PET und PET/CT - Stellenwert beim Mammakarzinom

Zusammenfassung

Das Mammakarzinom ist der häufigste maligne Tumor der Frau in Deutschland. Trotz steigender Inzidenz ist die Mortalität leicht gesunken, was unter anderem auf Verbesserungen in der Diagnostik und Therapie zurückgeführt wird. Die FDG-PET besitzt insbesondere beim Nachweis von Lymphknoten- und Fernmetastasen eine hohe Treffsicherheit beim Nachweis von Tumorgewebe. Da die Sensitivität der FDG-PET bei kleinen Lymphknotenmetastasen limitiert ist, stellt sie keine Alternative zur axillären Dissektion oder zur Sentinel-Node-Biopsie dar. Beim N-Staging kann die PET relevante Zusatzinformationen liefern, wenn eine Mammaria-interna- oder mediastinale Lymphknotenmetastasierung nachgewiesen werden soll (1 b-Indikation). In Einzelfällen kann die FDG-PET zur Detektion von Fernmetastasen bei fortbestehendem Tumorverdacht trotz negativer konventioneller Bildgebung beitragen (2-Indikation). Die FDG-PET zeigt hervorragende Eigenschaften zum frühen Therapiemonitoring bei präoperativer Chemotherapie, die mit keinem anderen bildgebenden Verfahren möglich sind. Hierzu stehen noch größere Studien aus.

Abstract

Breast cancer is the most frequent malignant tumor of women in Germany. In spite of an increasing incidence mortality has slightly declined most likely due to improvements in diagnosis and therapy of the disease. FDG-PET has a high diagnostic accuracy for the detection of lymph node and distant metastases. However, PET is no alternative to axillary dissection or sentinel node biopsy because sensitivity for small lymph node metastases is limited. For N-staging, FDG-PET delivers valuable information if mammaria-interna or mediastinal lymph node disease has to be proven (1 b-indication). Individually, PET can add important diagnostic information in patients with suspected distant metastases but unsuspicious or equivocal conventional imaging (2-indication). FDG-PET shows unique and favourable properties for early therapy monitoring during preoperative chemotherapy. Larger studies have to confirm these results.

Mammakarzinom - FDG - PET - PET/CT

Breast cancer - F-18 Fluordeoxyglucose - positron emission tomography - PET - integrated PET/CT

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