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Bildgebung der Prostata

Imaging diagnostics of the prostate

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Zusammenfassung

Das Prostatakarzinom ist das häufigste Malignom des Mannes mit insgesamt rund 32.000 Neuerkrankungen und 11.000 an dieser Erkrankung verstorbenen Patienten pro Jahr in Deutschland. Zur Früherkennung des Prostatakarzinoms wird überwiegend der PSA-Test eingesetzt, wobei ein generelles Screening derzeit wegen des nicht eindeutig belegten medizinischen und ökonomischen Nutzens nicht empfohlen wird. Unter den bildgebenden Verfahren sind neben der Ultraschalldiagnostik, die derzeit um die Elastographie und das HistoScanning® erweitert worden ist, die Magnetresonanztomographie unter Verwendung der Endorektalspule sowie die Positronenemissionstomographie in Kombination mit der Computertomographie (PET-CT) die Methoden der Wahl. Neben der Differenzierung zwischen einer Prostatitis und einem Prostatakarzinom und der Möglichkeit der Stadieneinteilung eines Malignoms ist mit den bildgebenden Methoden mit unterschiedlicher Sensitivität und Spezifität die Beurteilung der „dominanten intraprostatischen Läsion“ (DIL) möglich, deren Definition für die Anwendung minimal-invasiver Therapieverfahren von hoher Bedeutung ist.

Abstract

Prostate cancer is the most common malignancy of men with approximately 32,000 new cases of prostate cancer in Germany and approximately 11,000 men who would die of the disease each year. For early diagnosis of prostate cancer PSA testing is used, whereas at present screening cannot be recommended due to the lack of confirmed medical and economic benefits. Regarding the imaging modalities, ultrasound of the prostate, currently performed in combination with elastography and histoscanning, magnetic resonance imaging of the prostate in combination with endorectal coils and positron emission tomography combined with computed tomography (PET-CT) are the methods of choice. Using these methods benign prostatitis can be differentiated from prostate cancer and staging of the tumor can be accomplished. On the other hand using these imaging methods it is possible to define the dominant intraprostatic lesion with different sensitivities and specificities, which is important for minimally invasive therapeutic strategies.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Referententätigkeit für Novartis Pharma, Lilly Pharma, Siemens Healthcare, Guerbet AG.

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Authors and Affiliations

  1. Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland

    D.J. Dinter, A.M. Weidner & S.O. Schoenberg

  2. Klinik für Strahlentherapie und Radioonkologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland

    F. Wenz & M.S. Michel

  3. Urologische Klinik, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland

    A.E. Pelzer

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  1. D.J. Dinter
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  2. A.M. Weidner
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  3. F. Wenz
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  4. A.E. Pelzer
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  5. M.S. Michel
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  6. S.O. Schoenberg
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Correspondence to D.J. Dinter.

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Dinter, D., Weidner, A., Wenz, F. et al. Bildgebung der Prostata. Urologe 49, 963–975 (2010). https://doi.org/10.1007/s00120-010-2338-0

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  • DOI: https://doi.org/10.1007/s00120-010-2338-0

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