Die [F-18]FDG-PET ist bei eine Vielzahl onkologischer Applikationen etabliert. Die Primärdiagnostik des kolorektalen Karzinoms ist die Domäne endoskopischer Verfahren. Doch bereits zu diesem Zeitpunkt ist der Einsatz der [F-18]FDG-PET im Rahmen des Stagings sinnvoll, um das therapeutische Vorgehen in Abhängigkeit vom Stadium der Erkrankung zu planen und so ein sinnvolles Patientenmanagement zu ermöglichen. Insbesondere bei Vorhandensein einer Lebermetastasierung ist heute die [F-18]FDG-PET zur Planung einer Resektion der Läsionen mit möglicherweise kurativem Ansatz unverzichtbar. Umgekehrt können mit der [F-18]FDG-PET in Ganzkörpertechnik extrahepatische Herde mit hoher diagnostischer Sicherheit ausgeschlossen oder nachgewiesen werden, um in letzterem Fall unnötige operative Eingriffe zu vermeiden. Für das Restaging hat sich die [F-18 ]FDG-PET zum Nachweis eines Lokalrezidivs als den morphologischen Verfahren überlegen bewährt.
Abstract
[F-18]FDG PET is an established imaging modality in a wide variety of oncologic diseases. The primary diagnosis is usually performed with endoscopic procedures. However, in the pretherapeutic staging [F-18]FDG PET is helpful to clearly stage the patient's disease in order to plan the best therapeutic approach and allow for a correct patient management. Particulary when metastatic disease to the liver is present, [F-18]FDG PET is indispensable for a proper treatment of planning on curative resection. Also with [F-18]FDG PET extrahepatic lesions can be effectively ruled out or confirmed to avoid unnecessary surgery. For restaging in terms of diagnosing local recurrence [F-18]FDG PET has proven to be superior to morphological methods.
[F-18]FDG PET - colorectal cancer - liver metastasis
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