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Tables
Category Description Required descriptions of findings on… Quality of PET image, including any technical issues Visual analysis of clinically relevant findings, including… All sites of increased nonphysiologic focal uptake greater than local background suggestive of ER-positive lesions Any abnormal diffuse increased uptake Incidental findings with focal uptake, with further investigation suggested when needed Lesions identified by other imaging modalities as (suspected) tumor but not showing enhanced uptake (reported as [probable] ER-negative lesions) Quantitative analysis of sites of suspected disease, including where active disease is expected on basis of correlative imaging but visual inspection does not show uptake above background Detailed qualitative interpretation, specific to indication and individual clinical data, taking into consideration physiologic biodistribution of [18F]FES Synthesis of overall report impression Summary of patient history, including current and prior medications targeted to ER-expressing breast cancer Summary of technical components of scan, including injected activity and uptake time Description of areas with physiologic uptake, metabolism, and excretion of [18F]FES Identification and description of sites of qualitatively abnormal uptake above background that are suspected of being ER-expressing breast cancer, including anatomic localization on CT, qualitative level of uptake, and size of lesion by CT when relevant Quantitative uptake for sites identified by qualitative interpretation, noting that [18F]FES SUVmax > 1.5 is suggestive of ER expression Description of suspected false-positive or nonspecific findings Description of sites where uptake may be absent in lesions observed by other available imaging techniques Summary of heterogeneity of uptake across sites of known disease with reference to other correlative imaging, and specific discussion of concordance with contemporaneous [18F]FDG PET/CT findings when available Specific mention of qualitative and quantitative uptake by equivocal lesions, with conclusion on whether questioned lesions are ER-positive or -negative If [18F]FES PET is acquired for therapy purposes, specific mention of overall qualitative and quantitative ER status of metastases, including heterogeneity of expression For interpreting physicians, section on limitations and pitfalls of [18F]FES PET This table is condensed from information in complete joint standard/guideline, available at https://www.snmmi.org/ClinicalPractice/content.aspx?ItemNumber=6414&navItemNumber=10790.
