Kontrastmittel-Sonographie der Leber in der Onkologie – Primäre Methode zum Staging und zur Verlaufskontrolle

Die Qualität der diagnostischen und interventionellen Sonographie der Leber wird für onkologische Patienten durch den Einsatz von Ultraschallkontrastmitteln erheblich gesteigert. Die Diagnose von Leberherden, der Nachweis von Lebermetastasen und die Präzision von ultraschallgezielten Interventionen (Punktion, Radiofrequenzablation) werden deutlich verbessert. Die Kontrastmittel-Sonographie ist die primäre Methode zum Staging und zur Verlaufskontrolle für überwiegend hepatisch metastasierende Malignome (z.B. gastrointestinale Tumore). Ohne Kontrastmittelsonographie ist der sonographische Ausschluß von Lebermetastasen bei differentialtherapeutischer Konsequenz nicht mehr vertretbar (z. B. kolorektale Lebermetastasen). Die notwendige Ausbildung und Qualität der Untersucher wird durch das Mehrstufenmodell der DEGUM (Deutsche Gesellschaft für Ultraschall in der Medizin) gewährleistet.

In patients with known cancer, the correct detection and characterization of focal liver lesions has important therapeutic consequences. Conventional ultrasonography (US) is the most frequently used modality for liver imaging in cancer patients. However, US has limited accuracy for the diagnosis of liver tumors and/or liver staging. Therefore, contrast-enhanced computed tomography (CT) and/or magnetic resonance (MR) imaging are often used in cancer patients. The introduction of contrast-enhanced US (CEUS) has dramatically improved the ability of US to characterize focal liver lesions and/or to detect liver metastases, with comparable accuracy to that of contrast-enhanced CT and/or MR imaging. CEUS is easy to use, poses no risk of nephrotoxicity and/or ionizing radiation, reduces patients anxiety from unclear US diagnoses, and reduces the need for further CT and/or MR imaging.

In view of the oncologist, CEUS represents an important step forward in the management and care of cancer patients. CEUS particularly improves the staging and follow-up of cancer patients for whom the liver is the dominant site of metastases, such as gastrointestinal tumors, and patients with known or suspected hepatocellular carcinomas.

Key words

contrast-enhanced ultrasound (CEUS) - liver tumor - focal liver lesion - liver metastases - tumor characterization

• Literatur

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