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AbdomenNCT05151939

Endoscopic Ultrasound (EUS) Artificial Intelligence Model for Normal Mediastinal and Abdominal Strictures Assessment

An observational study of Abdomen and Mediastinum, run by Instituto Ecuatoriano de Enfermedades Digestivas at 1 site in Ecuador.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Therefore, a high number of procedures is necessary to achieve EUS competency, but interobserver agreement still varies widely. Artificial intelligence (AI) aided recognition of anatomical structures may improve the training process and inter-observer agreement. Robles-Medranda et al. Read more about this study

Who is it for?
Ages 18 to 79 years
Conditions the study is for
Abdomen, Mediastinum, Anatomic Abnormality
What is being tested?
Identification or discharge visualization of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos by an expert endoscopist and Recognition of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos using artificial intelligence (AI)
How many people
60 participants
Where
1 siteEcuador
Study dates
1 Oct 2021to 30 Jun 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 79 years
  • All sexes
  • Adult, Older adult

Study population: Adult patients with normal mediastinal and abdominal organ/anatomic strictures after imaging test and EUS assessment due to chronic dyspepsia.

Who may be able to join

  • Patients with no history of the thorax and abdominal abnormalities confirmed through an imaging test requested for healthcare purposes in the last twelve months (e.g., thorax X-ray and abdominal ultrasound or thorax and abdominal CT)
  • Patients who undergo EUS assessment due to chronic dyspepsia.

Who cannot join

  • Morphological alteration on at least one mediastinal and abdominal organ/anatomic strictures documented through any imaging test or EUS.
  • Uncontrolled coagulopathy, kidney/liver failure, or any comorbidity with a meaningful impact on cardiac risk assessment (NHYA III/IV);
  • Refuse to participate in the study or to sign corresponding informed consent.

Trial locations and contacts

1 site in 1 country.

Carlos Robles-Medranda contact

+59342109180

carlosoakm@yahoo.es

Ecuador1 site, 1 recruiting
  • Ecuadorian Institute of Digestive Diseases

    Guayaquil, Guayas, 090505

    Carlos A Robles-Medranda, MD, +593989158865, carlosoakm@yahoo.es

    Carlos Robles-Medranda, MD FASGE

    Recruiting

Other trials in Ecuador

About this study

Official title: Endoscopic Ultrasound (EUS) Assessment of Normal Mediastinal and Abdominal Organ/Anatomic Strictures Using a Novel Developed Artificial Intelligence Model

Therefore, a high number of procedures is necessary to achieve EUS competency, but interobserver agreement still varies widely. Artificial intelligence (AI) aided recognition of anatomical structures may improve the training process and inter-observer agreement. Robles-Medranda et al. developed an AI model that recognizes normal anatomical structures during linear and radial EUS evaluations. We pursue to design an external validation of our developed AI model, considering an endoscopist expert as the gold standard.

Read the detailed description

Endoscopic ultrasound (EUS) is a high-skilled procedure with a limited number of facilities available for training. Therefore, a high number of procedures is necessary to achieve competency. However, the agreement between observers varies widely. Artificial intelligence (AI) aided recognition and characterization of anatomical structures may improve the training process while improving the agreement between observers. However, developed EUS-AI models have been explicitly trained or only with disease samples or for detecting abdominal anatomical features.

In other fields as Radiation Oncology, developed AI models have been widely used. They must recognize in unison healthy and disease strictures throughout any part of the human body during the contouring. It avoids unnecessary irradiation of normal tissue. EUS-AI models not trained with healthy samples can cause an increase in false-positive cases during real-life practice. It implies potential overdiagnosis of abnormal/disease strictures. EUS-AI models not trained with samples outside

Using an automated machine learning software, Robles-Medranda et al. have previously developed a convolutional neuronal networks (CNN) AI model that recognizes the anatomical structures during linear and radial EUS evaluations (AI Works, MD Consulting group, Ecuador). To the best of our knowledge, this EUS-AI model is the first trained with EUS videos from patients without pathologies and, thus, with normal mediastinal and abdominal organ/anatomic strictures. In this second stage, we pursue to design an external validation of our developed AI model, considering an endoscopist expert as the gold standard.

Being tested
Identification or discharge visualization of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos by an expert endoscopist, Recognition of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos using artificial intelligence (AI)
Keywords
Endoscopic ultrasound, Artificial intelligence
Medical subject headings
Congenital Abnormalities, Constriction, Pathologic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Identification or discharge visualization of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos by an expert endoscopistDiagnostic test

    An expert endoscopist will select a dataset of mediastinal and abdominal EUS videos (one per patient). An expert endoscopist will identify or discharge visualization of the following organs correctly: aorta, vertebral spine, aortic arch, trachea, AP window, left kidney, liver, spleen, pancreas body, pancreas tail, coeliac trunk, splenic artery, splenic vein, inferior vena cava, adrenal gland, right kidney, gallbladder, common bile duct, ampulla of Vater, portal vein.

  • Recognition of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos using artificial intelligence (AI)Diagnostic test

    Using the same previous dataset of mediastinal and abdominal EUS videos, the EUS-AI model will recognize the following organs: aorta, vertebral spine, aortic arch, trachea, AP window, left kidney, liver, spleen, pancreas body, pancreas tail, coeliac trunk, splenic artery, splenic vein, inferior vena cava, adrenal gland, right kidney, gallbladder, common bile duct, ampulla of Vater, portal vein. Considering each patient (and not data frame videos) as the study unit, a contingency table per each mediastinal and abdominal organ/anatomic stricture will be designed.

Study groups in NCT05151939
Study groupRoleWhat they receive
Patients with normal mediastinal and abdominal organ/anatomic stricturesAdult patients with normal mediastinal and abdominal organ/anatomic strictures after imaging test and EUS assessment due to chronic dyspepsia.
Receives: Diagnostic Test: Identification or discharge visualization of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos by an expert endoscopist; Diagnostic Test: Recognition of mediastinal and abdominal organ/anatomic strictures through Endoscopic ultrasound (EUS) videos using artificial intelligence (AI)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall accuracy of Endoscopic ultrasound (EUS) artificial intelligence (AI) model for identifying normal mediastinal and abdominal organ/anatomic strictures

    Overall accuracy features will be calculated: sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and observed agreement. In addition, there will be defined the following probabilities:

    • True-positive (TP): mediastinal/abdominal organ/anatomic stricture recognized by the EUS-AI model. The expert endoscopist previously correctly identified it.
    • False-positive (FP): mediastinal/abdominal organ/anatomic stricture recognized by the EUS-AI model. The expert endoscopist previously correctly discharged its visualization.
    • False-negative (FN): mediastinal/abdominal organ/anatomic stricture not recognized by the EUS-AI model. The expert endoscopist previously correctly identified it.
    • True-negative (TN): mediastinal/abdominal organ/anatomic stricture not recognized by the EUS-AI model. The expert endoscopist previously correctly discharged its visualization.

    Measured: Three months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Dec 2021
  2. Study start1 Oct 2021
  3. Primary completion30 Mar 2022 (estimated)
  4. Study completion30 Jun 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Cross-sectional
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05151939
Sponsor's protocol ID
IECED-26112021
Status last verified
Dec 2021
First submitted
26 Nov 2021
Last updated
30 Dec 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Zhang J, Zhu L, Yao L, Ding X, Chen D, Wu H, Lu Z, Zhou W, Zhang L, An P, Xu B, Tan W, Hu S, Cheng F, Yu H. Deep learning-based pancreas segmentation and station recognition system in EUS: development and validation of a useful training tool (with video). Gastrointest Endosc. 2020 Oct;92(4):874-885.e3. doi: 10.1016/j.gie.2020.04.071. Epub 2020 May 6.

    PubMed 32387499
  • Kuwahara T, Hara K, Mizuno N, Haba S, Okuno N, Koda H, Miyano A, Fumihara D. Current status of artificial intelligence analysis for endoscopic ultrasonography. Dig Endosc. 2021 Jan;33(2):298-305. doi: 10.1111/den.13880. Epub 2020 Dec 5.

    PubMed 33098123
  • Robles-Medranda C, Oleas R, Del Valle R, Mendez JC, Alcívar-Vásquez JM, Puga-Tejada M, Lukashok H. Intelligence for real-time anatomical recognition during endoscopic ultrasound evaluation: a pilot study. Gastrointestinal Endoscopy. 2021; 93(6), AB221. https://doi.org/10.1016/J.GIE.2021.03.491

  • Udristoiu AL, Cazacu IM, Gruionu LG, Gruionu G, Iacob AV, Burtea DE, Ungureanu BS, Costache MI, Constantin A, Popescu CF, Udristoiu S, Saftoiu A. Real-time computer-aided diagnosis of focal pancreatic masses from endoscopic ultrasound imaging based on a hybrid convolutional and long short-term memory neural network model. PLoS One. 2021 Jun 28;16(6):e0251701. doi: 10.1371/journal.pone.0251701. eCollection 2021.

    PubMed 34181680
  • Yao L, Zhang J, Liu J, Zhu L, Ding X, Chen D, Wu H, Lu Z, Zhou W, Zhang L, Xu B, Hu S, Zheng B, Yang Y, Yu H. A deep learning-based system for bile duct annotation and station recognition in linear endoscopic ultrasound. EBioMedicine. 2021 Mar;65:103238. doi: 10.1016/j.ebiom.2021.103238. Epub 2021 Feb 24.

    PubMed 33639404
  • Tonozuka R, Mukai S, Itoi T. The Role of Artificial Intelligence in Endoscopic Ultrasound for Pancreatic Disorders. Diagnostics (Basel). 2020 Dec 24;11(1):18. doi: 10.3390/diagnostics11010018.

    PubMed 33374181
  • Marya NB, Powers PD, Chari ST, Gleeson FC, Leggett CL, Abu Dayyeh BK, Chandrasekhara V, Iyer PG, Majumder S, Pearson RK, Petersen BT, Rajan E, Sawas T, Storm AC, Vege SS, Chen S, Long Z, Hough DM, Mara K, Levy MJ. Utilisation of artificial intelligence for the development of an EUS-convolutional neural network model trained to enhance the diagnosis of autoimmune pancreatitis. Gut. 2021 Jul;70(7):1335-1344. doi: 10.1136/gutjnl-2020-322821. Epub 2020 Oct 7.

    PubMed 33028668
  • Minoda Y, Ihara E, Komori K, Ogino H, Otsuka Y, Chinen T, Tsuda Y, Ando K, Yamamoto H, Ogawa Y. Efficacy of endoscopic ultrasound with artificial intelligence for the diagnosis of gastrointestinal stromal tumors. J Gastroenterol. 2020 Dec;55(12):1119-1126. doi: 10.1007/s00535-020-01725-4. Epub 2020 Sep 11.

    PubMed 32918102
  • Cazacu IM, Udristoiu A, Gruionu LG, Iacob A, Gruionu G, Saftoiu A. Artificial intelligence in pancreatic cancer: Toward precision diagnosis. Endosc Ultrasound. 2019 Nov-Dec;8(6):357-359. doi: 10.4103/eus.eus_76_19. No abstract available.

    PubMed 31854344

Questions about this trial

What is this clinical trial studying?

An observational study of Abdomen and Mediastinum, run by Instituto Ecuatoriano de Enfermedades Digestivas at 1 site in Ecuador.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 30 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Ecuador. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Carlos Robles-Medranda (+59342109180, carlosoakm@yahoo.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall accuracy of Endoscopic ultrasound (EUS) artificial intelligence (AI) model for identifying normal mediastinal and abdominal organ/anatomic strictures (time frame: Three months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05151939, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Dec 2021.

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