Point-of-care Ultrasound Screening and Assessment of Chronic Liver Diseases and NASH

Study Overview
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Brief Summary
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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
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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.

Official Title
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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

Conditions
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Liver Diseases, Liver Cirrhosis, NASH - Nonalcoholic Steatohepatitis, Non-Alcoholic Fatty Liver Disease, Fibrosis, Liver, Steatosis of Liver

Intervention / Treatment
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* Device: Ultrasound liver assessment


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Interventional 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)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Main arm<br>Main study arm | Device: Ultrasound liver assessment<br>* The intervention consists in an ultrasound exam performed with the ultrasound medical device subject of the research.<br>* Other names: Sound speed;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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. | At study completion, 1 year | 
| 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 | At study completion, 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 | At study completion, 1 year | 
| 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 | At study completion, 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Elastography, Ultrasound attenuation, Sound speed, Ultrasound