title: Positron tomographic assessment of 16 alpha-[18F] fluoro-17 beta-estradiol uptake in metastatic breast carcinoma.
abstract: The positron-emitting estrogenic steroid 16 alpha-[18F]fluoro-17 beta-estradiol (FES) has been shown to exhibit selective uptake in primary breast carcinomas; the uptake of tracer by positron emission tomography (PET) is strongly correlated with the tumor estrogen-receptor concentration. We have now extended the use of this radiopharmaceutical for imaging of metastases of breast carcinoma by PET in 16 patients with clinical or radiographic evidence of metastatic disease. Increased uptake of FES was identified on PET images in 53 of 57 metastatic lesions (93%); only two apparent false-positive foci of FES uptake were seen. In seven of the patients, evaluable PET studies were obtained both before and after initiation of antiestrogen therapy. In all cases, there was a decrease in FES uptake in the tumor deposits after initiation of antiestrogen therapy, and the mean (+/- standard deviation) uptake decreased from 2.22 (+/- 1.23) to 0.80 (+/- 0.42) x 10(3)+ dose/ml. These results indicate that PET with FES has high sensitivity and specificity for detecting metastatic breast carcinoma and provide additional confirmatory evidence that the tumor uptake of this ligand is a receptor-mediated process.
authors.affiliation: Division of Nuclear Medicine, Edward Mallinckrodt Institute of Radiology, St. Louis, MO 63110.
authors.forename: A H
authors.initials: AH
authors.lastname: McGuire
authors.forename: F
authors.initials: F
authors.lastname: Dehdashti
authors.forename: B A
authors.initials: BA
authors.lastname: Siegel
authors.forename: A P
authors.initials: AP
authors.lastname: Lyss
authors.forename: J W
authors.initials: JW
authors.lastname: Brodack
authors.forename: C J
authors.initials: CJ
authors.lastname: Mathias
authors.forename: M A
authors.initials: MA
authors.lastname: Mintun
authors.forename: J A
authors.initials: JA
authors.lastname: Katzenellenbogen
authors.forename: M J
authors.initials: MJ
authors.lastname: Welch
mesh_terms: D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D004958:Estradiol / Q000031:analogs & derivatives; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging*; D011869:Radioligand Assay; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed
chemical_list: D004965:Estrogen Antagonists; D005462:Fluorine Radioisotopes; D004958:Estradiol; C043436:16-fluoroestradiol