Der Stellenwert der Sonografie in der Hämatologie und Onkologie - Eine retrospektive Studie von Sonografie-Zuweisungen in einem interdisziplinärem Ultraschallzentrum

Problem definition: In everyday clinical practice, the proportion of patients with hematological/oncological questions on sonography seems high. The guidelines for haematological/oncological clinical pictures primarily recommend PET-CT, CT and MRT for diagnostic imaging. The aim of the thesis is an analysis of sonography requirements with haemato-/oncological questions of inpatients and outpatients in a university ultrasound centre over a period of 4 months. Patients, material, method: In the period from January to April 2017, 5019 examinations were performed in the interdisciplinary ultrasound centre. In n=1506 cases (30%) a hemato-oncological problem was present. A retrospective evaluation of requirements and ultrasound findings was performed with regard to the following data: 1. haematological/oncological questions (screening, primary diagnosis, spread diagnosis, response to therapy, follow-up care, current problems); 2. referring physicians (ward, outpatient clinic); 3. examination methodology (B-scan ultrasound (US),, contrast-enhanced sonography (CEUS), US guided interventions); 4. examination (abdomen, thorax, neck, extremities); 5. clinical background (haematology, oncology). Results: Haemato-/oncological questions concerned: screening examinations (n=165; 11%), primary diagnostics (n=508; 34%), propagation diagnostics (n=92; 6%), response to therapy (n=264; 18%), aftercare (n=100; 7%), and current problems (n=377; 25%). The patients examined were outpatients (n=675; 44.8%) or inpatients (n=831; 55.2%). In addition to the B-scan US (100%), the FDS (n=125;8%), CEUS (n=162;11%) and interventions (n=79;5%) were used. Only examinations of the abdomen (n=1033; 69%), the thorax (n=54;4%), the extremities (n=45;3%) and the neck area (n=30;2%) were requested, as well as several compartments (n=344; 23%). The clinical background were haematological (n=339; 22.5%) or oncological (n=1167; 77.5%) clinical pictures/questions. Conclusion: Haemato-oncological questions are frequent in sonography and play an outstanding role in primary tumor diagnostics and acute problems. A high level of sonografic competence (thoracic sonography, CEUS, intervention) is necessary in these patients. Systematic education and training in the field of "haemato-oncological sonography" should be demanded.