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31.08.2022 | Originalien

Klinische Aspekte bei der Diagnose und Therapie des Prostatakarzinoms

verfasst von: Dr. med. Philipp Krausewitz, M. Ritter

Erschienen in: Journal für Urologie und Urogynäkologie/Österreich | Ausgabe 3/2022

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Zusammenfassung

Hintergrund

Diagnostik und Therapie des primären Prostatakarzinoms (PCA) haben in den letzten Jahren einen signifikanten Wandel durch moderne Bildgebung erfahren.

Ziel der Arbeit/Fragestellung

Etablierte und innovative diagnostische und therapeutische Verfahren zur Detektion und Behandlung des primären PCA werden dargelegt und gegeneinander abgewogen.

Material und Methoden

Hintergrundwissen und behandlungsrelevante Leitlinienempfehlungen zum primären PCA werden veranschaulicht und um aktuelle Studienergebnisse ergänzt.

Ergebnisse

Die Integration moderner Bildgebung, insbesondere der multiparametrischen Magnetresonanztomographie (mpMRT), in den diagnostischen Algorithmus hat die Primärdiagnostik des PCA wesentlich verbessert. Aggressive Karzinome werden bei gleichzeitiger Reduktion von Überdiagnostik klinisch insignifikanter PCA sowohl in der initialen als auch in der Rebiopsie signifikant besser detektiert. Kurative Therapieansätze wie „active surveillance“, radikale Prostatektomie und fokale Therapien orientieren sich zunehmend an der im Rahmen der mpMRT ermittelten Tumorausdehnung und -aggressivität. Neben ihrer etablierten Rolle in der Rezidivdiagnostik wird aktuell der mögliche Einsatz der PSMA-PET/CT (PSMA: prostataspezifisches Membranantigen, PET/CT: Positronen-Emissions-Tomographie/Computertomographie) in der Primärdiagnostik evaluiert.

Schlussfolgerung

Moderne Bildgebung, allen voran mpMRT und PSMA-PET/CT, hat einen signifikanten Mehrwert für Diagnostik und Therapie des primären PCA. Der multiparametrische Ultraschall ist eine zukunftsträchtige Ergänzung des radiologischen Armamentariums beim primären PCA.
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Metadaten
Titel
Klinische Aspekte bei der Diagnose und Therapie des Prostatakarzinoms
verfasst von
Dr. med. Philipp Krausewitz
M. Ritter
Publikationsdatum
31.08.2022
Verlag
Springer Vienna
Erschienen in
Journal für Urologie und Urogynäkologie/Österreich / Ausgabe 3/2022
Print ISSN: 1023-6090
Elektronische ISSN: 1680-9424
DOI
https://doi.org/10.1007/s41972-022-00169-7

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