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Nuklearmedizinisch-onkologische Einführung

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Dermatologie und Nuklearmedizin

Zusammenfassung

Einleitend wird eine Übersicht vermittelt zur Radiopharmazie: Tumoraffine (67Ga, 201TI), melanom-affine (131J, 123J-Quinoline, -tyrosine), tumorselektive (131J, 111In-carzinoembryonales Antigen), radioaktiv markierte Metabolite (11C-Aminosäuren), Zellmarkierung (111In-Granulozyten). Postulate auf dem Gerätesektor werden definiert: Digital-rotierbare Gammakamera mit Rechneranschluß zur Tomoszintigraphie. Im klinischen Teil wird die Bedeutung der direkten und indirekten Tumor-und Lymphabflußszintigraphie (67Ga, 99mTc-Sb2S3) bei folgenden Primärtumoren und Metastasen abgehandelt: Melano-Malignom mit Leber-, Milz-, Hirn-, Lungen- und Skelettmetastasen, unter Berücksichtigung, der Knochenmarkszintigraphie, bei kutanem T-Zell-Lymphom (111In-Leukozy-ten), bei Weichteilneoplasmen (Skelett- und weichteilaffine 99mTc-MDP) unter Angabe von Sensitivi-ät und Spezifität für Melanom-Metastasen-Szinztigraphie mit 67Ga (Sensitivität 88, Spezifität 91, Genauigkeit 91%, gültig für Tomographietechnik). Skelettszintigraphische Funktionsmuster bei systemischer Mastozytose werden im Unterschied zur osteogenetischen Reaktion primär maligner Tumoren diskutiert. Abschließend finden Möglichkeiten der Tumortherapie-Kontrolle mit Verfahren der Nuklearmedizin Erwähnung unter Hinweis auf deren komplementäre diagnostische Rolle im Rahmen anderer bildgebender Verfahren (Sonographie, Computertomographie): in Metastasensuche, Verifizierung einer Organbeteiligung von Systemerkrankungen, Kontrolle der Therapieeffektivität, Erfassung von Folgen bzw. Komplikationen der Tumortherapie.

Summary

The introduction comprises a review on radiopharmaceuticals: Tumorseeking (67Ga, 201T1), melanoma-seeking (131J, 123J-Qinolines, -tyrosine), tumor-selective (131J, 111In-carcinoembryonic antigen), radioactive metabolites (11C-Aminoacids), cell-labelling (111In-granulocytes). Instrumental prerequisites are defined: Digital-rotating gamacamera, interfaced to computer for tomoscintigraphy. The clinical part concerns the importance of the direct and indirect tumor and lymph drainage scintigraphy (67Ga, 99mTc-Sb2S3) in following primary tumors and metastases: malignant melanoma associated with metastases in Hver, spleen, brain, lung, bone, also considering the adjuvant bone marrow scans, in cutaneous T-cell lymphoma (111In-Leucocytes), in soft tissue neoplasms (99mTc-MDP). The sensitivity of 67Ga-tomoscintigraphy in metastases of malignant melanoma is 88% (specifity 91, accuracy 91). Functional patterns of skeletal scintigraphy in systemic mastocytosis are mentioned as compared to osteogenetic reaction of malignant origin. Finally possibilities of nuclear medicine procedures are outlined: their complementary role as compared to other imaging modalities (sonography, computerized-x-ray-tomography) for screening of metastases, verifying organ involvement in systemic diseases, control of therapeutic effectiveness, detecting complications of therapy. Future tendencies are mentioned.

Herrn Prof. Dr. W. Lorenz, Frankfurt, zum 65. Geburtstag gewidmet

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Hör, G. (1985). Nuklearmedizinisch-onkologische Einführung. In: Holzmann, H., Altmeyer, P., Hör, G., Hahn, K. (eds) Dermatologie und Nuklearmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-70279-2_16

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  • DOI: https://doi.org/10.1007/978-3-642-70279-2_16

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