Proposal of a computed tomography classification for hepatic alveolar echinococcosis

Graeter, Tilmann; Kratzer, Wolfgang; Oeztuerk, Suemeyra; Haenle, Mark Martin; Mason, Richard; Hillenbrand, Andreas; Kull, Thomas; Barth, Thomas F.E.; Kern, Peter; Gruener, Beate

doi:10.3748/wjg.v22.i13.3621

Cited by 61 publications

(91 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, no integrative typing system has been established so far, and they were asymmetric when de ning clinical stage or lesion activity regarding different lesion types. Besides, among the lesion types that proposed by Kodama et al, Kratzer et al and Graeter et al, there were not clear integrative bridge to de nitely link them, and no relevant study which used all these imaging tools in same patient cohort has been reported [18][19][20]. And this was why we chose to reclassify lesions based on two factors (calci cation and necrosis).…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Aini

Yimingjiang

Yasen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Alveolar echinococcosis (AE) lesion microenvironment (LME) is crucial site where parasite-host interactions happen and of great significance during surgery and obtaining liver samples for basic research targeting immunology. However, little is known about quantification of LME range and its’ metabolic activity regarding different lesion types.Methods: A prospective analysis of LME from consecutive surgical AE cases with relevant imaging results was performed. Patients (n=39) received abdominal computed tomography (CT) and position emission tomography/computed tomography using 18F-fluodeoxyglucose (18F-FDG-PET/CT) within one week prior to surgery. Tumor to background ratios (TBRs) of standard uptake value (SUV) in PET/CT was calculated for corresponding LME regions. Multi-site sampling method (MSS, n=26) was introduced to obtain histological slides from LME at different levels off the lesion to evaluate immune cell infiltrative ranges quantitatively. At last, data was statistically analyzed from the perspective of different lesion types.Results: Altogether six major lesion categories have been identified based on different morphology and calcification pattern (A: non-calcified uniform density lesion; B: diffuse calcified solid lesion; C: half necrotic and half solid lesion with minor calcification; D: half necrotic and half solid lesion with obvious calcification; E: subtotal necrotic lesion with minor calcification; F: total necrotic lesion with obvious calcification). Statistical significances were resulted from TBRs calculation (A>B, A>D, A>F, B<C, B<E, A+C+E>B+D+F, etc.). Less calcified lesions were evidenced with higher TBRs, however, not much was valuable for necrosis. The 95% CI of LME ranges were (10.0, 12.1) mm and (9.9, 14.0) mm by PET/CT and MSS. And, weak regressions between TBRs and LME ranges indicated by PET/CT or MSS (r2 respectively were 0.2436 and 0.3171) were observed.Conclusions: PET/CT showed distinct TBRs for different lesion types with heterogenic calcification. PET/CT and MSS had similar discoverability for LME ranges, which also varied among different lesion types. Higher activity meant wider LME range within certain limit. This pioneering study would be able to provide references for both surgical removal of lesions and sample acquisitions more accurately for basic research targeted to immunology.

show abstract

Section: Discussionmentioning

confidence: 98%

“…In the past, several imaging tools demonstrated lesion types for hepatic AE [18][19][20]. And there were some other imaging methods and researches on comparison of different imaging tools [21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Aini

Yimingjiang

Yasen

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…And there were some other imaging methods and researches on comparison of different imaging tools [21][22][23][24][25]. These no relevant study which used all these imaging tools in same patient cohort has been reported [18][19][20]. And this was why we chose to reclassify lesions based on two factors (calcification and necrosis).…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Aini

Yimingjiang

Yasen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Alveolar echinococcosis (AE) lesion microenvironment (LME) is crucial site where parasite-host interactions happen and of great significance during surgery and obtaining liver samples for basic research targeting immunology. However, little is known about quantification of LME range and its’ metabolic activity regarding different lesion types. Materials and Methods: A prospective analysis of LME from consecutive surgical AE cases with relevant imaging results was performed. Patients (n=39) received abdominal computed tomography (CT) and position emission tomography/computed tomography using 18F-fluodeoxyglucose (18F-FDG-PET/CT) within one week prior to surgery. Tumor to background ratios (TBRs) of standard uptake value (SUV) in PET/CT was calculated for corresponding LME regions. Multi-site sampling method (MSS, n=26) was introduced to obtain histological slides from LME at different levels off the lesion to evaluate immune cell infiltrative ranges quantitatively. At last, data was statistically analyzed from the perspective of different lesion types. Results: Altogether six major lesion categories have been identified based on different morphology and calcification pattern (A: non-calcified uniform density lesion; B: diffuse calcified solid lesion; C: half necrotic and half solid lesion with minor calcification; D: half necrotic and half solid lesion with obvious calcification; E: subtotal necrotic lesion with minor calcification; F: total necrotic lesion with obvious calcification). Statistical significances were resulted from TBRs calculation (A>B, A>D, A>F, BB+D+F, etc.). Less calcified lesions were evidenced with higher TBRs, however, not much was valuable for necrosis. The 95% CI of LME ranges were (10.0, 12.1) mm and (9.9, 14.0) mm by PET/CT and MSS. And, weak regressions between TBRs and LME ranges indicated by PET/CT or MSS (r2 respectively were 0.2436 and 0.3171) were observed. Conclusions: PET/CT showed distinct TBRs for different lesion types with heterogenic calcification. PET/CT and MSS had similar discoverability for LME ranges, which also varied among different lesion types. Higher activity meant wider LME range within certain limit. This pioneering study would be able to provide references for both surgical removal of lesions and sample acquisitions more accurately for basic research targeted to immunology.

show abstract

“…However, imaging in alveolar echinococcosis has seen major developments in recent years. Recently, a first CT‐based classification (EMUC‐CT; Echinococcosis Multilocularis Ulm Classification ‐ CT) and an ultrasound classification for lesions of alveolar echinococcosis have been published to facilitate comparability, but it remains to be seen whether it is also informative for the clinical course of the disease. Dual‐energy CT may allow to examine the vascularity of hepatic lesions of alveolar echinococcosis and awaits evaluation as a tool to assess the risk of progression .…”

Section: Discussionmentioning

confidence: 99%

FDG‐PET/MRI imaging for the management of alveolar echinococcosis: initial clinical experience at a reference centre in Austria

Lötsch

Waneck

Groger

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

background [ 18 F]-2-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (FDG-PET/CT) imaging provides important information about the size and metabolic activity of lesions caused by Echinococcus multilocularis and is therefore recommended for the initial assessment and follow-up of human alveolar echinococcosis (AE). The introduction of positron emission tomography/magnetic resonance imaging (PET/MRI) into clinical practice in affluent health care systems provides an alternative dual imaging modality, which has not yet been evaluated for AE.objective Here, we describe the initial clinical experience with comparative PET/CT and PET/MR imaging in four human AE patients at an Austrian reference centre.results PET/MR imaging showed comparable diagnostic capacity for liver lesions attributable to E. multilocularis infection, with a discrepancy only in the assessment of calcifications in one patient. Effective doses of radiation were 30.4-31 mSV for PET/CT, which were reduced in PET/MRI to the exposure of 18 F-FDG only (4.9-5.5 mSv).conclusions PET/MRI provides comparable diagnostic information for AE management. The reduction in radiation exposure compared to PET/CT may be of particular importance for children and young patients not amenable for curative surgery requiring repeated long-term follow-up with dual imaging modalities. Further studies are warranted to prospectively evaluate the potential of PET/ MRI in the management of AE.keywords Alveolar echinococcosis, Echinococcus multilocularis, 18F-FDG PET/MRI, 18F-FDG PET/CT Tropical Medicine and International Health

show abstract

Proposal of a computed tomography classification for hepatic alveolar echinococcosis

Cited by 61 publications

References 22 publications

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method

FDG‐PET/MRI imaging for the management of alveolar echinococcosis: initial clinical experience at a reference centre in Austria

Contact Info

Product

Resources

About