title: The preliminary study of 16α-[18F]fluoroestradiol PET/CT in assisting the individualized treatment decisions of breast cancer patients.
abstract: OBJECTIVE
  To evaluate the clinical value of 16α-[18F]fluoroestradiol (18F-FES) PET/CT in assisting the individualized treatment decisions of breast cancer patients.
  
  
  METHODS
  Thirty-three breast cancer patients, who underwent both 18F-FES and 18F-FDG PET/CT from July 2010 to March 2013 in our center, were enrolled in this preliminary study. All the patients used 18F-FES PET/CT as a diagnostic tool with a clinical dilemma. We used the maximum Standardized Uptake Value (SUVmax) to quantify ER expression and a cutoff value of 1.5 to dichotomize results into ER positive and negative lesions. All patients were clinically followed up at least 6 months.
  
  
  RESULTS
  In evaluating equivocal lesions on conventional work-up group (n = 4), three lung lesions and another iliac lesion were enrolled. As for three lung lesions, 18F-FES PET/CT showed one lesion with high uptake, which suggested it was an ER positive metastasis. The other two lesions were 18F-FES negative, which meant an ER negative metastasis or secondary primary tumor. Additionally, one iliac lesion was detected by MRI. 18F-FDG uptake was high at the suspected lesion, whereas 18F-FES uptake was absent; In predicting origin of metastasis group (n = 2), two breast cancer patients had secondary primary tumors were collected. They were 18F-FES negative, which showed low possibility of metastasis from breast cancer and they were all confirmed by biopsy. In detecting ER status in metastasis group (n = 27), 18F-FES PET/CT showed increased 18F-FES uptake in all metastatic lesions in 11 patients; absent in all lesions in 13 patients; and the remaining 3 patients had both 18F-FES positive and negative lesions. Totally, on the basis of the 18F-FES PET/CT results, we found changes in the treatment plans in 16 patients (48.5%, 16/33).
  
  
  CONCLUSIONS
  18F-FES PET/CT could assess the entire tumor volume receptor status; therefore, it may be used to assist the individualized treatment decisions of breast cancer patients.
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Zhongyi
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Yongping
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xue
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Mingwei
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Beiling
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Silong
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Yao
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Herong
authors.initials: H
authors.lastname: Pan
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Center for Biomedical imaging, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, China.
authors.forename: Yingjian
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D020000:Decision Support Systems, Clinical; D004958:Estradiol / Q000031:analogs & derivatives* / Q000737:chemistry; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011960:Receptors, Estrogen / Q000235:genetics
chemical_list: D005462:Fluorine Radioisotopes; D011960:Receptors, Estrogen; D004958:Estradiol; C043436:16-fluoroestradiol