Positronenemissionstomographie (PET) zur Diagnostik und zum Therapiemonitoring bei urologischen Tumoren

Abstract

Positron emission tomography (PET) using ((18)F)2-fluoro-D-2-desoxyglucose (FDG) has been shown to be a highly sensitive and specific imaging modality in the diagnosis of primary and recurrent tumors and in the control of therapies in numerous non-urologic cancers. It was the aim of this review to validate the significance of PET as a diagnostic tool in malignant tumors of the urogenital tract. A systematic review of the current literature concerning the role of PET for malignant tumors of the kidney, testicles, prostate, and bladder was carried out. The role of FDG PET for renal cell cancer can be seen in the detection of recurrences after definitive local therapy and metastases. The higher sensitivity of PET in comparison to other therapeutic modalities (CT, ultrasound, MRI) in recurrent and metastatic renal cell cancer suggests a supplemental role of this diagnostic procedure to complement other imaging modalities.The clinical value of PET is established for the identification of vital tumor tissue after chemotherapy of seminomatous germ cell tumors. This diagnostic method has little significance for primary tumor staging and diagnosis of non-seminomatous germ cell tumor because of the high probability of false-negative results in adult teratomas. FDG PET is not sensitive enough in the diagnosis of primary or recurrent tumors in prostate or bladder cancer. Also PET did not prove to be superior to conventional bone scintigram in the detection of mostly osteoblastic metastases in prostate cancer. The recent use of alternative tracers, which are partly not eliminated by urinary secretion (acetate, choline) has increased the sensitivity and specificity of PET also in this tumor entity so that further clinical investigations are needed to validate these technical modifications in their significance for this imaging modality. PET appears to be sufficiently evaluated only for the diagnostic follow-up of patients with seminomatous germ cell tumors after chemotherapy to regard it is the diagnostic tool of first choice. For all other tumors of the urogenital tract this proof is still awaited.

Characterization of Osteolytic, Osteoblastic, and Mixed Lesions in a Prostate Cancer Mouse Model Using 18F-FDG and 18F-Fluoride PET/CT

“…18 F-FDG is not specific to tumor metabolism and can accumulate in metabolically active inflammatory cells; however, the usefulness of 18 F-FDG in human prostate adenocarcinoma is unclear. Some investigators have reported low uptake of 18 F-FDG in patients with prostate cancer, whereas in other studies, 18 F-FDG PET/CT scans have been used to identify osseous and soft-tissue metastasis from prostate adenocarcinoma (17,18,(35)(36)(37). Our data demonstrated early tracer uptake (2 wk) and a strong correlation between soft-tissue tumor burden measurements with 18 F-FDG.…”

Diagnostic value of multislice computed tomography and magnetic resonance imaging in the diagnosis of retroperitoneal spread of testicular cancer: a literature review

“…There were six publications obtained from more than one of the databases (13Á18). Three publications in non-English language were excluded: one in German (16), one in French (19), and one in Czech (20). There were thus 44 publications for further analysis (Fig.…”

Elucidating the Relationship Between Diabetes Mellitus and Parkinson’s Disease Using 18F-FP-(+)-DTBZ, a Positron-Emission Tomography Probe for Vesicular Monoamine Transporter 2

“…Positron emission tomography has shown prominent features compared with other molecular imaging approaches. PET can trace suspicious malignant lesions and provide functional imaging of those areas, which is useful for early diagnosis of diseases ( Kang et al, 2004 ; Machtens et al, 2004 ). Although magnetic resonance imaging (MRI) has a higher resolution, the specificity of its related contrast agents for β cells is not as good as PET imaging.…”