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Bildgebende Diagnostik des fortgeschrittenen Prostatakarzinoms

Imaging diagnostics of advanced prostate cancer

Zusammenfassung

Die Diagnostik des Prostatakarzinoms stellt den behandelnden Urologen nach wie vor vor große Herausforderungen. Im Hinblick auf eine individualisierte und risikostratifizierte Evaluation unterschiedlicher Therapieoptionen ist eine exakte Diagnostik jedoch zur bestmöglichen Unterscheidung zwischen lokal begrenztem und fortgeschrittenem Prostatakarzinom unerlässlich. Die Bildgebung des fortgeschrittenen Prostatakarzinoms befindet sich aktuell aufgrund zahlreicher technischer Innovationen im Wandel. Während sich die cholinbasierte Hybrid-Positronenemissionstomographie/Computertomographie (-PET/CT) als neuer diagnostischer Parameter im Rahmen der Bildgebung des fortgeschrittenen Prostatakarzinoms im klinischen Alltag durchgesetzt hat, besitzen etablierte Methoden wie Magnetresonanztomographie (MRT) oder Knochenszintigraphie durch technische Weiterentwicklungen weiterhin großes diagnostisches Potenzial. Der gezielte Einsatz der Bildgebung beim fortgeschrittenen Prostatakarzinom kann helfen, eine auf den Patienten maßgeschneiderte onkologische Therapie anzubieten. Inwiefern hierdurch die Prognose des Patienten verbessert werden kann, ist Stand aktueller Forschung.

Abstract

The diagnostic approach to prostate cancer is still a big challenge for the treating physician. Regarding an individualized and risk-adapted evaluation of different therapeutic options, precise diagnostic tools are crucial to accurately distinguish between localized and advanced prostate cancer. Imaging of advanced prostate cancer is currently changing due to numerous technical innovations. While choline-based hybrid positron emission tomography-computed tomography (PET/CT) has been established as an important diagnostic tool in clinical imaging of advanced prostate cancer, well-investigated methods, such as magnetic resonance imaging (MRI) and bone scintigraphy are currently expanding the diagnostic potential due to technical improvements. The specific use of imaging for advanced prostate cancer may help to offer the patient a well-tailored oncologic therapy. Further research is needed to evaluate whether this individualized therapy can consistently improve the prognosis of patients suffering from advanced prostate cancer.

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Correspondence to A. Kretschmer.

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Kretschmer, A., Seitz, M., Graser, A. et al. Bildgebende Diagnostik des fortgeschrittenen Prostatakarzinoms. Urologe 52, 497–503 (2013). https://doi.org/10.1007/s00120-012-3095-z

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Schlüsselwörter

  • Staging
  • Rezidiv
  • Magnetresonanztomographie
  • Positronenemissionstomographie
  • Knochenszintigraphie

Keywords

  • Staging
  • Recividism
  • Magnetic resonance tomography
  • Positron emission tomography
  • Bone scintigraphy