Stellenwert der Bildgebung für das Re-Staging von Halslymphknotenmetastasen nach primärer Strahlentherapie − HN-Onkoimage-1

Zusammenfassung

Derzeit existieren für Kopf- und Halskarzinome (HNSCC) keine evidenzbasierten Leitlinien für das Re-Staging oder die Tumornachsorge nach primärer Radio(chemo)therapie. In Deutschland ist die hochauflösende Sonografie mit Verwendung von Farbduplexverfahren neben der Computertomografie (CT) und der Magnetresonanztomografie (MRT) ein bewährtes Verfahren zur Therapiekontrolle (Re-Staging) im Rahmen der Tumornachsorge nach der Primärtherapie von Kopf-Hals-Karzinomen. Die PET/CT gilt seit Kurzem als Standard. Es fehlt an klaren Empfehlungen, wie sich die unterschiedlichen in der Routine angewendeten Verfahren ergänzen. Außerdem fehlt es an validen Selektionsalgorithmen für die Indikation zur PET/CT. Indikationen für und wider eine Salvage Neck Dissection werden häufig als Einzelfallentscheidung getroffen. Dieser Artikel soll die gängigen Re-Staging Modalitäten darstellen und ein aktuelles Studienkonzept kurz erläutern.

Abstract

For head and neck carcinomas (HNSCC), there are currently no evidence-based guidelines for re-staging or tumor follow-up after primary radio (chemo) therapy. In Germany, high-resolution ultrasonography using color duplex techniques in addition to computed tomography (CT) and magnetic resonance imaging (MRI) is a proved procedure for restoring therapy in the context of tumor follow-up after the first-line treatment of head and neck carcinomas. PET/CT has recently become standard. There is a lack of clear guidance on how to complement the different procedures used in routine practice. In addition, there is a lack of valid selection algorithms for the indication for PET/CT. Indications for and against salvage neck dissection are often made as an individual case decision. This article is intended to illustrate the common re-staging modalities and briefly explain a current study concept.

Schlüsselwörter

Re-Staging - Halslymphknotenmetastase - Ultraschall - CT - MRT - PET-CT

Keywords

Re-Staging - Cervical Metastases - Ultrasound - CT - MRI - PET-CT

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