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Song L, Jiang S, Yang Q, Huang W, Qiu Y, Chen Z, Sun X, Wang T, Wu S, Chen Y, Zeng H, Wang Z, Kang L. Development of a Novel Peptide-Based PET Tracer [ 68Ga]Ga-DOTA-BP1 for BCMA Detection in Multiple Myeloma. J Med Chem 2024. [PMID: 39167092 DOI: 10.1021/acs.jmedchem.4c00759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
B-cell maturation antigen (BCMA) has emerged as a promising tumor marker for the diagnosis and treatment of multiple myeloma. The noninvasive and rapid detection of BCMA expression in vivo provides significant value in screening and evaluating multiple myeloma patients receiving BCMA-targeted therapy. We identified the BCMA-targeting peptide BP1 from a one-bead-one-compound (OBOC) peptide library using a high-throughput microarray strategy. The BCMA-targeting specificity and affinity of BP1 were assessed by surface plasmon resonance imaging (SPRi), flow cytometry, and confocal imaging. BCMA-positive (H929) and BCMA-negative (K562) subcutaneous tumor models were established and labeled with 68Ga for BP1, followed by PET imaging and biodistribution studies. PET imaging demonstrated that 68Ga-labeled BP1 has significant specific uptake in multiple myeloma, enabling rapid identification of BCMA expression and precise delineation of the disease. Thus, BP1 represents an ideal candidate for multiple myeloma imaging.
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Affiliation(s)
- Lele Song
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Sujun Jiang
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian 350122, China
| | - Qi Yang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Wenpeng Huang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Yongkang Qiu
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Zhao Chen
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Xinyao Sun
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Tianyao Wang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Sitong Wu
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
| | - Yongshou Chen
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Huajie Zeng
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian 350122, China
| | - Zihua Wang
- Fujian Provincial Key Laboratory of Brain Aging and Neurodegenerative Diseases, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian 350122, China
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Lei Kang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China
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Keigley QJ, Fowler AM, O'Brien SR, Dehdashti F. Molecular Imaging of Steroid Receptors in Breast Cancer. Cancer J 2024; 30:142-152. [PMID: 38753748 PMCID: PMC11101139 DOI: 10.1097/ppo.0000000000000715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
ABSTRACT Steroid receptors regulate gene expression for many important physiologic functions and pathologic processes. Receptors for estrogen, progesterone, and androgen have been extensively studied in breast cancer, and their expression provides prognostic information as well as targets for therapy. Noninvasive imaging utilizing positron emission tomography and radiolabeled ligands targeting these receptors can provide valuable insight into predicting treatment efficacy, staging whole-body disease burden, and identifying heterogeneity in receptor expression across different metastatic sites. This review provides an overview of steroid receptor imaging with a focus on breast cancer and radioligands for estrogen, progesterone, and androgen receptors.
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Affiliation(s)
- Quinton J Keigley
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | - Sophia R O'Brien
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Farrokh Dehdashti
- Division of Nuclear Medicine, Edward Mallinckrodt Institute of Radiology, Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
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Pedersen MA, Munk OL, Dias AH, Steffensen JH, Møller AL, Johnsson AL, Hansen KV, Bender D, Jakobsen S, Busk M, Gormsen LC, Tramm T, Borgquist S, Vendelbo MH. Dynamic whole-body [ 18F]FES PET/CT increases lesion visibility in patients with metastatic breast cancer. EJNMMI Res 2024; 14:24. [PMID: 38436824 PMCID: PMC10912074 DOI: 10.1186/s13550-024-01080-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Correct classification of estrogen receptor (ER) status is essential for prognosis and treatment planning in patients with breast cancer (BC). Therefore, it is recommended to sample tumor tissue from an accessible metastasis. However, ER expression can show intra- and intertumoral heterogeneity. 16α-[18F]fluoroestradiol ([18F]FES) Positron Emission Tomography/Computed Tomography (PET/CT) allows noninvasive whole-body (WB) identification of ER distribution and is usually performed as a single static image 60 min after radiotracer injection. Using dynamic whole-body (D-WB) PET imaging, we examine [18F]FES kinetics and explore whether Patlak parametric images ( K i ) are quantitative and improve lesion visibility. RESULTS This prospective study included eight patients with metastatic ER-positive BC scanned using a D-WB PET acquisition protocol. The kinetics of [18F]FES were best characterized by the irreversible two-tissue compartment model in tumor lesions and in the majority of organ tissues. K i values from Patlak parametric images correlated with K i values from the full kinetic analysis, r2 = 0.77, and with the semiquantitative mean standardized uptake value (SUVmean), r2 = 0.91. Furthermore, parametric K i images had the highest target-to-background ratio (TBR) in 162/164 metastatic lesions and the highest contrast-to-noise ratio (CNR) in 99/164 lesions compared to conventional SUV images. TBR was 2.45 (95% confidence interval (CI): 2.25-2.68) and CNR 1.17 (95% CI: 1.08-1.26) times higher in K i images compared to SUV images. These quantitative differences were seen as reduced background activity in the K i images. CONCLUSION [18F]FES uptake is best described by an irreversible two-tissue compartment model. D-WB [18F]FES PET/CT scans can be used for direct reconstruction of parametric K i images, with superior lesion visibility and K i values comparable to K i values found from full kinetic analyses. This may aid correct ER classification and treatment decisions. Trial registration ClinicalTrials.gov: NCT04150731, https://clinicaltrials.gov/study/NCT04150731.
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Affiliation(s)
- Mette A Pedersen
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Ole L Munk
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - André H Dias
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark
| | | | - Anders L Møller
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Kim Vang Hansen
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark
| | - Dirk Bender
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steen Jakobsen
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark
| | - Morten Busk
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Lars C Gormsen
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Trine Tramm
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Signe Borgquist
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Mikkel H Vendelbo
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle-Juul-Jensens Boulevard 165, 8200, Aarhus, Denmark.
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
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Ndlovu H, Lawal IO, Mokoala KMG, Sathekge MM. Imaging Molecular Targets and Metabolic Pathways in Breast Cancer for Improved Clinical Management: Current Practice and Future Perspectives. Int J Mol Sci 2024; 25:1575. [PMID: 38338854 PMCID: PMC10855575 DOI: 10.3390/ijms25031575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Breast cancer is the most frequently diagnosed cancer and leading cause of cancer-related deaths worldwide. Timely decision-making that enables implementation of the most appropriate therapy or therapies is essential for achieving the best clinical outcomes in breast cancer. While clinicopathologic characteristics and immunohistochemistry have traditionally been used in decision-making, these clinical and laboratory parameters may be difficult to ascertain or be equivocal due to tumor heterogeneity. Tumor heterogeneity is described as a phenomenon characterized by spatial or temporal phenotypic variations in tumor characteristics. Spatial variations occur within tumor lesions or between lesions at a single time point while temporal variations are seen as tumor lesions evolve with time. Due to limitations associated with immunohistochemistry (which requires invasive biopsies), whole-body molecular imaging tools such as standard-of-care [18F]FDG and [18F]FES PET/CT are indispensable in addressing this conundrum. Despite their proven utility, these standard-of-care imaging methods are often unable to image a myriad of other molecular pathways associated with breast cancer. This has stimulated interest in the development of novel radiopharmaceuticals targeting other molecular pathways and processes. In this review, we discuss validated and potential roles of these standard-of-care and novel molecular approaches. These approaches' relationships with patient clinicopathologic and immunohistochemical characteristics as well as their influence on patient management will be discussed in greater detail. This paper will also introduce and discuss the potential utility of novel PARP inhibitor-based radiopharmaceuticals as non-invasive biomarkers of PARP expression/upregulation.
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Affiliation(s)
- Honest Ndlovu
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa; (H.N.); (K.M.G.M.)
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
| | - Ismaheel O. Lawal
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Kgomotso M. G. Mokoala
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa; (H.N.); (K.M.G.M.)
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
| | - Mike M. Sathekge
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa; (H.N.); (K.M.G.M.)
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
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Çelik B, Boge M, Dilege E. Does F-18 FDG-PET/CT Have an Additional Impact on Axillary Approach in Early-Stage Breast Cancer? Eur J Breast Health 2024; 20:45-51. [PMID: 38187104 PMCID: PMC10765458 DOI: 10.4274/ejbh.galenos.2023.2023-10-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
Objective Breast cancer (BC) is a significant health concern and one of the most diagnosed cancers in women, both in Turkey and globally. Despite advances in the management of BC, axillary lymph node involvement remains a significant consideration for treatment planning, local recurrence, and prognosis. We aimed to evaluate the contribution of F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG-PET/CT) in detecting axillary lymph node metastasis compared to ultrasound (US). Materials and Methods Eighty patients who were diagnosed with stage I and II BC and underwent US and F-18 FDG-PET/CT scans before surgery were enrolled in this study. Those who did not undergo F-18 FDG-PET/CT imaging, patients with distant metastases at the time of diagnosis and patients with micrometastases in the axilla were excluded from the analysis. Imaging results of the status of axillary lymph nodes were verified with the final pathology report of axillary lymph nodes. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of F-18 FDG-PET/CT for the detection of ipsilateral axillary lymph node metastases were 75%, 77.27%, 72.97%, 79.07%, and 76.25%. The corresponding values for US were 72.22%, 81.82%, 76.47%, 78.26%, and 77.50%, respectively. When US finding is negative or suspicious in axillary lymph node evaluation, the accuracy of F-18 FDG-PET/CT for the detection of ipsilateral axillary lymph node metastases were 65.38%, 83.33%, 70.83%, and 79.55%, respectively. Conclusion This study found that F-18 FDG-PET/CT does not provide an additional advantage over US in assessing the axilla in early-stage disease.
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Affiliation(s)
- Burak Çelik
- Department of General Surgery, Koç University School of Medicine, İstanbul, Turkey
| | - Medine Boge
- Department of Radiology, Koç University School of Medicine, İstanbul, Turkey
| | - Ece Dilege
- Department of General Surgery, Koç University School of Medicine, İstanbul, Turkey
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Covington MF, O'Brien SR, Lawhn-Heath C, Pantel AR, Ulaner GA, Linden HM, Dehdashti F. Fluorine-18-Labeled Fluoroestradiol PET/CT: Current Status, Gaps in Knowledge, and Controversies-AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2023. [PMID: 38117098 DOI: 10.2214/ajr.23.30330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PET/CT using 16α-[18F]-fluoro-17β-estradiol (FES) noninvasively images tissues expressing estrogen receptors (ERs). FES has undergone extensive clinicopathologic validation for ER+ breast cancer and received FDA approval in 2020 for clinical use as an adjunct to biopsy in patients with recurrent or metastatic ER+ breast cancer. Clinical use of FES PET/CT is increasing, but is not widespread in the United States. This AJR Expert Panel Narrative Review explores the present status and future directions of FES PET/CT, including image interpretation, existing and emerging uses, knowledge gaps, and current controversies. Specific controversies discussed include whether both FES PET/CT and FDG PET/CT are warranted in certain scenarios, whether further workup is required after negative FES PET/CT results, whether FES PET/CT findings should inform endocrine therapy selection, and whether immunohistochemistry should remain the standalone reference standard for determining ER status for all breast cancers. Consensus opinions from the panel include agreement with the appropriate clinical uses of FES PET/CT published by a multidisciplinary expert workgroup in 2023; anticipated expanded clinical use of FES PET/CT for staging ER-positive invasive lobular carcinomas and low-grade invasive ductal carcinomas pending ongoing clinical trial results; and the need for further research regarding use of FES PET/CT for ER-expressing nonbreast malignancies.
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Affiliation(s)
- Matthew F Covington
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute
- Department of Radiology and Imaging Sciences, University of Utah
| | - Sophia R O'Brien
- Department of Radiology, Hospital of the University of Pennsylvania
| | - Courtney Lawhn-Heath
- Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Austin R Pantel
- Department of Radiology, Hospital of the University of Pennsylvania
| | - Gary A Ulaner
- Molecular Imaging and Therapy, Hoag Family Cancer Institute
- Radiology and Translational Genomics, University of Southern California, Los Angeles, CA
| | - Hannah M Linden
- Department of Medicine, Division of Hematology and Oncology University of Washington, and Fred Hutchinson Cancer Center
| | - Farrokh Dehdashti
- Mallinckrodt Institute of Radiology, Siteman Cancer Center, Washington University in St. Louis
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Kiatkittikul P, Mayurasakorn S, Promteangtrong C, Kunawudhi A, Siripongsatian D, Hirata N, Jantarato A, Boonkawin N, Yaset S, Kongsakorn P, Phewnual W, Chotipanich C. Head-to-head comparison of 18F-FDG and 18F-FES PET/CT for initial staging of ER-positive breast cancer patients. Eur J Hybrid Imaging 2023; 7:23. [PMID: 38105347 PMCID: PMC10725859 DOI: 10.1186/s41824-023-00176-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/28/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To compare the diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) and 18F-fluoroestradiol (18F-FES) positron emission tomography/computed tomography (PET/CT) for initial staging of estrogen receptor (ER) positive breast cancer. METHODS Twenty-eight patients with ER-positive breast cancer underwent 18F-FDG and 18F-FES PET/CT for initial staging. Diagnostic performance and concordance rates were analyzed for both radiotracers. Semiquantitative parameters of maximum standardized uptake value (SUVmax) and tumor-to-normal ratio (T/N ratio) were compared using Wilcoxon signed-rank test. Factors potentially affecting the degree of radiotracer uptake were analyzed by multi-level linear regression analysis. RESULTS The overall diagnostic performance of 18F-FES was comparable to 18F-FDG, except for higher specificity and NPV, with sensitivity, specificity, PPV, NPV, and accuracy of 87.56%, 100%, 100%, 35.14%, and 88.35%, respectively, for 18F-FES and 83.94%, 30.77%, 94.74%, 11.43%, and 95.37%, respectively, for 18F-FDG. Diagnostic performance of strong ER expression was better in 18F-FES but worse for 18F-FDG. There was a correlation of mucinous cell type and Allred score 7-8 with 18F-FES uptake, with correlation coefficients of 26.65 (19.28, 34.02), 5.90 (- 0.005, 11.81), and p-value of < 0.001, 0.05, respectively. Meanwhile, luminal B and Ki-67 were related to 18F-FDG uptake, with correlation coefficients of 2.76 (1.10, 0.20), 0.11 (0.01, 0.2), and p-value of 0.018, 0.025, respectively. CONCLUSION Diagnostic performance of 18F-FES is comparable to 18F-FDG, but better for strongly ER-positive breast cancer. Combination of 18F-FES and 18F-FDG would potentially overcome the limitations of each tracer with more accurate staging.
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Affiliation(s)
- Peerapon Kiatkittikul
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand.
| | - Supanida Mayurasakorn
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Chetsadaporn Promteangtrong
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Anchisa Kunawudhi
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Dheeratama Siripongsatian
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Natdanai Hirata
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Attapon Jantarato
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Natphimol Boonkawin
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Sukanya Yaset
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Pattanapong Kongsakorn
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Warunya Phewnual
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
| | - Chanisa Chotipanich
- National Cyclotron and PET Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, 906 Kamphaeng Phet 6 Rd., Lak Si, Bangkok, 10210, Thailand
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Phillips EF, Karak PK. Diffuse bilateral 18F-Fluoroestradiol pulmonary uptake in patients with metastatic estrogen receptor positive breast cancer: A case report. J Med Imaging Radiat Sci 2023; 54:726-731. [PMID: 37620179 DOI: 10.1016/j.jmir.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION Breast cancer is the most commonly diagnosed cancer in women and hormonal therapy is an established treatment for estrogen receptor (ER) positive breast cancers. 18F-Fluoroestradiol (FES) is an emerging radiotracer used to determine hormone status in patients with ER positive breast cancer as FES specifically binds to the alpha subtype of estrogen receptors. As with all radiotracers, FES demonstrates background uptake within various tissues and organs besides the targeted breast cancer and metastatic disease. To date, FES has mostly been shown to demonstrate uptake within the lungs from metastatic disease or in a more focal region after radiation therapy. CASE AND OUTCOMES We present two patients with stage IV ER positive breast cancer who underwent FES positron emission tomography and computed tomography (PET/CT) scans to evaluate for metastatic disease; both of which demonstrated diffuse bilateral mild-moderate pulmonary uptake. The first patient had a severe lung injury which was improving but still present at the time of her FES PET/CT. The second patient had a remote history of prior right breast radiation therapy for a prior breast cancer as well as emphysema and mild interstitial disease. DISCUSSION To date, FES uptake within the lungs has been shown to be secondary to fibrotic changes secondary to prior radiation therapy and the uptake is localized to a focal region within the lung corresponding to the localized region around the tumor needing radiation therapy. We present two FES PET/CT scans that demonstrate diffuse bilateral mild-moderate uptake. We believe the first patient's bilateral FES uptake was secondary to inflammatory changes from her acute lung injury. Our second patient has a remote history of right breast radiation therapy that would not account for her diffuse lung uptake but does have emphysema and mild interstitial disease which can account for the FES uptake seen in her FES PET/CT. CONCLUSION 18F-Fluoroestradiol is an emerging radiotracer that binds to estrogen receptors and is being used to determine hormone receptor status in women with ER positive breast cancers, which is the most commonly diagnosed cancer in women. Therefore, it's important to understand where it might demonstrate uptake and why. We highlighted two unique cases of mild-moderate pulmonary uptake of FES to provide further information about FES. Overall, we conclude that diffuse bilateral mild-moderate FES uptake within the lungs is likely secondary to inflammation, interstitial disease, or a combination thereof.
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Affiliation(s)
- Emily F Phillips
- Section of Nuclear Medicine, Department of Radiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06106, United States.
| | - Prasanta K Karak
- Section of Nuclear Medicine, Department of Radiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06106, United States
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Abstract
Breast cancer (BC) remains one of the leading causes of death among women. The management and outcome in BC are strongly influenced by a multidisciplinary approach, which includes available treatment options and different imaging modalities for accurate response assessment. Among breast imaging modalities, MR imaging is the modality of choice in evaluating response to neoadjuvant therapy, whereas F-18 Fluorodeoxyglucose positron emission tomography, conventional computed tomography (CT), and bone scan play a vital role in assessing response to therapy in metastatic BC. There is an unmet need for a standardized patient-centric approach to use different imaging methods for response assessment.
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Affiliation(s)
- Saima Muzahir
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, 1364 Clifton Road, Atlanta GA 30322, USA; Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, Room E152, 1364 Clifton Road, Atlanta, GA 30322, USA.
| | - Gary A Ulaner
- Molecular Imaging and Therapy, Hoag Family Cancer Institute, Newport Beach, CA, USA; Radiology and Translational Genomics, University of Southern California, Los Angeles, CA, USA
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, Room E152, 1364 Clifton Road, Atlanta, GA 30322, USA
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10
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Matushita CS, Coelho FDARFB, Stasiak CES, Rodrigues DF, Pianta DB, Kurkowski FD, da Silva MM, de Souza SAL, Lopes RW, de Castro PHR. 18F-fluoroestradiol positron emission tomography in patients with breast cancer: a systematic review and meta-analysis. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e2023S116. [PMID: 37556635 PMCID: PMC10411708 DOI: 10.1590/1806-9282.2023s116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/21/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Cristina S. Matushita
- Sociedade Brasileira de Medicina Nuclear – São Paulo (SP), Brazil
- Pontifícia Universidade Católica do Rio Grande do Sul, Instituto Do Cérebro do Rio Grande do Sul – Porto Alegre (RS), Brazil
- São Marcos Diagnósticos por Imagem – Joinville (SC), Brazil
| | | | - Camila Edith Stachera Stasiak
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Radiologia – Rio de Janeiro (RJ), Brazil
- Universidade Federal Fluminense, Serviço de Medicina Nuclear – Niterói (RJ), Brazil
| | - Denise Ferreira Rodrigues
- Nuclear Medcenter – Belo Horizonte (MG), Brazil
- Axial Inteligência Diagnóstica – Belo Horizonte (MG), Brazil
| | - Diego Bromfman Pianta
- Sociedade Brasileira de Medicina Nuclear – São Paulo (SP), Brazil
- Pontifícia Universidade Católica do Rio Grande do Sul, Instituto Do Cérebro do Rio Grande do Sul – Porto Alegre (RS), Brazil
- São Marcos Diagnósticos por Imagem – Joinville (SC), Brazil
| | - Flávia Dornelas Kurkowski
- Pontifícia Universidade Católica do Rio Grande do Sul, Instituto Do Cérebro do Rio Grande do Sul – Porto Alegre (RS), Brazil
| | - Marcelo Moreira da Silva
- São Marcos Diagnósticos por Imagem – Joinville (SC), Brazil
- Instituto de Medicina Nuclear e Endo de Brasília – Brasília (DF), Brazil
| | - Sergio Augusto Lopes de Souza
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Radiologia – Rio de Janeiro (RJ), Brazil
| | - Rafael Willain Lopes
- Sociedade Brasileira de Medicina Nuclear – São Paulo (SP), Brazil
- Hospital do Coração, Setor de Medicina Nuclear – São Paulo (SP), Brazil
| | - Paulo Henrique Rosado de Castro
- Sociedade Brasileira de Medicina Nuclear – São Paulo (SP), Brazil
- Pontifícia Universidade Católica do Rio Grande do Sul, Instituto Do Cérebro do Rio Grande do Sul – Porto Alegre (RS), Brazil
- São Marcos Diagnósticos por Imagem – Joinville (SC), Brazil
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11
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Huang YT, Chen TWW, Chen LY, Huang YY, Lu YS. The Application of 18F-FES PET in Clinical Cancer Care: A Systematic Review. Clin Nucl Med 2023:00003072-990000000-00634. [PMID: 37482660 DOI: 10.1097/rlu.0000000000004760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
INTRODUCTION [18F]fluoroestradiol (FES) can be used for the noninvasive visualization and quantification of tumor estrogen receptor (ER) expression and activity and was FDA-approved as a diagnostic agent in May 2022 for detecting ER-positive lesions in patients with recurrent or metastatic breast cancer. PET imaging was also used to detect ER-positive lesions and malignancy among patients with uterine, ovarian, and other ER-positive solid tumors. We conducted a systemic review of the studies on FES PET imaging used among patients with cancer not limited to breast cancer to better understand the application of FES PET imaging. METHODS PubMed/MEDLINE and Cochrane Library databases were used to perform a comprehensive and systematic search and were updated until August 15, 2022. Two authors independently reviewed the titles and abstracts of the retrieved articles by using the search algorithm and selected the articles based on the inclusion and exclusion criteria. All statistical analyses were conducted using R statistical software. RESULTS Forty-three studies with 2352 patients were included in the qualitative synthesis, and 23 studies with 1388 patients were included in the quantitative analysis, which estimated the FES-positive detection rate. Thirty-two studies (77%) included breast cancer patients in 43 included studies. The FES SUVmean was higher in patients with endometrial cancer (3.4-5.3) than in those with breast cancer (2.05) and uterine sarcoma (1.1-2.6). The pooled detection rates of FES PET imaging were 0.80 for breast and 0.84 for ovarian cancer patients, both similar to that of 18F-FDG. The FES uptake threshold of 1.1 to 1.82 could detect 11.1% to 45% ER heterogeneity, but the threshold of FES uptake did not have consistent predictive ability for prognosis among patients with breast cancer, unlike uterine cancer. However, FES uptake can effectively predict and monitor treatment response, especially endocrine therapy such as estradiol, ER-blocking agents (fulvestrant and tamifoxen), and aromatase inhibitors (such as letrozole and Z-endoxifen). CONCLUSIONS [18F]fluoroestradiol PET is not only a convenient and accurate diagnostic imaging tool for detecting ER-expressing lesions in patients with breast and ovarian cancer but also among patients with uterine cancer. [18F]fluoroestradiol PET is a noninvasive predictive and monitoring tool for treatment response and prognosis.
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Affiliation(s)
| | | | - Li-Yu Chen
- From the Primo Biotechnology Co, Ltd, Taipei
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12
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Nogami M, Tsujikawa T, Maeda H, Kosaka N, Takahashi M, Kinoshita N, Mori T, Makino A, Kiyono Y, Murakami T, Goi T, Okazawa H. [ 18F]FES PET Resolves the Diagnostic Dilemma of COVID-19-Vaccine-Associated Hypermetabolic Lymphadenopathy in ER-Positive Breast Cancer. Diagnostics (Basel) 2023; 13:diagnostics13111851. [PMID: 37296702 DOI: 10.3390/diagnostics13111851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Coronavirus disease (COVID-19) vaccination is known to cause a diagnostic dilemma due to false-positive findings on [18F]FDG PET in vaccine-associated hypermetabolic lymphadenopathy. We present two case reports of women with estrogen-receptor (ER)-positive cancer of the breast who were vaccinated for COVID-19 in the deltoid muscle. [18F]FDG positron emission tomography (PET) demonstrated primary breast cancer and multiple axillary lymph nodes with increased [18F]FDG uptake, diagnosed as vaccine-associated [18F]FDG-avid lymph nodes. Subsequent [18F]FES PET revealed single axillary lymph node metastasis in the vaccine-associated [18F]FDG-avid lymph nodes. To the best of our knowledge, this is the first study showing the usefulness of [18F]FES PET in diagnosing axillary lymph node metastasis in COVID-19-vaccinated patients harboring ER-positive breast cancer. Thus, [18F]FES PET has potential applications in the detection of true-positive metastatic lymph nodes in patients with ER-positive breast cancer regardless of the ipsilateral or contralateral side, who have received COVID-19 vaccination.
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Affiliation(s)
- Munenobu Nogami
- Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
- Department of Radiology, Kobe University Hospital, Kobe 650-0017, Japan
| | - Tetsuya Tsujikawa
- Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Hiroyuki Maeda
- First Department of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Mizuho Takahashi
- First Department of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Naoki Kinoshita
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Tetsuya Mori
- Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
| | - Akira Makino
- Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
| | - Yasushi Kiyono
- Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
| | | | - Takanori Goi
- First Department of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
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13
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O'Brien SR, Edmonds CE, Lanzo SM, Weeks JK, Mankoff DA, Pantel AR. 18F-Fluoroestradiol: Current Applications and Future Directions. Radiographics 2023; 43:e220143. [PMID: 36821506 DOI: 10.1148/rg.220143] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
In the United States, breast cancer is the second leading cause of cancer death in all women and the leading cause of cancer death in Black women. The breast cancer receptor profile, assessed with immunohistochemical staining of tissue samples, allows prediction of outcomes and direction of patient treatment. Approximately 80% of newly diagnosed breast cancers are hormone receptor (HR) positive, which is defined as estrogen receptor (ER) and/or progesterone receptor (PR) positive. Patients with ER-positive disease can be treated with therapies targeting the ER; however, the assessment of ER expression with immunohistochemical staining of biopsy specimens has several limitations including sampling error, false-negative results, challenging or inaccessible biopsy sites, and the inability to synchronously and serially assess all metastatic sites to identify spatial and/or temporal ER heterogeneity. In May 2020, after decades of research, the U.S. Food and Drug Administration approved the PET radiotracer fluorine 18 (18F) fluoroestradiol (FES) for clinical use in patients with ER-positive recurrent or metastatic breast cancer as an adjunct to biopsy. FES binds to the ER in the nucleus of ER-expressing cells, enabling whole-body in vivo assessment of ER expression. This article is focused on the approved uses of FES in the United States, including identification of a target lesion for confirmatory biopsy, in vivo assessment of biopsy-proven ER-positive disease, and evaluation of spatial and temporal ER heterogeneity. FES is an example of precision medicine that has been leveraged to optimize the care of patients with breast cancer. © RSNA, 2023 See the invited commentary by Fowler in this issue. Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- Sophia R O'Brien
- From the Department of Radiology, Division of Breast Imaging (S.R.O., C.E.E.) and Division of Nuclear Medicine Imaging and Therapy (S.R.O., S.M.L., J.K.W., D.A.M., A.R.P.), Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein-Radiology Administration, Philadelphia, PA 19104
| | - Christine E Edmonds
- From the Department of Radiology, Division of Breast Imaging (S.R.O., C.E.E.) and Division of Nuclear Medicine Imaging and Therapy (S.R.O., S.M.L., J.K.W., D.A.M., A.R.P.), Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein-Radiology Administration, Philadelphia, PA 19104
| | - Shannon M Lanzo
- From the Department of Radiology, Division of Breast Imaging (S.R.O., C.E.E.) and Division of Nuclear Medicine Imaging and Therapy (S.R.O., S.M.L., J.K.W., D.A.M., A.R.P.), Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein-Radiology Administration, Philadelphia, PA 19104
| | - Joanna K Weeks
- From the Department of Radiology, Division of Breast Imaging (S.R.O., C.E.E.) and Division of Nuclear Medicine Imaging and Therapy (S.R.O., S.M.L., J.K.W., D.A.M., A.R.P.), Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein-Radiology Administration, Philadelphia, PA 19104
| | - David A Mankoff
- From the Department of Radiology, Division of Breast Imaging (S.R.O., C.E.E.) and Division of Nuclear Medicine Imaging and Therapy (S.R.O., S.M.L., J.K.W., D.A.M., A.R.P.), Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein-Radiology Administration, Philadelphia, PA 19104
| | - Austin R Pantel
- From the Department of Radiology, Division of Breast Imaging (S.R.O., C.E.E.) and Division of Nuclear Medicine Imaging and Therapy (S.R.O., S.M.L., J.K.W., D.A.M., A.R.P.), Hospital of the University of Pennsylvania, 3400 Spruce St, 1 Silverstein-Radiology Administration, Philadelphia, PA 19104
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14
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Yadav D, Kumar R, Phulia A, Basu S, Alavi A. Molecular Imaging Assessment of Hormonally Sensitive Breast Cancer: An Appraisal of 2-[18F]-Fluoro-2-Deoxy-Glucose and Newer Non-2-[18F]-Fluoro-2-Deoxy-Glucose PET Tracers. PET Clin 2022; 17:399-413. [PMID: 35717099 DOI: 10.1016/j.cpet.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Hormone-sensitive breast cancer, which demonstrates hormone receptor positivity, accounts for approximately 75% of newly diagnosed breast cancer. 2-[18F]-Fluoro-2-deoxy-glucose is the nonspecific radiotracer of glucose metabolism as opposed to specific receptor based tracers like 16α-[18F]-fluoro-17β-estradiol and [18F]-fluoro-furanyl-norprogesterone, which provide essential information about receptor status in the management of hormonally active malignancies. The complementary information provided by (a) 2-[18F]-fluoro-2-deoxy-glucose imaging for staging and prognostication along with (b) analyzing the hormonal receptor status with receptor-based PET imaging in breast cancer can optimize tumor characterization and influence patient management.
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Affiliation(s)
- Divya Yadav
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Rakesh Kumar
- Division of Diagnostic Nuclear Medicine, Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
| | - Ankita Phulia
- Maulana Azad Medical College, New Delhi, 110002, India
| | - Sandip Basu
- Radiation Medicine Centre (B.A.R.C), Tata Memorial Centre Annexe, Parel, Mumbai; Homi Bhabha National Institute, Mumbai, India
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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15
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Association between tumor 18F-fluorodeoxyglucose metabolism and survival in women with estrogen receptor-positive, HER2-negative breast cancer. Sci Rep 2022; 12:7858. [PMID: 35552460 PMCID: PMC9098458 DOI: 10.1038/s41598-022-11603-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/26/2022] [Indexed: 11/08/2022] Open
Abstract
We examined whether 18F-fluorodeoxyglucose metabolism is associated with distant relapse-free survival (DRFS) and overall survival (OS) in women with estrogen receptor (ER)-positive, HER2-negative breast cancer. This was a cohort study examining the risk factors for survival that had occurred at the start of the study. A cohort from Asan Medical Center, Korea, recruited between November 2007 and December 2014, was included. Patients received anthracycline-based neoadjuvant chemotherapy. The maximum standardized uptake value (SUV) of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) was measured. The analysis included 466 women. The median (interquartile range) follow-up period without distant metastasis or death was 6.2 (5.3-7.6) years. Multivariable analysis of hazard ratio (95% confidence interval [CI]) showed that the middle and high tertiles of SUV were prognostic for DRFS (2.93, 95% CI 1.62-5.30; P < 0.001) and OS (4.87, 95% CI 1.94-12.26; P < 0.001). The 8-year DRFS rates were 90.7% (95% CI 85.5-96.1%) for those in the low tertile of maximum SUV vs. 73.7% (95% CI 68.0-79.8%) for those in the middle and high tertiles of maximum SUV. 18F-fluorodeoxyglucose PET/CT may assess the risk of distant metastasis and death in ER-positive, HER2-negative patients.
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16
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O’Brien SR, Edmonds CE, Katz D, Mankoff DA, Pantel AR. 18F-Fluoroestradiol (FES) PET/CT: review of current practice and future directions. Clin Transl Imaging 2022. [DOI: 10.1007/s40336-022-00494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Bodapati S, Abraham P, Chen A, Guilbault D, McDonald M, Matro J, Shatsky R, Obrzut S. 18F-FES PET/CT Improves the Detection of Intraorbital Metastases in Estrogen-Receptor-Positive Breast Cancer: Two Representative Cases and Review of the Literature. Tomography 2022; 8:1060-1065. [PMID: 35448720 PMCID: PMC9024434 DOI: 10.3390/tomography8020086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/17/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
Orbital metastases are a rare but life-altering complication in cancer. Most commonly seen in breast cancer, metastases to the optic nerves or extraocular muscles can have a devastating impact on visual acuity and quality of life. Hormone receptor status plays a central role in metastatic breast cancer treatment, with endocrine therapy often representing first-line therapy in hormone-receptor-positive cancers. Staging and treatment response evaluation with positron emission tomography (PET) computed tomography (CT) imaging with 18F-fluorodeoxyglucose (18F-FDG) is limited by high physiologic uptake in the intracranial and intraorbital compartments. Thus, traditional staging scans with 18F-FDG PET/CT may under-detect intraorbital and intracranial metastatic disease and inaccurately evaluate active metastatic disease burden. In comparison, 18F-fluoroestradiol (18F-FES) is a novel estrogen-receptor-specific PET radiotracer, which more accurately assesses the intracranial and intraorbital compartments in patients with estrogen-receptor-positive (ER+) cancers than 18F-FDG, due to lack of physiologic background activity in these regions. We present two cases of breast cancer patients with orbital metastases confirmed on MR imaging who underwent PET/CT imaging with 18F-FES and 18F-FDG. Multimodality imaging with 18F-FES PET/CT offers higher detection sensitivity of orbital metastases, compared with traditional 18F-FDG PET/CT imaging, and can improve the assessment of treatment response in patients with estrogen-receptor-positive (ER+) cancers.
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Affiliation(s)
- Sandhya Bodapati
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 E. Second St., Pomona, CA 91766, USA;
| | - Peter Abraham
- Department of Radiology, University of California San Diego School of Medicine, 200 W Arbor Dr., San Diego, CA 92103, USA; (P.A.); (A.C.); (M.M.)
| | - Angela Chen
- Department of Radiology, University of California San Diego School of Medicine, 200 W Arbor Dr., San Diego, CA 92103, USA; (P.A.); (A.C.); (M.M.)
| | | | - Marin McDonald
- Department of Radiology, University of California San Diego School of Medicine, 200 W Arbor Dr., San Diego, CA 92103, USA; (P.A.); (A.C.); (M.M.)
| | - Jennifer Matro
- Division of Hematology/Oncology, University of California San Diego School of Medicine, 3855 Health Sciences Dr., La Jolla, CA 92037, USA; (J.M.); (R.S.)
| | - Rebecca Shatsky
- Division of Hematology/Oncology, University of California San Diego School of Medicine, 3855 Health Sciences Dr., La Jolla, CA 92037, USA; (J.M.); (R.S.)
| | - Sebastian Obrzut
- Department of Radiology, University of California San Diego School of Medicine, 200 W Arbor Dr., San Diego, CA 92103, USA; (P.A.); (A.C.); (M.M.)
- Correspondence:
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18
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Ulaner GA. 16α-18F-fluoro-17β-Fluoroestradiol (FES): Clinical Applications for Patients With Breast Cancer. Semin Nucl Med 2022; 52:574-583. [DOI: 10.1053/j.semnuclmed.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 12/25/2022]
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19
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Discrepancy between [18F]-FES and [18F]-FDG PET/CT in ER-positive breast cancer with oesophageal metastasis. Eur J Nucl Med Mol Imaging 2022; 49:3297-3298. [PMID: 35362795 DOI: 10.1007/s00259-022-05759-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/09/2022] [Indexed: 11/04/2022]
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20
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Piccardo A, Fiz F, Treglia G, Bottoni G, Trimboli P. Head-to-Head Comparison between 18F-FES PET/CT and 18F-FDG PET/CT in Oestrogen Receptor-Positive Breast Cancer: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11071919. [PMID: 35407526 PMCID: PMC8999922 DOI: 10.3390/jcm11071919] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/18/2022] [Accepted: 03/28/2022] [Indexed: 12/26/2022] Open
Abstract
18F-FDG PET/CT is a powerful diagnostic tool in breast cancer (BC). However, it might have a reduced sensitivity in differentiated, oestrogen receptor-positive (ER+) BC. In this setting, specific molecular imaging with fluorine-oestradiol (18F-FES) PET/CT could help in overcoming these limitations; however, the literature on the diagnostic accuracy of this method is limited. We therefore planned this systematic review and meta-analysis to compare 18F-FDG and 18F-FES PET/CT in ER+ BC patients. We performed a literature search to identify all studies performing a head-to-head comparison between the two methods; we excluded review articles, preclinical studies, case reports and small case series. Finally, seven studies were identified (overall: 171 patients; range: 7–49 patients). A patients-based analysis (PBA) showed that 18F-FDG and 18F-FES PET/CT had a similar high pooled sensitivity (97% and 94%, respectively) at the lesion-based analysis (LBA), 18F-FES performed slightly better than 18F-FDG (pooled sensitivity: 95% vs. 85%, respectively). Moreover, when we considered only the studies dealing with the restaging setting (n = 3), this difference in sensitivity was even more marked (98% vs. 81%, respectively). In conclusion, both tracers feature an excellent sensitivity in ER+ BC; however, 18F-FES PET/CT could be preferred in the restaging setting.
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Affiliation(s)
- Arnoldo Piccardo
- Nuclear Medicine Department, Ente Ospedaliero “Ospedali Galliera”, 16128 Genoa, Italy; (F.F.); (G.B.)
- Correspondence: ; Tel.: +39-(0)10-5634541
| | - Francesco Fiz
- Nuclear Medicine Department, Ente Ospedaliero “Ospedali Galliera”, 16128 Genoa, Italy; (F.F.); (G.B.)
| | - Giorgio Treglia
- Faculty of Biomedical Sciences, University della Svizzera Italiana (USI), 6900 Lugano, Switzerland; (G.T.); (P.T.)
- Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland
- Academic Education, Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
| | - Gianluca Bottoni
- Nuclear Medicine Department, Ente Ospedaliero “Ospedali Galliera”, 16128 Genoa, Italy; (F.F.); (G.B.)
| | - Pierpaolo Trimboli
- Faculty of Biomedical Sciences, University della Svizzera Italiana (USI), 6900 Lugano, Switzerland; (G.T.); (P.T.)
- Clinic of Endocrinology and Diabetology, Lugano and Mendrisio Regional Hospital, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
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21
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PET imaging in breast cancer. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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22
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Abstract
Imaging plays an integral role in the clinical care of patients with breast cancer. This review article focuses on the use of PET imaging for breast cancer, highlighting the clinical indications and limitations of 2-deoxy-2-[18F]fluoro-d-glucose (FDG) PET/CT, the potential use of PET/MRI, and 16α-[18F]fluoroestradiol (FES), a newly approved radiopharmaceutical for estrogen receptor imaging.
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Affiliation(s)
- Amy M Fowler
- Breast Imaging and Intervention Section, Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, WI 53705, USA; University of Wisconsin Carbone Cancer Center, 600 Highland Avenue, Madison, WI 53792, USA.
| | - Steve Y Cho
- University of Wisconsin Carbone Cancer Center, 600 Highland Avenue, Madison, WI 53792, USA; Nuclear Medicine and Molecular Imaging Section, Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA
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23
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Ivanidze J, Subramanian K, Youn T, Cigler T, Osborne JR, Magge RS, Balogun OD, Knisely JPS, Ramakrishna R. Utility of [18F]-fluoroestradiol (FES) PET/CT with dedicated brain acquisition in differentiating brain metastases from posttreatment change in estrogen receptor-positive breast cancer. Neurooncol Adv 2021; 3:vdab178. [PMID: 34988456 PMCID: PMC8713741 DOI: 10.1093/noajnl/vdab178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jana Ivanidze
- Division of Molecular Imaging and Therapeutics, Department of Radiology, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Kritika Subramanian
- Division of Molecular Imaging and Therapeutics, Department of Radiology, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Trisha Youn
- Division of Molecular Imaging and Therapeutics, Department of Radiology, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Tessa Cigler
- Department of Breast Oncology, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Joseph R Osborne
- Division of Molecular Imaging and Therapeutics, Department of Radiology, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Rajiv S Magge
- Department of Neurology, Weill Cornell Brain Tumor Center, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Onyinye D Balogun
- Department of Radiation Oncology, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Jonathan P S Knisely
- Department of Radiation Oncology, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
| | - Rohan Ramakrishna
- Department of Neurological Surgery, NewYork-Presbyterian Hospital—Weill Cornell Campus, New York, New York, USA
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