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Das Cholin-PET/CT in der Primär- und Rezidivdiagnostik des Prostatakarzinoms

Gibt es evidenzbasierte Indikationen?

Choline PET/CT in the diagnosis of primary and recurrent prostate cancer

Are there evidence-based indications?

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Zusammenfassung

Unnötige Diagnostik und daraus resultierende Übertherapie des Prostatakarzinoms sind Gegenstand intensiver Diskussion in den urologischen Fachgesellschaften, aber auch in der Öffentlichkeit und in der Laienpresse. Sensitive und spezifische diagnostische Methoden könnten ein Weg sein, zur Lösung dieser Problematik beizutragen. Das Cholin-PET/CT (Positronenemissionstomographie/Computertomographie) ist in der Lage, im Rahmen einer Fusionsbildgebung anatomisch-morphologische Informationen mit metabolisch-funktionellen Daten zu kombinieren. Trotz vielversprechender präklinischer und interessanter initialer klinischer Daten hat die kostenintensive und logistisch anspruchsvolle Methode bislang nicht Eingang in die klinische Routine gefunden, die Aussagen der europäischen und deutschen Leitlinien sind vorsichtig und zurückhaltend. Ziel dieser Übersicht ist es, sowohl für die initiale Diagnostik des Prostatakarzinoms als auch für Staging und Diagnostik im biochemischen Rezidiv einen Überblick über die aktuelle Datenlage zum Cholin-PET/CT zu geben und Hinweise darauf zusammenzufassen, wo in Zukunft bei Umsetzung entsprechender klinischer Forschungsprojekte die Rolle dieser innovativen Technologie liegen kann.

Abstract

Overdiagnosis and resulting overtreatment in prostate cancer are under intensive discussion both in the urologic communities and in the public media. Sensitive and specific diagnostic modalities could be one step forward to overcome this problem. Choline PET/CT provides fusion imaging that combines anatomical/morphological information with metabolic/functional data. Despite promising preclinical data and interesting initial clinical results, this cost-intensive and logistically demanding technology has not yet found its way into routine clinical practice; the German and European guideline recommendations are careful and reluctant. This review has the goal to give an overview of the recent data both on initial diagnosis and on staging/diagnosis for biochemical recurrence by choline PET/CT and to summarize the possible role of this innovative technology in the future, if adequate research projects can be realized.

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Authors and Affiliations

  1. Klinik für Urologie und Kinderurologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Baldingerstraße, 35033, Marburg, Deutschland

    P.J. Olbert, R. Hofmann & A. Hegele

  2. Klinik für Nuklearmedizin, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Prostatakarzinomzentrum, Comprehensive Cancer Center Marburg, Marburg, Deutschland

    J. Heinis

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  1. P.J. Olbert
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  2. J. Heinis
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  3. R. Hofmann
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  4. A. Hegele
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Correspondence to P.J. Olbert.

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Olbert, P., Heinis, J., Hofmann, R. et al. Das Cholin-PET/CT in der Primär- und Rezidivdiagnostik des Prostatakarzinoms. Urologe 51, 843–847 (2012). https://doi.org/10.1007/s00120-012-2830-9

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  • DOI: https://doi.org/10.1007/s00120-012-2830-9

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