Röthke M C, Afshar-Oromieh A, Schlemmer H-P
Abteilung für onkologische Radiologie, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 280, 69120 Heidelberg, Deutschland.
Radiologe. 2013 Aug;53(8):676-81. doi: 10.1007/s00117-013-2499-0.
CLINICAL/METHODICAL ISSUE: A present goal is to improve detection and staging of prostate cancer using innovative imaging technology such as PET/MRI.
The modality of choice for detection of prostate cancer is multiparametric MRI. Furthermore, PET/CT is used, in particular, for the detection and staging of distant metastases and recurrent disease. For assessment of bone metastases, the method most commonly used is bone scintigraphy.
The development of a simultaneous hybrid PET/MRI system is the last great "fusion" of the known cross-sectional image modalities. In addition, synthesis of new, innovative tracers such as (18)F-FACBC or (68)Ga-PSMA allows more specific detection of prostate cancer.
Hybrid PET/MRI imaging has the potential to replace conventional imaging techniques in the future.
The method is just starting the broad application. Clinical studies must be expanded in order to substantiate the additional value of the method.
Currently, there is still a low distribution situation, since it is a new and cost-intensive method. At the same time, there is still no consistent solution for reimbursement. The importance in practice first rises by clarifying the payment situation and further demonstration of the method's benefit by larger studies.
临床/方法学问题:当前的一个目标是使用正电子发射断层扫描/磁共振成像(PET/MRI)等创新成像技术来改善前列腺癌的检测和分期。
检测前列腺癌的首选方式是多参数磁共振成像。此外,PET/CT尤其用于检测远处转移和复发性疾病并进行分期。对于骨转移的评估,最常用的方法是骨闪烁显像。
同步混合型PET/MRI系统的开发是已知断层图像模态的最后一次重大“融合”。此外,新型创新示踪剂如(18)F-FACBC或(68)Ga-PSMA的合成能够更特异性地检测前列腺癌。
混合型PET/MRI成像未来有可能取代传统成像技术。
该方法刚刚开始广泛应用。必须扩大临床研究以证实该方法的附加价值。
目前,由于这是一种新的且成本高昂的方法,其普及程度仍然较低。同时,报销方面仍没有统一的解决方案。在实践中的重要性首先通过明确支付情况以及通过更大规模研究进一步证明该方法的益处而提高。