期刊
LANCET ONCOLOGY
卷 14, 期 11, 页码 E465-E475出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/S1470-2045(13)70292-4
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资金
- Dutch Cancer Society [RUG 2009-4529]
- Centre for Translational Molecular Medicine-Mammary Carcinoma Molecular Imaging for Diagnosis and Therapeutics (CTMM - MAMMOTH) Project [03O-201]
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 16 alpha-[F-18]-fluoro-17 beta-oestradiol (F-18-FES) as a tracer. Compared with biopsy, which enables assessment of individual sites, whole-body F-18-FES-PET enables quantification of oestrogen-receptor expression in all metastases. In several studies, measurement of tumour protein expression in oestrogen receptors by F-18-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, F-18-FES-positive and F-18-FES-negative metastases). Low tumour F-18-FES uptake in metastases can predict failure of hormonal therapy in patients with oestrogen-receptor-positive primary tumours. Finally, F-18-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 F-18-FES uptake must be taken into account.
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