ERN RARE-LIVER Webinar Series 14.10.2025: Alveolar Echinococcosis - New imaging modalities and new approaches in interventional therapy

Please use this link:https://uke-de.zoom-x.de/j/69579148158?pwd=Nbytzklfl6XDrGxdbfd0r409kJ9ZNO.1 

Speakers: 

Lars Husmann, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland 

Reto Bale, Interventional Oncology-Stereotaxy and Robotics (SIP), Radiology Department, Medical University Innsbruck, Austria

Chairs:

Anja Lachenmayer, Department of Visceral Surgery and Medicine, University Hospital Bern, Switzerland 

Beate Grüner, Department for Internal Medicine, University of Ulm, Germany

Agenda:

Alveolar echinococcosis (AE) is a rare and chronic parasitic disease caused by the larval form (metacestode) of Echinococcus multilocularis. In most cases, AE is detected in the liver as a slow-growing tumour-like lesion, which may cause local complications, such as obstruction of bile ducts, liver vessels and portal vein. The prognosis of untreated alveolar echinococcosis is poor; however, the life expectancy with adequate treatment is nowadays almost normal. With complete surgical resection of the parasitic lesion followed by two years of benzimidazole therapy, a definitive cure of AE may be achieved. However, many patients present initially with advanced disease, considered inoperable. In these patients, conservative treatment with lifelong continuous administration of benzimidazole is necessary. Notably, newly introduced interventional therapy (i.e., thermal ablation) for inoperable manifestations of AE have shown promising results in initial case series, and may impact patient treatment plans for patients with inoperable AE in the future. 

Imaging with contrast-enhanced CT, MRI, ultrasound and/or PET/CT is essential for staging, treatment planning, detection of complications (i.e., bile duct obstruction, cholangitis), for therapy control, and for identifying patients eligible for benzimidazole discontinuation in inoperable AE. However, it remains unclear, which imaging modality offers the most accurate clinical information, and weather quantitative imaging parameters may be useful in therapy control or in prediction of patient outcome in patients with AE. 

• Which imaging modality should be considered in staging, treatment planning, detection of complications, and therapy control of AE.
• May new imaging techniques, such as whole-body dynamic (Patlak parametric) PET/CT imaging, enhance sensitivity and accuracy in the assessment and reassessment of AE.
• Which imaging modality may be used to evaluate the course of the disease and potentially predict the duration of benzimidazole therapy.
• May patients with inoperable AE benefit from interventional therapies.

Short bios:

Lars Husmann is a board-certified radiologist and nuclear medicine physician, with special interest in PET/CT imaging, working at the University Hospital Zurich. His research focus is imaging of infection with particular interest in vascular graft infections and alveolar echinococcosis.

Reto Bale is a Professor of Radiology, Deputy Director of the Institute of Radiology, and Head of the Section of Interventional Oncology / Stereotaxy and Robotics at MUI. With a research focus on percutaneous ablation, image fusion, stereotaxy and robotics, he has published more than 140 scientific papers (h-index 53) and is involved in many international consensus papers on local liver tumor treatment. 

Anja Lachenmayer is a liver surgeon at the Department of Visceral Surgery and Medicine at the Bern University Hospital with a strong clinical and research focus on alveolar echinococcosis. She regularly treats patients with this rare parasitic liver disease, has led several related research projects, and initiated the Alveolar Echinococcosis Working Group within the ERN Rare Liver network. In addition, she has longstanding expertise in liver cancer and minimally invasive local therapies, having contributed to multiple clinical and translational studies in the field.

Beate Grüner is an internist and infectious disease specialist at University Hospital of Ulm. She has been involved in the clinical care of patients with echinococcosis since January 2000. Now she is responsible for the patient cohort with alveolar echinococcosis (AE) at Ulm University Hospital which now comprises more than 800 patients. Prof. Grüner is a senior physician at the Department of Internal Medicine III and heads the Infectious Diseases Division.  Under her leadership, the weekly Infectious Diseases Board meets to present echinococcosis patients from across the region and discuss them in an interdisciplinary setting. In addition to the management of AE, her clinical and scientific focus areas include infections in immunocompromised patients, including HIV/AIDS, complex tuberculosis, fungal infections, and differential diagnosis of focal liver lesions.