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LITMUS Imaging Study

Active, not recruiting
Conditions
NASH
NASH - Nonalcoholic Steatohepatitis
Fibrosis, Liver
Steatosis of Liver
NAFLD
Registration Number
NCT05479721
Lead Sponsor
University of Oxford
Brief Summary

The LITMUS Imaging Study is a prospectively recruited, observational study of patients with histologically characterised non-alcoholic fatty liver disease (NAFLD). It aims to evaluate the diagnostic performance of imaging biomarkers (ultrasound elastography and magnetic resonance biomarkers) against NAFLD histological scores in a cross-sectional analysis and the natural history of NAFLD in a longitudinal study.

Detailed Description

The LITMUS Imaging study is a non-interventional, observational study conducted in parallel to the European NAFLD Registry (NCT04442334), collecting cross-sectional and longitudinal ultrasound elastography and magnetic resonance elastography and imaging data. The LITMUS Imaging study recruits patients with NAFLD who are having a clinically indicated liver biopsy and are already participating in the European NAFLD Registry. Patients in the LITMUS Imaging study have additional imaging assessments at baseline (within 100 days of baseline liver biopsy) and 2 years after baseline (no follow-up biopsy necessary). Imaging assessments include point shear wave elastography, 2D shear wave elastography, MRI scans (Liver Multiscan, deMILI, diffusion weighted imaging, proton density fat fraction, T1 mapping) and MR elastography. Link-anonymised magnetic resonance data are uploaded to a central online portal and analysed centrally by 4 imaging core labs provided by Perspectum (Liver Multiscan), Antaros Medical (MR elastography and DWI), Resoundant (vendor specific PDFF) and University of Seville (deMILI).

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
450
Inclusion Criteria
  1. Recruited to the European NAFLD Registry
  2. Patient had a liver biopsy less than 3 months prior to enrolment into the study or is having a liver biopsy in less than 3 months' time for the assessment of NAFLD.
  3. Participant is willing and able to give informed consent for participation in the study.
Exclusion Criteria
  1. Patients that do not speak the language in which the patient information is written will be excluded. Due to the nature of the study, being able to read the information about the study or access to a relevant interpreter is a necessary criterion for participant's safety in regards to MR scanning.
  2. Patients judged by the investigator to be unsuitable for inclusion in the study (e.g. where the investigator feels that the participant will not be able to comply with the study procedures)
  3. Any contra-indication to Magnetic Resonance Imaging (MRI) (e.g. ferrous metal implants/fragments, implantable cardiac defibrillator or permanent pacemaker, metal clips following neurosurgery, pregnancy, other condition that would make MR scanning unsafe in the opinion of the scanner operator)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Diagnostic accuracy of imaging biomarkers for severity of liver fibrosis on histology as reference standardbaseline

sensitivity, specificity, positive predictive value, negative predictive value, area under the receiver operating characteristic curve

Secondary Outcome Measures
NameTimeMethod
To evaluate reproducibility and observer dependent variability in reporting of liver imaging biomarkersevaluation of biomarkers within 30 days

Statistical correlation of MR and US elastography data obtained from the same patients acquired or analysed on two time points

Diagnostic accuracy of imaging biomarkers for diagnosis of NASH on histology as reference standardbaseline

sensitivity, specificity, positive predictive value, negative predictive value, area under the receiver operating characteristic curve

To identify physiological factors that confound the performance of imaging biomarkers for the assessment of fibrosisbaseline

Statistical correlation of MR scans and US elastography imaging biomarkers with liver histology parameters (steatosis, iron deposition, inflammation) and other clinical data (demographics, lab results, patient characteristics)

Diagnostic accuracy of imaging biomarkers for histologically assessed fat and iron deposition as reference standardbaseline

sensitivity, specificity, positive predictive value, negative predictive value, area under the receiver operating characteristic curve

To study the natural history of NAFLD and how this may impact prognosisevaluation of biomarkers at baseline and after 2 years

1. Longitudinal correlation of change (δ) in MR and US elastography biomarker values with clinical phenotype data\*

2. Survival analysis for the change (δ) in biomarker values

Trial Locations

Locations (18)

Institute of Biomedicine of Sevilla (IBiS), Virgen del Rocío University Hospital

🇪🇸

Sevilla, Spain

Universitätsklinikums Würzburg

🇩🇪

Würzburg, Germany

Department of Medical Sciences University of Torino

🇮🇹

Torino, Italy

Inselspital, University Hospital

🇨🇭

Bern, Switzerland

Università di Palermo

🇮🇹

Palermo, Italy

Helsinki University Hospital

🇫🇮

Helsinki, Finland

Pinnacle Clinical Research

🇺🇸

San Antonio, Texas, United States

Le Centre de Recherche Clinique (CRC) du CHU d'Angers

🇫🇷

Angers, France

Institut ICAN - Institute of Cardiometabolism And Nutrition Hôpital de la Pitié Salpêtrière

🇫🇷

Paris, France

UNIVERSITÄTSMEDIZIN der Johannes Gutenberg Universität Mainz

🇩🇪

Mainz, Germany

Laiko General Hospital of Athens

🇬🇷

Athens, Greece

Vall d'Hebron University Hospital

🇪🇸

Barcelona, Spain

HU Clínico de Valladolid

🇪🇸

Valladolid, Spain

Linköping University Hospital

🇸🇪

Linköping, Sweden

Addenbrookes Hospital

🇬🇧

Cambridge, United Kingdom

The Newcastle Upon Tyne Hospitals Nhs Foundation Trust

🇬🇧

Newcastle Upon Tyne, United Kingdom

Oxford University Hospitals NHS Foundation Trust

🇬🇧

Oxford, United Kingdom

Queens Medical Centre

🇬🇧

Nottingham, United Kingdom

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