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Clinical Validity of 16α-[18F]Fluoro-17β-Estradiol Positron Emission Tomography/Computed Tomography to Assess Estrogen Receptor Status in Newly Diagnosed Metastatic Breast Cancer

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Title: Clinical Validity of 16α-[18F]Fluoro-17β-Estradiol Positron Emission Tomography/Computed Tomography to Assess Estrogen Receptor Status in Newly Diagnosed Metastatic Breast Cancer
Authors: van Geel, J.J.L., Boers, J., Elias, S.G., Glaudemans, A.W.J.M., de Vries, E.F.J., Hospers, G.A., van Kruchten, M., Kuip, E.J.M., Jager, A., Menke-van der Houven van Oordt, W.C., van der Vegt, B., de Vries, E.G., Schröder, C.P.
Contributors: Hart- en Vaatziekten Team A, Epi Kanker Team C, Cancer, JC onderzoeksprogramma Cancer
Source: van Geel, J J L, Boers, J, Elias, S G, Glaudemans, A W J M, de Vries, E F J, Hospers, G A P, van Kruchten, M, Kuip, E J M, Jager, A, Menke-van der Houven van Oordt, W C, van der Vegt, B, de Vries, E G E & Schröder, C P 2022, 'Clinical Validity of 16α-[18F]Fluoro-17β-Estradiol Positron Emission Tomography/Computed Tomography to Assess Estrogen Receptor Status in Newly Diagnosed Metastatic Breast Cancer', Journal of Clinical Oncology, vol. 53, JCO.22.00400. https://doi.org/10.1200/JCO.22.00400
Journal of Clinical Oncology, 40, 31, pp. 3642-3652
Publisher Information: American Society of Clinical Oncology (ASCO), 2022.
Publication Year: 2022
Subject Terms: Cancer Research, Estradiol, Anesthesiology - Radboud University Medical Center, Breast Neoplasms, Radboudumc 14: Tumours of the digestive tract RIHS: Radboud Institute for Health Sciences, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Oncology, SDG 3 - Good Health and Well-being, Receptors, Estrogen, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Humans, Multicenter Studies as Topic, Female
Description: PURPOSE Determining the estrogen receptor (ER) status is essential in metastatic breast cancer (MBC) management. Whole-body ER imaging with 16α-[18F]fluoro-17β-estradiol positron emission tomography ([18F]FES-PET) is increasingly used for this purpose. To establish the clinical validity of the [18F]FES-PET, we studied the diagnostic accuracy of qualitative and quantitative [18F]FES-PET assessment to predict ER expression by immunohistochemistry in a metastasis. METHODS In a prospective multicenter trial, 200 patients with newly diagnosed MBC underwent extensive workup including molecular imaging. For this subanalysis, ER expression in the biopsied metastasis was related to qualitative whole-body [18F]FES-PET evaluation and quantitative [18F]FES uptake in the corresponding metastasis. A review and meta-analysis regarding [18F]FES-PET diagnostic performance were performed. RESULTS Whole-body [18F]FES-PET assessment predicted ER expression in the biopsied metastasis with good accuracy: a sensitivity of 95% (95% CI, 89 to 97), a specificity of 80% (66 to 89), a positive predictive value (PPV) of 93% (87 to 96), and a negative predictive value (NPV) of 85% (72 to 92) in 181 of 200 evaluable patients. Quantitative [18F]FES uptake predicted ER immunohistochemistry in the corresponding metastasis with a sensitivity/specificity of 91%/69% and a PPV/NPV of 90%/71% in 156 of 200 evaluable patients. For bone metastases, PPV/NPV was 92%/81%. Meta-analysis with addition of our data has increased diagnostic performance and narrowed the 95% CIs compared with previous studies with a sensitivity/specificity of both 86% (81 to 90 and 73 to 93, respectively). CONCLUSION In this largest prospective series so far, we established the clinical validity of [18F]FES-PET to determine tumor ER status in MBC. In view of the high diagnostic accuracy of qualitatively assessed whole-body [18F]FES-PET, this noninvasive imaging modality can be considered a valid alternative to a biopsy of a metastasis to determine ER status in newly MBC (ClinicalTrials.gov identifier: NCT01957332 ).
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.22.00400
Access URL: https://pubmed.ncbi.nlm.nih.gov/35584346
https://pure.eur.nl/en/publications/a6ac503b-ce36-4ba2-8739-5649a4183203
https://doi.org/10.1200/JCO.22.00400
https://research.rug.nl/en/publications/94547ff6-0669-4052-9f74-221e971f0e65
https://hdl.handle.net/11370/94547ff6-0669-4052-9f74-221e971f0e65
https://doi.org/10.1200/JCO.22.00400
https://research.vumc.nl/en/publications/5556155c-108e-4f26-a7c2-d5a568035933
https://dspace.library.uu.nl/handle/1874/448420
https://repository.ubn.ru.nl//bitstream/handle/2066/286734/286734.pdf
https://hdl.handle.net/2066/286734
Rights: taverne
Accession Number: edsair.doi.dedup.....d6c0f722952ec576b48f9f4b0b177684
Database: OpenAIRE
Description
Abstract:PURPOSE Determining the estrogen receptor (ER) status is essential in metastatic breast cancer (MBC) management. Whole-body ER imaging with 16α-[18F]fluoro-17β-estradiol positron emission tomography ([18F]FES-PET) is increasingly used for this purpose. To establish the clinical validity of the [18F]FES-PET, we studied the diagnostic accuracy of qualitative and quantitative [18F]FES-PET assessment to predict ER expression by immunohistochemistry in a metastasis. METHODS In a prospective multicenter trial, 200 patients with newly diagnosed MBC underwent extensive workup including molecular imaging. For this subanalysis, ER expression in the biopsied metastasis was related to qualitative whole-body [18F]FES-PET evaluation and quantitative [18F]FES uptake in the corresponding metastasis. A review and meta-analysis regarding [18F]FES-PET diagnostic performance were performed. RESULTS Whole-body [18F]FES-PET assessment predicted ER expression in the biopsied metastasis with good accuracy: a sensitivity of 95% (95% CI, 89 to 97), a specificity of 80% (66 to 89), a positive predictive value (PPV) of 93% (87 to 96), and a negative predictive value (NPV) of 85% (72 to 92) in 181 of 200 evaluable patients. Quantitative [18F]FES uptake predicted ER immunohistochemistry in the corresponding metastasis with a sensitivity/specificity of 91%/69% and a PPV/NPV of 90%/71% in 156 of 200 evaluable patients. For bone metastases, PPV/NPV was 92%/81%. Meta-analysis with addition of our data has increased diagnostic performance and narrowed the 95% CIs compared with previous studies with a sensitivity/specificity of both 86% (81 to 90 and 73 to 93, respectively). CONCLUSION In this largest prospective series so far, we established the clinical validity of [18F]FES-PET to determine tumor ER status in MBC. In view of the high diagnostic accuracy of qualitatively assessed whole-body [18F]FES-PET, this noninvasive imaging modality can be considered a valid alternative to a biopsy of a metastasis to determine ER status in newly MBC (ClinicalTrials.gov identifier: NCT01957332 ).
ISSN:15277755
0732183X
DOI:10.1200/jco.22.00400