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Pancreatitis, ChronicRECURNCT05778929

Radiomic fEatures of Pancreas From Contrast Enhanced CT Image Predict One-Year RecUrrence Risk of Acute PancReatitis

An observational study of Pancreatitis, Chronic, run by Peking University People's Hospital.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

One-year recurrence rate of acute pancreatitis at about 20%. 36% of the patients with recurrent acute pancreatitis will develop into chronic pancreatitis. In addition to negative impact on patient's quality of life, chronic pancreatitis is also associated with the occurrence of pancreatic cancer. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Pancreatitis, Chronic
What is being tested?
Radiomics Model
How many people
694 participants
Where
No sites listed yet
Study dates
1 Apr 2023to 1 Apr 2025
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 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The subjects enrolled in this prospective study are adult patients diagnosed as the first onset of acute pancreatitis and recommended for enhanced pancreatic CT scan within 14 days after onset of symptoms and accepted follow-up via telephone or returning to the site at 1, 3, 6 and 12 months.

Who may be able to join

  • 18 -70 years old
  • The subject met the following three criteria and diagnosed with acute pancreatitis according to the Atlanta Classification of Acute Pancreatitis.
  • 2.1 Abdominal pain indicative of pancreatitis 2.2 Serum levels of amylase or lipase >3 times the upper limit of normal 2.3 Characteristic findings from abdominal imaging (unenhanced CT\MR\ultrasonography)
  • Referred for an enhanced CT examination with Iopromide 370 in 14 days after symptom onset by clinicians
  • Sign the informed consent

Who cannot join

  • Has history of allergy to iodinated contrast agent
  • Confirmed or suspected hyperthyroidism or pheochromocytoma;
  • Pregnant or lactating women
  • Patients who are participating another clinical study
  • Disturbance of consciousness
  • Has a history of acute pancreatitis
Show all 12Show fewer
  • Has acute attack of chronic pancreatitis
  • Has a history of pancreatic surgery
  • Has co-morbidities such as cancer or other severe chronic wasting diseases
  • Has a history of other surgeries or surgical implants that affects imaging and quality of pancreatic imaging
  • Typical indications for pancreatic surgery, gallbladder surgery or endoscopic retrograde cholangiopancreatography as judged by the clinician
  • Any patient who is considered unsuitable for iodinated contrast agent-enhanced pancreatic CT scan at the discretion of the investigator

About this study

Official title: Radiomic fEatures of Pancreas From High-Concentration Contrast Enhanced CT Image Predict One-Year RecUrrence Risk of Acute PancReatitis: A Prospective, Multicenter Study

One-year recurrence rate of acute pancreatitis at about 20%. 36% of the patients with recurrent acute pancreatitis will develop into chronic pancreatitis. In addition to negative impact on patient's quality of life, chronic pancreatitis is also associated with the occurrence of pancreatic cancer. The etiology of recurrent acute pancreatitis (RAP) can be divided into mechanical obstructive factors (e.g. cholelithiasis, cholestasis), metabolic abnormality and toxic substance factors (e.g. hyperlipidemia and alcoholism), and other or idiopathic factors. At present, the diagnosis and treatment of RAP remains highly challenging. Early identification and intervention on risk factors of recurrence will be effective in reducing incidence and improving prognosis.

Contrast-enhanced Computed Tomography (CT) can not only provide more imaging information and further assess the severity of acute pancreatitis, but also aid in the differentiation of other diseases associated with acute abdominal pain. In addition, radiomics based on raw radiographic data has become a research hotspot in recent years. The purpose of this study is to establish and validate a deep learning model based on high concentration iopromide-enhanced abdominal CT images which is designed to predict the recurrence of pancreatitis in patients with first episode of pancreatitis within the 1-year follow-up period.

Read the detailed description

Primary objective(s) To evaluate the sensitivity and specificity of the deep-learning integrated model established with relevant clinical factors and radiomic features based on the high concentration (370 mgI/ml) Iopromide-enhanced pancreatic CT obtained within 14 days after the first onset of symptoms for quantitative prediction of (the first) recurrence of acute pancreatitis in 12 months follow-up period.

Sample Size:

According to previously published data, the average time of occurrence of RAP is 12.5 ± 3.6 months and one-year recurrence rate of acute pancreatitis is about 20%. In addition, the recurrence rate is estimated to be about 17% within the 12-month follow-up window in this study, when taking into account the clinical experience of our hospital.

The calculation parameters for sample size of the training set in the study are as follows:

  1. Z1-α/2 is1.96 at α=0.05
  2. L, the width of the acceptable 95% confidential interval of sensitivity or specificity, 0.03-0.1
  3. The sensitivity is 0.85, the specificity is 0.98, and the disease prevalence is 0.17 Calculated based on sensitivity, N1= 1.962X0.85 X (1-0.85)/0.12 X 0.17= 0.490/0.0017=288 Calculated based on specificity, N2=1.962X0.98 X (1-0.98)/0.12 X (1-0.17) = 0.075/0.008=61 The sample size of the training set is 288 x 1.2 = 346 considering a dropout rate of 20% in the study.

The training set, test set and validation set are estimated in a ratio of 5:2:3. The total sample size for this prospective study is 694. According to the order of patient enrollment, the last 200 patients recruited will form the validation set.

Statistical Analyses:

At baseline and follow-up, descriptive statistics will be used to describe the entire population and subgroups of interest. Summary statistics such as mean, median, standard deviation and range will be used to describe continuous variables. Categorical variables will be presented in a frequency table.

  • Primary endpoint analysis For patients with acute pancreatitis undergoing enhanced CT scan, the model that used the combination of radiomics and clinical features is used to predict the recurrence probability of acute pancreatitis within 12 months. The sensitivity and specificity of prediction and corresponding 95% CI are calculated.
  • Secondary endpoint analysis Chi-square testing for all potential clinical risk factors included (as described in the Chapter on Variables and Criteria Used in Determining Primary Endpoints). The variables with p< 0.05 are analyzed for multivariate logistic regression and clinical modeling. Also based on the logistic regression model, a combination model of radioomic features and clinical factors is established.

The sensitivity, specificity and corresponding 95% CI for prediction of recurrence within 1, 3, 6 and 12 months are calculated based on the model that used both clinical features and/or radiomics features. Only the first recurrence is calculated.

Brief statistics of the quality of CT images will be provided.

  • Baseline demographic characteristics Demographic and baseline characteristics will be summarized descriptively. Sensitivity= TP/(TP+FN) Specificity=TN/(TN+FP) Accuracy = (TP+TN)/(TP+FN+TN+FP) TP=True positive TP=True negative FN=False negative FP=False positive TP+FN+TN+FP=Total number of patients Statistical analyses are performed using R software (R Core Team, Vienna, Austria) version 3.4.3 All tests are two-sided. A P value < 0.05 is considered statistically significant.

All therapies will be coded using the World Health Organization - Drug Dictionary (WHO-DD). Medical history and any disease will be coded using the most current version of ICH Medical Dictionary for Regulatory Activities (MedDRA).

Being tested
Radiomics Model
Medical subject headings
Pancreatitis, Chronic

What participants receive

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

  • Radiomics ModelDiagnostic test

    A total of 694 consecutive eligible patients with first episode of "acute pancreatitis" that recommended for iopromide 370 mgI/ml enhanced pancreatic CT scan within 14 days after onset of symptoms (the sample size ratio of training set: test set: validation set is 5:2:3) will be sequentially enrolled at 10 sites (This study is observational in nature. The routine enhanced pancreatic CT protocol at all selected sites is similar or equivalent to that used in the PI site in the study).

    Relevant clinical information of the enrolled subjects is collected. Radiomics features are extracted from the selected regions of interest on pancreatic CT images and classified. The subjects are followed up for 12 months and divided into recurrent group and non-recurrent group according to the first recurrence status.

Study groups in NCT05778929
Study groupRoleWhat they receive
patients diagnosed as recurrent acute pancreatitis in 12 monthRecurrent acute pancreatitis: relapse occurs more than three months after the previous episode ended, with the exclusion of re-hospitalization due to local or systemic complications of the initial episode and chronic pancreatitis.
Receives: Diagnostic Test: Radiomics Model
patients not diagnosed as recurrent acute pancreatitis in 12 monthsNo relapse occurs more than three months after the previous episode ended, with the exclusion of re-hospitalization due to local or systemic complications of the initial episode and chronic pancreatitis.
Receives: Diagnostic Test: Radiomics Model

What is being measured

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

  1. The sensitivity and specificity of the model established with relevant clinical factors and radiomic features

    Image acquisition at each site is performed by an independent radiologist with ≥ 5 years of work experience. Radiomics features will be extracted from 370 mgI/ml Iopromide-enhanced pancreatic CT obtained within 14 days after the first onset of symptoms to quantitative predict the first recurrence of acute pancreatitis in 12 months follow-up period.Sensitivity= TP/(TP+FN) Specificity=TN/(TN+FP) Accuracy = (TP+TN)/(TP+FN+TN+FP) TP=True positive TP=True negative FN=False negative FP=False positive TP+FN+TN+FP=Total number of patients.

    Measured: 12 months

Secondary outcomes (5)
  1. The total number of subjects who developed the first recurrence of acute pancreatitis (subjects with multiple recurrences, calculated and analyzed according to the time of the earliest recurrence) within 3, 6 and 12 months

    Recurrent acute pancreatitis: relapse occurs more than three months after disappearance of symptoms of the first episode, with the exclusion of re-hospitalization due to local or systemic complications of the initial episode and chronic pancreatitis.

    Measured: in 12 months follow up period

  2. The sensitivity and specificity of the deep-learning integrated model established with relevant clinical factors and radiomic features to quantitative predict overall recurrence of acute pancreatitis in 3 and 6 months follow-up period;

    Sensitivity= TP/(TP+FN) Specificity=TN/(TN+FP) Accuracy = (TP+TN)/(TP+FN+TN+FP) TP=True positive TP=True negative FN=False negative FP=False positive

    Measured: 3 months, 6 months

  3. The image quality of Iopromide-enhanced pancreatic CT images obtained within 14 days after onset of symptoms

    The Imaging Department, Peking University People's Hospital served as quality control center. Objective quantitative evaluation and subjective evaluation of the quality of the images from all sites are performed by two radiologists with ≥ 10 years of abdominal imaging experience. A 4-point scale is used for subjective evaluation of the overall image quality in terms of noise, sharpness and contrast. Where, a score of 0 denotes poor image quality; 1 denotes fair image quality; 2 denotes good image quality; 3 denotes excellent image quality. The images with a score of 2 to 3 are classified into the high-quality image set.

    Measured: 14 days

  4. The sensitivity and specificity of the model determined by radiomics features extracted from images with high quality scores (2-3 points)

    Sensitivity= TP/(TP+FN) Specificity=TN/(TN+FP) Accuracy = (TP+TN)/(TP+FN+TN+FP) TP=True positive TP=True negative FN=False negative FP=False positive

    Measured: 3 months, 6 months and 12 months

  5. The sensitivity and specificity of the radiomics features in predicting (the first) recurrence of different types and severities of acute pancreatitis at 3, 6 and 12 months

    Sensitivity= TP/(TP+FN) Specificity=TN/(TN+FP) Accuracy = (TP+TN)/(TP+FN+TN+FP) TP=True positive TP=True negative FN=False negative FP=False positive

    Measured: 3 months, 6 months and 12 months

Timeline

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

  1. First posted22 Mar 2023
  2. Study start1 Apr 2023 (estimated)
  3. Primary completion1 Apr 2025 (estimated)
  4. Study completion1 Apr 2025 (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
Cohort
Time perspective
Prospective
Enrolment
694 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05778929
Sponsor's protocol ID
2022PHB174-001
Acronym
RECUR
Status last verified
Mar 2023
First submitted
19 Feb 2023
Last updated
22 Mar 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Pancreatitis, Chronic, run by Peking University People's Hospital.

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 5 inclusion and 12 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 22 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

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?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The sensitivity and specificity of the model established with relevant clinical factors and radiomic features (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 22 Mar 2023.

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