PET imaging of oestrogen receptors in patients with breast cancer.
Oestrogen receptors are overexpressed in around 70% of all breast cancers, and are a target for endocrine therapy. These receptors can be visualised on PET with use of 16α-[(18)F]-fluoro-17β-oestradiol ((18)F-FES) as a tracer. Compared with biopsy, which enables assessment of individual sites, whole-body (18)F-FES-PET enables quantification of oestrogen-receptor expression in all metastases. In several studies, measurement of tumour protein expression in oestrogen receptors by (18)F-FES-PET, concurrent with biopsy, detected oestrogen-receptor-positive tumour lesions with a sensitivity of 84% and specificity of 98%. Roughly 45% of patients with metastatic breast cancer have discordant oestrogen-receptor expression across lesions (ie, (18)F-FES-positive and (18)F-FES-negative metastases). Low tumour (18)F-FES uptake in metastases can predict failure of hormonal therapy in patients with oestrogen-receptor-positive primary tumours. Finally, (18)F-FES-PET has shown that oestrogen-receptor binding capacity changes after intervention with hormonal drugs, but findings need to be confirmed. Factors other than oestrogen-receptor expression, including menopausal status and concomitant therapies, that can affect tumour (18)F-FES uptake must be taken into account.
Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
Michel
M
van Kruchten
Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
Elisabeth G E
EGE
de Vries
Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
Myles
M
Brown
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
Erik F J
EFJ
de Vries
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
Andor W J M
AWJM
Glaudemans
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
Rudi A J O
RAJO
Dierckx
Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
Carolien P
CP
Schröder
Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands. Electronic address: g.a.p.hospers@umcg.nl.
Geke A P
GAP
Hospers
D000818:Animals; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D049268:Positron-Emission Tomography; D011960:Receptors, Estrogen / Q000378:metabolism*
D011960:Receptors, Estrogen