Zusammenfassung
Eine adäquate Bildgebung ist für die Detektion mitunter kleinster Läsionen, die non-invasive Charakterisierung von fokalen und diffusen Veränderungen, sowie die Planung chirurgischer Eingriffe von entscheidender Bedeutung. Zur Bewältigung dieser Aufgaben werden verschiedene bildgebende Verfahren wie die Multidetektor-Computertomographie (MDCT), Magnetresonanztomographie (MRT) und Positronen-Emissions-Tomographie/Computertomographie (PET/CT) eingesetzt, die wichtige morphologische, funktionelle oder metabolische Informationen liefern. In letzter Zeit gewinnt die PET/MRT aufgrund der Möglichkeit von Kombination hochauflösender Bildgebung und metabolischer Bildgebung zunehmend an Aufmerksamkeit. Die PET/MRT ist eine neuartige Hybridbildgebungstechnologie, die in naher Zukunft eine zentrale Rolle bei der klinischen Behandlung von onkologischen und entzündlichen Abdomen-Becken-Erkrankungen spielen könnte. Trotz der noch begrenzten Anzahl publizierter klinischer Studien hat sich die PET/MRT bei einer Vielzahl von onkologischen Erkrankungen als zumindest gleichwertig wie PET/CT und MRT als Einzeluntersuchung erwiesen. In ausgewählten und fokussierten klinischen Studien wurde zudem nachgewiesen, dass es die derzeitige Standardbildgebung beispielsweise in der Beurteilung von Cholangiokarzinomen, Lebermetastasen sowie unbehandelten und behandelten Rektumkarzinomen übertrifft. Dies hat sich in einigen Studien auch auf das therapeutische Management ausgewirkt. Daher ist die PET/MRT in einigen Institutionen zur neue Standardbildgebungsmethode, z. B. bei unbehandelten intrahepatischen Cholangiokarzinomen sowie vor komplizierten Leberoperationen geworden.
Abstract
Accurate imaging is crucial for lesion detection in abdominal organs, for the noninvasive characterization of focal and diffuse abnormalities, and for surgical planning. To accomplish these tasks, several imaging modalities such as multidetector computer tomography (MDCT), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) are used for abdominal imaging, providing important morphological, functional or metabolic information. More recently, PET/MRI has been gaining attention due to the possibility of combining high-resolution imaging with metabolic imaging. PET/MRI is a novel hybrid imaging technology that in the near future might play a pivotal role in the clinical management of oncologic and inflammatory abdominopelvic diseases. Despite the still limited number of published clinical studies, PET/MRI has been proven to be at least equivalent to PET/CT and to stand-alone MRI in a variety of oncologic disease. Moreover, in selected and focused clinical studies, it has been proven to outperform current standard of care imaging, for example, in evaluating cholangiocarcinomas, liver metastases, untreated and treated rectal cancer. This has also had an impact on therapeutic management in some studies. Therefore in some institutions, including those of the authors, PET/MRI is becoming the new standard imaging modality in staging treatment-naïve intrahepatic mass-forming cholangiocarcinomas and prior to complicated hepatic surgery.
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Suarez-Weiss, K.E., Herold, A., Gervais, D. et al. Hybridbildgebung bei abdominellen Erkrankungen. Radiologe 60, 394–404 (2020). https://doi.org/10.1007/s00117-020-00660-y
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DOI: https://doi.org/10.1007/s00117-020-00660-y