Kombinierte Positronen-Emissions-Tomographie/Computertomographie (PET/CT) für die klinische Onkologie: Technische Grundlagen und Akquisitionsprotokolle

Zusammenfassung

Die kombinierte PET/CT ist eine nicht-invasive bildgebende Methode zur Darstellung anatomischer und molekularer Zusammenhänge durch eine quasi-simultane Untersuchung. Seit der Einführung des PET/CT-Prototypen im Jahr 1998 hat sich die Technologie dieser Bildgebung rasant entwickelt. Die Einführung schneller PET-Detektormaterialien in die PET/CT-Tomographie sowie die Nutzung des CT zur Schwächungskorrektur erlauben onkologische Ganzkörperuntersuchungen in weniger als 30 min. PET/CT bringt auch einen logistischen Vorteil sowohl für den Partienten als auch für den Kliniker, da beide Untersuchungen - soweit klinisch indiziert - quasi-simultan akquiriert werden können und nur ein einziger, integrierter Befund entsteht. Trotzdem gibt es eine Reihe von möglichen methodischen Fehlerquellen, vorrangig durch die CT-basierte Schwächungskorrektur, die jedoch verstanden sind und durch optimierte Akquisitionsprotokolle adressiert werden können. Mittlerweile ist das PET/CT als Bestandteil der diagnostischen Bildgebung etabliert und führt in vielen Fällen zu einer engen Zusammenarbeit der verschiedenen, aber komplementären diagnostischen und therapeutischen Disziplinen der Medizin.

Abstract

Combined PET/CT imaging is a non-invasive means of reviewing both, the anatomy and the molecular pathways of a patient during a quasi-simultaneous examination. Since the introduction of the prototype PET/CT in 1998 a rapid development of this imaging technology is being witnessed. The incorporation of fast PET detector technology into PET/CT designs and the routine use of the CT transmission images for attenuation correction of the PET allow for anato-metabolic whole-body examinations to be completed in less than 30 min. Thus, PET/CT imaging offers a logistical advantage to both, the patient and the clinicians since the two complementary exams - whenever clinically indicated - can be performed almost at the same time and a single integrated report can be created. Nevertheless, a number of pitfalls, primarily from the use of CT-based attenuation correction, have been identified and are being addressed through optimized acquisiton protocols. It is fair to say, that PET/CT has been integrated in the diagnostic imaging arena, and in many cases has led to a close collaboration between different, yet complementary diagnostic and therapeutic medical disciplines.

PET/CT - Onkologie - Diagnostik - Protokolle

PET/CT - oncology - diagnostics - protocols

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