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Bedeutung der Schnittbildverfahren für das Staging des Rektumkarzinoms

The role of cross-sectional imaging in staging of rectal cancer

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Zusammenfassung

Die Diversifizierung der Behandlungskonzepte für das Rektumkarzinom wird eine zunehmende Spezialisierung der radiologischen Bildgebung erfordern. Eine Vielzahl von aktuellsten Studien belegt, dass die MRT in der Lage ist, die für Therapieentscheidung und Prognose relevanten Parameter zu bestimmen. Die CT besitzt im Hinblick auf das lokale Staging keinen Stellenwert, wird aber vielerorts noch das 1. Verfahren zur Abklärung von Fernmetastasen bleiben. Mit steigender Akzeptanz können hier umfassendere, MR-basierte Stagingkonzepte zu einer Vereinfachung und Kostenreduktion des bisherigen Patientenmanagements beitragen. Die FDG-PET/CT hat ihren Stellenwert in der Response-Evaluation und Rezidivdiagnostik, wird aber gegenwärtig nicht für den Einsatz in der klinischen Routine empfohlen.

Abstract

The ongoing diversification of treatment strategies for rectal cancer justifies the demand for highly specialized radiological imaging. Currently, numerous studies have underlined the ability of magnetic resonance imaging (MRI) to determine those parameters that are critical for therapeutic decision-making and prognosis in rectal cancer. Computed tomography (CT) does not meet the criteria of a first line diagnostic procedure with regard to local staging but will remain the workhorse in the search for distant metastases. The increasing acceptance of extended MRI-based concepts will, however, improve cost-effectiveness and simplify patient management. Response evaluation and detection of recurrent disease are the major indications for positron emission tomography (PET)/CT, which is currently not routinely recommended.

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  1. Radiologische Klinik, Abteilung Röntgendiagnostik, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland

    A.O. Schäfer, M. Langer & T. Baumann

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  1. A.O. Schäfer
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  2. M. Langer
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  3. T. Baumann
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Correspondence to A.O. Schäfer.

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Schäfer, A., Langer, M. & Baumann, T. Bedeutung der Schnittbildverfahren für das Staging des Rektumkarzinoms. Chirurg 83, 439–447 (2012). https://doi.org/10.1007/s00104-011-2204-7

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