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DOI: 10.1055/s-2008-1004626
© Georg Thieme Verlag Stuttgart · New York
FDG-PET und FDG-PET / CT: Möglicher Stellenwert im Rahmen der Strahlentherapie des Rektumkarzinoms
FDG PET and FDG PET / CT: Its Possible Role in Irradiation Treatment of Colorectal CancerPublikationsverlauf
Publikationsdatum:
28. Februar 2008 (online)
![](https://www.thieme-connect.de/media/nuklmed/200801/lookinside/thumbnails/10.1055-s-2008-1004626-1.jpg)
Zusammenfassung
In dieser Arbeit wird der Stellenwert der FDG-PET und der FDG-PET / CT im Rahmen der Strahlentherapie von Rekumkarzinomen untersucht. Da diese Tumoren bis auf Frühstadien grundsätzlich multimodal behandelt werden, müssen unterschiedliche Aspekte (Staging, Bestrahlungsplanung und Prognoseabschätzung bzw. Patientenstratifizierung) getrennt beurteilt werden. Der Stellenwert der FDG-PET und FDG-PET / CT im primären Tumorstaging ist bislang noch unzureichend definiert. In der Rezidivsituation ist die FDG-PET wegen der Möglichkeit zur Differenzierung zwischen Narbe und Rezidiv der konventionellen Schnittbilddiagnostik überlegen. Im Rahmen der Bestrahlungsplanung kann das FDG-PET / CT wesentlich zur Identifizierung der Tumorausdehnung im Planungs-CT beitragen und bei entsprechender Tumorlokalisation eine Schonung des Analsphinkters ermöglichen. Dennoch ist der generelle Einsatz zur Therapieplanung fraglich, da das Zielvolumens neben dem manifesten Tumor auch Regionen mit Befallsrisiko (Mesorektum und Lymphabfluss) beinhaltet. Erste kleinere Studien zeigen eine gute Korrelation zwischen metabolischem Ansprechen auf die Induktionstherapie und dem onkologischen Ergebnis. Besonders relevant wäre eine frühzeitige Vorhersage über den zu erwartenden Therapieerfolg unter laufender Radiochemotherapie, um die Patienten entsprechend stratifizieren zu können.
Abstract
This paper aims to analyze the role of FDG-PET and FDG-PET / CT in the course of multimodal therapy of rectal cancer (tumor staging, radiotherapy planning and prognosis). The role of FDG-PET or FDG-PET / CT in the staging of rectal cancer has not fully elucidated yet. However, as FDG-PET can distinguish between scars and tumor tissue it is superior to CT or MRI in detecting local recurrence. For radiotherapy planning FDG-PET / CT can localize the tumor extension thus offering important additional information. This may result in sparing of the rectal sphincter. Still, the primary target volume encloses mesorectal tissues and other local lymphatics, thus the value of additional PET / CT information remains limited. First studies revealed a correlation between metabolic response to radiochemotherapy and oncological results. An early prediction of therapeutic response during the course of neoadjuvant radiochemotherapy would be extremely helpful to stratify the patients.
Schlüsselwörter
Rektumkarzinom - PET - PET / CT - FDG - Strahlentherapie
Key words
rectal cancer - PET - PET / CT - FDG - external beam therapy
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Prof. Dr. J. Meller
Nuklearmedizin
Robert-Koch-Str. 40
37075 Göttingen
Telefon: +49 / 5 51 / 39 85 12
Fax: +49 / 5 51 / 39 85 26
eMail: jmeller@med.uni-goettingen.de