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PET-CT bei kolorektalen und Lebertumoren

PET/CT for colorectal and hepatic tumors

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Zusammenfassung

Es werden klinische und technische Aspekte von PET und CT beim kombinierten Einsatz der PET-CT bei Patienten mit kolorektalen Tumoren sowie zur Charakterisierung unklarer Leberherde und die Frage diskutiert, in welcher Weise und bei welchen Patienten die kombinierte PET-CT der CT oder PET als Einzeltechnik überlegen ist. PET-CT kann die meisten Erfordernisse an die Bildgebung im prä- und postoperativen Management von Patienten mit kolorektalen Tumoren erfüllen und kommt dem Wunsch nach einer optimalen Bildgebung am nächsten. Einige Nachteile der häufig eingesetzten CT werden durch die Kombination mit FDG-PET überwunden und sowohl die Sensitivität bei der Detektion von Läsionen als auch die Spezifität bei deren Charakterisierung erhöht. Die Frage des Therapieansprechens bietet Raum für neue Studienkonzepte und die Erforschung neuer PET-Tracer. Trotz weniger Publikationen meinen wir, dass die durch den Einsatz der PET-CT ermöglichte Kombination funktioneller und anatomischer Bildinformation das Management präoperativ als auch in der Nachsorge verbessern kann. Eine optimale Zusammenarbeit zwischen Nuklearmedizinern und Radiologen ist hierfür allerdings zwingend erforderlich.

Abstract

This contribution presents clinical and technical aspects of combining positron emission tomography (PET) and computed tomography (CT) for patients with colorectal tumors and characterization of unclear liver foci. In which manner and for which patients combined PET/CT is superior to PET or CT alone is also discussed. PET/CT can fulfil most prerequisites for imaging in pre- and postoperative management of patients with colorectal tumors and best meets the desire for optimal imaging procedures. Some of the disadvantages encountered in frequently employed CT can be overcome by the combination of PET and CT while increasing both sensitivity in detecting lesions and specificity in their characterization. Questions regarding treatment response offer an opportunity for devising novel study concepts and initiating research on new PET tracers. Although few publications are available, we are of the opinion that the combination of functional and anatomical imaging provided by PET/CT can improve both preoperative management and aftercare. To this end, however, optimum cooperation between practitioners of nuclear medicine and radiology is imperative.

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  1. Institut für Röntgendiagnostik, Klinikum rechts der Isar der TU München

    J. Stollfuss & E. Rummeny

  2. Klinik und Poliklinik für Nuklearmedizin, Klinikum rechts der Isar der TU München

    H. Wieder & M. Schwaiger

  3. Institut für Röntgendiagnostik, Klinikum rechts der Isar der TU, Ismaningerstraße 22, 81675 , München

    J. Stollfuss

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Stollfuss, J., Wieder, H., Rummeny, E. et al. PET-CT bei kolorektalen und Lebertumoren. Radiologe 44, 1068–1078 (2004). https://doi.org/10.1007/s00117-004-1123-8

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