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Der Nuklearmediziner 2011; 34(04): 214-219
DOI: 10.1055/s-0031-1297945
Neuroendokrine Tumoren
© Georg Thieme Verlag KG Stuttgart · New York

Einsatz der Positronen-Emissions-Tomografie bei ­neuroendokrinen Tumoren

Positron Emission Tomography for Neuroendocrine Tumors
M. Miederer
1   Klinik und Poliklinik für Nuklearmedizin, Universitätsmedizin Mainz
,
C. Fottner
2   Klinik für Endokrinologie, Universitätsmedizin Mainz
,
K. Antwi
1   Klinik und Poliklinik für Nuklearmedizin, Universitätsmedizin Mainz
,
M. Weber
2   Klinik für Endokrinologie, Universitätsmedizin Mainz
,
M. Schreckenberger
1   Klinik und Poliklinik für Nuklearmedizin, Universitätsmedizin Mainz
› Author Affiliations
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Publication History

Publication Date:
20 December 2011 (online)

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Zusammenfassung

Neuroendokrine Tumoren (NET) sind eine genetisch heterogene Gruppe von Tumoren mit malignem Potenzial, die eine große klinische Variation aufweisen. Die Klassifikation basiert unter anderem auf der proliferativen Aktivität, wobei G1-Tumoren einen Proliferationsindex von ≤ 2%, G2-Tumoren einen von 3–20% und G3-Tumoren einen von > 20% aufweisen. Molekulare bildgebende Verfahren basieren großteils auf der Eigenschaft von hoher Somatostatinrezeptorexpression. Von den 5 bekannten Rezeptorsubtypen spielt der Subtyp 2 die größte Rolle. PET/CT mit 68Gallium markierten Somatostatinanaloga ist zumindest an großen Zentren die Bildgebung der ersten Wahl. Die wichtigsten Vorteile gegenüber konventioneller Szintigrafie sind verbesserte Sensitivität und Spezifität, kurze Aufnahmeprotokolle und die Möglichkeit einer zuverlässigen Uptake-Quantifizierung. Des Weiteren sind in der klinischen Routine PET-Tracer, die z. B. den Glukosemetabolismus oder Amine-precurser-Metabolismus abbilden, verfügbar, die bei vielen Fragestellungen eine hohe klinische Wertigkeit aufweisen.

Abstract

Neuroendocrine tumours (NETs) are a genetically diverse group of diseases with malignant potential, displaying a great variability in clinical outcome. They are classified into well differentiated neuroendocrine tumors or carcinomas (proliferation index ≤ 2%), well-differentiated neuroendocrine carcinoma (proliferation index 3–20%) and poorly differentiated neuroendocrine carcinoma (proliferation index > 20%). The molecular imaging of NETs is strongly based on the property of these tumor cells to express somatostatin receptors which appear in 5 subtypes, SSTR 1–5 with the subtype 2 being predominant. Gallium-68 labeled somatostatin analogue PET/CT is an increasingly applied method for staging and restaging of patients with neuroendocrine carcinomas. Key advantages over conventional scintigraphy are increased sensitivity and specificity, short scanning protocols and the possibility of accurate uptake quantification. Additionally, a wide variety of routinely used functional imaging is able to characterise NETs for example in regard of glucose metabolism and amine-precurser metabolism with clinical impact in staging, therapy monitoring and prognosis.

Schlüsselwörter

68-Gallium - Somatostatinanaloga - PET/CT - neuroendokrine Tumoren

Key words

68-Gallium - somatostatin analogue - PET/CT - neuroendocrine tumors
 

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