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Erschienen in: Die Urologie 12/2021

30.11.2021 | Prostatakarzinom | Leitthema

Bildgebung oligometastasierter Tumoren des Harntraktes

verfasst von: S. A. Koerber, C. A. Fink, K. Dendl, D. Schmitt, G. Niegisch, E. Mamlins, Univ.-Prof. Dr. F. L. Giesel

Erschienen in: Die Urologie | Ausgabe 12/2021

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Zusammenfassung

Hintergrund

Klinische Studien zeigen für die Lokaltherapie von Primarius und Metastasen urologischer Tumoren im metastasierten Stadium Vorteile gegenüber einer alleinigen Systemtherapie und definieren ein potenziell kuratives oligometastasiertes Stadium.

Fragestellung

Bildgebungsmodalitäten zur sensitiven lokalen und systemischen Diagnostik von urologischen Tumoren im oligometastasierten Stadium werden verglichen.

Material und Methode

Es wird eine Übersicht über und Zusammenfassung von vergleichenden Studien zu Gütekriterien unterschiedlicher Bildgebungsmodalitäten zusammengestellt.

Ergebnisse

Abhängig vom betroffenen Organsystem und der Tumorentität bestimmen konventionelle Bildgebungsmodalitäten wie Computertomographie (CT) und Knochenszintigraphie weiterhin die Praxis in Deutschland. Die Hybridbildgebung (PET [Positronenemissionstomographie]/CT) konnte sich in den vergangenen Jahren aufgrund überlegener Gütekriterien in der Onkologie und insbesondere beim Prostatakarzinom durch neue Liganden (PSMA, „prostate-specific membrane antigen“) etablieren. Bei allen Entitäten ist die Entwicklung neuer Bildgebungsliganden (z. B. FAP-Liganden [„fibroblast activated protein“]) und deren klinische Anwendung Gegenstand aktueller Forschung.

Schlussfolgerungen

Die Entwicklung sensitiverer Bildgebungen durch neue Liganden besonders in der Nuklearmedizin legt die Grundlage zur exakten Definition oligometastasierter Stadien. Hierdurch werden Lokaltherapien möglich, die eine Progression oder Systemtherapie hinauszögern, aber auch kurative Therapieoptionen durch Behandlung sämtlicher Tumorlokalisationen ermöglichen können.
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Metadaten
Titel
Bildgebung oligometastasierter Tumoren des Harntraktes
verfasst von
S. A. Koerber
C. A. Fink
K. Dendl
D. Schmitt
G. Niegisch
E. Mamlins
Univ.-Prof. Dr. F. L. Giesel
Publikationsdatum
30.11.2021
Verlag
Springer Medizin
Erschienen in
Die Urologie / Ausgabe 12/2021
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-021-01708-0

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