SPECT/CT bei differenziertem Schilddrüsenkarzinom

Zusammenfassung

Die szintigrafische Bildgebung der Verteilung von Iodisotopen wird zum Staging von Patienten mit differenziertem Schilddrüsenkarzinom verwendet. Planare Szintigrafien mit einer Gammakamera sowie SPECT visualisieren iodakkumulierende Herde mit hoher Sensitivität. Allerdings ist die diagnostische Genauigkeit dieser Technik aufgrund des weitgehenden Fehlens morphologischer Informationen begrenzt. Diese Limitation lässt sich durch den Einsatz von Hybridsystemen bei denen eine SPECT Kamera und ein CT Scanner integriert sind umgehen. Aktuelle Studien haben gezeigt, dass ungefähr ein Drittel der Patienten mit einem diagnostisch unklaren Radioiod anreichernden Fokus vom Einsatz der SPECT/CT profitieren, auch im Bezug auf das therapeutische Management. Daher entwickelt sich die SPECT/CT zu einem neuen klinischen Verfahren bei differenziertem Schilddrüsenkarzinom.

Abstract

Scintigraphic imaging of the distribution of isotopes of radioiodine is frequently performed for staging patients with differentiated thyroid carcinoma. Planar gamma-camera imaging, as well as SPECT, visualize foci of radioiodine accumulation with high sensitivity. However, owing to only poor visualization of the morphology by these techniques, their diagnostic accuracy is limited. This limitation is overcome when hybrid systems integrating a SPECT camera with a x-ray CT scanner are used. Recent evidence has demonstrated that approximately a third of patients with diagnostically unclear foci of radioiodine accumulation will benefit from the use of SPECT/CT, also in terms of therapeutic management. Therefore, SPECT/CT is rapidly evolving as a new clinical tool in differentiated thyroid carcinoma.

Schlüsselwörter

SPECT/CT - Hybridbildgebung - Schilddrüsenkarzinom - Radioiod

Key words

SPECT/CT - hybrid imaging - thyroid carcinoma - radioiodine

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