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Der Nuklearmediziner 2012; 35(03): 161-166
DOI: 10.1055/s-0032-1321823
Diagnostik und Therapie von Skeletterkrankungen – Update 2012
© Georg Thieme Verlag KG Stuttgart · New York

SPECT/CT und Fluorid-PET/CT bei Metastasen des Skelettes und primären malignen Knochentumoren

SPECT/CT and Fluoride-PET/CT in Bone Metastases and Primary Malignant Bone Tumors
K. Strobel
1   Institut für Nuklearmedizin und Röntgendiagnostik, Luzerner Kantonsspital, Luzern, Schweiz
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Publication History

Publication Date:
11 September 2012 (online)

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Zusammenfassung

Die Ergänzung der planaren Szintigrafie durch ein gezieltes SPECT/CT führt in ca. 90% der Fälle von unklaren Anreicherungen zu einer definitiven Diagnose und stellt derzeit die Hauptanwendung der SPECT/CT beim Staging von Malig­nompatienten dar. Die Implementierung eines Mehrfeld-SPECT/CT des Stammskeletts in das Standardprotokoll bei Metastasensuche ist eine alternative Möglichkeit, um die Genauigkeit der Skelettszintigrafie zu verbessern. Die FDG-PET/CT hat die Skelettszintigrafie bei vielen Tumoren, vor allem Bronchuskarzinom, GI-Tumoren und High-risk-Mammakarzinom ersetzt. Besonders beim Prostatakarzinom ist die Fluorid-PET/CT die derzeit genaueste Methode zur Knochenmetastasensuche und auch der SPECT/CT überlegen. Der breitere Einsatz der Fluorid-PET/CT ist derzeit noch durch die limitierte Verfügbarkeit und ungeklärte Kostenerstattungsfrage eingeschränkt.

Abstract

The supplementation of the planar bone scintigraphy with a targeted SPECT/CT leads to a definite diagnosis in approx 90% of unclear uptakes and represents the main application of SPECT/CT in cancer patients. The implementation of multiple field SPECT/CT of the axial skeleton into the standard bone scan protocol is an alternative possibility to increase the accuracy of bone scintigraphy. FDG-PET/CT has replaced conventional bone scintigraphy in many tumors, especially lung, GI cancer and high-risk breast cancer. In prostate cancer fluoride-PET/CT is the most accurate modality for the detection of bone metastases and superior to SPECT/CT. The more frequent use of fluoride-PET/CT is currently limited by the restricted availability and unclear reimbursement.

Schlüsselwörter

SPECT/CT - Skelettszintigrafie - Fluorid-PET/CT - FDG-PET/CT - Kochenmetastasen - Knochentumoren

Key words

SPECT/CT - bone scintigraphy - fluoride-PET/CT - FDG-PET/CT - bone metastases - bone tumor
 

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