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Author Spotlight: Advancing Pathogen Detection and Disease Assessment in Real-Time Using M-ROSE

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Sectional Imaging for Alveolar Echinococcosis.

Nina Eberhardt¹, Benedikt Haggenmüller²

¹Department of Nuclear Medicine, University Hospital Ulm, Ulm, Germany.

Visceral Medicine

|December 11, 2025

Summary

Alveolar echinococcosis (AE) diagnosis and staging are significantly improved by F-18-FDG-PET/CT, which assesses metabolic activity and disease extent. This whole-body imaging is more consistent than MRI for AE staging, especially in specialized centers.

Keywords:

Alveolar echinococcosis Magnetic resonance imaging Positron emission tomography Sectional imaging

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Area of Science:

Radiology
Nuclear Medicine
Parasitology

Background:

Alveolar echinococcosis (AE) is a rare, life-threatening parasitic liver disease caused by *Echinococcus multilocularis*.
Sectional imaging is crucial for AE diagnosis, staging, and treatment planning.
This study evaluated initial imaging findings in suspected AE cases.

Purpose of the Study:

To systematically evaluate initial imaging findings in patients with suspected AE.
To focus on morphological and metabolic imaging features.
To assess their implications for staging and therapeutic decision-making.

Main Methods:

Retrospective analysis of 203 patients with suspected AE from 2019-2023.
Utilized F-18-FDG-PET/CT and/or MRI within 6 months of presentation.
Assessed PET for FDG uptake, classified lesions by Kodama MRI classification, and staged using PNM classification.

Main Results:

PET imaging was performed in 97.5% of cases; MRI in 46.3%.
PET activity was high in Kodama types 2 and 3, absent in type 5.
Imaging-based PNM staging disagreed with clinical staging in 27.6% of cases.

Conclusions:

F-18-FDG-PET/CT is essential for AE diagnosis and staging, assessing extent and activity.
MRI offers morphological detail but has limitations in availability and standardization for staging.
Standardized protocols and PET/CT are vital for managing newly diagnosed AE.