FDG-PET bei entzündlichen Erkrankungen der Lunge

Zusammenfassung

Entzündliche Erkrankungen der Lunge sind meistens ein (häufiger) Nebenbefund bei der FDG-PET, die für die Diagnostik von Malignomen ausgeführt wird. Vielfach ergibt sich dadurch ein differenzialdiagnostisches Problem, da die Spezifität der PET nur aufgrund der FDG-Aufnahme eine eindeutige Differenzierung zwischen Metastase/Tumor und entzündlicher Ursache nicht verlässlich ermöglicht. Daher ist die Erkennung bestimmter Muster und die korrekte Interpretation der Verteilung von Läsionen im klinischen Kontext entscheidend für den Beitrag der PET für das klinische Management der Patienten. In dieser Arbeit wird eine Übersicht über die möglichen Ursachen und pathophysiologischen Mechanismen entzündlicher Veränderungen in der Lunge (bakteriell, Pilze, Hefen, Mycobakterien, interstitielle Lungenerkrankungen, Pneumonitis usw.) sowie typische Muster in der PET gegeben, inklusive der Differenzialdiagnosen und Hinweisen zur Bildinterpretation.

Abstract

Inflammatory lung diseases are frequently found on PET scans performed for the work-up of patients with malignancies. In many if not most cases, the ability of PET imaging to differentiate between inflammation and malignancy is limited due to low specificity, which often causes a diagnostic dilemma. Therefore, recognition of uptake patterns as well as distribution of lesions in the clinical context is of crucial importance for the role of PET scans in the clinical management of patients. In this paper, an overview of potential causes and pathophysiological mechanisms of inflammatory lung pathology is provided (bacteria, fungi, yeast, mycobacteria, interstitial lung disease, pneumonitis etc.) together with typical patterns of FDG uptake, including possible differential diagnoses as well as suggestions for image interpretation.

Schlüsselwörter

FDG - PET - COPD - entzündliche ­Lungenerkrankung

Key words

FDG - PET - COPD - inflammatory lung disease

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