{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:17:45Z","timestamp":1787818665550,"version":"build-2784847793"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate automated CT-derived spleen volumetry as an opportunistic imaging biomarker for postoperative risk stratification in patients with surgically treated hepatic alveolar echinococcosis (AE) and to compare its prognostic performance with clinical and laboratory parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective single-center cohort study included consecutive patients undergoing curative-intent R0 resection for hepatic AE. Baseline was defined as the immediate postoperative CT. Automated spleen segmentation was performed on baseline and 12-month CT using\n                      <jats:italic>TotalSegmentator<\/jats:italic>\n                      , and relative spleen volume change was calculated. The primary endpoint was imaging-defined disease recurrence within 24 months. Clinical, laboratory, serological (indirect hemagglutination assay [IHA], total IgE), and imaging variables were analyzed using univariate logistic regression; significant predictors entered multivariate analysis. ROC analysis assessed discriminatory performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      62 patients were included; 21 developed recurrence within 24 months. In univariate analysis, 4 features were significant, with relative spleen volume change showing the strongest association with recurrence (OR 1.158; 95% CI 1.082\u20131.239;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In multivariate analysis, only relative spleen volume change remained independently associated with recurrence (OR 1.152; 95% CI 1.056\u20131.255;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Relative spleen volume change showed excellent discrimination (AUC 0.926; 95% CI 0.851\u20130.978); a 24.3% increase yielded sensitivity of 0.81 and specificity of 0.90. Total IgE and IHA titers, including longitudinal changes, were not associated with recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Automated postoperative CT-derived spleen volumetry may provide an objective imaging biomarker for postoperative risk stratification after curative-intent surgery for hepatic AE, independently predicting recurrence, whereas routinely available clinical, serological and laboratory markers showed no significant association in this cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02957-x","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:26:44Z","timestamp":1787815604000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative CT-derived spleen volumetry for recurrence risk stratification after curative-intent surgery for hepatic alveolar echinococcosis"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1817-2598","authenticated-orcid":false,"given":"Lukas","family":"Endr\u00f6s","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Martignoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Br\u00fcckner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Mergen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Spitzl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felianty","family":"Teresa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Nickel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Goetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Martinez","family":"Heinemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Maegerlein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan S.","family":"Kirschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rickmer","family":"Braren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Steinhelfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"issue":"1","key":"2957_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.actatropica.2009.11.001","volume":"114","author":"E Brunetti","year":"2010","unstructured":"Brunetti E, Kern P, Vuitton DA. 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PLoS Negl Trop Dis. 2015;9(9):e0003964. https:\/\/doi.org\/10.1371\/journal.pntd.0003964.","journal-title":"PLoS Negl Trop Dis"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02957-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-026-02957-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-026-02957-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:26:46Z","timestamp":1787815606000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-026-02957-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":40,"alternative-id":["2957"],"URL":"https:\/\/doi.org\/10.1007\/s15010-026-02957-x","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"assertion":[{"value":"6 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Jochen Schneider has received grants, personal fees, and non-financial support from AbbVie, Gilead Sciences, Janssen-Cilag, GSK\/ViiV Healthcare, MSD, Dr. Falk Pharma GmbH, and Diasorin. He has also received support from the Deutsche Forschungsgemeinschaft and the Central Innovation Program for small and medium-sized enterprises, outside the submitted work. Christian Maegerlein has received consulting fees from Eppdata GmbH, Hamburg, Germany, and T\u00dcV S\u00dcD, Munich, Germany; honoraria for lectures, presentations, manuscript writing, or educational events from phenox GmbH, Bochum, Germany; and holds stock or stock options in Penumbra Inc., Alameda, CA, USA. The remaining authors declare that they have no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The institutional ethical review board of the Technical University of Munich approved this retrospective cohort study (reference 87\/18S), which was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for informed consent was waived due to the retrospective study design.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No generative AI or AI-assisted technologies were used in the writing, editing, or preparation of this manuscript.\n                      TotalSegmentator\n                      was used as an AI-based image segmentation tool for automated spleen segmentation on CT images as part of the study methodology. All segmentations were reviewed by the authors and manually corrected when necessary.","order":4,"name":"Ethics","label":"Declaration of generative AI and AI-assisted technologies in the manuscript preparation process","group":{"name":"EthicsHeading","label":"Declarations"}}]}}