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01.05.2014 | CME Zertifizierte Fortbildung

Prostatakarzinom

verfasst von: PD Dr. T. Franiel, N. Eckardt, M. Waginger, M. Horstmann

Erschienen in: Die Radiologie | Ausgabe 5/2014

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Zusammenfassung

Für viele klinische Fragestellungen zum Prostatakarzinom wird die Magnetresonanztomographie (MRT) der Prostata immer wichtiger. Die hohe morphologische Auflösung von T2w-Sequenzen ist im Vergleich zu anderen Bildgebungsmodalitäten unübertroffen und ermöglicht neben Detektion und Lokalisation des Prostatakarzinoms auch die Beurteilung eines kapselüberschreitenden Wachstums. Die funktionellen MRT-Methoden wie DWI, DCE-MRI und ¹H-MRS erhöhen insbesondere die Spezifität und in geringerem Maße auch die Sensitivität der Diagnostik. Gemäß der interdisziplinären S3-Leitlinie wird die MRT der Prostata bei Patienten mit mindestens einmaliger negativer Biopsie zur Detektion des Karzinoms empfohlen. Demnach sollten karzinomsuspekte Areale zusätzlich zur systematischen Biopsie auch gezielt biopsiert werden. Für die Befundübermittlung der suspekten Areale hat sich das Vorgehen entsprechend der PI-RADS-Klassifikation bewährt. Lokalisation und Staging des Prostatakarzinoms gelingen bildgebend mit Hilfe der MRT am genauesten und werden in der S3-Leitlinie insbesondere für Tumoren im klinischen Stadium cT3/4 oder einem Gleason-Score von 8 oder mehr empfohlen. Zusätzlich zu den erwähnten Anwendungen wird die MRT momentan hauptsächlich unter Studienbedingungen ebenfalls für die Rezidivdiagnostik und die aktive Überwachung eingesetzt.

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Titel: Prostatakarzinom
verfasst von: PD Dr. T. Franiel
N. Eckardt
M. Waginger
M. Horstmann
Publikationsdatum: 01.05.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Die Radiologie / Ausgabe 5/2014
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI: https://doi.org/10.1007/s00117-013-2608-0

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