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- Title
Diagnostic effectiveness of [<sup>18</sup>F]Fluoroestradiol PET/CT in oestrogen receptor-positive breast cancer: the key role of histopathology. Evidence from an international multicentre prospective study.
- Authors
Bottoni, Gianluca; Fiz, Francesco; Puntoni, Matteo; Matteucci, Federica; Monti, Manuela; DeCensi, Andrea; Nanni, Oriana; Brain, Etienne; Alberini, Jean Louis; Dib, Bassam; Sacchetti, Gianmauro; Trimboli, Pierpaolo; Treglia, Giorgio; Harbeck, Nadia; Sola, Simona; Gennari, Alessandra; Piccardo, Arnoldo
- Abstract
Introduction: [18F]Fluoroestradiol ([18F]FES) PET/CT has been proposed as a tool for detecting the oestrogen receptor density in patients with metastatic breast cancer (BC) non-invasively across all disease localizations. However, its diagnostic potential in terms of the detection rate (DR) of metastases is unclear. In this study, we pitted this method against [18F]FDG PET/CT and tried to identify predictors of the diagnostic superiority of the [18F] FES-based method. Materials and methods: From a multicentre database, we enrolled all patients with metastatic BC who had undergone both [18F]FES PET/CT and [18F]FDG PET/CT. Two readers assessed both images independently and used a patient-based (PBA) and lesion-based analysis (LBA) to calculate the DR. Pathology-related and clinical factors were tested as predictors of [18F]FES PET/CT superiority using a multivariate model. Results: 92 patients, bearing a total of 2678 metastases, were enrolled. On PBA, the DR of [18F]FDG and [18F]FES PET/CT was 97% and 86%, respectively (p = 0.018). On LBA, the [18F]FES method proved more sensitive than [18F]FDG PET/CT in lymph nodes, bone, lung and soft tissue (p < 0.01). This greater sensitivity was associated with lobular histology, both on PBA (Odds Ratio (OR) 3.4, 95%CI 1.0–12.3) and on LBA (OR 4.4, 95%CI 1.2–16.1 for lymph node metastases and OR 3.29, 95%CI 1.1–10.2 for bone localizations). Conclusions: The overall DR of [18F]FES PET/CT appears to be lower than that of [18F]FDG PET/CT on PBA. However, the [18F]FES method, if positive, can identify more lesions than [18F]FDG at most sites. The higher sensitivity of [18F]FES PET/CT was associated with lobular histology.
- Subjects
METASTATIC breast cancer; BREAST; BREAST cancer; LYMPHATIC metastasis; LONGITUDINAL method; HISTOPATHOLOGY
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2023, Vol 50, Issue 8, p2477
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-023-06173-9