Cysts of the Liver

This research aims to describe the clinical, histological, and radiological features of rare primary liver cancers. It focuses on collecting tumor and blood samples to better understand these cancers and to evaluate how well treatments used in real-world practice work, with the goal of identifying the best treatment sequences. The study serves as a foundation for future research to find new molecular and imaging biomarkers that could improve diagnosis and prognosis. The study is observational and retrospective, meaning it reviews past cases from multiple centers in France. It collects biological samples and clinical data from patients diagnosed with rare primary liver cancers after January 2018. The study evaluates treatments patients have received in clinical practice without assigning any new treatments or interventions. Participants' data, including clinical characteristics, tumor biology, and imaging, will be reviewed for up to five years from diagnosis. Researchers will measure outcomes such as recurrence-free survival for patients without metastases, progression-free survival for those with metastases, and overall survival. The study includes both living patients who consent to participate and deceased patients, aiming to gather comprehensive information to support future translational studies.

Researchers are studying the effect of the hormone-related drug leuprorelin on liver growth in pre-menopausal women with very severe polycystic liver disease. The trial focuses on women whose liver volume continues to grow despite current treatments and who are at risk of needing a liver transplant. This phase 2, randomized, single-blind study is sponsored by the University Medical Center Groningen and aims to assess liver growth over 36 months. Participants are assigned to one of two groups: the direct start group receives leuprorelin injections for 36 months, beginning with monthly doses for the first three months followed by injections every three months; the delayed start group receives standard care for 18 months before starting leuprorelin for the next 18 months. The study monitors multiple health aspects including liver and kidney growth, hormone levels, bone density, and vital signs throughout the treatment period. Women involved in the trial will undergo regular MRI or CT scans, blood tests, and assessments of physical and mental health over three years. Researchers will track liver size changes as the primary outcome, along with symptoms related to liver disease, menopause, depression, and overall health. Safety is monitored by recording any serious adverse events, and participants provide informed consent before joining the study.

Researchers are evaluating a deep learning-based model to predict infections caused by multidrug-resistant Klebsiella pneumoniae in patients with liver abscess, an infection of the abdomen with significant mortality risk. The study aims to improve early detection of resistant bacteria using clinical data and imaging to guide better treatment decisions, addressing challenges due to resistance and prior antibiotic use. Liver abscesses caused by Klebsiella pneumoniae have become more common, especially in China, making this research important for managing infections effectively. This observational study collects clinical features, laboratory results, and CT images from patients with pyogenic liver abscesses confirmed by surgery or interventional procedures. Patients undergo abdominal enhanced CT scans before their treatment. The study compares cases with resistant and non-resistant bacterial infections to develop and evaluate a predictive model for multidrug-resistant infections based on this combined data. During the study, researchers obtain bacterial cultures and drug resistance test results within the first week before any surgical or interventional treatment, up to 4 weeks. They use this information to validate the model's accuracy in identifying resistant bacteria early. Participants contribute their clinical data and imaging to this research without receiving experimental treatment. The study continues until March 2025, aiming to improve infection management through advanced prediction methods.

Researchers are studying the effects of foam sclerotherapy on large kidney or liver cysts in patients with autosomal dominant polycystic kidney disease (ADPKD) and autosomal dominant polycystic liver disease (ADPLD). These cysts can cause discomfort and reduce quality of life, and this observational study aims to understand how foam sclerotherapy influences cyst size and patient-reported quality of life over a 12-month period. The study leverages a patient-reported outcome tool approved by the FDA to measure symptom burden in polycystic liver disease. The study observes patients who undergo foam sclerotherapy using 3% Sodium Tetradecyl Sulfate (Sotradecol®), a treatment currently approved for varicose veins. Patients have 1 to 3 large, non-exophytic cysts causing compressive symptoms, and researchers monitor changes in cyst volume and symptoms. The procedure targets cysts in the liver or kidney, and follow-up visits occur up to 12 months after treatment to assess changes. Participants will be assessed at baseline and then at 1 month, 6 months, and 12 months after treatment. Researchers collect data on pain, quality of life, and health-related quality of life using specialized questionnaires validated for this condition. Organ volumes are measured through imaging to track cyst changes. Patients must comply with follow-up visits, provide informed consent, and the study excludes those who are pregnant or have too many or too small cysts. Overall participation can last over a year to measure the treatment's impact.

Researchers are building a comprehensive registry for Hepato-Renal Fibrocystic Diseases (HRFD), which include rare conditions like Autosomal Recessive Polycystic Kidney Disease (ARPKD) and related disorders such as Joubert syndrome and congenital hepatic fibrosis. The goal is to gather clinical and genetic information and create educational resources to help families, doctors, and genetic counselors better understand these diseases. This observational study is designed to support research progress and community awareness through a shared database and biospecimen resources. Participants may choose to contribute to various parts of the study, including a clinical database, genetic testing, tissue donation, and educational resources. Medical records will be reviewed, with data entered into a secure database after removing personal identifiers. Blood or saliva samples may be collected from patients and their parents for genetic analysis, with samples stored at a specialized biorepository. Tissue samples from procedures like nephrectomy or autopsy may also be collected and stored for research. Participants will provide access to their medical information without needing to visit the study center. Data collection includes past, current, and future medical records, with annual updates for ongoing participation. Genetic and tissue samples will be stored and used to support research. The study team monitors the development of this resource over five years to enhance knowledge and treatment options for HRFD. Participation duration varies depending on continued involvement and consent.

Researchers are evaluating ways to improve surgical treatment outcomes for liver echinococcosis complicated by biliary fistulas. The study aims to optimize diagnostic methods for early detection of biliary fistulas and improve surgical techniques to better eliminate these complications. This research focuses on refining both the diagnosis and treatment approaches to enhance patient recovery and reduce postoperative issues. The study involves conservative surgical treatment for liver echinococcosis where occult biliary fistulas are identified and managed by applying a U-shaped suture followed by medical cyanoacrylate glue between suture stitches on the fibrous capsule near the fistula. This method is being assessed to determine its effectiveness in managing biliary fistulas during surgery. Participants will be monitored for up to three months after surgery. Researchers will measure the incidence of bile leakage, the time it takes for biliary fistulas to close, treatment costs, and patients' quality of life after surgery. Detailed postoperative data including patient condition, discharge characteristics, complications, and hospital stay duration will be collected to evaluate outcomes and recovery progress.

Liver abscess is a serious medical condition that requires prompt treatment using antimicrobials, with or without drainage of the abscess. This trial investigates the comparison between intravenous Beta-lactam antimicrobials plus Metronidazole and oral Cefixime plus Metronidazole for treating uncomplicated liver abscesses. The study aims to clarify the best antimicrobial approach, as current practices lack clear clinical trial evidence, especially regarding the use of intravenous antibiotics upfront. Participants diagnosed with liver abscess through imaging will be randomly assigned to one of two treatment groups. One group receives intravenous Beta-lactam antimicrobials (such as Piperacillin-Tazobactum, Ceftriaxone, Meropenem, or Imipenem-Cilastatin) plus intravenous Metronidazole for two weeks. The other group receives oral Cefixime plus oral Metronidazole for two weeks. Both groups will receive standard care, including drainage or aspiration when indicated, and will be followed for eight weeks. During the study, participants will be monitored for clinical cure, treatment failure, mortality, therapy duration, recurrence, adverse reactions, complications, hospital stay length, and readmissions over an eight-week period. Researchers will assess these outcomes to compare the effectiveness and safety of the two treatment strategies. The study includes regular evaluations and aims to provide evidence to guide antimicrobial use in liver abscess management.

Echinococcosis is a serious parasitic disease caused by tapeworm larvae, leading to alveolar or cystic echinococcosis. Treatment often involves surgery or benzimidazole drugs like albendazole, which slows parasite growth but doesn't kill it, requiring lifelong use and regular monitoring. Diagnosis uses imaging and blood tests, but sensitivity varies, especially in patients with weakened immune systems. Researchers are evaluating a new multiplex quantitative PCR (QPCR-Echino) test to detect DNA from the parasites in blood and tissues, aiming to improve diagnosis and monitoring, particularly in immunocompromised patients who face delays in diagnosis. The study involves collecting blood samples to perform the new QPCR-Echino test at the start and after one year. This test targets DNA from Echinococcus multilocularis and Echinococcus granulosus species found in Europe. The goal is to assess how well this new technique performs compared to current methods for diagnosing echinococcosis. Participants will provide blood samples upon joining the trial and again after one year. Researchers will analyze these samples using the QPCR-Echino method to evaluate diagnostic accuracy and effectiveness over time. The study will measure performance indicators of this diagnostic technique within one year, helping to improve detection and management of echinococcosis. The total participation time includes initial and one-year follow-up blood testing.

Researchers are evaluating, treating, and monitoring patients who have known or suspected parasitic infections, including those with malaria, intestinal worms, GI protozoa, echinococcus, and strongyloides. This prospective observational study aims to understand diagnosis, treatment, and disease progression using standard medical practices without experimental treatments. The study is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID). Participants will be grouped based on the type of parasitic infection they have, such as GI parasites, echinococcus, intestinal worms, malaria, or other parasitic infections. Treatment plans are individualized according to each patient's condition and follow standard medical care. The number and length of clinic visits and diagnostic evaluations vary per patient and are determined by the study doctor. During the study, participants will undergo physical exams, medical history reviews, and routine lab tests including blood, stool, and urine samples. Blood draws will be limited to safe amounts based on age and weight. Additional tests may include x-rays, EKGs, or tissue biopsies if needed. Responses to treatment will be assessed at scheduled visits, with timing and total duration personalized to each patient's medical situation. The main outcome measured is the diagnosis, treatment, and understanding of parasitic infections over a one-year period.

This research focuses on cystic lesions in the anterior mediastinum, such as thymic cysts, bronchogenic cysts, pericardial cysts, cystic thymoma, and cystic teratoma. The study aims to improve the accuracy of diagnosing these cystic lesions by reviewing cases from 2000 to 2022. It is an observational, multicenter trial led by Maastricht University Medical Center to better understand these conditions and their treatment options. The study does not involve any specific intervention or treatment but collects and analyzes patient data, characteristics, complications, and comorbidities related to anterior mediastinal cysts. The research includes patients who have undergone radiological imaging and have approval for follow-up. Data from these patients will be reviewed to assess diagnostic accuracy and clinical outcomes. Participants will be involved through data collection based on their existing medical records and follow-up approvals. Researchers will evaluate diagnostic success rates and associated patient information over the study period. No additional procedures or treatments are administered as part of the study. The study began in December 2022 and will continue until December 2027, aiming to gather extensive clinical data on these cystic lesions.