The Preliminary Study of 16α-[18F]fluoroestradiol PET/CT in Assisting the Individualized Treatment Decisions of Breast Cancer Patients

• Yifei Sun ,
  Affiliations: 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

  ¶‡ These authors contributed equally to this work.

  ⨯
• Zhongyi Yang ,
  Affiliations: 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

  ¶‡ These authors contributed equally to this work.

  ⨯
• Yongping Zhang,
  Affiliations: 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

  ⨯
• Jing Xue,
  Affiliations: 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

  ⨯
• Mingwei Wang,
  Affiliations: 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

  ⨯
• Wei Shi,
  Affiliations: 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

  ⨯
• Beiling Zhu,
  Affiliations: 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

  ⨯
• Silong Hu,
  Affiliations: 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

  ⨯
• Zhifeng Yao,
  Affiliations: 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

  ⨯
• Herong Pan,
  Affiliations: 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

  ⨯
• Yingjian Zhang 
  * E-mail: profzhangyj@163.com

  Affiliations: 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

  ⨯

• Published: January 24, 2015
• DOI: 10.1371/journal.pone.0116341

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.

Full article: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116341