¹²⁴I-PET(/CT) bei differenzierten Schilddrüsenkarzinomen

Zusammenfassung

Die ¹²⁴I-PET(/CT) hat im Rahmen der prätherapeutischen Dosimetrie und der Bildgebung ein hohes Potenzial im Einsatz bei Patienten mit differenzierten Schilddrüsenkarzinomen (DTC): Die Dosimetrie ermöglicht im Sinne eines „molecular targeting” eine individualisierte Radioiodtherapie – die häufig von den bisher verwendeten standardisierten Protokollen abweicht. Es besteht die Hoffnung, dass die PET-basierten, individuellen Therapiekonzepte langfristig einen erheblicher klinischen Nutzen bieten können, da die Therapie hinsichtlich des Ergebnisses, der Nebenwirkungen und des Strahlenschutzes optimiert wird. Darüber hinaus kann die ¹²⁴I-PET/CT-Bildgebung bei Patienten, bei denen eine Radioiodtherapie nicht erfolgversprechend ist, wertvolle Informationen zur weiteren Therapieplanung geben, insbesondere wenn sie mit der FDG-PET kombiniert wird.

Abstract

¹²⁴I-PET(/CT) has a high clinical potential in patients with differentiated thyroid cancer (DTC). Two aspects deserve special interest: Pre-therapeutic dosimetry and imaging. In the clinical application the pre-therapeutic ¹²⁴I-PET dosimetry can lead to a significant alteration of the therapeutic procedure compared to standard therapy. ¹²⁴I-PET dosimetry is a useful procedure in advanced DTC and may allow the application of safer or more effective radioiodine activities and earlier multimodal interventions than do standard empirical protocols. Used together, ¹²⁴I-PET and CT allow localization of foci of highly specific ¹²⁴I uptake as well as noniodine-avid lesions. The combination of whole-body ¹²⁴I-PET/CT and FDG-PET improves restaging in recurrent DTC by enabling detection of local recurrence or metastases that are often not found if only one of the methods or other imaging modalities are applied.

Schlüsselwörter

differenziertes Schilddrüsenkarzinom - Dosimetrie - ¹²⁴I - ¹³¹I - Radioiodtherapie - PET - PET/CT

Key words

differentiated thyroid cancer - dosimetry - ¹²⁴I - ¹³¹I - radioiodine therapy - PET - PET/CT

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