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

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

Background: 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...

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Autores principales: Jorianne Boers, Naila Loudini, Robbert J. de Haas, Antoon T. M. Willemsen, Bert van der Vegt, Elisabeth G. E. de Vries, Geke A. P. Hospers, Carolina P. Schröder, Andor W. J. M. Glaudemans, Erik F. J. de Vries
Formato: article
Lenguaje:EN
Publicado: MDPI AG 2021
Materias:
FES-PET/CT
breast cancer
liver metastases
estrogen receptor
quantification
Medicine (General)
R5-920
Acceso en línea:https://doaj.org/article/55c90a5881014d0d86ff8c95e773378a
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Sumario:Background: 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. Methods: Patients with metastatic breast cancer (<i>n</i> = 23) were included if they had undergone a [<sup>18</sup>F]-FES-PET, liver metastasis biopsy, CT-scan, and [<sup>18</sup>F]-FDG-PET. [<sup>18</sup>F]-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. Results: 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. Conclusion: In the majority of liver metastases, ER status can be determined with [<sup>18</sup>F]-FES-PET if background correction and separate thresholds are applied.

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