title: Fortuitously discovered liver lesions.
abstract: The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrast-enhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as image-guided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g., in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible.
authors.forename: Christoph F
authors.initials: CF
authors.lastname: Dietrich
authors.forename: Malay
authors.initials: M
authors.lastname: Sharma
authors.forename: Robert N
authors.initials: RN
authors.lastname: Gibson
authors.forename: Dagmar
authors.initials: D
authors.lastname: Schreiber-Dietrich
authors.forename: Christian
authors.initials: C
authors.lastname: Jenssen
mesh_terms: D058070:Asymptomatic Diseases; D001706:Biopsy; D003952:Diagnostic Imaging / Q000379:methods / Q000592:standards; D055088:Early Detection of Cancer; D006801:Humans; D033162:Incidental Findings; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
keywords: Contrast-enhanced ultrasound; Focal nodular hyperplasia; Guidelines; Hemangioma; Hepatocellular carcinoma; Metastasis; Recommendations; Ultrasonography