Kratochwil C
Klinik für Nuklearmedizin, Universität Ulm, 89081, Ulm.
Urologe A. 2007 Aug;46(8):891-6. doi: 10.1007/s00120-007-1520-5.
Bone metastases are common by prostate and renal carcinomas but prostate carcinomas are predominantly osteoblastic metastases and renal carcinomas often osteolytic. Apart from bone scintigraphy and conventional X-ray imaging, computed tomography (CT), magnetic resonance tomography (MRT) and positron emission tomography (PET) can also be used for primary diagnosis. X-rays and CT are less sensitive but better for evaluating the stability of metastases. Primary diagnosis of prostate carcinomas should encompass selective bone imaging and skeletal scintigraphy is also recommended. Local recurrences or lymph node metastases can be detected using PET with (11)C-choline. MRT is the method with higher sensitivity and specificity but for whole body scans is, at present, very time-consuming and, therefore, impractical and cost-intensive. However, for selective, non-invasive valency evaluation of suspect metastases, it is considered the gold standard for the tumor entities prostate and renal carcinomas where the results of FDG PET are consistently negative.
骨转移在前列腺癌和肾癌中很常见，但前列腺癌主要是成骨性转移，而肾癌通常是溶骨性转移。除骨闪烁显像和传统X线成像外，计算机断层扫描（CT）、磁共振断层扫描（MRT）和正电子发射断层扫描（PET）也可用于初步诊断。X线和CT敏感性较低，但在评估转移灶稳定性方面表现更好。前列腺癌的初步诊断应包括选择性骨显像，也推荐进行骨骼闪烁显像。使用（11）C-胆碱的PET可检测局部复发或淋巴结转移。MRT是敏感性和特异性较高的方法，但目前用于全身扫描非常耗时，因此不切实际且成本高昂。然而，对于可疑转移灶的选择性、非侵入性效能评估，它被认为是前列腺癌和肾癌实体的金标准，在这些肿瘤中，FDG PET的结果始终为阴性。
