Subharmonic Aided Pressure Estimation of Portal Hypertension

Overview

About this study

The purpose of this study is to determine the reproducibility of the SHAPE algorithm across two different ultrasound contrast agents in the same subjects to estimate portal pressures with a Logiq E10 state-of-the-art ultrasound scanner (GE Healthcare). Examine if serial SHAPE every 6 ± 2 months can accurately predict development of ascites and other liver related events in patients with compensated cirrhosis undergoing routine hepatocellular carcinoma surveillance in a multi-center setting. Use SHAPE to monitor treatment response (in particular non-selective beta blockers) in patients identified with portal hypertension and compare results to elastography measurements, or clinical outcomes (i.e., rate of esophageal variceal hemorrhage and/or decompensation, need for TIPS, transplantation, and survival free of liver related outcomes) in a multi-center setting. Compare the predictive ability of SHAPE for allocating patients with compensated advanced chronic liver disease to screening of varices compared to the Baveno VI and the expanded-Baveno VI criteria as well as the AST to Platelet Ratio Index (APRI) and FIB-4.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria: 

All subjects accepted for this trial must fulfill all the following criteria:

  • Be at least 18 years of age.

  • Be medically stable.

  • If a female of child-bearing potential, must have a negative pregnancy test.

  • Be conscious and able to comply with study procedures.

  • Have read and signed the IRB-approved Informed Consent form for participating in the study.

Also there are specific inclusion criteria for each cohort:

Cohort 1:

  • Be scheduled for transjugular liver biopsy where HVPG measurements will be obtained.

Cohort 2:

  • Have  clinically significant portal hypertension undergoing routine HCC surveillance.

Cohort 3:

  • Have a diagnosis of portal hypertension and starting treatment with non-selective β-blockers.

Cohort 4:

  • Have clinically significant portal hypertension and be scheduled for endoscopy to screen for varices.

Exclusion Criteria: 

Subjects who fulfill any of the following conditions or who have had the following procedures will be excluded from this trial:

  • Females who are pregnant or nursing.

  • Patients with pulmonary hypertension or unstable cardiopulmonary conditions.

  • Patients currently on chemotherapy or with other primary cancers requiring systemic or hepatic loco-regional treatment.

  • Patients who are medically unstable, patients who are seriously or terminally ill, and patients whose clinical course is unpredictable.  For example:
    • Patients on life support or in a critical care unit.
    • Patients with unstable occlusive disease (e.g., crescendo angina)
    • Patients with clinically unstable cardiac arrhythmias, such as recurrent ventricular tachycardia.
    • Patients with uncontrolled congestive heart failure (NYHA Class IV)
    • Patients with recent cerebral hemorrhage.
    • Patients who have undergone surgery within 24 hours prior to the study sonographic examination.
  • Patients with a history of anaphylactic allergy to eggs or egg products, manifested by one or more of the following symptoms: generalized urticaria, difficulty in breathing, swelling of the mouth and throat, hypotension, or shock.  (Subjects with nonanaphylactic allergies to eggs or egg products may be enrolled in the study, but must be watched carefully for 1 hour following the administration of Sonazoid).
  • Patients with congenital heart defects.
  • Patients with severe emphysema, pulmonary vasculitis, or a history of pulmonary emboli.
  • Patients with respiratory distress syndrome.
  • Patients with thrombosis within the hepatic, portal, or mesenteric veins.

Also there is one additional exclusion criteria for cohort 1:

  • Patients with a history of anaphylactic allergy to perflutren or any other components of Definity.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 4/15/2025. Questions regarding updates should be directed to the study team contact.
 

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Jaydev Dave, Ph.D.

Contact us for the latest status

Contact information:

Beatrice Hartke

Hartke.Bea@mayo.edu

More information

Publications

Publications are currently not available
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CLS-20592214

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