Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography?
Correct staging is the most crucial for the treatment outcome in cancer management. Molecular imaging with 18F-fluoroestradiol (FES) positron emission tomography-computed tomography (PET-CT) targets estrogen receptor (ER) and may have a higher incremental value in diagnosis by aiding specificity. We...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2017-04-01
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| Series: | World Journal of Nuclear Medicine |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.203071 |
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| author | Manoj Gupta Anupama Datta Partha Choudhury Maria Dsouza Ullas Batra Anil Mishra |
| author_facet | Manoj Gupta Anupama Datta Partha Choudhury Maria Dsouza Ullas Batra Anil Mishra |
| author_sort | Manoj Gupta |
| collection | DOAJ |
| description | Correct staging is the most crucial for the treatment outcome in cancer management. Molecular imaging with 18F-fluoroestradiol (FES) positron emission tomography-computed tomography (PET-CT) targets estrogen receptor (ER) and may have a higher incremental value in diagnosis by aiding specificity. We enrolled 12 female breast cancer patients prospectively and did 18F-FES PET-CT and 18F-fluorodeoxyglucose (FDG) PET-CT within 1 week interval time. Lesion detection sensitivity was compared for a total number of lesions and for nonhepatic lesions only by McNemar test. 18F-FES PET-CT was taken as reference in case of indeterminate lesions. The incremental value reported by identifying 18F-FES exclusive lesions and by characterization of 18F-FDG indeterminate lesions. Spearman rank test was used to correlate ER expression and maximum standardized uptake value (SUVmax). Two ER-negative patients with no 18F-FES uptake were excluded. Ten ER-positive patients with 154 disease lesions were finally analyzed. 18F-FDG picked-up 142 lesions (sensitivity 92.21%), whereas 18F-FES picked-up 116 lesions (sensitivity 75.32%) and this difference was statistically significant. For nonhepatic lesions (n = 136) detectability, 18F-FDG picked-up 124 (sensitivity 91.18%), whereas 18F-FES picked-up 116 (sensitivity 85.29%) lesions and this difference was not statistically significant. Beside 12 exclusive lesions, 18F-FES characterized 41 (27.5%) 18F-FDG indeterminate lesions. Overall 18F-FES impacted 20% patient management. The positive trend was also seen with 18F-FES SUVmax with ER expression and negative with 18F-FDG SUVmax. We conclude, 18F-FDG has overall better sensitivity than 18F-FES PET-CT, however for nonhepatic metastasis difference was not significant. 18F-FES PET-CT better-characterized lesions and impacted 20% patient management. Therefore, 18F-FES PET-CT should be used with 18F-FDG PET-CT in strongly ER expressing patients for better specificity. |
| format | Article |
| id | doaj-art-7809cbefe5304ed8a486e6a90b9f91f7 |
| institution | DOAJ |
| issn | 1450-1147 1607-3312 |
| language | English |
| publishDate | 2017-04-01 |
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| series | World Journal of Nuclear Medicine |
| spelling | doaj-art-7809cbefe5304ed8a486e6a90b9f91f72025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122017-04-01160213313910.4103/1450-1147.203071Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography?Manoj Gupta0Anupama Datta1Partha Choudhury2Maria Dsouza3Ullas Batra4Anil Mishra5Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDivision of Cyclotron and Radiopharmaceutical Sciences, Institute of Nuclear Medicine and Allied Sciences, New DelhiDepartment of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDivision of PET Imaging, Institute of Nuclear Medicine and Allied Sciences, New DelhiDepartment of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDivision of Cyclotron and Radiopharmaceutical Sciences, Institute of Nuclear Medicine and Allied Sciences, New DelhiCorrect staging is the most crucial for the treatment outcome in cancer management. Molecular imaging with 18F-fluoroestradiol (FES) positron emission tomography-computed tomography (PET-CT) targets estrogen receptor (ER) and may have a higher incremental value in diagnosis by aiding specificity. We enrolled 12 female breast cancer patients prospectively and did 18F-FES PET-CT and 18F-fluorodeoxyglucose (FDG) PET-CT within 1 week interval time. Lesion detection sensitivity was compared for a total number of lesions and for nonhepatic lesions only by McNemar test. 18F-FES PET-CT was taken as reference in case of indeterminate lesions. The incremental value reported by identifying 18F-FES exclusive lesions and by characterization of 18F-FDG indeterminate lesions. Spearman rank test was used to correlate ER expression and maximum standardized uptake value (SUVmax). Two ER-negative patients with no 18F-FES uptake were excluded. Ten ER-positive patients with 154 disease lesions were finally analyzed. 18F-FDG picked-up 142 lesions (sensitivity 92.21%), whereas 18F-FES picked-up 116 lesions (sensitivity 75.32%) and this difference was statistically significant. For nonhepatic lesions (n = 136) detectability, 18F-FDG picked-up 124 (sensitivity 91.18%), whereas 18F-FES picked-up 116 (sensitivity 85.29%) lesions and this difference was not statistically significant. Beside 12 exclusive lesions, 18F-FES characterized 41 (27.5%) 18F-FDG indeterminate lesions. Overall 18F-FES impacted 20% patient management. The positive trend was also seen with 18F-FES SUVmax with ER expression and negative with 18F-FDG SUVmax. We conclude, 18F-FDG has overall better sensitivity than 18F-FES PET-CT, however for nonhepatic metastasis difference was not significant. 18F-FES PET-CT better-characterized lesions and impacted 20% patient management. Therefore, 18F-FES PET-CT should be used with 18F-FDG PET-CT in strongly ER expressing patients for better specificity.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.203071 18f-fluorodeoxyglucose positron emission tomography-computed tomography 18f-fluoroestradiol positron emission tomography-computed tomographydiagnostic strengthestrogen receptor-positive breast cancerincremental value |
| spellingShingle | Manoj Gupta Anupama Datta Partha Choudhury Maria Dsouza Ullas Batra Anil Mishra Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography? World Journal of Nuclear Medicine 18f-fluorodeoxyglucose positron emission tomography-computed tomography 18f-fluoroestradiol positron emission tomography-computed tomography diagnostic strength estrogen receptor-positive breast cancer incremental value |
| title | Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography? |
| title_full | Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography? |
| title_fullStr | Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography? |
| title_full_unstemmed | Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography? |
| title_short | Can 18F-Fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor-positive breast cancer patient: A prospective comparative study with 18F-Fluorodeoxyglucose positron emission tomography? |
| title_sort | can 18f fluoroestradiol positron emission tomography become a new imaging standard in the estrogen receptor positive breast cancer patient a prospective comparative study with 18f fluorodeoxyglucose positron emission tomography |
| topic | 18f-fluorodeoxyglucose positron emission tomography-computed tomography 18f-fluoroestradiol positron emission tomography-computed tomography diagnostic strength estrogen receptor-positive breast cancer incremental value |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.203071 |
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