Head-to-head comparison of 18F-FDG and 18F-FES PET/CT for initial staging of ER-positive breast cancer patients

IF 1.7 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Journal of Hybrid Imaging Pub Date : 2023-12-18 DOI:10.1186/s41824-023-00176-3
Peerapon Kiatkittikul, Supanida Mayurasakorn, Chetsadaporn Promteangtrong, Anchisa Kunawudhi, Dheeratama Siripongsatian, Natdanai Hirata, Attapon Jantarato, Natphimol Boonkawin, Sukanya Yaset, Pattanapong Kongsakorn, Warunya Phewnual, Chanisa Chotipanich
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Abstract

To compare the diagnostic performance of 18F-fluorodeoxyglucose (18F-FDG) and 18F-fluoroestradiol (18F-FES) positron emission tomography/computed tomography (PET/CT) for initial staging of estrogen receptor (ER) positive breast cancer. Twenty-eight patients with ER-positive breast cancer underwent 18F-FDG and 18F-FES PET/CT for initial staging. Diagnostic performance and concordance rates were analyzed for both radiotracers. Semiquantitative parameters of maximum standardized uptake value (SUVmax) and tumor-to-normal ratio (T/N ratio) were compared using Wilcoxon signed-rank test. Factors potentially affecting the degree of radiotracer uptake were analyzed by multi-level linear regression analysis. The overall diagnostic performance of 18F-FES was comparable to 18F-FDG, except for higher specificity and NPV, with sensitivity, specificity, PPV, NPV, and accuracy of 87.56%, 100%, 100%, 35.14%, and 88.35%, respectively, for 18F-FES and 83.94%, 30.77%, 94.74%, 11.43%, and 95.37%, respectively, for 18F-FDG. Diagnostic performance of strong ER expression was better in 18F-FES but worse for 18F-FDG. There was a correlation of mucinous cell type and Allred score 7–8 with 18F-FES uptake, with correlation coefficients of 26.65 (19.28, 34.02), 5.90 (− 0.005, 11.81), and p-value of < 0.001, 0.05, respectively. Meanwhile, luminal B and Ki-67 were related to 18F-FDG uptake, with correlation coefficients of 2.76 (1.10, 0.20), 0.11 (0.01, 0.2), and p-value of 0.018, 0.025, respectively. Diagnostic performance of 18F-FES is comparable to 18F-FDG, but better for strongly ER-positive breast cancer. Combination of 18F-FES and 18F-FDG would potentially overcome the limitations of each tracer with more accurate staging.
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18F-FDG 和 18F-FES PET/CT 对 ER 阳性乳腺癌患者初步分期的正面比较
目的:比较18F-氟脱氧葡萄糖(18F-FDG)和18F-氟雌二醇(18F-FES)正电子发射断层扫描/计算机断层扫描(PET/CT)对雌激素受体(ER)阳性乳腺癌初步分期的诊断效果。28名ER阳性乳腺癌患者接受了18F-FDG和18F-FES PET/CT进行初步分期。分析了两种放射性核素的诊断性能和吻合率。使用Wilcoxon符号秩检验比较了最大标准化摄取值(SUVmax)和肿瘤与正常比(T/N比)的半定量参数。对可能影响放射性示踪剂摄取程度的因素进行了多级线性回归分析。18F-FES的敏感性、特异性、PPV、NPV和准确性分别为87.56%、100%、100%、35.14%和88.35%,而18F-FDG的敏感性、特异性、PPV、NPV和准确性分别为83.94%、30.77%、94.74%、11.43%和95.37%。18F-FES 对强 ER 表达的诊断效果较好,而 18F-FDG 则较差。粘液细胞类型和 Allred 评分 7-8 与 18F-FES 摄取存在相关性,相关系数分别为 26.65(19.28,34.02)、5.90(- 0.005,11.81),P 值分别小于 0.001、0.05。同时,管腔 B 和 Ki-67 与 18F-FDG 摄取相关,相关系数分别为 2.76(1.10,0.20)、0.11(0.01,0.2),P 值分别为 0.018、0.025。18F-FES 的诊断效果与 18F-FDG 相当,但对 ER 强阳性乳腺癌的诊断效果更好。将 18F-FES 和 18F-FDG 结合使用可能会克服每种示踪剂的局限性,分期更准确。
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来源期刊
European Journal of Hybrid Imaging
European Journal of Hybrid Imaging Computer Science-Computer Science (miscellaneous)
CiteScore
3.40
自引率
0.00%
发文量
29
审稿时长
17 weeks
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