Skip to main content
SpringerLink
Log in

PET-CT in der Strahlentherapie

PET/CT in radiotherapy

  • PET-CT
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Die gleichzeitige Kombination von Positronenemissionstomographie (PET) und Computertomographie (CT) kann gegenüber der Summe der einzelnen Verfahren die Diagnostik von Tumorerkrankungen verbessern. Darüber hinaus besteht ein hohes Potenzial für den Einsatz in der Strahlentherapie. Neben der Indikationsstellung und der Therapieplanung können metabolische Informationen auch verwendet werden, um den Therapieerfolg frühzeitig zu überprüfen. Klinische Verfahren zur Darstellung therapierelevanter Tumoreigenschaften, wie der Oxygenierung oder des Einsetzens von Apoptose, werden zurzeit entwickelt. Der Einsatz von Hybridgeräten erleichtert und beschleunigt Arbeitsabläufe und bietet die in der Strahlentherapie besonders wichtige hohe Fusionsgenauigkeit. Prospektive Studien sind erforderlich, um nachzuweisen, dass die neue Technologie zu einer Verbesserung von Effizienz und Qualität der Patientenversorgung führt.

Abstract

Combining positron emission tomography (PET) and X-ray computed tomography (CT) with simultaneous acquisition may improve diagnostic accuracy in oncology. Moreover this combination holds considerable promise in radiotherapy. Metabolic information may be used in decision making in radiotherapy and in planning target volumes. Furthermore early evaluation of treatment efficacy becomes possible. New tracers for the assessment of tumour hypoxia or apoptosis in clinical routine are currently being developed. These tracers may yield high relevance in radiotherapy. Hybrid scanners facilitate patient handling and shorten the duration of acquisition. Furthermore fusion accuracy is optimal. Prospective studies have to be conducted to show that the new technology improves patient care in terms of efficiency and quality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2a–e
Abb. 3a–d

Literatur

  1. Allal AS, Dulguerov P, Allaoua M, Haenggeli CA, El-Ghazi el A, Lehmann W, Slosman DO (2002) Standardized uptake value of 2-[(18)F] fluoro-2-deoxy-D-glucose in predicting outcome in head and neck carcinomas treated by radiotherapy with or without chemotherapy. J Clin Oncol 20:1398–1404

    CAS  PubMed  Google Scholar 

  2. Antoch G, Stattaus J, Nemat AT, Marnitz S, Beyer T, Kuehl H, Bockisch A, Debatin JF, Freudenberg LS (2003) Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology 229:526–533

    PubMed  Google Scholar 

  3. Bradley J, Thorstad WL, Mutic S, Miller TR, Dehdashti F, Siegel BA, Bosch W, Bertrand RJ (2004) Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 59:78–86

    PubMed  Google Scholar 

  4. Buck AK, Halter G, Schirrmeister H, Kotzerke J, Wurziger I, Glatting G, Mattfeldt T, Neumaier B, Reske SN, Hetzel M (2003) Imaging proliferation in lung tumors with PET: 18F-FLT versus 18F-FDG. J Nucl Med 44:1426–1431

    CAS  PubMed  Google Scholar 

  5. Ciernik IF, Dizendorf E, Baumert BG, Reiner B, Burger C, Davis JB, Lutolf UM, Steinert HC, von Schulthess GK (2003) Radiation treatment planning with an integrated positron emission and computer tomography (PET/CT): a feasibility study. Int J Radiat Oncol Biol Phys 57:853–863

    Article  PubMed  Google Scholar 

  6. Coleman RE (2002) Value of FDG-PET scanning in management of lung cancer. Lancet 359:1361–1362

    PubMed  Google Scholar 

  7. De Jong IJ, Pruim J, Elsinga PH, Vaalburg W, Mensink HJ (2003) Preoperative staging of pelvic lymph nodes in prostate cancer by 11C-choline PET. J Nucl Med 44:331–335

    PubMed  Google Scholar 

  8. Dehdashti F, Mintun MA, Lewis JS, Bradley J, Govindan R, Laforest R, Welch MJ, Siegel BA (2003) In vivo assessment of tumor hypoxia in lung cancer with 60Cu-ATSM. Eur J Nucl Med Mol Imaging 30:844–850

    CAS  PubMed  Google Scholar 

  9. Eschmann SM, Paulsen F, Reimold M, Machulla HJ, Bares R (2004) Prognostic impact of 18F-misonidazole-PET in non small cell lung cancer and head-and neck-cancer prior to radiotherpay. J Nucl Med 45:83P

    Google Scholar 

  10. Franzius C (2004) FDG PET: advantages for staging the mediastinum? Lung Cancer 45:S69–S74

    Article  PubMed  Google Scholar 

  11. Graeter TP, Hellwig D, Hoffmann K, Ukena D, Kirsch CM, Schafers HJ (2003) Mediastinal lymph node staging in suspected lung cancer: comparison of positron emission tomography with F-18-fluorodeoxyglucose and mediastinoscopy. Ann Thorac Surg 75:231–235

    PubMed  Google Scholar 

  12. Grosu AL, Lachner R, Wiedenmann N, Stark S, Thamm R, Kneschaurek P, Schwaiger M, Molls M, Weber WA (2003) Validation of a method for automatic image fusion (BrainLAB System) of CT data and 11C-methionine-PET data for stereotactic radiotherapy using a LINAC: first clinical experience. Int J Radiat Oncol Biol Phys 56:1450–1463

    Article  PubMed  Google Scholar 

  13. Hellwig D, Ukena D, Paulsen F, Bamberg M, Kirsch CM (2001) Metaanalyse zum Stellenwert der Positronen-Emissions-Tomographie mit F-18-Fluorodesoxyglukose (FDG-PET) bei Lungentumoren. Diskussionsbasis der deutschen Konsensus-Konferenz Onko-PET 2000. Pneumologie 55:367–377

    CAS  PubMed  Google Scholar 

  14. Hollenbeak CS, Lowe VJ, Stack BC jr (2001) The cost-effectiveness of fluorodeoxyglucose 18-F positron emission tomography in the N0 neck. Cancer 92:2341–2348

    CAS  PubMed  Google Scholar 

  15. Hustinx R, Smith RJ, Benard F, Rosenthal DI, Machtay M, Farber LA, Alavi A (1999) Dual time point fluorine-18 fluorodeoxyglucose positron emission tomography: a potential method to differentiate malignancy from inflammation and normal tissue in the head and neck. Eur J Nucl Med 26:1345–1348

    CAS  PubMed  Google Scholar 

  16. Jager PL, Vaalburg W, Pruim J, de Vries EG, Langen KJ, Piers DA (2001) Radiolabeled amino acids: basic aspects and clinical applications in oncology. J Nucl Med 42:432–445

    CAS  PubMed  Google Scholar 

  17. Klabbers BM, Lammertsma AA, Slotman BJ (2003) The value of positron emission tomography for monitoring response to radiotherapy in head and neck cancer. Mol Imaging Biol 5:257–270

    PubMed  Google Scholar 

  18. Lahorte CM, Vanderheyden JL, Steinmetz N, van de Wiele C, Dierckx RA, Slegers G (2004) Apoptosis-detecting radioligands: current state of the art and future perspectives. Eur J Nucl Med Mol Imaging 31:887–919

    CAS  PubMed  Google Scholar 

  19. Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, von Schulthess GK, Steinert HC (2003) Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 348:2500–2507

    Article  PubMed  Google Scholar 

  20. Mac Manus MP, Hicks RJ, Ball DL, Kalff V, Matthews JP, Salminen E, Khaw P, Wirth A, Rischin D, McKenzie A (2001) F-18 fluorodeoxyglucose positron emission tomography staging in radical radiotherapy candidates with nonsmall cell lung carcinoma: powerful correlation with survival and high impact on treatment. Cancer 92:886–895

    PubMed  Google Scholar 

  21. Nestle U, Hellwig D, Schmidt S, Licht N, Walter K, Ukena D, Rübe C, Baumann M, Kirsch CM (2002) 2-Deoxy-2-[18F]fluoro-D-glucose positron emission tomography in target volume definition for radiotherapy of patients with non-small-cell lung cancer. Mol Imaging Biol 4:257–263

    PubMed  Google Scholar 

  22. Nishioka T, Shiga T, Shirato H, Tsukamoto E, Tsuchiya K, Kato T, Ohmori K, Yamazaki A, Aoyama H, Hashimoto S, Chang TC, Miyasaka K (2002) Image fusion between 18FDG-PET and MRI/CT for radiotherapy planning of oropharyngeal and nasopharyngeal carcinomas. Int J Radiat Oncol Biol Phys 53:1051–1057

    PubMed  Google Scholar 

  23. Pöpperl G, Lang S, Dagdelen O, Jager L, Tiling R, Hahn K, Tatsch K. Correlation of FDG-PET and MRI/CT with histopathology in primary diagnosis, lymph node staging and diagnosis of recurrency of head and neck cancer. Röfo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 174:714–720

  24. Rahn AN, Baum RP, Adamietz IA, Adams S, Sengupta S, Mose S, Bormeth SB, Hor G, Bottcher HD (1998) Value of 18F fluorodeoxyglucose positron emission tomography in radiotherapy planning of head-neck tumors. Strahlenther Onkol 174:358–364

    CAS  PubMed  Google Scholar 

  25. Reinartz P, Wieres FJ, Schneider W, Schur A, Buell U (2004) Side-by-side reading of PET and CT scans in oncology: which patients might profit from integrated PET/CT? Eur J Nucl Med Mol Imaging [Epub ahead of print, 10th July 2004]

  26. Reske SN, Kotzerke J (2001) FDG-PET for clinical use. Results of the 3rd German Interdisciplinary Consensus Conference, „Onko-PET III“, 21 July and 19 September 2000. Eur J Nucl Med 28:1707–1723

    Article  CAS  PubMed  Google Scholar 

  27. Schechter NR, Gillenwater AM, Byers RM, Garden AS, Morrison WH, Nguyen LN, Podoloff DA, Ang KK (2001) Can positron emission tomography improve the quality of care for head-and-neck cancer patients? Int J Radiat Oncol Biol Phys 51:4–9

    CAS  PubMed  Google Scholar 

  28. Smith TA (1998) FDG uptake, tumour characteristics and response to therapy: a review. Nucl Med Commun 19:97–105

    CAS  PubMed  Google Scholar 

  29. Stokkel MP, Draisma A, Pauwels EK (2001) Positron emission tomography with 2-[18F]-fluoro-2-deoxy-D-glucose in oncology. Part IIIb: therapy response monitoring in colorectal and lung tumours, head and neck cancer, hepatocellular carcinoma and sarcoma. J Cancer Res Clin Oncol 127:278–285

    Article  CAS  PubMed  Google Scholar 

  30. Terhaard CH, Bongers V, van Rijk PP, Hordijk GJ (2001) F-18-fluoro-deoxy-glucose positron-emission tomography scanning in detection of local recurrence after radiotherapy for laryngeal/ pharyngeal cancer. Head Neck 23:933–941

    CAS  PubMed  Google Scholar 

  31. Toloza EM, Harpole L, Detterbeck F, McCrory DC (2003) Invasive staging of non-small cell lung cancer: a review of the current evidence. Chest 123:157S–166S

    PubMed  Google Scholar 

  32. Van der Hiel B, Pauwels EK, Stokkel MP (2001) Positron emission tomography with 2-[18F]-fluoro-2-deoxy-D-glucose in oncology. Part IIIa: therapy response monitoring in breast cancer, lymphoma and gliomas. J Cancer Res Clin Oncol 127:269–277

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Münster

    M. Weckesser & O. Schober

  2. Klinik und Poliklinik für Strahlentherapie—Radioonkologie, Universitätsklinikum Münster

    S. Könemann, M. Brinkmann & N. Willich

  3. Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum, Albert-Schweitzer-Straße 33, 48129 , Münster

    M. Weckesser

Authors
  1. M. Weckesser
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Könemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Brinkmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Willich
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Schober
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

M. Weckesser und S. Könemann sind gemeinsame Erstautoren.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weckesser, M., Könemann, S., Brinkmann, M. et al. PET-CT in der Strahlentherapie. Radiologe 44, 1096–1104 (2004). https://doi.org/10.1007/s00117-004-1124-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-004-1124-7

Schlüsselwörter

Keywords

Search

Navigation