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Der Nuklearmediziner 2012; 35(04): 227-237
DOI: 10.1055/s-0032-1329969
Strahlenexposition bei Hybridbildgebung
© Georg Thieme Verlag KG Stuttgart · New York

Risikobewertung, Rechtfertigung und Optimierung von PET/CT- und PET/MRT-Untersuchungen

Risk Assessment, Justification, and Optimization of PET/CT and PET/MRI Procedures
G. Brix
1   Abteilung für Medizinischen und Beruflichen Strahlenschutz, Bundesamt für Strahlenschutz
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Publication History

Publication Date:
12 December 2012 (online)

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Zusammenfassung

Klinische Studien belegen, dass durch kombinierte PET/CT-Untersuchungen die diagnostische Aussagekraft verglichen mit separat durchgeführten PET- und CT-Untersuchungen verbessert werden kann. Allerdings sind PET/CT-Untersuchungen für Patienten mit einer im Vergleich zu anderen medizinischen Bildgebungsverfahren relativ hohen Strahlenexposition verbunden, so dass sie einer sorgfältigen Rechtfertigung und Optimierung bedürfen, um Wiederholungsuntersuchungen bzw. unnötig hohe Strahlenexpositionen zu vermeiden. Die derzeitige Einführung der hybriden PET/MRT-Technologie in die klinische Routine kann nicht nur zu einer weiteren Verbesserung der bildgebenden Diagnostik führen, sondern insbesondere auch zu einer Reduktion der Patientenexposition. Aber auch beim Einsatz der MRT sind Gesundheitsrisiken für die Patienten sorgfältig zu berücksichtigen. Dieser Übersichtsartikel soll Radiologen und Nuklearmedizinern die notwendigen biophysikalischen und biologischen Grundlagen für die Risikobewertung von PET/CT- und PET/MRT-Untersuchungen vermitteln. Darüber hinaus werden Überlegungen und Strategien zur Rechtfertigung bzw. Optimierung dieser Bildgebungstechniken vorgestellt, die dem Ziel dienen, die diagnostischen Anforderungen mit denjenigen des Patientenschutzes in Einklang zu bringen.

Abstract

Clinical studies demonstrate a gain in diagnostic accuracy by employing combined PET/CT instead of separate CT and PET studies. However, whole-body PET/CT examinations result in a comparatively high radiation exposure to patients as compared to other imaging techniques and thus require a proper justification and optimization to avoid repeated examinations or unnecessary high radiation exposures. The advent of the hybrid PET/MRI technology in clinical practice may not only lead to a further progress in diagnostic imaging but can also substantially reduce exposure of patients to ionizing radiation. But there are also health risks associated with the use of MRI that have to be considered carefully. This review provides for radiologists and nuclear physicians the essential biophysical and biological basics for the assessment of risks associated with PET/CT and PET/MRI procedures. Moreover, considerations and strategies regarding the justification and the optimization of these imaging procedures, respectively, will be presented with the objective of balancing the diagnostic needs and potential health risks.

Schlüsselwörter

PET/CT - PET/MRT - Risikobewertung - Rechtfertigung - Optimierung

Key words

PET/CT - PET/MRI - risk assessment - justification - optimization
 

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