Trial Outcomes & Findings for Beyond Confounders: Addressing Source of Measurement Variability and Error in Shear Wave Elastography (NCT NCT03342560)

NCT ID: NCT03342560

Last Updated: 2019-10-28

Results Overview

We collected guideline suggested shear wave elastography measurements from 20 patients. Guidelines suggest collecting 1) 10 measurements, 2) Asking patient to hold breath during the measurements. As a deviation from guideline suggestions, we collected measurements during free breath movements without asking patient to hold breath. As a deviation from the guideline suggestions, fewer number of measurements (3 measurements) were collected with asking the patient to hold breath during the measurements. All measurements were collected using one type of ultrasound system. All measurements were collected by 2 operators in 2 visits.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

30 participants

Primary outcome timeframe

Visit 1 and Visit 2, an average of 2.5 hours for each visit

Results posted on

2019-10-28

Participant Flow

All 30 patients were scanned in clinic ultrasound setting. 2 visits were scheduled for each patient. Mean difference between visits was 11 days. Mean difference between liver biopsy date and first visit date was 89 days. 2 patients were lost to followup for 2nd visit.

Participant milestones

Participant milestones
Measure
Chronic Liver Disease Patients With Known Liver Biopsy Results
Patients with chronic liver disease with known biopsy results Sonographic SWE measurements with Toshiba/Canon APLIO500: Sonographic Shear wave elastography will be performed to quantify liver fibrosis Sonographic SWE measurements with Siemens ACUSON S3000: Sonographic Shear wave elastography will be performed to quantify liver fibrosis Sonographic SWE measurements with GE LOGIQ E9: Sonographic Shear wave elastography will be performed to quantify liver fibrosis SWE measurements with FibroScan: Transient elastography will be performed to quantify liver fibrosis
Overall Study
STARTED
30
Overall Study
COMPLETED
28
Overall Study
NOT COMPLETED
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Chronic Liver Disease Patients With Known Liver Biopsy Results
Patients with chronic liver disease with known biopsy results Sonographic SWE measurements with Toshiba/Canon APLIO500: Sonographic Shear wave elastography will be performed to quantify liver fibrosis Sonographic SWE measurements with Siemens ACUSON S3000: Sonographic Shear wave elastography will be performed to quantify liver fibrosis Sonographic SWE measurements with GE LOGIQ E9: Sonographic Shear wave elastography will be performed to quantify liver fibrosis SWE measurements with FibroScan: Transient elastography will be performed to quantify liver fibrosis
Overall Study
Lost to Follow-up
2

Baseline Characteristics

Beyond Confounders: Addressing Source of Measurement Variability and Error in Shear Wave Elastography

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
30 Patients With Known Liver Biopsy Results
n=30 Participants
Patients with chronic liver disease with known biopsy results Sonographic SWE measurements with Toshiba APLIO500: Sonographic Shear wave elastography will be performed to quantify liver fibrosis Sonographic SWE measurements with Siemens ACUSON S3000: Sonographic Shear wave elastography will be performed to quantify liver fibrosis Sonographic SWE measurements with GE LOGIQ E9: Sonographic Shear wave elastography will be performed to quantify liver fibrosis SWE measurements with FibroScan: Transient elastography will be performed to quantify liver fibrosis Sonographic speed of sound measurements with GE LOGIQ E9: Sonographic speed of sound function of the machine will be used to quantify liver steatosis
Age, Continuous
49 years
n=5 Participants
Sex: Female, Male
Female
19 Participants
n=5 Participants
Sex: Female, Male
Male
11 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
Race (NIH/OMB)
White
27 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Fibrosis stage
Fibrosis 0
10 participants
n=5 Participants
Fibrosis stage
Fibrosis 1
7 participants
n=5 Participants
Fibrosis stage
Fibrosis 2
3 participants
n=5 Participants
Fibrosis stage
Fibrosis 3
5 participants
n=5 Participants
Fibrosis stage
Fibrosis 4
5 participants
n=5 Participants

PRIMARY outcome

Timeframe: Visit 1 and Visit 2, an average of 2.5 hours for each visit

We collected guideline suggested shear wave elastography measurements from 20 patients. Guidelines suggest collecting 1) 10 measurements, 2) Asking patient to hold breath during the measurements. As a deviation from guideline suggestions, we collected measurements during free breath movements without asking patient to hold breath. As a deviation from the guideline suggestions, fewer number of measurements (3 measurements) were collected with asking the patient to hold breath during the measurements. All measurements were collected using one type of ultrasound system. All measurements were collected by 2 operators in 2 visits.

Outcome measures

Outcome measures
Measure
Guideline Suggested Measurements
n=20 Participants
10 measurements in an area between 2cm from liver capsule and 6.5cm from skin
Fewer Number of Measurements
n=20 Participants
3 SWE measurements were collected.
Free Breath Measurements
n=20 Participants
10 SWE measurements were collected during free breath
Deviations From Suggested Guidelines- Any Effect on Agreement
ICC for inter-operator agreement in visit1
0.77 correlation coefficient
Interval 0.45 to 0.9
0.75 correlation coefficient
Interval 0.4 to 0.9
0.69 correlation coefficient
Interval 0.26 to 0.87
Deviations From Suggested Guidelines- Any Effect on Agreement
ICC for inter-operator agreement in visit2
0.86 correlation coefficient
Interval 0.64 to 0.94
0.80 correlation coefficient
Interval 0.48 to 0.92
0.68 correlation coefficient
Interval 0.2 to 0.87
Deviations From Suggested Guidelines- Any Effect on Agreement
ICCfor intra-op agreement between 2 visits for op1
0.94 correlation coefficient
Interval 0.84 to 0.97
0.90 correlation coefficient
Interval 0.75 to 0.96
0.93 correlation coefficient
Interval 0.61 to 0.98
Deviations From Suggested Guidelines- Any Effect on Agreement
ICCfor intra-op agreement between 2 visits for op2
0.89 correlation coefficient
Interval 0.74 to 0.96
0.89 correlation coefficient
Interval 0.73 to 0.96
0.95 correlation coefficient
Interval 0.87 to 0.98

PRIMARY outcome

Timeframe: Visit 1 and Visit 2, an average of 2.5 hours for each visit

In 20 patients we collected 10 shear wave elastography measurements in m/s and kPA units. Using one of the available ultrasound systems, 2 operators collected these measurements in 2 visits. Theoretically, m/s to kPA conversion can be made using an equation. However, some systems provide opportunity to get data in both units. Although algebraically m/s and kPA can be converted to each other, we found some minor differences in terms of inter-operator and intra-operator agreement.

Outcome measures

Outcome measures
Measure
Guideline Suggested Measurements
n=20 Participants
10 measurements in an area between 2cm from liver capsule and 6.5cm from skin
Fewer Number of Measurements
n=20 Participants
3 SWE measurements were collected.
Free Breath Measurements
10 SWE measurements were collected during free breath
Interoperator and Intraoperator Agreement in m/s and kPA Units
ICC for inter-operator agreement in visit1
0.87 Intraclass correlation coefficient value
Interval 0.47 to 0.96
0.84 Intraclass correlation coefficient value
Interval 0.36 to 0.95
Interoperator and Intraoperator Agreement in m/s and kPA Units
ICC for inter-operator agreement in visit2
0.80 Intraclass correlation coefficient value
Interval 0.26 to 0.94
0.77 Intraclass correlation coefficient value
Interval 0.13 to 0.94
Interoperator and Intraoperator Agreement in m/s and kPA Units
ICC for intra-operator agreement for opt1
0.92 Intraclass correlation coefficient value
Interval 0.71 to 0.97
0.88 Intraclass correlation coefficient value
Interval 0.57 to 0.96
Interoperator and Intraoperator Agreement in m/s and kPA Units
ICC for intra-operator agreement for opt2
0.81 Intraclass correlation coefficient value
Interval 0.35 to 0.94
0.78 Intraclass correlation coefficient value
Interval 0.27 to 0.94

Adverse Events

30 Patients With Known Liver Biopsy Results

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Anthony E. Samir

Massachusetts General Hospital

Phone: 6176432009

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place