Zusammenfassung
Die Magnetresonanztomografie (MRT) stellt inzwischen einen integralen Bestandteil im lokalen prätherapeutischen Staging des Zervixkarzinoms dar. Zahlreiche Veröffentlichungen der vergangenen Jahre haben die Überlegenheit der MRT im lokalen Tumorstaging gezeigt. Sie ist nicht nur die Methode der Wahl zur Therapieentscheidung und Therapieplanung, sondern auch in der Therapiekontrolle unter Strahlentherapie, im Rezidivausschluss in der Nachsorge und bei der Beurteilung tumor- bzw. therapiebedingter Komplikationen. Der Hauptgrund liegt in ihrer überragenden Abbildungsqualität der Bauch- und Beckenorgane infolge des hohen Weichteilkontrasts. In der folgenden Übersicht sollen die diagnostischen Möglichkeiten und Grenzen der MRT und der ergänzenden bildgebenden Modalitäten CT und PET bzw. PET/CT im primären Staging des Zervixkarzinoms unter Berücksichtigung der bisherigen wissenschaftlichen Erkenntnisse erörtert werden. Ebenso wird auf den aktuellen Stand im Lymphknoten-Staging und die Limitationen der bildgebenden Methoden eingegangen.
Abstract
Magnetic resonance imaging (MRI) has evolved into an integral component of the pretherapeutic local staging of cervical cancer. Many recent studies have demonstrated the superiority of MRI for this indication. It is the method of choice for therapeutic decision making and planning, monitoring of the response to radiotherapy, excluding of tumor recurrence, and assessing of patients for tumor or therapy-related complications. The superiority of MRI is mainly due to its high soft-tissue contrast that allows depiction of the abdominal and pelvic organs with excellent image quality. This article provides an overview of the diagnostic potential and limitations of MRI in the primary staging of cervical cancer and supplementary imaging modalities – CT, PET, and PET/CT – on the basis of the current scientific literature. Also included is a discussion of state-of-the-art lymph node staging and the limitations of imaging in lymph node assessment.
Key words
MR imaging - uterus - cervix - PET - PET-CT
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Dr. Uta Lemke
Charité, Institut für Radiologie
Charitéplatz 1
10117 Berlin
Telefon: + + 49/30/4 50 62 73 47
Fax: + + 49/30/4 50 52 79 11
eMail: uta.lemke@charite.de
