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Bedeutung der Ganzkörper-MRT beim Staging des kolorektalen Karzinoms

Importance of whole body MRI for staging of colorectal cancer

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Zusammenfassung

Klinisches/methodisches Problem

Staging/Follow-up beim kolorektalen Karzinom wird normalerweise mit multimodalen Bildgebungsverfahren durchgeführt. Diese können jedoch zeitintensiv sein und bergen die Gefahr einer untersucherabhängigen Befundvarianz. Alternativ bietet die Ganzkörper-MRT eine onkologische Bildgebung mit einem systemischen Ansatz.

Radiologische Standardverfahren

Sonographie, dedizierte MRT, Mehrzeilencomputertomographie (MSCT) oder Positronenemissionstomographie/CT (PET/CT).

Methodische Innovationen

Hochauflösende Ganzkörper-MRT mit fokussierten Untersuchungen einzelner Organe, z. B. Becken und Bauchorgane, Lunge, Gehirn oder Skelettsystem mit unterschiedlichen Sequenztechniken und Kontrastierungen.

Leistungsfähigkeit

Kolorektale Rezidiverkennung mit der Ganzkörper-MRT: 83% Genauigkeit (Lymphknotenmetastasen 80%, Fernmetastasen 86%).

Bewertung

Potenzielle Kostenreduktion durch Verringerung der Untersuchungszeiten und Personalkosten.

Empfehlung für die Praxis

Strahlungsfreie Alternative zu klassischen Stufenalgorithmen beim Staging/Follow-up des kolorektalen Karzinoms

Abstract

Clinical/methodical issue

Staging and follow-up of colorectal cancer are usually performed with multimodal imaging strategies. These can be time-intensive and potentially lead to examiner-dependent bias. Alternatively, whole body magnetic resonance imaging (WB-MRI) provides oncologic imaging with a systemic approach.

Standard radiological methods

Ultrasound, multislice computed tomography (MSCT), dedicated MRI and positron emission tomography/CT (PET/CT).

Methodical innovations

High-resolution WB-MRI with focused examination of various organs, such as the pelvis and abdomen, lungs, brain and skeletal system, using different sequence and contrast techniques.

Performance

Detection of colorectal tumor recurrence with WB-MRI provides 83% accuracy (lymph node metastases 80%, organ metastases 86%).

Achievements

Potential cost reduction through decreased examination time and personnel costs.

Practical recommendations

Whole body MRI is a radiation-free alternative to standard sequential algorithms of staging and follow-up of colorectal cancer.

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  1. Institut für klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland

    G. Schmidt

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Correspondence to G. Schmidt.

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Schmidt, G. Bedeutung der Ganzkörper-MRT beim Staging des kolorektalen Karzinoms. Radiologe 52, 537–544 (2012). https://doi.org/10.1007/s00117-011-2285-9

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