Die Positronen-Emissions-Tomographie in der Diagnostik von Mammatumoren

Zusammenfassung

Die Positronen-Emissions-Tomographie stellt in der bildgebenden Diagnostik von Malignomen bzw. deren Metastasen ein nicht invasives Verfahren dar, welches auf dem Prinzip des unterschiedlichen Stoffwechselverhaltens in verschiedenen Geweben beruht. Mit dem Einsatz von Fluordeoxyglukose (FDG) [¹⁸]F-FDG bei der PET konnte in der vorliegenden prospektiven Studie in der Diagnostik von Mammakarzinomen bei selektiertem Hochrisikokollektiv (n = 40 Patientinnen: 31 Malignome, 9 benigne Tumoren) für das Vorliegen eines Mammakarzinoms eine Sensitivität von 94 % und eine Spezifität von 89 % erzielt werden. Inwiefern diese Ergebnisse auf ein nicht selektiertes Kollektiv übertragbar sind, ist derzeit noch nicht zu beantworten. Die bisherigen Ergebnisse weisen jedoch auf einen möglichen hohen Stellenwert der PET in der Differentialdiagnostik von benignen und malignen Mammaläsionen hin.

Abstract

Objective: Positron emission tomography (PET) is a noninvasive imaging technique that detects altered metabolic activity in tissue. The objective of this study was to evaluate PET in the evaluation of breast masses suspected to be malignant.Methods:Forty women scheduled for surgery for breast lesions suspected to be malignant were evaluated by palpation, mammography, ultrasonography and PET.Results:Thirty patients were found to have breast carcinomas (14 pT1, 14 pT2, 2 pT3), nine had benign tumors, and one had an axillary lymph node metastasis of a malignant melanoma. PET showed high tracer uptake in 29 of the 31 malignant lesions. The sensitivity and specificity of PET for detecting carcinoma was 94 and 89 %, respectively. PET demonstrated one 5-mm carcinoma that was missed by palpation and ultrasonography.Conclusions:In this series of high-risk patients PET had higher detection rates for breast cancer than ultrasonography, palpation, or mammography. PET may be useful in the evaluation of breast lesions.

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