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10.08.2018 | Hepatozelluläres Karzinom | Leitthema

Bildgebende radiologische Diagnostik und Verlaufsbeurteilung beim HCC

verfasst von: C. J. Zech, A. Potthoff, Prof. Dr. J. Ricke

Erschienen in: Die Onkologie | Ausgabe 9/2018

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Zusammenfassung

Hintergrund

Die bildgebende radiologische Diagnostik ist heute aus den Untersuchungen beim hepatozellulären Karzinom (HCC) nicht mehr wegzudenken. Die Multidetektor-Computertomographie (CT) und Magnetresonanztomographie (MRT) spielen hierbei eine entscheidende Rolle. Die Kontrastmittelsonographie (CE-US, „contrast enhanced ultrasound“) stellt zudem für die Charakterisierung des HCC bei einer in der B‑Bild-Sonographie zufällig entdeckten Leberläsion bei Hochrisikopatienten eine Alternative dar.

Methode

Es wurden eine Recherche und Analyse aktueller Literatur durchgeführt.

Ergebnisse

Die CT ist als schnell und universell verfügbare Bildgebungsmodalität eine wichtige Methode zur Diagnostik des HCC. Sie profitiert von den technischen Weiterentwicklungen der letzten Jahrzehnte, die sich neben reduzierter Strahlendosis v. a. in schnellerer Akquisition niederschlagen. Mit der MRT können noch weitere Diagnosekriterien für die Evaluation und Differenzialdiagnose von fokalen Leberläsionen in der zirrhotischen Leber herangezogen werden. Sie ist heute ausreichend robust, um bei den allermeisten Patienten adäquate Bilder zu generieren. Die CE-US ist in der aktuellen nationalen S3-Leitlinie zur Diagnostik und Therapie des HCC als alternatives bildgebendes Verfahren zur CT und MRT für die Charakterisierung des HCC empfohlen, wenn ein unklarer Leberrundherd unabhängig von seiner Größe in einer Hochrisikogruppe in der B‑Bild-Sonographie detektiert wird. Die Vorteile liegen in den geringen Kosten, der raschen Verfügbarkeit, der fehlenden Strahlenbelastung und der fehlenden Nephrotoxizität. Im klinischen Alltag hat sich die Responsebeurteilung mit den mRECIST-Kriterien beim HCC weitestgehend durchgesetzt.
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Metadaten
Titel
Bildgebende radiologische Diagnostik und Verlaufsbeurteilung beim HCC
verfasst von
C. J. Zech
A. Potthoff
Prof. Dr. J. Ricke
Publikationsdatum
10.08.2018
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 9/2018
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-018-0435-7

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GI-Tumore und die Rolle von Angiogenesehemmern

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Entdecken Sie mit praxisrelevanten Patientenfällen, kompakten Studieninhalten, informativen Experteninterviews und weiteren spannenden Inhalten, wie Sie den vielseitigen Herausforderungen bei GI-Tumoren begegnen können. Hier erfahren Sie mehr! PP-RB-DE-2009