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Nuklearmedizinische Diagnostik neuroendokriner Tumoren

Nuclear medicine diagnosis of neuroendocrine tumors

  • Leitthema: endokrine Tumoren
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Die Somatostatinrezeptorszintigraphie (SMRS) dient dem spezifischen Nachweis neuroendokriner Tumoren (NET) sowie Rezeptor-positiver Metastasen mit hoher Sensitivität (80–>95%) und ermöglicht eine Ganzkörperdiagnostik in einem Untersuchungsgang. Auch kleine Primärtumoren und Metastasen, die mit CT, MRT und Sonographie nicht oder nur schwer nachweisbar sind, können bei hoher Rezeptorexpression szintigraphisch detektiert werden. Die SMRS sollte bei substanziellem Verdacht auf einen GEP-Tumor oder nach dem immunhistochemischen Nachweis eines NET als primäres diagnostisches Verfahren vor CT und MRT zum Staging eingesetzt werden. Weitere Indikationen sind Verlaufskontrolle nach Operation, Rezidivdiagnostik bei Tumormarkeranstieg, Beurteilung des Ansprechens auf eine Chemotherapie oder biologische Therapie sowie die Differenzialdiagnose NET vs. nicht endokriner Tumor bei Nachweis einer Raumforderung, sofern eine bioptische Klärung nicht möglich ist. Letzlich ist die SMRS für die Indikationsstellung zur Radiorezeptortherapie (Intensität der Rezeptorexpression) sowie zur Verlaufskontrolle von essenzieller Bedeutung.

Abstract

Somatostatin receptor scintigraphy (SMRS) specifically detects neuroendocrine tumors (NET) and receptor-positive metastases with high sensitivity (80 to >95%) and allows whole body diagnosis with one scintigraphic examination. Even small primary tumors and metastases, which are difficult to diagnose with CT, MRI, or sonography, can be detected if the receptor density is high. If there is strong suspicion of a GEP tumor, or if a NET has been proven by immunohistochemistry, SMRS should be the first diagnostic procedure for staging (before CT and MRI). Further indications are follow-up after operation and diagnosis of recurrences in cases of increasing specific tumor markers, evaluation of the therapeutic response after chemotherapy or biotherapy, and differential diagnosis of neuroendocrine tumor vs nonendocrine tumor in cases of a space-occupying mass if a final diagnosis cannot be obtained by biopsy or operation. Finally, there is an essential role for somatostatin receptor scintigraphy in the pretherapeutic evaluation (receptor density) before peptide receptor radiotherapy and in the follow-up after treatment.

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Authors and Affiliations

  1. Klinik für Nuklearmedizin/PET-Zentrum, Zentralklinik Bad Berka GmbH

    R. P. Baum

  2. Medizinische Hochschule Hannover

    M. Hofmann

  3. Klinik für Nuklearmedizin/PET-Zentrum, Zentralklinik Bad Berka GmbH, 99437 , Bad Berka

    R. P. Baum

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  1. R. P. Baum
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  2. M. Hofmann
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Correspondence to R. P. Baum.

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Baum, R.P., Hofmann, M. Nuklearmedizinische Diagnostik neuroendokriner Tumoren. Onkologe 10, 598–610 (2004). https://doi.org/10.1007/s00761-004-0716-1

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  • DOI: https://doi.org/10.1007/s00761-004-0716-1

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