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Prostatakarzinom

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Weiterbildung Radiologie

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Zusammenfassung

Für viele klinische Fragestellungen zum Prostatakarzinom wird die Magnetresonanztomographie (MRT) der Prostata immer wichtiger. Die hohe morphologische Auflösung von T2w-Se- quenzen ist im Vergleich zu anderen Bildgebungsmodalitäten unübertroffen und ermöglicht neben Detektion und Lokalisation des Prostatakarzinoms auch die Beurteilung eines kapselüberschreitenden Wachstums. Die funktionellen MRT-Methoden wie DWI, DCE-MRI und 1H-MRS erhöhen insbesondere die Spezifität und in geringerem Maße auch die Sensitivität der Diagnostik. Gemäß der interdisziplinären S3-Leitlinie wird die MRT der Prostata bei Patienten mit mindestens einmaliger negativer Biopsie zur Detektion des Karzinoms empfohlen. Demnach sollten karzinomsuspekte Areale zusätzlich zur systematischen Biopsie auch gezielt biopsiert werden. Für die Befundübermittlung der suspekten Areale hat sich das Vorgehen entsprechend der PI-RADS-Klassifikation bewährt. Lokalisation und Staging des Prostatakarzinoms gelingen bildgebend mit Hilfe der MRT am genauesten und werden in der S3- Leitlinie insbesondere für Tumoren im klinischen Stadium cT3/4 oder einem Gleason-Score von 8 oder mehr empfohlen. Zusätzlich zu den erwähnten Anwendungen wird die MRT momentan hauptsächlich unter Studienbedingungen ebenfalls für die Rezidivdiagnostik und die aktive Überwachung eingesetzt.

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Authors and Affiliations

  1. Institut für Diagnostische und Interventionelle Radiologie II, Universitätsklinikum Jena, Jena

    T. Franiel, N. Eckardt & M. Waginger

  2. Klinik für Urologie, Universitätsklinikum Jena, Jena

    M. Horstmann

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  1. T. Franiel
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  2. N. Eckardt
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  3. M. Waginger
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  4. M. Horstmann
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Editors and Affiliations

  1. Institut für Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg

    Stefan Delorme

  2. Zentralinstitut für Bildgebende Diagnostik, Karlsruhe

    Peter Reimer

  3. Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Homburg

    Wolfgang Reith

  4. KW Hilversum, The Netherlands

    Cornelia Schäfer-Prokop

  5. Klinik für Radiodiagnostik, AKH, Wien

    Claudia Schüller-Weidekamm

  6. Kinderklinik, Universitätsklinikum Freiburg, Freiburg

    Markus Uhl

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Franiel, T., Eckardt, N., Waginger, M., Horstmann, M. (2015). Prostatakarzinom. In: Delorme, S., Reimer, P., Reith, W., Schäfer-Prokop, C., Schüller-Weidekamm, C., Uhl, M. (eds) Weiterbildung Radiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46785-5_11

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