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Funktionelle Bildgebung beim Harnblasenkarzinom

Functional imaging in bladder cancer

Zusammenfassung

Die Computertomographie (CT) stellt die aktuelle präoperative Standardbildgebung beim muskelinvasiven Harnblasenkarzinom dar. Allerdings weist sie Schwächen hinsichtlich des lokalen Tumor- und Lymphknotenstagings auf. Die Magnetresonanztomographie (MRT) mit Spezialsequenzen [diffusionsgewichtete MRT, Messung des ADC-Wertes („apparent diffusion coefficient“)] oder der Einsatz von supraparamagnetischen Eisennanopartikeln bieten evtl. Vorteile in der Beurteilung des Lokalbefunds sowie der Lymphknoten und könnten zukünftig im Staging beim Blasenkarzinom eine größere Rolle spielen. Ebenso wird die Positronenemissionstomographie (PET) mit den Tracern 18F-FDG, 11C-Cholin und 11C-Acetat und meist fusioniert mit einer diagnostischen CT zum Staging des Blasenkarzinoms evaluiert. Obwohl für diese PET/CT-Untersuchungen z. T. vielversprechende Ergebnisse beschrieben wurden, kann deren Wertigkeit aktuell noch nicht abschließend beurteilt werden.

Abstract

Computed tomography (CT) represents the current standard imaging modality in muscle invasive bladder cancer; however, local tumor and lymph node staging is often impaired. Magnetic resonance imaging (MRI) with diffusion-weighted sequences, determination of apparent diffusion coefficient (ADC) values or utilization of supraparamagnetic iron nanoparticles potentially exhibits advantages in the assessment of local tumor and lymph node involvement and therefore might play a role in the staging of bladder tumor in the future. Likewise, positron emission tomography (PET) with the currently used tracers 18F fluorodeoxyglucose (18F-FDG), 11C-choline and 11C-acetate is being investigated in bladder cancer patients, mostly in combination with diagnostic CT. Although promising results could be obtained for PET/CT investigations to some extent, the true value cannot be determined at present.

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Abbreviations

CT:

Computertomographie

MRT:

Magnetresonanztomographie

PET:

Positronenemissionstomographie

FDG:

Fluordesoxyglukose

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Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Correspondence to Dr. T. Maurer.

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Maurer, T., Horn, T., Beer, A. et al. Funktionelle Bildgebung beim Harnblasenkarzinom. Urologe 52, 509–514 (2013). https://doi.org/10.1007/s00120-012-3097-x

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Schlüsselwörter

  • Magnetresonanztomographie
  • Positronenemissionstomographie
  • Fluordesoxyglukose
  • Cholin
  • Computertomographie

Keywords

  • Magnetic resonance imaging
  • Positron emission tomography
  • Fluorodeoxyglucose
  • Choline
  • Computed tomography