Discrepancy between [18F]-FES and [18F]-FDG PET/CT in ER-positive breast cancer with oesophageal metastasis

Robust ERα-Targeted Near-Infrared Fluorescence Probe for Selective Hydrazine Imaging in Breast Cancer

“…12−14 For instance, 18 F-fluoroestradiol ( 18 F-FES), 15 an ERα-targeted positron emission tomography (PET) radiotracer, has been widely investigated for the imaging effect in patients with ERα-positive cancers, which even exhibits higher sensitivity in metastatic breast cancer compared with traditional PET probe 18 F-fluorodeoxyglucose ( 18 F-FDG). 16 However, a careful analysis of these reported probes found that they were developed mainly through labeling ERα-targeted ligands with fluorophore, radionuclide, or metal. 17 Although this strategy offers an excellent method for the construction of ERα-imaging probes, the selected ligands frequently need to be specifically modified before being prepared into probes, which significantly reduces the affinity of probes to ERα, resulting in low signal-tobackground ratios.…”

“…Thus, the development of an ERα-targeted molecular probe for breast tumor imaging is urgent. To overcome this problem, a number of ERα-targeted probes have been developed in recent years. − For instance, 18 F-fluoroestradiol ( 18 F-FES), an ERα-targeted positron emission tomography (PET) radiotracer, has been widely investigated for the imaging effect in patients with ERα-positive cancers, which even exhibits higher sensitivity in metastatic breast cancer compared with traditional PET probe 18 F-fluorodeoxyglucose ( 18 F-FDG) . However, a careful analysis of these reported probes found that they were developed mainly through labeling ERα-targeted ligands with fluorophore, radionuclide, or metal .…”

Molecular Imaging of Steroid Receptors in Breast Cancer

“…In a subsequently published study of FDG and FES PET/CT for initial staging of 28 patients with ER-positive breast cancer, overall diagnostic performance was similar with the exception of higher specificity and negative predictive value observed with FES. 75 In a subset analysis of strongly ER-positive breast cancer, the accuracy of FES increased from 88% to 95%, while the accuracy of FDG decreased from 81% to 70%. 75 The authors propose that more accurate staging could be achieved through combined imaging by overcoming the limitations of each tracer.…”

“…75 In a subset analysis of strongly ER-positive breast cancer, the accuracy of FES increased from 88% to 95%, while the accuracy of FDG decreased from 81% to 70%. 75 The authors propose that more accurate staging could be achieved through combined imaging by overcoming the limitations of each tracer. 75 Recognizing clinical scenarios for which FES PET was rated "rarely appropriate" is also important as these questions may arise during multidisciplinary care conferences.…”

“…75 The authors propose that more accurate staging could be achieved through combined imaging by overcoming the limitations of each tracer. 75 Recognizing clinical scenarios for which FES PET was rated "rarely appropriate" is also important as these questions may arise during multidisciplinary care conferences. FES PET is not recommended for diagnosing and routine staging of primary breast cancer (T staging) or routine staging of axillary lymph nodes.…”