Zusammenfassung
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.
Schlüsselwörter
[F-18]FDG-PET - kolorektale Karzinome - Lebermetastasierung
Key words
[F-18]FDG PET - colorectal cancer - liver metastasis
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Priv. Doz. Dr. Stefan Dresel
Klinik und Poliklinik für Nuklearmedizin · Ludwig-Maximilians-Universität München
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