PET (und PET/CT) - Stellenwert in der Diagnostik von primären Hirntumoren

Zusammenfassung

Die Beurteilung von Hirntumoren bei Erstdiagnosestellung hinsichtlich Grading, exakter Ausdehnung und Abgrenzung zum umliegenden Hirngewebe stellt ebenso wie die Rezidivdiagnostik nach verschiedenen Therapieformen eine Herausforderung an die unterschiedlichen bildgebenden Verfahren dar. Während morphologisch orientierte Verfahren (MRT, CT) aufgrund reaktiver perifokaler Veränderungen, unspezifischer oder bei niedriggradigen Tumoren sogar fehlender Kontrastmittelaufnahme häufig limitiert sind, gewinnt die Positronen-Emissions-Tomographie (PET) als funktionelles bildgebendes Verfahren in der Hirntumordiagnostik zunehmend an Bedeutung. Aktuell wird die PET unter Verwendung von [¹⁸F]FDG und ¹⁸F- bzw. ¹¹C-markierten Aminosäuretracern zur Therapieplanung (vor stereotaktischer Biopsie, Operation und Strahlentherapie), in der Rezidivdiagnostik und zum Therapiemonitoring nach unterschiedlichen systemischen und lokalen Therapieformen eingesetzt. Diese Arbeit fasst eigene Erfahrungen und die wichtigsten in der Literatur publizierten Daten zur PET-Diagnostik bei Hirntumoren zusammen.

Abstract

Assessment of newly diagnosed brain tumors regarding grading, exact delination and demarcation of tumor to surrounding brain tissue as well as diagnosis of recurrency after various forms of treatment is a diagnostic challenge for different imaging modalities. Whereas morphological methods (MRI, CT) are often hampered by reactive perifocal changes, unspecific or in low grade tumors even lacking contrast enhancement, positron emission tomography (PET) as functional imaging method has gained clinical importance in the diagnosis of brain tumors. Currently, PET using [¹⁸F]FDG and ¹⁸F- or ¹¹C-labelled amino acid tracers is applied for therapy planning (before stereotactic biopsy, surgery and radiation therapy), diagnosis of recurrency and for monitoring the therapeutic effect after various systemic or locoregional therapeutic approaches. This paper offers a comprehensive summary of own experiences and PET results reported in the literature dealing with this topic.

Positronen-Emissions-Tomographie - Hirntumoren - [¹⁸F]FDG - Aminosäuretracer

Positron-emission-tomography - brain tumors - [¹⁸F]FDG - amino acid tracers

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