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Rofo 2020; 192(07): 657-668
DOI: 10.1055/a-1091-8897
Review
© Georg Thieme Verlag KG Stuttgart · New York

Kriterien-basierte Bildgebung und Responsebeurteilung bei Lymphomen 20 Jahre nach Cheson: Was gibt es Neues?

Eine Übersicht zu den aktuellen Klassifikationen Article in several languages: English | deutsch
Christopher Skusa
1   Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
,
Marc-André Weber
1   Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
,
Sebastian Böttcher
2   Department of Medicine, Clinic III – Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
,
Kolja M. Thierfelder
1   Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
› Author Affiliations
Further Information

Publication History

07 September 2019

10 December 2019

Publication Date:
26 March 2020 (online)

Also available at
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Zusammenfassung

Hintergrund Der schnelle Fortschritt in der onkologischen Forschung bedingt eine Vielzahl neuer wissenschaftlicher Publikationen. Dieser Beitrag möchte daher einen Überblick über den aktuellen Wissensstand bezüglich der Kriterien-basierten Bildgebung und Responsebeurteilung bei Lymphomen liefern. So sind gemeinsame Kriterien in der Auswertung von Daten, insbesondere der bildgebenden Responseevaluation, für die Vergleichbarkeit der Studien essenziell. Während Kriterien-basierte Klassifikationen für solide Tumoren bereits länger etabliert sind, gibt es nun zunehmend auch Klassifikationen für Lymphomerkrankungen. Als Ziel dieser Übersichtsarbeit soll die Entwicklung der Kriterien-basierten Auswertung von Lymphomerkrankungen mit besonderem Schwerpunkt auf die Bildgebung bis hin zu den derzeit gültigen Leitlinien beschrieben werden.

Methode Die Literaturrecherche erfolgte in PubMed in den Sprachen Englisch und Deutsch. Dieser Übersichtsartikel enthält die wichtigsten Kriterien-basierten Responseevaluationen von Lymphomerkrankungen, die von Januar 1999 bis Juli 2019 publiziert wurden.

Ergebnisse und Schlussfolgerung Es gibt aktuell 2 Klassifikationen zur Evaluation des Therapieansprechens von Lymphomerkrankungen: Die seit 20 Jahren stetig weiterentwickelte, insbesondere dem technischen Fortschritt angepasste Lugano-Klassifikation sowie die Auswertmethode RECIL (Response Evaluation Criteria In Lymphoma), die sich an der bereits für solide Tumoren etablierten RECIST (Response Evaluation Criteria in Solid Tumors)-Klassifikation orientiert. Die wesentlichen Bestandteile beider Klassifikationen sind die anatomische Messung von Lymphommanifestationen in der Bildgebung und die Messung der metabolischen Response des Tumorgewebes durch die Positronen-Emissions-Tomografie (PET/CT).

Kernaussagen: 

  • Standardisierte Kriterien-basierte Responsebeurteilungen sind zur objektiven und vergleichbaren Auswertung der Wirksamkeit neuer Medikamente zur Behandlung von Lymphomerkrankungen essenziell.

  • Mit der neuesten Klassifikation nach RECIL wurde die Therapiebeurteilung deutlich vereinfacht und eine bessere Vergleichbarkeit zur Therapiebeurteilung von soliden Tumoren nach RECIST hergestellt.

  • Weitere Studien werden zeigen, welche der Klassifikationen in welchem Studiensetting am besten geeignet ist.

Zitierweise

  • Skusa C, Weber M, Böttcher S et al. Criteria-Based Imaging and Response Evaluation of Lymphoma 20 Years After Cheson: What is New?. Fortschr Röntgenstr 2020; 192: 657 – 668

Key words

lymphoma - CT - PET-CT - staging
 

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