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Ganzkörper-MRT und PET-CT in der Tumordiagnostik

Whole-body MRI and PET/CT in tumor diagnosis

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Zusammenfassung

Das Tumorstadium nach dem TNM-System beeinflusst die Prognose und das therapeutische Vorgehen bei Patienten mit Tumorerkrankungen. Aufgabe der bildgebenden Diagnostik ist es, die genaue Lokalisation und Ausdehnung des Primärtumors darzustellen und Lymphknoten und Fernmetastasen nachzuweisen oder auszuschließen. Dabei sollte der ganze Körper erfasst werden und das diagnostische Vorgehen eine hohe Sensitivität und Spezifität besitzen. Da diese Voraussetzungen bei den bisher gebräuchlichen Verfahren nicht oder nur teilweise erfüllt werden, müssen bislang mehrere unterschiedliche Modalitäten zum Einsatz gelangen. Nicht zuletzt unter dem Gesichtspunkt der Kosten wäre es wünschenswert, diese Kaskade unterschiedlicher Untersuchungsverfahren durch eine „Ganzkörperuntersuchung“ zu ersetzen, vorausgesetzt, dass damit eine gleich hohe Genauigkeit erreicht wird.

Mit der PET-CT und der Ganzkörper-MRT wurden 2 vielversprechende Methoden für das systemische Tumorstaging entwickelt. Erste Erfahrungen sprechen hierbei für die PET-CT als Methode der 1. Wahl. Durch die Einführung neuer hochauflösender Ganzkörperscanner mit paralleler Bildgebungstechnik (iPAT) und freier Tischbewegung gewinnt die MRT in der Tumordiagnostik jedoch zunehmend an Bedeutung.

Abstract

Tumor staging according to the TNM-system influences prognosis and therapeutical options of patients with a malignant disease. It is the challenge of diagnostic imaging to depict the exact localization of the primary tumor and to detect or rule out lymph node involvement or distant metastases. In doing so, the complete body anatomy should be covered with a modality that offers high sensitivity and specificity. As these requirements could not or only partially be achieved by previous ordinary procedures, the use of multiple different modalities became necessary. Last but not least, in consideration of the costs it would be preferable to replace this cascade of different modalities by a “whole body examination”, preconditioned that the same accuracy is achieved.

With PET/CT and whole-body MRI, two newly available promising methods for a systemic tumor staging have been developed. First experiences indicate PET/CT as a method of first choice. With the introduction of new whole-body MRI scanners using parallel imaging technique (iPAT) and free table movement, MRI plays a more and more important role in whole body tumor staging.

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum Großhadern der Ludwig-Maximilians-Universität München

    G. P. Schmidt & M. F. Reiser

  2. Klinik und Poliklinik für Nuklearmedizin, Klinikum Großhadern der Ludwig-Maximilians-Universität München

    R. Schmid & K. Hahn

  3. Institut für Klinische Radiologie, Klinikum Großhadern der Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377 , München

    G. P. Schmidt

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Correspondence to G. P. Schmidt.

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Schmidt, G.P., Schmid, R., Hahn, K. et al. Ganzkörper-MRT und PET-CT in der Tumordiagnostik. Radiologe 44, 1079–1087 (2004). https://doi.org/10.1007/s00117-004-1128-3

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