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CompletedNCT06034587Updated Sep 13, 2023

Multimodal Ultrasound Imaging Assessment on Keloid

An observational study in Keloid, sponsored by Chongqing Medical University. Completed at 1 site in China. Open to participants aged 16 Years and older. Per ClinicalTrials.gov, last updated 2023-09-13.

Sponsored by Chongqing Medical University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
34
Ages
16 Years and older
Sex
All
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Study summary

Skin keloids are common dermatological conditions that can lead to physical limitations, functional impairments, and deformities. Beyond the physiological implications, the aesthetic ramifications of keloids can also result in significant psychological distress, including anxiety and depression, causing both physical and emotional suffering to the affected individuals. The incidence of keloids is high, characterized by their chronicity, resistance to treatment, and high recurrence rate. They have become one of the most challenging conditions to treat across burn surgery, plastic surgery, and dermatology disciplines. The lack of standardized clinical treatment guidelines globally, combined with an absence of a well-defined standardized evaluation system, means that the effectiveness of various treatments is not consistently and objectively assessed, creating significant challenges in clinical applications. This project integrates traditional high-frequency ultrasound with cutting-edge technologies like real-time shear wave elastography and ultra-micro blood flow imaging. By using multimodal ultrasound, investigators aim to observe the therapeutic response of 90Sr-90Y patch treatment on skin keloids. Investigators seek to determine the objectivity and quantification role of multimodal ultrasound data and indicators in assessing keloid severity, including blood flow information and elasticity hardness. Another goal is to obtain quantitative data on keloid thickness, volume, stiffness, and microvascular distribution before and after treatment to monitor the therapy response. This would address the current limitations of subjective keloid scoring scales. It would also serve as an objective assessment standard for precise diagnosis, treatment, and follow-up of keloids in a clinical setting, thereby standardizing the clinical diagnosis and treatment of keloids.

Read the detailed description

Currently, no one-size-fits-all approach exists and a universally accepted, standardized evaluation and treatment protocol remains elusive, making it challenging to determine which method is the most effective. Commonly used methods for assessing keloids, such as the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS), rely heavily on subjective evaluations based on observer perception and patient-reported experiences. These methods lack objective quantitative evaluation indicators and the ability to visualize subcutaneous tissues, limiting their individual clinical applicability. The Vancouver Scar Scale (VSS) is the most established questionnaire used for the evaluation of pathological scarring. This scale evaluates aspects of scar vascularity, pigmentation, pliability, and height, with the scoring system ranging from 0 to 15, where 0 is the least severe and 15 is the most severe. In the study, keloids were classified into three categories based on the VSS score: mild (0-5), moderate (6-9), and severe (10-15).

02

Conditions studied

  • Keloid

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Keywords

  • multimodal ultrasound
  • shear wave elastography
  • microvessel imaging
03

In context

Keloid

138 studies on the registry are indexed under Keloid; 26 are open to participants now.

This study's enrollment of 34 is below the median of 100 across 23 observational studies indexed under Keloid.

Browse Keloid studies →

Lead sponsor

Chongqing Medical University is the lead sponsor of 78 studies on the registry; 17 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
16 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

34 outpatients (mean age 43 ± 10.4 years, 14 male, 20 female) with untreated 63 keloids in different anatomical locations and 63 corresponding normal skin sites was performed

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male and female patients aged 16 years and above
  • Outpatients with no received any treatment in previous 6 months
  • Willing to participate in this trial and have signed an form

Exclusion criteria

Exclusion Criteria:

  • Pregnant or breastfeeding women
  • patients with malignant tumors, hypertension, diabetes, skin rupture, skin infection which may influence keloid healing and other dermatologic diseases
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
34 participants (actual)
Patient registry
No

Groups and cohorts

  • good response group of treated keloids

    The Vancouver Scar Scale (VSS) is the most established questionnaire used for the evaluation of pathological scarring. This scale evaluates aspects of scar vascularity, pigmentation, pliability, and height, with the scoring system ranging from 0 to 15, where 0 is the least severe and 15 is the most severe.All the keloids in the study were classified into three categories based on the VSS score: mild (0-5), moderate (6-9), and severe (10-15). For treatment assessment, investigators further divided the treated participants into two groups: a good response group (showing an improvement of 5 or more points in the VSS score) and a poor response group (less than 5 points improvement in the VSS score)

    Diagnostic Test: multimodal ultrasound · Radiation: radioisotope applicator therapy

  • poor response group of treated keloids

    The Vancouver Scar Scale (VSS) is the most established questionnaire used for the evaluation of pathological scarring. This scale evaluates aspects of scar vascularity, pigmentation, pliability, and height, with the scoring system ranging from 0 to 15, where 0 is the least severe and 15 is the most severe. All the keloids in the study keloids were classified into three categories based on the VSS score: mild (0-5), moderate (6-9), and severe(10-15). For treatment assessment, investigators further divided the treated participants into two groups: a good response group (showing an improvement of 5 or more points in the VSS score) and a poor response group (less than 5 points improvement in the VSS score)

    Diagnostic Test: multimodal ultrasound · Radiation: radioisotope applicator therapy

Interventions

  • Diagnostic testmultimodal ultrasound

    An Aixplorer ultrasound machine (SuperSonic Imaging, Ltd, Aixen-Provence, France), equipped with AngioPLUS(AP) and shear wave elastography(SWE) functions, was used for all examinations using a 4-15MHz linear probe.AP function can detect microvessels of lesions,SWE can evaluate the stiffness of lesions and high frequency ultrasound can measure the thickness and volume of keloid.

  • Radiationradioisotope applicator therapy

    The radioisotope applicator therapy utilized 90Sr-90Y(0094SR814975) isotope, customized by the China Atomic Energy Research Institute. The element therapy instrument used had overall dimensions of 2.8cm x 2.8cm, with an effective treatment area of 2.0cm x 2.0cm. It delivered a radiation dose of 5.0Gy/h. Each patient received superficial radiation therapy through a single 90Sr source, administered in repeated doses. The isotope therapy instrument was customized to fit the exact size of the keloid, ensuring coverage the irradiation range extending 0.5cm beyond the keloid's edge. During treatment, the surface of the applicator was aligned with the irradiated area and directly contact the surface of the keloid tissue. The treatment was carried out low-dose irradiation method, over 5 sessions, with each session delivering a dose of 2Gy. Each irradiation lasted for 25min.

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What researchers measure

Primary outcomes

  1. Change in stiffness measured by SWE

    The difference of stiffness in good response group and poor response group

    Time frame: from baseline to 6 months

  2. Change in microvessel signal grade measured by AP

    The difference of microvessel signal grade in good response group and poor response group

    Time frame: from baseline to 6 months

  3. Change in thickness measured by high frequency ultrasound

    The difference of thickness in good response group and poor response group

    Time frame: from baseline to 6 months

07

Study locations

1 site
  • The Second Affiliated Hospital of Chongqing Medical University
    Chongqing, Chongqing 400010, China
08

References and documents

Publications

  • Dirrichs T, Quack V, Gatz M, Tingart M, Rath B, Betsch M, Kuhl CK, Schrading S. Shear Wave Elastography (SWE) for Monitoring of Treatment of Tendinopathies: A Double-blinded, Longitudinal Clinical Study. Acad Radiol. 2018 Mar;25(3):265-272. doi: 10.1016/j.acra.2017.09.011. Epub 2017 Nov 16. PubMed 29153963 ↗
  • DeJong H, Abbott S, Zelesco M, Spilsbury K, Ziman M, Kennedy BF, Martin L, Wood FM. Objective quantification of burn scar stiffness using shear-wave elastography: Initial evidence of validity. Burns. 2020 Dec;46(8):1787-1798. doi: 10.1016/j.burns.2020.05.009. Epub 2020 May 19. PubMed 32534890 ↗
  • Schwaiger H, Reinholz M, Poetschke J, Ruzicka T, Gauglitz G. Evaluating the Therapeutic Success of Keloids Treated With Cryotherapy and Intralesional Corticosteroids Using Noninvasive Objective Measures. Dermatol Surg. 2018 May;44(5):635-644. doi: 10.1097/DSS.0000000000001427. PubMed 29701618 ↗
  • Nast A, Gauglitz G, Lorenz K, Metelmann HR, Paasch U, Strnad V, Weidmann M, Werner RN, Bauerschmitz J. S2k guidelines for the therapy of pathological scars (hypertrophic scars and keloids) - Update 2020. J Dtsch Dermatol Ges. 2021 Feb;19(2):312-327. doi: 10.1111/ddg.14279. Epub 2020 Oct 4. No abstract available. PubMed 33015930 ↗
  • Yang Y, Wang L, Yan F, Xiang X, Tang Y, Zhang L, Liu J, Qiu L. Determination of Normal Skin Elasticity by Using Real-time Shear Wave Elastography. J Ultrasound Med. 2018 Nov;37(11):2507-2516. doi: 10.1002/jum.14608. Epub 2018 Mar 25. PubMed 29575120 ↗
  • Yang Y, Qiu L, Wang L, Xiang X, Tang Y, Li H, Yan F. Quantitative Assessment of Skin Stiffness Using Ultrasound Shear Wave Elastography in Systemic Sclerosis. Ultrasound Med Biol. 2019 Apr;45(4):902-912. doi: 10.1016/j.ultrasmedbio.2018.11.015. Epub 2019 Jan 18. PubMed 30665723 ↗
  • Tsai WY, Hsueh YY, Chen PY, Hung KS, Huang CC. High-Frequency Ultrasound Elastography for Assessing Elastic Properties of Skin and Scars. IEEE Trans Ultrason Ferroelectr Freq Control. 2022 Jun;69(6):1871-1880. doi: 10.1109/TUFFC.2022.3154235. Epub 2022 May 26. PubMed 35201987 ↗
  • Guo R, Xiang X, Wang L, Zhu B, Cheng S, Qiu L. Quantitative Assessment of Keloids Using Ultrasound Shear Wave Elastography. Ultrasound Med Biol. 2020 May;46(5):1169-1178. doi: 10.1016/j.ultrasmedbio.2020.01.010. Epub 2020 Feb 13. PubMed 32063394 ↗
  • Reinholz M, Schwaiger H, Poetschke J, Epple A, Ruzicka T, Von Braunmuhl T, Gauglitz GG. Objective and subjective treatment evaluation of scars using optical coherence tomography, sonography, photography, and standardised questionnaires. Eur J Dermatol. 2016 Dec 1;26(6):599-608. doi: 10.1684/ejd.2016.2873. PubMed 27762215 ↗
  • Elrefaie AM, Salem RM, Faheem MH. High-resolution ultrasound for keloids and hypertrophic scar assessment. Lasers Med Sci. 2020 Mar;35(2):379-385. doi: 10.1007/s10103-019-02830-4. Epub 2019 Jun 25. PubMed 31240510 ↗
  • DeJong H, Abbott S, Zelesco M, Spilsbury K, Martin L, Sanderson R, Ziman M, Kennedy BF, Wood FM. A Novel, Reliable Protocol to Objectively Assess Scar Stiffness Using Shear Wave Elastography. Ultrasound Med Biol. 2020 Jul;46(7):1614-1629. doi: 10.1016/j.ultrasmedbio.2020.03.003. Epub 2020 May 5. PubMed 32386847 ↗
  • Xu C, Ting W, Teng Y, Long X, Wang X. Laser Speckle Contrast Imaging for the Objective Assessment of Blood Perfusion in Keloids Treated With Dual-Wavelength Laser Therapy. Dermatol Surg. 2021 Apr 1;47(4):e117-e121. doi: 10.1097/DSS.0000000000002836. PubMed 33795568 ↗
  • Son Y, Phillips EON, Price KM, Rosenberg LZ, Stefanovic B, Wolfe CM, Shaath TS, Om A, Cohen GF, Gunjan A. Treatment of keloids with a single dose of low-energy superficial X-ray radiation to prevent recurrence after surgical excision: An in vitro and in vivo study. J Am Acad Dermatol. 2020 Nov;83(5):1304-1314. doi: 10.1016/j.jaad.2020.06.023. Epub 2020 Jun 12. PubMed 32540415 ↗
  • Tang Y, Cheng S, Tang X, Guo R, Zhang L, Qiu L. Quantification of skin lesions using high-frequency ultrasound and shear wave elastography in port-wine stain patients: a clinical study. Ann Transl Med. 2019 Dec;7(24):803. doi: 10.21037/atm.2019.12.57. PubMed 32042819 ↗
  • Xiang X, Yan F, Yang Y, Tang Y, Wang L, Zeng J, Qiu L. Quantitative Assessment of Healthy Skin Elasticity: Reliability and Feasibility of Shear Wave Elastography. Ultrasound Med Biol. 2017 Feb;43(2):445-452. doi: 10.1016/j.ultrasmedbio.2016.10.002. Epub 2016 Dec 2. PubMed 27919522 ↗
  • Poetschke J, Schwaiger H, Gauglitz GG. Current and Emerging Options for Documenting Scars and Evaluating Therapeutic Progress. Dermatol Surg. 2017 Jan;43 Suppl 1:S25-S36. doi: 10.1097/DSS.0000000000000698. PubMed 27153039 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 13, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06034587
Lead sponsor
Chongqing Medical University
Responsible party
Wang Zhigang (chief physician, Chongqing Medical University) — Principal investigator
First posted
Sep 13, 2023
Start date
Jul 21, 2021
Primary completion
Aug 30, 2023
Completion
Aug 30, 2023
Last update
Sep 13, 2023

Study contacts

Wang Zhigang
study chair · Chongqing Medical University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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