Beyond Confounders: Addressing Source of Measurement Variability and Error in Shear Wave Elastography
NCT ID: NCT03342560
Last Updated: 2019-10-28
Study Results
Results available
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
30 participants
Study Classification
INTERVENTIONAL
Study Start Date
2017-06-29
Study Completion Date
2018-08-30
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Chronic liver disease is a major problem in the general population and there is an unmet need to diagnose(and screen) for liver disease with using noninvasive, cost-effective and sensitive techniques.The investigators hypothesize that variation using ultrasound elastography for the estimation of stage of liver fibrosis and steatosis in patients with diffuse liver disease exists due to different methods of measurements, and/or different systems. The proposed investigation is a cross-sectional study using ultrasound elastography and fat quantification modalities. The investigators are planning to enroll 30 subjects 18 years old and older in whom diffuse liver disease is suspected, and who have undergone non-focal liver biopsy in the past 6 months or are scheduled to undergo biopsy within 3 months of enrollment, as part of their routine clinical care. The investigators will use 4 different ultrasound devices with their shear wave elastography and speed of sound functions.
Specific aims;
* Compare shear wave elastography(SWE) measurements from different ultrasound systems; using histopathology as reference standards.
* Assess intra-operator and inter-operator reliability by measuring variability in elastography values by two operators on a single system.
* Determine the effect of deviations from guidelines(less number of measurements and measurements during active breath)
Specific aims;
* Compare shear wave elastography(SWE) measurements from different ultrasound systems; using histopathology as reference standards.
* Assess intra-operator and inter-operator reliability by measuring variability in elastography values by two operators on a single system.
* Determine the effect of deviations from guidelines(less number of measurements and measurements during active breath)
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Evaluation of Liver Disease With Elastography Measurements in Patients Undergoing Liver Transplant Surgery
NCT01890460
Liver Transplantation
COMPLETED
Endosonographic Shear Wave Elastography for Liver Stiffness
NCT04533932
Liver Cirrhosis
UNKNOWN
Liver Fibrosis Assessment With ShearWave Elastography
NCT02181452
Liver Fibrosis
COMPLETED
A Study to Evaluate Liver Stiffness With Shear Wave Elastography
NCT05097963
Chronic Liver Disease
Advanced Fibrosis
Advanced Cirrhosis
COMPLETED
NA
Sonoelastography: Ultrasound Method to Measure Liver Fibrosis
NCT01747772
Chronic Liver Disease
Non-Alcoholic Fatty Liver Disease
Hepatitis C Virus (HCV) Coinfection
+2 more
COMPLETED
NA
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Liver disease and cirrhosis are important causes of morbidity and mortality in the United States and are a major public health problem with 40,000 deaths and more than 1.4 billion dollars spent on medical services. Hepatic fibrosis is the final common pathway for many different liver insults and is known to be a dynamic process, which is reversible if diagnosed early and treated. If untreated, fibrosis eventually progresses to cirrhosis, which is irreversible. The diagnosis of fibrosis relies on liver biopsy (the gold standard) however, is an invasive procedure with risks and sampling errors. Indirect biomarkers of fibrogenesis can measure some of these components to determine categories of fibrosis, with a sensitivity and specificity of 47% and 90% respectively.It is shown in the literature that, fat content of liver is related with fibrosis development. Biopsy is accepted as the most accurate technique to assess liver fat and fibrosis amount.
Fibrotic livers demonstrate increased stiffness, a property that can be measured using technology named Ultrasound Elastography or sonoelastography (SWE). SWE is performed by insonating the patient with a low energy, amplitude, and frequency shear wave created by a vibrating probe. The propagated wave travels faster with increasing fibrosis: the stiffer the tissue, the faster the shear wave propagates. A pulse-echo ultrasound acquisition allows measurement of the wave velocity and the results are presented as kilopascals (kPa). Prior reports have described sensitivity and specificity for liver fibrosis detection of 80% and 97% respectively for SWE. The benefits of SWE are that it is inexpensive, reproducible, painless, rapid (\< 10 min), easy to perform, and can be used for diagnosis, prognosis and monitoring disease progression.
The objective of this study is to compare the variation in elastography values and study the factors that might cause these variations.
The proposed investigation is a cross-sectional study using ultrasound elastography. The investigators are planning to enroll 30 subjects 18 years old and older in whom diffuse liver disease is suspected, and who have undergone non-focal liver biopsy in the past 6 months or are scheduled to undergo biopsy within 3 months of enrollment, as part of their routine clinical care.
All subjects will be required to come to the MGH main campus for 2 study visits within 60 days of each other. In addition, subjects will need to fast for at least 4 hours prior to study visits
There will be two visits in this study and maximum 60 days time frame between the visits is anticipated. Two operators will perform the ultrasound examination. Reproducibility and repeatability of the ultrasound devices will be estimated.
Ultrasound examination including sonoelastography will be performed using four FDA-approved ultrasound units; Both operators will perform;
* Median Elastograpy (10 measurements) on regular and variable map at a depth(in the area between 2cm from capsule and 6.5cm from skin)
* Median SWE value with active/free breath(10measurements)
* Median SWE value with less number of acquisitions(3measurements)
These measurements will be collected in subgroups using specific systems. In second visit, all measurements will be repeated with the same operators.
Fibrotic livers demonstrate increased stiffness, a property that can be measured using technology named Ultrasound Elastography or sonoelastography (SWE). SWE is performed by insonating the patient with a low energy, amplitude, and frequency shear wave created by a vibrating probe. The propagated wave travels faster with increasing fibrosis: the stiffer the tissue, the faster the shear wave propagates. A pulse-echo ultrasound acquisition allows measurement of the wave velocity and the results are presented as kilopascals (kPa). Prior reports have described sensitivity and specificity for liver fibrosis detection of 80% and 97% respectively for SWE. The benefits of SWE are that it is inexpensive, reproducible, painless, rapid (\< 10 min), easy to perform, and can be used for diagnosis, prognosis and monitoring disease progression.
The objective of this study is to compare the variation in elastography values and study the factors that might cause these variations.
The proposed investigation is a cross-sectional study using ultrasound elastography. The investigators are planning to enroll 30 subjects 18 years old and older in whom diffuse liver disease is suspected, and who have undergone non-focal liver biopsy in the past 6 months or are scheduled to undergo biopsy within 3 months of enrollment, as part of their routine clinical care.
All subjects will be required to come to the MGH main campus for 2 study visits within 60 days of each other. In addition, subjects will need to fast for at least 4 hours prior to study visits
There will be two visits in this study and maximum 60 days time frame between the visits is anticipated. Two operators will perform the ultrasound examination. Reproducibility and repeatability of the ultrasound devices will be estimated.
Ultrasound examination including sonoelastography will be performed using four FDA-approved ultrasound units; Both operators will perform;
* Median Elastograpy (10 measurements) on regular and variable map at a depth(in the area between 2cm from capsule and 6.5cm from skin)
* Median SWE value with active/free breath(10measurements)
* Median SWE value with less number of acquisitions(3measurements)
These measurements will be collected in subgroups using specific systems. In second visit, all measurements will be repeated with the same operators.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Liver Fibrosis
Liver Diseases
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
Allocation Method
NA
Intervention Model
SINGLE_GROUP
Primary Study Purpose
DIAGNOSTIC
Blinding Strategy
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
30 Patients with known liver biopsy results
Patients with chronic liver disease with known biopsy results
Group Type
EXPERIMENTAL
Sonographic SWE measurements with 4 different ultrasound systems
Intervention Type
DEVICE
Sonographic Shear wave elastography will be performed to quantify liver fibrosis
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Sonographic SWE measurements with 4 different ultrasound systems
Sonographic Shear wave elastography will be performed to quantify liver fibrosis
Intervention Type
DEVICE
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Adult Patients
* Men or Woman
* Suspected diffuse liver disease and have had a liver biopsy within the last 6 months or are scheduled for a liver biopsy in the next 3 months.
* Consent to participate in the study
* Men or Woman
* Suspected diffuse liver disease and have had a liver biopsy within the last 6 months or are scheduled for a liver biopsy in the next 3 months.
* Consent to participate in the study
Exclusion Criteria
* Pregnancy
* Acute illness/ cognitive impairment resulting in inability to cooperate with ultrasound
* Patients that do not consent to ultrasound examination
* Acute illness/ cognitive impairment resulting in inability to cooperate with ultrasound
* Patients that do not consent to ultrasound examination
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Canon Medical Systems, USA
INDUSTRY
Sponsor Role
collaborator
Siemens Medical Solutions
INDUSTRY
Sponsor Role
collaborator
Radiological Society of North America
OTHER
Sponsor Role
collaborator
Massachusetts General Hospital
OTHER
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Anthony Samir
Service Chief,Body Ultrasound Department of Radiology, Assistant Professor at Harvard Medical School
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Anthony E. Samir, MD, MPH
Role: PRINCIPAL_INVESTIGATOR
Associate Medical Director, Ultrasound Imaging Services
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Massachusetts General Hospital
Boston, Massachusetts, United States
Site Status
Countries
Review the countries where the study has at least one active or historical site.
United States
References
Explore related publications, articles, or registry entries linked to this study.
Younossi ZM, Stepanova M, Afendy M, Fang Y, Younossi Y, Mir H, Srishord M. Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol. 2011 Jun;9(6):524-530.e1; quiz e60. doi: 10.1016/j.cgh.2011.03.020. Epub 2011 Mar 25.
Reference Type
BACKGROUND
Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J, Murray CJ, Naghavi M. Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Med. 2014 Sep 18;12:145. doi: 10.1186/s12916-014-0145-y.
Reference Type
BACKGROUND
Pinzani M, Rombouts K. Liver fibrosis: from the bench to clinical targets. Dig Liver Dis. 2004 Apr;36(4):231-42. doi: 10.1016/j.dld.2004.01.003.
Reference Type
BACKGROUND
Scholmerich J, Holstege A. Aetiology and pathophysiology of chronic liver disorders. Drugs. 1990;40 Suppl 3:3-22. doi: 10.2165/00003495-199000403-00003.
Reference Type
BACKGROUND
Pellicoro A, Ramachandran P, Iredale JP, Fallowfield JA. Liver fibrosis and repair: immune regulation of wound healing in a solid organ. Nat Rev Immunol. 2014 Mar;14(3):181-94. doi: 10.1038/nri3623.
Reference Type
BACKGROUND
Actis GC, Olivero A, Lagget M, Pellicano R, Smedile A, Rizzetto M. The practice of percutaneous liver biopsy in a gastrohepatology day hospital: a retrospective study on 835 biopsies. Dig Dis Sci. 2007 Oct;52(10):2576-9. doi: 10.1007/s10620-006-9724-x. Epub 2007 Apr 12.
Reference Type
BACKGROUND
Cadranel JF, Rufat P, Degos F. Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF). Hepatology. 2000 Sep;32(3):477-81. doi: 10.1053/jhep.2000.16602.
Reference Type
BACKGROUND
van der Poorten D, Kwok A, Lam T, Ridley L, Jones DB, Ngu MC, Lee AU. Twenty-year audit of percutaneous liver biopsy in a major Australian teaching hospital. Intern Med J. 2006 Nov;36(11):692-9. doi: 10.1111/j.1445-5994.2006.01216.x.
Reference Type
BACKGROUND
Sparchez Z. Complications after percutaneous liver biopsy in diffuse hepatopathies. Rom J Gastroenterol. 2005 Dec;14(4):379-84.
Reference Type
BACKGROUND
Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med. 2001 Feb 15;344(7):495-500. doi: 10.1056/NEJM200102153440706. No abstract available.
Reference Type
BACKGROUND
Rousselet MC, Michalak S, Dupre F, Croue A, Bedossa P, Saint-Andre JP, Cales P; Hepatitis Network 49. Sources of variability in histological scoring of chronic viral hepatitis. Hepatology. 2005 Feb;41(2):257-64. doi: 10.1002/hep.20535.
Reference Type
BACKGROUND
Regev A, Berho M, Jeffers LJ, Milikowski C, Molina EG, Pyrsopoulos NT, Feng ZZ, Reddy KR, Schiff ER. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol. 2002 Oct;97(10):2614-8. doi: 10.1111/j.1572-0241.2002.06038.x.
Reference Type
BACKGROUND
Bedossa P, Dargere D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003 Dec;38(6):1449-57. doi: 10.1016/j.hep.2003.09.022.
Reference Type
BACKGROUND
Friedrich-Rust M, Buggisch P, de Knegt RJ, Dries V, Shi Y, Matschenz K, Schneider MD, Herrmann E, Petersen J, Schulze F, Zeuzem S, Sarrazin C. Acoustic radiation force impulse imaging for non-invasive assessment of liver fibrosis in chronic hepatitis B. J Viral Hepat. 2013 Apr;20(4):240-7. doi: 10.1111/j.1365-2893.2012.01646.x. Epub 2012 Jul 31.
Reference Type
BACKGROUND
Fierbinteanu-Braticevici C, Andronescu D, Usvat R, Cretoiu D, Baicus C, Marinoschi G. Acoustic radiation force imaging sonoelastography for noninvasive staging of liver fibrosis. World J Gastroenterol. 2009 Nov 28;15(44):5525-32. doi: 10.3748/wjg.15.5525.
Reference Type
BACKGROUND
Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C; Liver Fibrosis Study Group. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology. 2012 Dec;56(6):2125-33. doi: 10.1002/hep.25936. Epub 2012 Aug 31.
Reference Type
BACKGROUND
Poynard T, Munteanu M, Luckina E, Perazzo H, Ngo Y, Royer L, Fedchuk L, Sattonnet F, Pais R, Lebray P, Rudler M, Thabut D, Ratziu V. Liver fibrosis evaluation using real-time shear wave elastography: applicability and diagnostic performance using methods without a gold standard. J Hepatol. 2013 May;58(5):928-35. doi: 10.1016/j.jhep.2012.12.021. Epub 2013 Jan 12.
Reference Type
BACKGROUND
Chen S, Sanchez W, Callstrom MR, Gorman B, Lewis JT, Sanderson SO, Greenleaf JF, Xie H, Shi Y, Pashley M, Shamdasani V, Lachman M, Metz S. Assessment of liver viscoelasticity by using shear waves induced by ultrasound radiation force. Radiology. 2013 Mar;266(3):964-70. doi: 10.1148/radiol.12120837. Epub 2012 Dec 6.
Reference Type
BACKGROUND
Goertz RS, Zopf Y, Jugl V, Heide R, Janson C, Strobel D, Bernatik T, Haendl T. Measurement of liver elasticity with acoustic radiation force impulse (ARFI) technology: an alternative noninvasive method for staging liver fibrosis in viral hepatitis. Ultraschall Med. 2010 Apr;31(2):151-5. doi: 10.1055/s-0029-1245244. Epub 2010 Mar 19.
Reference Type
BACKGROUND
Takahashi H, Ono N, Eguchi Y, Eguchi T, Kitajima Y, Kawaguchi Y, Nakashita S, Ozaki I, Mizuta T, Toda S, Kudo S, Miyoshi A, Miyazaki K, Fujimoto K. Evaluation of acoustic radiation force impulse elastography for fibrosis staging of chronic liver disease: a pilot study. Liver Int. 2010 Apr;30(4):538-45. doi: 10.1111/j.1478-3231.2009.02130.x. Epub 2009 Oct 27.
Reference Type
BACKGROUND
Friedrich-Rust M, Wunder K, Kriener S, Sotoudeh F, Richter S, Bojunga J, Herrmann E, Poynard T, Dietrich CF, Vermehren J, Zeuzem S, Sarrazin C. Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology. 2009 Aug;252(2):595-604. doi: 10.1148/radiol.2523081928.
Reference Type
BACKGROUND
Wang QB, Zhu H, Liu HL, Zhang B. Performance of magnetic resonance elastography and diffusion-weighted imaging for the staging of hepatic fibrosis: A meta-analysis. Hepatology. 2012 Jul;56(1):239-47. doi: 10.1002/hep.25610. Epub 2012 Jun 6.
Reference Type
BACKGROUND
Sterling RK, Lissen E, Clumeck N, Sola R, Correa MC, Montaner J, S Sulkowski M, Torriani FJ, Dieterich DT, Thomas DL, Messinger D, Nelson M; APRICOT Clinical Investigators. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology. 2006 Jun;43(6):1317-25. doi: 10.1002/hep.21178.
Reference Type
BACKGROUND
Cales P, Oberti F, Michalak S, Hubert-Fouchard I, Rousselet MC, Konate A, Gallois Y, Ternisien C, Chevailler A, Lunel F. A novel panel of blood markers to assess the degree of liver fibrosis. Hepatology. 2005 Dec;42(6):1373-81. doi: 10.1002/hep.20935.
Reference Type
BACKGROUND
Adams LA, Bulsara M, Rossi E, DeBoer B, Speers D, George J, Kench J, Farrell G, McCaughan GW, Jeffrey GP. Hepascore: an accurate validated predictor of liver fibrosis in chronic hepatitis C infection. Clin Chem. 2005 Oct;51(10):1867-73. doi: 10.1373/clinchem.2005.048389. Epub 2005 Jul 28.
Reference Type
BACKGROUND
Forns X, Ampurdanes S, Llovet JM, Aponte J, Quinto L, Martinez-Bauer E, Bruguera M, Sanchez-Tapias JM, Rodes J. Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model. Hepatology. 2002 Oct;36(4 Pt 1):986-92. doi: 10.1053/jhep.2002.36128.
Reference Type
BACKGROUND
Crespo G, Fernandez-Varo G, Marino Z, Casals G, Miquel R, Martinez SM, Gilabert R, Forns X, Jimenez W, Navasa M. ARFI, FibroScan, ELF, and their combinations in the assessment of liver fibrosis: a prospective study. J Hepatol. 2012 Aug;57(2):281-7. doi: 10.1016/j.jhep.2012.03.016. Epub 2012 Apr 17.
Reference Type
BACKGROUND
Rosenberg WM, Voelker M, Thiel R, Becka M, Burt A, Schuppan D, Hubscher S, Roskams T, Pinzani M, Arthur MJ; European Liver Fibrosis Group. Serum markers detect the presence of liver fibrosis: a cohort study. Gastroenterology. 2004 Dec;127(6):1704-13. doi: 10.1053/j.gastro.2004.08.052.
Reference Type
BACKGROUND
Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, Lok AS. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003 Aug;38(2):518-26. doi: 10.1053/jhep.2003.50346.
Reference Type
BACKGROUND
Imbert-Bismut F, Ratziu V, Pieroni L, Charlotte F, Benhamou Y, Poynard T; MULTIVIRC Group. Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study. Lancet. 2001 Apr 7;357(9262):1069-75. doi: 10.1016/S0140-6736(00)04258-6.
Reference Type
BACKGROUND
Provided Documents
Download supplemental materials such as informed consent forms, study protocols, or participant manuals.
Document Type: Study Protocol and Statistical Analysis Plan
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
2017P000940
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
ShearWave™ Elastography to Assess Liver Fibrosis in Chinese Patients With Hepatitis B
NCT02313649
COMPLETED
Quantitative Evaluation of the Progression of Liver Disease, Using ShearWaveTM
NCT02070315
COMPLETED
Endoscopic Ultrasound Shear Wave Elastography in Patients With Non-alcoholic Fatty Liver Disease
NCT05728697
RECRUITING
Ultrasonography SWE for Hepatic Fibrosis Evaluation
NCT02673411
COMPLETED
Liver and Spleen Stiffness Measured by 2D-SWE for Diagnosis of Liver Fibrosis in Patients With cACLD
NCT06147934
RECRUITING
SWE Liver Stiffness as a Predictor of Progression of Chronic Liver Diseases
NCT03389152
COMPLETED
Prospective Comparison Between TE, SWE and MRE (FULLFIBRO01)
NCT03293953
UNKNOWN
Liver Fibrosis Evaluation Using Ultrasound Shear Wave Imaging
NCT03637959
COMPLETED
NA
Assessment of Hepatic Fibrosis by Shear Wave Elastography in Patients With Liver Malignancy: A Prospective Single-center Study
NCT02958592
COMPLETED
Competitive Accuracy of Radiological Imaging Compared to Liver Biopsy in Patients With Liver Fibrosis
NCT05008263
COMPLETED
The Sonic Incytes Liver Incytes System, Evaluation of Liver Fibrosis and Steatosis Versus MRE and MRI PDFF
NCT04682600
UNKNOWN
NA
Ultrasound Quantification of Liver Fat
NCT04523584
COMPLETED
A Prospective Study to Monitor Liver Diseases Dynamically by Ultrasound Viscoelasticity
NCT03777293
UNKNOWN
NA
Evaluating Ultrasound, Elastometry, Minilaparoscopy and Histology for the Diagnosis of Compensated Liver Cirrhosis.
NCT01807013
UNKNOWN
Use of Shear Wave Elastography to Assess Non-alcoholic Fatty Liver Disease (NAFLD)
NCT03587298
UNKNOWN
Shear-wave Elastography Diffuse Liver Disease
NCT05163132
UNKNOWN
Viscoelasticity Imaging to Assess Liver Cancer
NCT04409340
UNKNOWN
Endosonographic Shear Wave Elastography to Assess Liver and Splenic Fibrosis
NCT06867731
ENROLLING_BY_INVITATION
MR Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B
NCT06779058
RECRUITING
Assessment of Liver Fibrosis and Prognosis in Chinese Patients With CHB Infection Using STE/STQ Elastography
NCT03530657
UNKNOWN
Impact of Fluid Status on Liver Elastography and T1-mapping Results in Patients Undergoing CMR.
NCT05239260
UNKNOWN
Combination Diagnostic Strategies in NAFLD
NCT04384159
COMPLETED
Evaluation of Liver Fibrosis With 2D-Shear Wave Elastography
NCT04759521
COMPLETED
Optimal Measurement of Spleen Stiffness Among Veterans With Metabolic Dysfunction-Associated Steatotic Liver Disease
NCT06953830
ENROLLING_BY_INVITATION
NA