TY - JOUR
T1 - 18F-Labeled Fluoroestradiol PET/CT
T2 - Current Status, Gaps in Knowledge, and Controversies—AJR Expert Panel Narrative Review
AU - Covington, Matthew F.
AU - O’Brien, Sophia R.
AU - Lawhn-Heath, Courtney
AU - Pantel, Austin R.
AU - Ulaner, Gary A.
AU - Linden, Hannah M.
AU - Dehdashti, Farrokh
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2024/10
Y1 - 2024/10
N2 - PET/CT using 16α-[18F]-fluoro-17β-estradiol (FES) noninvasively images tissues expressing estrogen receptors (ERs). FES has undergone extensive clinicopathologic validation for ER-positive breast cancer and in 2020 received FDA approval for clinical use as an adjunct to biopsy in patients with recurrent or metastatic ER-positive 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 stand-alone 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 work group 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 the use of FES PET/CT for nonbreast malignancies expressing ER.
AB - PET/CT using 16α-[18F]-fluoro-17β-estradiol (FES) noninvasively images tissues expressing estrogen receptors (ERs). FES has undergone extensive clinicopathologic validation for ER-positive breast cancer and in 2020 received FDA approval for clinical use as an adjunct to biopsy in patients with recurrent or metastatic ER-positive 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 stand-alone 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 work group 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 the use of FES PET/CT for nonbreast malignancies expressing ER.
KW - FES
KW - PET
KW - breast cancer
KW - fluoroestradiol
UR - http://www.scopus.com/inward/record.url?scp=85208772362&partnerID=8YFLogxK
U2 - 10.2214/AJR.23.30330
DO - 10.2214/AJR.23.30330
M3 - Review article
C2 - 38117098
AN - SCOPUS:85208772362
SN - 0361-803X
VL - 223
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 4
M1 - e2330330
ER -