SPECT/CT bei neuroendokrinen Tumoren

Zusammenfassung

Die Koregistrierung anatomischer Informationen führt insbesondere bei der funktionellen Bildgebung mit hochspezifischen Radiopharmaka, die bei neuroendokrinen Tumoren zum Einsatz kommen, zu einer deutlichen Verbesserung der diagnostischen Genauigkeit. Nebenschilddrüsenadenome können mit ^99mTc-MIBI nicht nur sensitiv nachgewiesen werden, sondern auch anatomisch exakt lokalisiert werden. Dies wird für minimal-invasive chirurgische Techniken eine zunehmende Rolle spielen. Mit SPECT/CT lassen sich insbesondere extra-adrenale Manifestationen von Phäochromozytomen und Tumoren der Nebennierenrinde mit hoher Sensitivität und Spezifität nachweisen. Durch die Verfügbarkeit des PET-Radiopharmakons ⁶⁸Ga-DOTATOC hat die ¹¹¹In-Octreotidszintigrafie zum Nachweis von Manifestationen neuroendokriner Tumoren zuletzt an Bedeutung verloren. Aufgrund der besseren Verfügbarkeit repräsentieren SPECT und SPECT/CT jedoch weiterhin Standardverfahren in der Diagnostik neuroendokriner Tumoren. Für Verlaufsbeobachtungen und das Monitoring radiopeptidbasierter Therapien, die bei neuroendokrinen Tumoren zunehmend eingesetzt werden, stellt SPECT/CT eine überlegene Diagnostik dar.

Abstract

The accuracy of functional SPECT imaging has been significantly improved by addition of CT. This is especially relevant for functional imaging of neuroendocrine tumors using highly specific radiopharmaceuticals. Parathyroid adenomas can be detected by ^99mTc-MIBI SPECT/CT with very high sensitivity and specificity, playing an important role especially when minimally invasive techniques are used for surgical resection. With SPECT/CT, extra-adrenal manifestations of pheochromocytomas and tumors of the adrenal cortex can be detected with high accuracy. Because of the availability of PET radiopharmaceuticals such as ⁶⁸Ga-DOTATOC, the clinical relevance of ¹¹¹In-Octreotide SPECT for detection of neuroendocrine cancers has been recently reduced. Because of the better availability, SPECT and SPECT/CT still represent standard tools for imaging neuroendocrine cancers. SPECT/CT represents the superior imaging modality for monitoring radiopeptide based therapies, which are now increasingly used for treatment of neuroendocrine cancers.

Schlüsselwörter

SPECT/CT - Hybridbildgebung - SPECT-Tracer - neuroendokrine Tumoren

Key words

SPECT/CT - hybrid imaging - SPECT tracer - neuroendocrine tumors

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