Abstract：
The estrogen receptor (ER), a steroid hormone receptor important in female physiology, is a significant contributor to breast carcinogenesis and progression and, as such, is an important therapeutic target. Approximately 70% of breast cancers will express ER at presentation, and the determination of ER expression by tissue assay, usually by immunohistochemistry, is part of the standard of care for newly diagnosed breast cancer. ER expression is important in guiding the approach to treatment, especially with the increase in relevant systemic therapies. The ER-targeting imaging agent 16α-[18F]fluoro-17β-estradiol ([18F]FES) is approved for clinical use by regulatory agencies in France and the United States. Multiple studies suggest the advantages of [18F]FES PET in assessing tumor ER expression, the ability of both qualitative and quantitative [18F]FES PET measures to predict response to ER-targeted therapy, and the ability of [18F]FES PET to clarify equivocal staging and restaging results in patients with ER-expressing cancers. [18F]FES PET/CT may also be helpful in staging invasive lobular breast cancer and low-grade ER-expressing invasive ductal cancers and, in some cases, may be a substitute for biopsy. The Society of Nuclear Medicine and Molecular Imaging and the European Association of Nuclear Medicine in June 2023 released a procedure standard/practice guideline for [18F]FES PET ER imaging of patients with breast cancer. The goal of the standard/guideline is to assist physicians in recommending, performing, interpreting, and reporting the results of [18F]FES PET studies for patients with breast cancer and to provide clinicians with the best available evidence, inform them about areas where robust evidence is lacking, and help them deliver the best possible diagnostic efficacy and study quality for their patients. Also reviewed are standardized quality control, quality assurance, and imaging procedures for [18F]FES PET. The authors emphasize the importance of precision, accuracy, repeatability, and reproducibility for both clinical management of patients and for use of [18F]FES PET in multicenter trials. A standardized imaging procedure, in combination with already published appropriate-use criteria, will help promote the use of [18F]FES PET and enhance subsequent research. This brief summary article reviews the content of the joint standard/guideline, which is available in its entirety at https://www.snmmi.org/ClinicalPractice/content.aspx?ItemNumber=6414&navItemNumbe=10790.
摘要：
雌激素受体（ER），在女性生理中很重要的类固醇激素受体，是乳腺癌发生和进展的重要因素，因此，是一个重要的治疗靶点。大约70％的乳腺癌在出现时会表达ER，并通过组织试验测定ER的表达，通常通过免疫组织化学，是新诊断乳腺癌护理标准的一部分。ER表达在指导治疗方法中很重要，特别是随着相关系统治疗的增加。ER靶向成像剂16α-[18F]氟-17β-雌二醇([18F]FES)被法国和美国的监管机构批准用于临床使用。多项研究表明[18F]FESPET在评估肿瘤ER表达方面的优势，定性和定量[18F]FESPET措施预测对ER靶向治疗的反应的能力，和[18F]FESPET阐明ER表达癌症患者的模棱两可的分期和重新分级结果的能力。[18F]FESPET/CT也可能有助于分期浸润性小叶乳腺癌和低级别ER表达浸润性导管癌，在某些情况下,可能是活检的替代品。核医学与分子成像协会和欧洲核医学协会于2023年6月发布了乳腺癌患者[18F]FESPETER成像的程序标准/实践指南。标准/指南的目标是帮助医生推荐，表演,口译,报告乳腺癌患者的[18F]FESPET研究结果，并为临床医生提供最佳的可用证据，告诉他们缺乏有力证据的领域，并帮助他们为患者提供尽可能好的诊断效果和研究质量。还审查了标准化的质量控制，质量保证,和[18F]FESPET的成像程序。作者强调精确的重要性,准确度,重复性,患者的临床管理和[18F]FESPET在多中心试验中的使用的可重复性。标准化的成像程序，结合已经公布的适当使用标准，将有助于推广[18F]FESPET的使用并加强后续研究。这篇简短的摘要文章回顾了联合标准/指南的内容，它可以在https://www上完整获得。snmmi.org/ClinicalPractice/content.aspx?ItemNumber=6414&navItemNumbe=10790。
