Endosonographic Shear Wave Elastography to Assess Liver and Splenic Fibrosis
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Endosonographic Elastography, Endosonographic shear wave elastography.
- Who it may be relevant to
- Registry conditions: Liver Fibrosis, Cirrhosis. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Endosonographic Shear Wave Elastography to Assess Liver Fibrosis
Overview
The study is being done to collect information on the effectiveness of endosonographic elastography (a technique which uses sound waves) to measure the stiffness of the liver and spleen. Investigators are trying to determine if shear wave elastography is a good way to measure fibrosis instead of biopsy.
Detailed description
Study design This is a single-center, prospective, non-randomized, comparative study which will compare the diagnostic accuracy of Endoscopic ultrasound guided shear wave elastography (EUS-SWE) with liver biopsy for liver fibrosis.
Patients who will undergo a standard-of-care EUS guided liver biopsy (or have clinically obvious liver cirrhosis) will be prospectively enrolled after obtaining informed consent. All enrolled patients will undergo EUS guided liver biopsy, unless they have an obvious diagnosis of cirrhosis. EUS-SWE of the liver and spleen.
In selected patients who have been referred for EUS PPG measurement in addition to EUS liver biopsy, portal pressures will be measured as well and correlated with elastography of the spleen.
The patients will be initially assessed for need for liver biopsy by the gastroenterology/hepatology team as per the current standard of care. Only patients with a clear clinical indication for liver biopsy will be enrolled for the study.
Per current standard of practice at Providence Sacred Heart Medical Center, patients who need liver biopsy are referred to the interventional GI service for the procedure. These patients will be offered participation in the trial prior the endoscopic procedure. This detailed discussion will include participation in the study, background of the proposed study, inclusion and exclusion criteria, benefits and risks of the procedures and follow-up.
Interventions
- Procedure Endosonographic Elastography
The patient will undergo a standard-of-care endoscopic ultrasound with liver biopsy. At the time, elastography of the liver and spleen will be performed while using the echoendoscope. Different degrees of pressure will be applied while performing elastography of the left and right lobes of the liver as well as the spleen. The E values and VsN values will be recorded and then compared to liver histology. - Diagnostic test Endosonographic shear wave elastography
The patient will undergo an upper endoscopic ultrasound procedure. During this procedure, the patient will be put to sleep and a trained endosonographer physician will insert an echo-endoscope through the mouth and guide it down to the stomach and the duodenum. This endoscope is equipped with technology that uses sound waves to assess the stiffness of the liver and spleen. For research purposes, the doctor will also press on these organs in order to take the additional measurements.
Primary outcome measures
- Degree of fibrosis [Time frame: Enrollment to 4 weeks]
Secondary outcome measures (2)
- Comparative lobar pressure [Time frame: Enrollment to 4 weeks]
- Spleen elasticity [Time frame: Enrollment to 4 weeks]
Eligibility criteria
Inclusion criteria
- Age > 18 years (irrespective of sex)
- Patients determined clinically to have liver cirrhosis needing EUS for other reasons
- Patients determined clinically to be candidates for EUS guided liver biopsy
- Elevated liver enzymes without obvious etiology
- Clinical concern for cirrhosis requiring histological confirmation
- Patients with known cirrhosis without diagnostic dilemma
- Ability to provide informed consent and willing to participate
Exclusion criteria
- Surgically altered foregut anatomy which precludes safe endoscopic liver biopsy
- Coagulopathy with INR greater than 1.6 in patients on anticoagulant therapy
- Thrombocytopenia with platelet count less than 50,000/mL
- Pregnancy (positive urine pregnancy test in females of childbearing age)
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Case-only
Study locations
United States · 1 center
- Providence Sacred Heart Medical Center — Spokane
Publications
- Kohli DR, Mettman D, Andraws N, Haer E, Porter J, Ulusurac O, Ullery S, Desai M, Siddiqui MS, Sharma P. Comparative accuracy of endosonographic shear wave elastography and transcutaneous liver stiffness measurement: a pilot study. Gastrointest Endosc. 2023 Jan;97(1):35-41.e1. doi: 10.1016/j.gie.2022.08.035. Epub 2022 Aug 29. PMID 36049537
Identifiers
NCT: NCT06867731 · 2024000651