Inzidenz und Differentialdiagnose unterschiedlicher synchroner Leberraumforderungen bei Erstdiagnose einer malignen Grunderkrankung : Stellenwert von Klinik, Ultraschall, CT, MRT, PET-CT und Histologie

Background: The study aimed to determine the incidence of synchronous liver lesions with newly diagnosed underlying malignant disease. Furthermore, the role of CEUS, CT, MRI, and PET-CT in the evaluation of liver lesions was investigated. Patients and methods: N = 446 patients with synchronous liver lesions and newly diagnosed underlying malignant disease were included in the study. The final diagnosis of the hepatic lesions was used for analysis in the study. The use and results of CEUS, CT, MRI, and PET-CT were compared. Results: Of the n = 446 liver lesions, n = 264 (59,2%) were malignant and n = 182 (40,8%) benign. The malignant lesions were n = 250 metastases (56,1%) and n = 14 primary liver tumours (3,1%). The benign liver lesions were n = 94 cysts (21,1%), n = 55 haemangiomas (12,3%), n = 21 focal fatty sparing (4,7%), n = 4 focal nodular hyperplasia (0,9%), n = 3 unspecified benign lesions (0,7%), n = 2 regenerative nodules (0,4%) and n = 1 adenoma (0,2%). There was no significant difference in the sensitivity to malignancy of a hepatic lesion between the various imaging procedures CEUS, CT, MRI, and PET-CT. In specificity for malignancy, CT is significantly lower than CEUS, all other methods do not differ significantly in specificity. Conclusion: Synchronous liver lesions with newly diagnosed underlying malignant disease are malignant in 59.2% of cases and should always be clarified conclusively due to the high therapeutic relevance of liver metastases. Ultrasound with CEUS, CT, MRT, and PET-CT are almost of equal value in clinical practice for the differentiation and specification of synchronous liver lesions with newly diagnosed underlying malignant disease. Since the detection of liver metastases often leads to palliative treatment in the initial diagnosis of a malignant disease, further findings from CT, MRI, and PET-CT would not be relevant for therapy decisions.