Distinctive FDG and FES accumulation pattern of two tamoxifen-treated patients with endometrial hyperplasia.
16alpha-[(18)F]Fluoro-17beta-estradiol (FES) is an estrogen receptor (ER) ligand used for the detection of ER-positive malignant tumors such as breast cancer. We recently reported the feasibility of combined FES-and 2-[(18)F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) scans for the differential diagnosis of endometrial tumors. ER expression measured by FES-PET was preserved in endometrial hyperplasia, whereas ERs were assumed to be reduced in endometrial carcinoma with accelerated glucose metabolism measured by FDG-PET. We report two postmenopausal patients under suspicion of endometrial carcinoma on the basis of cytology and/or magnetic resonance imaging (MRI), who were on tamoxifen treatment since undergoing surgery for breast cancer. Pelvic MRI suggested endometrial carcinomas, whereas FDG-and FES-PET showed no abnormal tracer accumulation. A postoperative histopathologic examination revealed that the lesions were endometrial hyperplasias with no malignant findings. FES-PET enables us to evaluate the ERalpha expression of endometrium noninvasively, whereas the evaluation of ER expression using FES-PET requires careful attention regarding the influence of hormonal therapy because tamoxifen greatly affects FES accumulation of even endometrial hyperplasia, which should be an FES-avid lesion.
Tsujikawa
Tetsuya
T
Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan. awaji@u-fukui.ac.jp
Okazawa
Hidehiko
H
Yoshida
Yoshio
Y
Mori
Tetsuya
T
Kobayashi
Masato
M
Tsuchida
Tatsuro
T
Fujibayashi
Yasuhisa
Y
D000368:Aged; D000369:Aged, 80 and over; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism*; D004958:Estradiol / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013629:Tamoxifen / Q000627:therapeutic use; D014018:Tissue Distribution
D019275:Radiopharmaceuticals; D013629:Tamoxifen; D019788:Fluorodeoxyglucose F18; D004958:Estradiol; C043436:16-fluoroestradiol