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Präklinische Bildgebung im Tiermodell bei Strahlentherapie

Preclinical imaging in animal models of radiation therapy

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Zusammenfassung

Klinisches/methodisches Problem

Die moderne Strahlentherapie profitiert maßgeblich von einer detaillierten wie auch funktionellen prätherapeutischen Bildgebung.

Radiologische Standardverfahren

Die üblicherweise prätherapeutisch eingesetzten radiologischen Standardverfahren wie die Computertomographie liefern zwar hochwertige morphologische Details, jedoch keine funktionelle Information.

Methodische Innovationen

Es ist somit ein zunehmender Bedarf an funktionellen und molekularen Bildgebungsmodalitäten feststellbar, mit denen ergänzend zur morphologischen Bildgebung auch biologisch-funktionelle Informationen über den Tumor zur Verfügung gestellt werden.

Leistungsfähigkeit

Die dynamische kontrastmittelverstärkte MRT-, CT- oder ultraschallbasierte Perfusionsbildgebung sowie Hybridverfahren wie PET/CT oder MRT/PET haben das Potenzial, vitale und/oder perfundierte Tumoranteile zu identifizieren und abzugrenzen, um so eine gezielte Strahlentherapie zu optimieren. Ziel ist eine genauere Abgrenzung und Behandlung des Tumors bei gleichzeitiger Reduzierung der Dosis und Schonung des umliegenden gesunden Gewebes.

Bewertung

In der Entwicklung neuer bildgebender Methoden für die Planung einer individualisierten Strahlentherapie kommt der präklinischen, wissenschaftlichen Bildgebung und Forschung eine besondere Rolle zu, da nur in einem präklinischen Setting, also in tierexperimentellen Tumormodellen, die Möglichkeiten einer multimodalen Bildgebung ausreichend genau evaluiert und weiterentwickelt werden können.

Empfehlung für die Praxis

Neue funktionelle bildgebende Methoden werden für die Überwachung einer frühen Therapieantwort („early response“) unter Strahlentherapie oder für die Darstellung der Wertigkeit neuer Kombinationstherapien (z. B. Antiangiogenese plus Strahlentherapie) eine zunehmende Rolle spielen.

Abstract

Clinical/methodical issue

Modern radiotherapy benefits from precise and targeted diagnostic and pretherapeutic imaging.

Standard radiological methods

Standard imaging modalities, such as computed tomography (CT) offer high morphological detail but only limited functional information on tumors.

Methodical innovations

Novel functional and molecular imaging modalities provide biological information about tumors in addition to detailed morphological information.

Performance

Perfusion magnetic resonance imaging (MRI) CT or ultrasound-based perfusion imaging as well as hybrid modalities, such as positron emission tomography (PET) CT or MRI-PET have the potential to identify and precisely delineate viable and/or perfused tumor areas, enabling optimization of targeted radiotherapy. Functional information on tissue microcirculation and/or glucose metabolism allow a more precise definition and treatment of tumors while reducing the radiation dose and sparing the surrounding healthy tissue.

Achievements

In the development of new imaging methods for planning individualized radiotherapy, preclinical imaging and research plays a pivotal role, as the value of multimodality imaging can only be assessed, tested and adequately developed in a preclinical setting, i.e. in animal tumor models.

Practical recommendations

New functional imaging modalities will play an increasing role for the surveillance of early treatment response during radiation therapy and in the assessment of the potential value of new combination therapies (e.g. combining anti-angiogenic drugs with radiotherapy).

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Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität, Campus Grosshadern, Marchioninistr. 15, 81377, München, Deutschland

    K. Nikolaou, C.C. Cyran, M.F. Reiser & D.-A. Clevert

  2. Klinik und Poliklinik für Strahlentherapie, Klinikum der Ludwig-Maximilians-Universität, München, Deutschland

    K. Lauber

Authors
  1. K. Nikolaou
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  2. C.C. Cyran
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  3. K. Lauber
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  4. M.F. Reiser
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  5. D.-A. Clevert
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Correspondence to K. Nikolaou.

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Nikolaou, K., Cyran, C., Lauber, K. et al. Präklinische Bildgebung im Tiermodell bei Strahlentherapie. Radiologe 52, 252–262 (2012). https://doi.org/10.1007/s00117-011-2194-y

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