PET und PET/CT - Stellenwert beim Lungenkarzinom

Zusammenfassung

Das präoperative Staging beim Lungenkarzinom ist entscheidend für die Prognose und die Therapieentscheidung. Ziel dieser Übersicht ist die Darstellung der FDG-PET und der CT als synergistische Verfahren. Zur Planung der Operation und der Strahlentherapie ist die präzise Definition der Tumorausdehnung erforderlich. Durch die integrierte PET/CT können die Tumorinfiltration in die Umgebung und kleinste Metastasen exakt lokalisiert werden. In der Übersicht werden die Anwendungen der PET und PET/CT beim nicht-kleinzelligen Bronchuskarziom, beim kleinzelligen Bronchuskarziom und beim malignen Pleuramesotheliom vorgestellt.

Abstract

Preoperative staging of lung cancer is essential for prognosis and management. The aim of this overview is to present the synergistic effects of FDG-PET and CT. For planning surgery and planning radiation treatment the precise definition of the tumor extend is essential. Integrated PET/CT scanning enables the exact localization of tumor infiltration into surrounding tissue and of small metastases. In this overwiew the applications of PET and PET/CT in non-small-cell lung cancer, small-cell lung cancer and malignant pleural mesothelioma are presented.

Schlüsselwörter

Lungenkarzinom - PET - PET/CT - Bildfusion - FDG

Key words

Lung cancer - PET - PET/CT - image fusion - FDG

Literatur

• 1 Antoch G, Jentzen W, Freudenberg L S. et al . Non-small cell lung cancer: dual modality PET/CT in preoperative staging.  Radiology. 2003;  229 784-789
• 2 Ciernik I F, Dizendorf E, Baumert B. et al . Radiation treatment planning with an integrated positron emission and computer tomography (PET/CT: a feasibility study.  Int J Radiat Oncol Biol Phys. 2003;  57 853-863
• 3 Chin B B, Wahl R. ¹⁸F-Fluoro-2-deoxyglucose positron emission tomography in the evaluation of gastrointestinal malignancies.  Gut. 2003;  52 23-29
• 4 Dwamena B A, Sonnad S S, Angobaldo J O, Wahl R L. Metastases from non-small cell lung cancer: mediastinal staging in the 1990s - meta-analytic comparison of PET and CT.  Radiology. 1999;  213 530-536
• 5 Erasmus J J, Patz E F, Mc Adams H P. et al . Evaluation of adrenal masses in patients with bronchogenic carcinoma using ¹⁸F-fluorodeoxyglucose positron emission tomography.  AJR. 1997;  168 1357-1362
• 6 Gupta N C, Maloof J, Gunel E. Probability of malignancy in solitary pulmonary nodules using flurine-18-FDF and PET.  J Nucl Med. 1996;  37 943-948
• 7 Hany T F, Steinert H C, Goerres G W, Buck A, von Schulthess G K. Improvement of diagnostic accuracy of PET imaging using a high performance in-line PET-CT system: preliminary results.  Radiology. 2002;  225 575-581
• 8 Hellwig D, Ukena D, Paulsen F, Bamberg M, Kirsch C M. Metaanalyse zum Stellenwert der Positronen-Emissions-Tomographie mit F-18-Fluorodesoxyglukose (FDG-PET) bei Lungentumoren.  Pneumologie. 2001;  55 367-377
• 9 Kamel E, Goerres G W, Burger C, von Schulthess G K, Steinert H C. Detection of recurrent laryngeal nerve palsy in patients with lung cancer using PET-CT image fusion.  Radiology. 2002;  224 153-156
• 10 Kamel E, Zwahlen D, Wyss M T, Stumpe K DM, von Schulthess G K, Steinert H C. Whole-body ¹⁸F-FDG PET improves the management of patients with small-cell lung cancer.  J Nucl Med. 2003;  44 1911-1917
• 11 Kernstine K H, McLaughlin K A, Menda Y. et al . Can-FDG PET reduce the need for mediastinoscopy in potentially resectable nonsmall cell lung cancer?.  Ann Thorac Surg. 2002;  73 394-402
• 12 Lardinois D, Weder W, Hany T F. et al . Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography.  N Engl J Med. 2003;  348 2500-2507
• 13 Nestle U, Walter K, Schmidt S. et al . ¹⁸F-deoxyglucose positron emission tomography (FDG-PET) for the planning of radiotherapy in lung cancer: High impact in patients with atelectasis.  Int J Radiat Oncol Biol Phys. 1999;  44 593-597
• 14 Marom E M, McAdams H P, Erasmus J J. Staging non-small cell lung cancer with whole-body PET.  Radiology. 1999;  212 803-809
• 15 Mountain C F. The International System for Staging Lung Cancer.  Semin Surg Oncol. 2000;  18 106-115
• 16 Pieterman R M, van Putten J WG, Meuzelaar J J. et al . Preoperative staging of non-small-cell lung cancer with positron-emission tomography.  N Engl J Med. 2000;  343 254-261
• 17 Santos Dellea M M, Burger C, Hany T. et al . Response evaluation in malignant pleural mesothelioma (MPM) with FDG-PET/CT.  Eur J Nucl Med Mol Imag. 2004;  31 408
• 18 Schneider D B, Clary-Macy C, Challa S. et al . Positron emission tomography with F18-fluorodeoxyglucose in the staging and preoperative evaluation of malignant pleural MPM.  J Thorac Cardiovasc Surg. 2000;  120 128-133
• 19 Steinert H C, Hauser M, Allemann F. et al . Non-small cell lung cancer: nodal staging with FDG PET versus CT with correlative lymph node mapping and sampling.  Radiology. 1997;  202 441-446
• 20 Steinert H C, Goerres G, Roudas M, Weder W, Lardinois D. Detection of a new solitary lesion by whole-body FDG PET-CT in patients with lung cancer: frequency and pathologic correlation.  J Nucl Med. 2004;  45 P376
• 21 Strauss L G. Fluorine-18-deoxyglucose and false-positive results: a major problem in the diagnosis of oncological patients.  Eur J Nucl Med. 1996;  23 1409-1414
• 22 Vansteenkiste J F, Stroobants S G, De Leyn P R. et al . Lymph node staging in non-small cell lung cancer with FDG PET scan: a prospective study on 690 lymph node stations from 68 patients.  J Clin Oncol. 1998;  16 2142-2149
• 23 Van Tinteren H, Hoekstra O, van den Bergh J HAM. et al . Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial.  Lancet. 2002;  359 1388-1392
• 24 Weder W, Schmid R, Bruchhaus H, Hillinger S, von Schulthess G K, Steinert H C. Detection of extrathoracic metastases by positron emission tomography in lung cancer.  Ann Thorac Surg. 1998;  66 886-893
• 25 Weyant M J, Flores R M. Imaging of pleural and chest wall tumors.  Thorac Surg Clin. 2004;  14 15-23
• 26 Zhuang H, Hickeson M, Chacko T K. et al . Incidental detection of colon cancer by FDG positron emission tomography in patients examined for pulmonary nodules.  Clin Nucl Med. 2002;  27 628-632