울산의대 / 채선영, 문대혁*
Abstract
Background: To compare the diagnostic sensitivity of [18F]fluoroestradiol ([18F]FES) and [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer.
Methods: Our database of consecutive patients enrolled in a previous prospective cohort study to assess [18F]FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent [18F]FDG PET/CT. The sensitivity of qualitative [18F]FES and [18F]FDG PET/CT interpretations was assessed, comparing them with histological diagnoses.
Results: Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of [18F]FES PET/CT was 71.1% (32/45, 95% CI, 55.7-83.6), while that of [18F]FDG PET/CT was 80.0% (36/45, 95% CI, 65.4-90.4) with a threshold of positive interpretation, and 93.3% (42/45, 95% CI, 81.7-98.6) when a threshold of equivocal was used. There was no significant difference in sensitivity between [18F]FES and [18F]FDG PET/CT (P = 0.48) with a threshold of positive [18F]FDG uptake, but the sensitivity of [18F]FDG was significantly higher than [18F]FES (P = 0.013) with a threshold of equivocal [18F]FDG uptake. One patient with a benign lesion showed negative [18F]FES but positive [18F]FDG uptake.
Conclusions: The restaging of patients who had ER-positive primary breast cancer and present with recurrent disease may include [18F]FES PET/CT as an initial test when standard imaging studies are equivocal or suspicious.
Affiliations
Sun Young Chae 1 , Hye Joo Son 1 , Dong Yun Lee 1 , Eonwoo Shin 1 , Jungsu S Oh 1 , Seung Yeon Seo 1 , Sora Baek 2 , Ji Young Kim 3 , Sae Jung Na 4 , Dae Hyuk Moon 5
1 Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
2 Department of Nuclear Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
3 Department of Nuclear Medicine, Guri Hospital of Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Republic of Korea.
4 Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
5 Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. dhmoon@amc.seoul.kr.
편집위원
유방암 가운데, 호르몬수용체가 있는 종양의 재발 평가에 F-18 fluoroestradiol의 가치를 보여준 임상연구로 여성호르몬 수용체영상용 핵의학 추적자의 임상진입에 도움이 되는 연구임. 유방암 관련 임사의사, 핵의학 의사 및 방사화학자에게 관심을 끌 논문으로 생각됨.
2020-07-02 14:32:49