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Der Nuklearmediziner 2002; 25(4): 230-237
DOI: 10.1055/s-2002-36478
Skelettdiagnostik

© Georg Thieme Verlag Stuttgart · New York

Primäre und sekundäre Neoplasien des Skeletts

Primary and Secondary Malignancies of the SkeletonD. Sandrock1 , D. L. Munz1
  • 1Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin
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Publication History

Publication Date:
07 January 2003 (online)

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Zusammenfassung

Für Staging und Restaging von primären und sekundären (malignen) Neoplasien des Skeletts stellt die Skelettszintigraphie nach wie vor ein valides Verfahren dar. Sie findet sich dabei aber in einer strengen Kosten/Nutzen-Diskussion und in Konkurrenz zu insbesondere MRT und, z. B. beim Prostatakarzinom, zu Tumormarkern als Verlaufsparameter (z. B. PSA). Obwohl für die Darstellung von Knochenmetastasen zahlenmäßig die Knochenmarkszintigraphie sensitiver (läsionsbezogen) als die Skelettszintigraphie ist, hat sie sich routinemäßig nicht durchgesetzt. Der klinische Stellenwert der F-18-Fluorid-PET ist noch nicht vollständig geklärt. Die Positivdarstellung von Metastasen im Skelett ist mit weiteren Radiopharmaka möglich, z. B. „unspezifisch” mit F-18-FDG oder „spezifisch (z. B. neuroendokrine Tumoren) mit I-123-MIBG.

Abstract

Bone scintigraphy is still a valid procedure for staging and restaging of primary and secondary malignancies of the skeleton. However, there is a strong discussion about cost-effectiveness and, especially, with competing procedures like magnetic resonance imaging, and, e. g. for prostate cancer, with tumor markers like PSA. Although bone marrow scintigraphy is more sensitive for the detection of bone metastases (on a lesion by lesion basis) than bone scintigraphy, it is routinely not the procedure of choice. The clinical value of F-18-Fluoride PET is not fully clarified yet. The direct imaging of bone metastases in positive contrast is possible with a number of substances, nonspecific with F-18-FDG or more specific (e. g. neuroendocrine tumors) with I-123-MIBG.

Schlüsselwörter

Knochentumor - Knochenneoplasie - Szintigraphie

Key words

Bone tumor - scintigraphy

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Priv.-Doz. Dr. Dirk Sandrock

Klinik und Poliklinik für Nuklearmedizin

Universitätsklinikum Charité

Medizinische Fakultät der Humboldt-Universität zu Berlin

Schumannstr. 20/21

10098 Berlin

Phone: +49/30/4 50 52 70 12

Fax: +49/30/4 50 52 79 12

Email: dirk.sandrock@charite.de