patients who consent in written to participate in the Clinical Investigation after being orally informed on the objectives and methods of the Clinical Investigation,
European patients covered by a social security program
Exclusion Criteria:
Patients under 18 years of age or over 80 years of age,
Patients with active implants such as pacemakers, defibrillators, pumps, etc.
Patients presenting wounds at the location where the ES1 probe shall be placed on patients' skin,
Adult patients under social tutorship, or unable to provide informed consent when not subject to tutorship measures,
Pregnant and breastfeeding women,
People deprived of their freedom rights
People who have been hospitalized without giving informed consent or under emergency situation,
People admitted in a social or sanitary institution for other reasons than the Clinical Investigation,
Patients included in another research study that could interfere with the present Clinical Investigation.
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Point-of-care Ultrasound Screening and Assessment of Chronic Liver Diseases and NASH
We'll reach out to this number within 24 hrs