Der Pneumologe

, Volume 2, Issue 2, pp 111–117 | Cite as

Diagnostik des Bronchialkarzinoms

Positronen-Emissions-Tomographie (PET)
Leitthema

Zusammenfassung

Die Positronen-Emissions-Tomographie mit 18F-Desoxyglukose (FDG-PET) ist ein nichtinvasives Verfahren zum sog. metabolischen „Imaging“ des Bronchialkarzinoms. Zwischenzeitlich liegen reichlich Daten hinsichtlich der diagnostischen Aussagekraft des FDG-PET bei der Beurteilung pulmonaler Verschattungen unklarer Dignität sowie zur Darstellung des N- und M-Status vor. Eine differenzierte Indikationsstellung ist notwendig. Das integrierte PET/CT kann die diagnostische Wertigkeit weiter steigern.

Schlüsselwörter

Bronchialkarzinom PET Positronen-Emissions-Tomographie Staging Integriertes PET/CT 

Diagnosis of lung cancer

Positron emission tomography (PET)

Abstract

Positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET) represents a noninvasive method for the so-called metabolic imaging of lung cancer. Presently, there are numerous data available with respect to the diagnostic accuracy of FDG-PET for pulmonary nodules or masses of unknown dignity as well as for N and M status. A rational indication is necessary. An integrated PET/CT (dual modality) may further enhance accuracy.

Keywords

Lung cancer PET Positron emission tomography Staging Integrated PET/CT 

Literatur

  1. 1.
    Antoch G, Stattaus J, Nemat AT et al. (2003) Non-small-cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology 229:526–533PubMedGoogle Scholar
  2. 2.
    Cheran SK, Nielsen ND, Patz EF (2004) False-negative findings for primary lung tumors on FDG positron emission tomography: staging and prognostic implications. AJR Am J Roentgenol 182:1129–1132Google Scholar
  3. 3.
    Detterbeck FC, Falen S, Rivera MP et al. (2004) Seeking a Home for a PET, Part 1. Defining the appropriate place for positron emission tomography imaging in the diagnosis of pulmonary nodules or masses. Chest 125:2294–2299CrossRefGoogle Scholar
  4. 4.
    Detterbeck FC, Falen S, Rivera MP et al. (2004) Seeking a Home for a PET, Part 2. Defining the appropriate place for positron emission tomography imaging in the staging of patients with suspected lung cancer. Chest 125:2300–2308CrossRefGoogle Scholar
  5. 5.
    Detterbeck FC, Vansteenkiste JF, Morris DE et al. (2004) Seeking a Home for a PET, Part 3. Defining the appropriate place for positron emission tomography imaging in the management of patients with lung cancer. Chest 126:1656–1666CrossRefGoogle Scholar
  6. 6.
    Dietlein M, Weber WA (2003) Positronen-Emissions-Tomographie (PET) mit 18F-Fluordesoxyglukose in der Stadienzuordnung und Therapieentscheidung des nicht-kleinzelligen Bronchialkarzinoms. Stellenwert der PET und der PET/CT-Koregistrierung. Atemw Lungenkr 29:481–490Google Scholar
  7. 7.
    Dwamena BA, Sonnad SS, Angobaldo JO et al. (1999) Metastases from non-small cell lung cancer: mediastinal staging in the 1990s; meta-analytic comparison of PET and CT. Radiology 213:530–536PubMedGoogle Scholar
  8. 8.
    Franzius C (2004) FDG PET: advantages for staging the mediastinum? Lung Cancer 45 [Suppl.2]:S69–S74Google Scholar
  9. 9.
    Gould M, Maclean C, WG K et al. (2001) Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta analysis. JAMA 285:914–924CrossRefPubMedGoogle Scholar
  10. 10.
    Hellwig D, Ukena D, Paulsen F et al. (2001) Metaanalyse zum Stellenwert der Positronen-Emissions-Tomography mit F-18-Fluorodesoxyglukose (FDG-PET) bei Lungentumoren. Pneumologie 55:367–377PubMedGoogle Scholar
  11. 11.
    Lardinois D, Weder W, Hany TF et al. (2003) Staging of non-small-cell lung cancer with integrated positron-emission-tomography and computed tomography. N Engl J Med 348:2500–2507CrossRefPubMedGoogle Scholar
  12. 12.
    MacManus MP, Hicks RJ, Matthews JP et al. (2001) High rate of detection of unsuspected distant metastases per PET in apparent stage III non-small cell lung cancer: implications for radical radiation therapy. Int J Radiat Oncol Biol Phys 50:287–293CrossRefGoogle Scholar
  13. 13.
    Pastorino L, Bellomi M, Landoni C et al. (2003) Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results. Lancet 362:593–597CrossRefPubMedGoogle Scholar
  14. 14.
    Pieterman R, VanPutten J, Meuzelaar J et al. (2000) Preoperative staging of non-small-cell lung cancer with positron emission tomography. N Engl J Med 343:254–261CrossRefPubMedGoogle Scholar
  15. 15.
    Stroobants S, Verschakelen J, Vansteenkiste J (2003) Value of FDG-PET in the management of non-small cell lung cancer. Eur J Radiol 45:49–59CrossRefGoogle Scholar
  16. 16.
    Toloza E, Harpole L, McCrory D (2003) Noninvasive staging of non-small cell lung cancer. A review of the current evidence. Chest 123:137S–146SCrossRefGoogle Scholar
  17. 17.
    Ukena D, Hellwig D (2004) Value of FDG-PET in the management of NSCLC. Lung Cancer 45 [Suppl.2]:S75–S78Google Scholar
  18. 18.
    Vansteenkiste JF (2002) Imaging in lung cancer: positron emission tomography scan. Eur Respir J 19 [Suppl.35]:49–60Google Scholar
  19. 19.
    Vansteenkiste JF, Stroobants SG (2001) The role of positron emission tomography with 18F-fluoro-2-deoxy-D-glucose in respiratory oncology. Eur Respir J 17:802–820CrossRefGoogle Scholar
  20. 20.
    Vansteenkiste JF, Stroobants SG, Dupont PJ et al. (1998) FDG-PET scan in potentially operable non-small cell lung cancer: do anatometabolic PET-CT fusion images improve the localisation of regional lymph node metastases? Eur J Nucl Med 25:1495–1501CrossRefGoogle Scholar
  21. 21.
    Vansteenkiste J, Fischer BM, Dooms C et al. (2004) Positron-emission tomography in prognostic and therapeutic assessment of lung cancer: systematic review. Lancet Oncol 5:531–540CrossRefGoogle Scholar
  22. 22.
    Van Tinteren H, Hoekstra OS, Smit EF et al. (2002) Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. Lancet 359:1388–1392CrossRefGoogle Scholar
  23. 23.
    Verboom P, van Tinteren H, Hoekstra OS et al. (2003) Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study. Eur J Nucl Med Mol Imaging 30:1444–1449CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  1. 1.Klinik für PneumologieKlinikum Bremen-Ost
  2. 2.Abteilung für NuklearmedizinUniversitätskliniken des SaarlandesHomburg/Saar
  3. 3.Klinik für PneumologieKlinikum Bremen-OstBremen

Personalised recommendations