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Kompendium Internistische Onkologie

Part of the book series: Springer Reference Medizin ((SRM))

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Zusammenfassung

Zur Beurteilung eines Therapieeffekts einer onkologischen Therapie kann die diagnostische Bildgebung durch die Bestimmung der volumetrischen Tumorlast dienen. Gängige Verfahren sind hierbei allem voran die CT, aber auch Ultraschall und MRT. Bei den daraus entstandenen standardisierten Regelwerken für die Response-Bestimmung, wie den RECIST, handelt es sich meist um vereinfachte Messungen. Für die individuelle Beurteilung eines Therapieeffekts bedarf es jedoch einer genaueren Erfassung des Tumorverhaltens im Verlauf. Weiterführende nichtinvasive Bestimmung von Veränderungen der Tumorgewebsbeschaffenheit und dessen funktionelle Eigenschaften können über eine Größenänderung hinaus der Therapieerfolgsbewertung dienen. Gängige bildgebende Verfahren sind die intravenös kontrastmittelgestützte Darstellung, aber auch die diffusionsgewichtete MRT sowie die PET. Vereinfachte und standardisierte Auswertungen der Tumorbeschaffenheit sind sowohl für die morphologischen Bildgebungsverfahren (z. B. mRECIST, EASL-Kriterien, CHOI) als auch für die funktionelle Bildgebung in Form der FDG-PET (PERCIST, EORTC-PET-Response-Kriterien) etabliert. Mit der zunehmenden Anwendung immuntherapeutischer Behandlungsverfahren und insbesondere mit der Anwendung von Immun-Checkpoint-Inhibitoren in der neoadjuvanten Behandlungssituation kommt der Beurteilung der Response auch in diesem Bereich eine wichtige zukünftige Rolle zu. Molekulare Marker sowie die Durchflusszytometrie werden bei verschiedenen Erkrankungen zunehmend zur Beurteilung der Remissionstiefe im Sinne einer Bestimmung der minimalen Resterkrankung oder der messbaren Resterkrankung (MRD) eingesetzt.

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Authors and Affiliations

  1. Klinik für Radiologie, Charité, Campus Virchow-Klinikum, Berlin, Deutschland

    Bernhard Gebauer

  2. Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Timm Denecke

  3. Klinik für Radiologie, Charité – Universitätsmedizin Berlin, Berlin, Deutschland

    Lynn Jeanette Savic

  4. Abteilung Nuklearmedizin Department für Strahlenmedizin, Universitätsklinikum Halle (Saale), Halle, Deutschland

    Andreas Hendrik Hering

  5. Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Katrin Schierle

  6. Medizinische Klinik und Poliklinik für Hämatologie, Zelltherapie und Hämostaseologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Madlen Jentzsch

  7. Medizinische Klinik und Poliklinik II Klinik und Poliklinik für Onkologie, Gastroenterologie, Hepatologie, Pneumologie und Infektiologie Department für innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland

    Ulrich Hacker

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  2. Timm Denecke
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  4. Andreas Hendrik Hering
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  5. Katrin Schierle
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  7. Ulrich Hacker
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Correspondence to Ulrich Hacker .

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  1. Abt. Hämatologie und Onkologie, Universitätsklinikum Halle-Wittenberg Klinik und Poliklinik Innere Medizin IV, Halle, Sachsen-Anhalt, Deutschland

    Hans-Joachim Schmoll

Section Editor information

  1. Halle, Deutschland

    Fabian Meinert

  2. Halle, Deutschland

    Franziska Cygon

  3. Klinik für Radiologie, Charité, Campus Virchow-Klinikum, Berlin, Deutschland

    Bernhard Gebauer

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Gebauer, B. et al. (2021). Remissionsparameter. In: Schmoll, HJ. (eds) Kompendium Internistische Onkologie . Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46764-0_1-1

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