Bildgebung beim Prostatakarzinom

Der Onkologe - Tập 19 - Trang 747-755 - 2013
U.I. Attenberger1, S.O. Schoenberg1, A. Weidner1, M. Niyazi2, L.K. Bittencourt3, D. Buergy4, M. Sertdemir1, D. Hausmann1
1Institut für Klinische Radiologie und Nuklearmedizin – IKRN, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
2Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Klinikum der Universität München – Campus Großhadern, München, Deutschland
3CDPI Clinics—Abdominal and Pelvic Imaging, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
4Klinik für Strahlentherapie und Radioonkologie, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland

Tóm tắt

Im Rahmen der Magnetresonanztomographie (MRT) kann die Prostata mit dem besten Weichgewebskontrast und der höchsten räumlichen Auflösung aller bildgebenden Verfahren beurteilt werden. Gleichzeitig können zusätzlich zur rein anatomisch-morphologischen Information auch funktionelle Parameter, wie Gewebedurchblutung (Perfusion), -stoffwechsel (MR-Spektroskopie, MRS) und Zelldichte (diffusionsgewichtete Bildgebung, DWI) bestimmt werden. Zahlreiche Studien belegen bereits den Stellenwert der MRT in der Lokalisation von Karzinomherden bei Patienten mit steigender Konzentration des prostataspezifischen Antigens (PSA) und stattgehabter Negativbiopsie. Insbesondere in der Drüsenperipherie, der häufigsten Manifestationsstelle eines PCa, erlaubt die kombinierte Analyse morphologischer und funktioneller Parameter, den PCa-Fokus von mit einer Prostatitis einhergehenden Veränderungen spezifisch zu differenzieren. Neben der Primärdiagnostik findet die MRT ihren wertvollen Einsatz auch in der präoperativen Beurteilung evtl. vorliegenden extrakapsulären Wachstums/Samenblasenbefalls und nach z. B. erfolgter Radiatio in der Rezidivsituation oder bei biochemischem Rezidiv nach radikaler Prostatektomie. Damit stellt die sog. multiparametrische (mMRT) ein sehr leistungsfähiges Verfahren für die Diagnose des PCa dar.

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