Klin Padiatr 2011; 223(06): 315-319
DOI: 10.1055/s-0031-1287834
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Die Bedeutung des FDG-PET für die Stadieneinteilung und Therapie des Hodgkin-Lymphoms im Kindesalter

Role of FDG-PET in Staging and Therapy of Children with Hodgkin Lymphoma
R. Kluge
1   Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig
,
D. Körholz
2   Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Halle/Saale
› Author Affiliations
Further Information

Publication History

Publication Date:
19 October 2011 (online)

Zusammenfassung

Die Therapieoptimierungskonzepte zielen beim pädiatrischen Hodgkin-Lymphom auf eine Reduktion der Therapieintensität bei Erhalt der hohen Heilungsraten. Eine Interim-FDG-PET nach 2 Zyklen Chemotherapie hat einen hohen prognostischen Wert. In der EuroNet-PHL-C1-Studie wird derzeit bei negativem Interim-PET auf die Strahlentherapie verzichtet. Alle Patienten erhalten darüber hinaus eine initiale PET-Untersuchung, die für das Staging der PatientenBerücksichtigung findet und als unverzichtbare Ausgangsuntersuchung zur Bewertung der Interim-PET dient. Es konnte gezeigt werden, dass ein Skelettbefall anhand eines typischen Befundmusters in der FDG-PET-Untersuchung mit hoher Sensitivität und Spezifität diagnostiziert werden kann. Für die derzeit in Planung befindliche EuroNet-PHL-C2-Studie werden die Knochenmarkbiopsie und die Skelettszintigrafie deshalb nicht mehr erforderlich sein.

Abstract

The paediatric Hodgkin lymphoma treatment optimisation concepts aim at reduction of treatment intensity with preservation of the high cure rates. A negative interim FDG-PET result after 2 cycles of chemotherapy is associated with a good prognosis. In the current EuroNet-PHL-C1 study radiotherapy is being omitted, if interim PET becomes negative. In addition to the early interim PET after 2 cycles of chemotherapy, all patients undergo an initial PET investigation which is part of the staging processs and plays an essential role for the interpretation of the interim PET. Skeletal involvement can be detected by a typical FDG-PET uptake pattern with high sensitivity and specifity. Therefore, in the forthcoming EuroNet-PHL-C2 study bone marrow biopsy and bone scintigraphy will no longer be part of the staging algorithm.

 
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