[18 F]-Fluoroestradiol PET (FES-PET) and [18 F] Flurodeoxyglucose PET (FDG-PET) Imaging May Aid in Managing Therapy in Patients with Metastatic Lobular Breast Cancer.

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Molecular Imaging and Biology Pub Date : 2025-06-01 Epub Date: 2025-05-14 DOI:10.1007/s11307-025-02015-2

Poorni M Manohar, Lanell M Peterson, Isaac C Jenkins, Qian Vicky Wu, Brenda F Kurland, Alena Novakova-Jiresova, Mark Muzi, Delphine L Chen, Jennifer M Specht, Suzanne Dintzis, Paul E Kinahan, David A Mankoff, Hannah M Linden

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引用次数: 0

Abstract

Aim: This study examines the combination of FES-PET and FDG-PET as complementary imaging for detection of metastatic ILC.

Methods: We retrospectively evaluated FES and FDG uptake in patients with metastatic ILC from an estrogen receptor (ER) positive primary tumor. We classified lesions into three categories (FES high/FDG low, FES high/FDG high, FES low/FDG low) using SUVmax cut-off values of 1.5 for FES and 5.0 for FDG. Qualitative evaluation included examination of the difference in the extent of disease between FES and FDG.

Results: Of the 38 patients, 82% had FES uptake in all tumor sites identified by FDG, with 18% lacking FES uptake in at least one lesion. Mean (range) SUVmax for FES and FDG was 4.0 (0.67-10.6) and 4.6 (1.3-12.5), respectively. The majority of ILC patients (25/38), had lesions with FES high/FDG low uptake, consistent with the strongly ER + indolent nature of ILC. Patients with disease classified as FES high/FDG low had longer median overall survival (OS) (3.2 years) and progression-free survival (PFS) (1.5 years) than FES high/FDG high (OS = 2.1 years and PFS = 0.46 years). The median overall OS for all patients was 3.0 years (95% CI 2.5, 4.8) and PFS of 1.3 years (95% CI 0.6, 2.5). 8 patients (21%) had qualitatively more extensive disease by FES-PET.

Conclusions: Our findings suggest that both FES-PET and FDG-PET can identify metastatic ILC and be useful in detecting the pattern and extent of disease. The imaging combination provides additional information for prognosis and clinical decision making, balancing suitability for endocrine therapy and aggressiveness/indolence of disease.

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[18 F]氟雌二醇PET （FES-PET）和氟脱氧葡萄糖PET （FDG-PET）成像可能有助于转移性小叶乳腺癌患者的治疗管理。

目的：本研究探讨FES-PET和FDG-PET联合成像作为检测转移性ILC的补充成像。方法：我们回顾性评估了雌激素受体（ER）阳性原发肿瘤转移性ILC患者的FES和FDG摄取情况。我们将病变分为三类（FES高/FDG低，FES高/FDG高，FES低/FDG低），FES的SUVmax临界值为1.5，FDG的临界值为5.0。定性评价包括检查FES和FDG之间疾病程度的差异。结果：在38例患者中，82%的患者在FDG识别的所有肿瘤部位都有FES摄取，18%的患者在至少一个病变中缺乏FES摄取。FES和FDG的平均（范围）SUVmax分别为4.0（0.67-10.6）和4.6（1.3-12.5）。大多数ILC患者（25/38）的病灶FES高/FDG低摄取，与ILC强烈的ER +惰性性质一致。FES高/FDG低患者的中位总生存期（OS）（3.2年）和无进展生存期（PFS）（1.5年）比FES高/FDG高（OS = 2.1年，PFS = 0.46年）更长。所有患者的中位总OS为3.0年（95% CI 2.5, 4.8）， PFS为1.3年（95% CI 0.6, 2.5）。8例患者（21%）经FES-PET定性为更广泛的疾病。结论：我们的研究结果表明FES-PET和FDG-PET都可以识别转移性ILC，并有助于检测疾病的模式和程度。影像学结合为预后和临床决策提供了额外的信息，平衡了内分泌治疗的适宜性和疾病的侵袭性/不痛性。

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

Molecular Imaging and Biology 医学-核医学

CiteScore

6.90

自引率

3.20%

发文量

审稿时长

3 months

期刊介绍： Molecular Imaging and Biology (MIB) invites original contributions (research articles, review articles, commentaries, etc.) on the utilization of molecular imaging (i.e., nuclear imaging, optical imaging, autoradiography and pathology, MRI, MPI, ultrasound imaging, radiomics/genomics etc.) to investigate questions related to biology and health. The objective of MIB is to provide a forum to the discovery of molecular mechanisms of disease through the use of imaging techniques. We aim to investigate the biological nature of disease in patients and establish new molecular imaging diagnostic and therapy procedures. Some areas that are covered are: Preclinical and clinical imaging of macromolecular targets (e.g., genes, receptors, enzymes) involved in significant biological processes. The design, characterization, and study of new molecular imaging probes and contrast agents for the functional interrogation of macromolecular targets. Development and evaluation of imaging systems including instrumentation, image reconstruction algorithms, image analysis, and display. Development of molecular assay approaches leading to quantification of the biological information obtained in molecular imaging. Study of in vivo animal models of disease for the development of new molecular diagnostics and therapeutics. Extension of in vitro and in vivo discoveries using disease models, into well designed clinical research investigations. Clinical molecular imaging involving clinical investigations, clinical trials and medical management or cost-effectiveness studies.