Developing & Validating a Clinical Decision Support Tool for ER-Targeted PET Imaging With 16α-18F-Fluoro-17β-Fluoroestradiol

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-02-01 DOI:10.1016/j.clbc.2024.10.013

Nicholas DiGregorio , Regina Munter-Young

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引用次数: 0

Abstract

Background

Estrogen receptor (ER) status in breast cancer (BC) is routinely determined by immunohistochemistry (IHC); however, this technique is not without limitations, including false results. Imaging of FES-PET (fluoroestradiol F18) injection provides high diagnostic accuracy of ER expression, supplementing information from biopsy. A Clinical Decision Support (CDS) tool was developed to better assess its clinical usefulness in metastatic and recurrent breast cancer management. This study evaluated a conceptual tool that reflects clinical practice variables.

Methods

Individual patient characteristics - candidacy for therapeutic treatment and rate of recurrence - determined initial eligibility. The CDS tool uses rules (IF-THEN statements) to produce an output on the diagnostic accuracy of ER status based on tumor burden, anatomical location(s) of metastasis, heterogeneity, and confidence in sample collection & pathology accuracy (CSC & PA). An Excel-based probability decision tree calculates the accuracy of ER expression.

Results

360 oncologists in the United States participated in the survey study. 223 respondents identified as medical oncologists (62%), 77 as clinical oncologists (21%), and 60 as hematologic oncologists (17%). 93% of respondents found the CDS tool intuitive and easy to follow with medical and clinical oncologists favoring the tool more than hematologic oncologists. Individual CDS attributes - clinical criteria, diagnostic comparator, true positive and true negative, patient inclusion and exclusion, and clinical patient level inputs - were tested with overall positive feedback.

Conclusions

Based on respondent feedback, further development of CDS tools are warranted for potential use in patients’ diagnostic workup.

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基于16α- 18f -氟-17β-氟雌二醇的er靶向PET成像临床决策支持工具的开发与验证

背景：乳腺癌（BC）的雌激素受体（ER）状态是通过免疫组化（IHC）常规检测的；然而，这种技术并非没有局限性，包括错误的结果。CeriannaTM（氟雌二醇F18）注射成像对ER表达的诊断准确性很高，补充了活检的信息。临床决策支持（CDS）工具的开发，以更好地评估其在转移性和复发性乳腺癌管理的临床用途。本研究评估了一个反映临床实践变量的概念工具。方法：个体患者的特点-治疗的候选资格和复发率-确定初始资格。CDS工具使用规则（IF-THEN语句）根据肿瘤负荷、转移的解剖位置、异质性以及样本收集和病理准确性的置信度（CSC & PA），产生ER状态诊断准确性的输出。基于excel的概率决策树计算ER表达式的准确性。结果：360名美国肿瘤学家参与了调查研究。223名被确定为医学肿瘤学家（62%），77名被确定为临床肿瘤学家（21%），60名被确定为血液肿瘤学家（17%）。93%的受访者发现CDS工具直观且易于遵循，医疗和临床肿瘤学家比血液肿瘤学家更喜欢该工具。个体CDS属性——临床标准、诊断比较、真阳性和真阴性、患者纳入和排除、临床患者水平输入——用总体正反馈进行测试。结论：根据受访者的反馈，进一步开发CDS工具在患者诊断检查中的潜在应用是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.