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Analyzing the Estrogen Receptor Status of Liver Metastases with [18F]-FES-PET in Patients with Breast Cancer.


ABSTRACT: Positron emission tomography (PET) with 16α-[18F]-fluoro-17β-estradiol ([18F]-FES) can visualize estrogen receptor (ER) expression, but it is challenging to determine the ER status of liver metastases, due to high physiological [18F]-FES uptake. We evaluated whether [18F]-FES-PET can be used to determine the ER status of liver metastases, using corresponding liver biopsies as the gold standard. Patients with metastatic breast cancer (n = 23) were included if they had undergone a [18F]-FES-PET, liver metastasis biopsy, CT-scan, and [18F]-FDG-PET. [18F]-FES-PET scans were assessed by visual and quantitative analysis, tracer uptake was correlated with ER expression measured by immunohistochemical staining and the effects of region-of-interest size and background correction were determined. Visual analysis allowed ER assessment of liver metastases with 100% specificity and 18% sensitivity. Quantitative analysis improved the sensitivity. Reduction of the region-of-interest size did not further improve the results, but background correction improved ER assessment, resulting in 83% specificity and 77% sensitivity. Using separate thresholds for ER+ and ER- metastases, positive and negative predictive values of 100% and 75%, respectively, could be obtained, although 30% of metastases remained inconclusive. In the majority of liver metastases, ER status can be determined with [18F]-FES-PET if background correction and separate thresholds are applied.

SUBMITTER: Boers J 

PROVIDER: S-EPMC8617814 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Analyzing the Estrogen Receptor Status of Liver Metastases with [<sup>18</sup>F]-FES-PET in Patients with Breast Cancer.

Boers Jorianne J   Loudini Naila N   de Haas Robbert J RJ   Willemsen Antoon T M ATM   van der Vegt Bert B   de Vries Elisabeth G E EGE   Hospers Geke A P GAP   Schröder Carolina P CP   Glaudemans Andor W J M AWJM   de Vries Erik F J EFJ  

Diagnostics (Basel, Switzerland) 20211030 11


<h4>Background</h4>Positron emission tomography (PET) with 16α-[<sup>18</sup>F]-fluoro-17β-estradiol ([<sup>18</sup>F]-FES) can visualize estrogen receptor (ER) expression, but it is challenging to determine the ER status of liver metastases, due to high physiological [<sup>18</sup>F]-FES uptake. We evaluated whether [<sup>18</sup>F]-FES-PET can be used to determine the ER status of liver metastases, using corresponding liver biopsies as the gold standard.<h4>Methods</h4>Patients with metastatic  ...[more]

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