The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) have issued a new procedure standard/practice guideline for estrogen receptor imaging of breast cancer patients using FES-PET. The standard/guideline, published ahead of print in The Journal of Nuclear Medicine, aims to assist physicians in recommending, conducting, interpreting, and reporting 18F-FES-PET studies for breast cancer patients.
Every year, more than two million women worldwide are diagnosed with breast cancer. The estrogen receptor (ER) significantly contributes to the development and progression of breast cancer and is therefore an important target for therapy. About 70% of breast cancer cases express ER, and determining ER expression through tissue analysis is part of the standard care for newly diagnosed breast cancer.
Several studies suggest 18F-FES PET, which is approved for clinical use in France and the United States, provides advantages in assessing tumor ER expression, predicting responses to ER-targeted therapies, and clarifying unclear staging and restaging results for patients with ER-expressing cancer. It can also be useful in staging invasive lobular breast cancer and low-grade ER-expressing invasive ductal carcinomas, and in some cases, replace a biopsy.
The procedure guideline/practice norm contains information on common clinical indications, procedure specifications, patient selection and preparation, tracer administration and imaging, as well as image interpretation and reporting. Additionally, standardized quality control, quality assurance, and imaging procedures for 18F-FES PET are presented.
„Precision, accuracy, repeatability, and reproducibility are important for both clinical patient care and the use of 18F-FES in multicenter studies,“ the authors emphasize. „The availability of a standardized imaging procedure will contribute to promoting the appropriate use of 18F-FES PET and improving subsequent research.“
SNMMI/EANM regularly define new standards/guidelines for nuclear medicine practice to advance the science of nuclear medicine and provide effective and safe medical care to patients. Each standard/guideline, representing a policy statement of SNMMI/EANM, undergoes a thorough consensus process, subjecting it to comprehensive review.
This article was published online in December 2023.
Society of Nuclear Medicine and Molecular Imaging
Mankoff, D., et al. (2023). Summary: SNMMI Procedure Standard/EANM Practice Guideline for Estrogen Receptor Imaging of Breast Cancer Patients Using 16α-[18F]Fluor-17β-Estradiol PET. Journal of Nuclear Medicine. doi.org/10.2967/jnumered.123.266938.