TY - JOUR T1 - Prognostic Value of 16α-<sup>18</sup>F-Fluoro-17β-Estradiol PET as a Predictor of Disease Outcome in Endometrial Cancer: A Prospective Study JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 636 LP - 642 DO - 10.2967/jnumed.120.244319 VL - 62 IS - 5 AU - Shizuka Yamada AU - Hideaki Tsuyoshi AU - Makoto Yamamoto AU - Tetsuya Tsujikawa AU - Yasushi Kiyono AU - Hidehiko Okazawa AU - Yoshio Yoshida Y1 - 2021/05/10 UR - http://jnm.snmjournals.org/content/62/5/636.abstract N2 - The purpose of this study was to evaluate the potential of 16α-18F-fluoro-17β-estradiol (18F-FES) PET to predict prognosis in patients with endometrial cancer (EC). Methods: In total, 67 patients with International Federation of Gynecology and Obstetrics (FIGO) stage I–IV EC underwent 18F-FES and 18F-FDG PET/CT before treatment. The SUVmean of the primary tumor was compared with the clinical characteristics, and the relationships between SUV and progression-free survival (PFS) or overall survival were analyzed. Results: 18F-FES SUV was significantly associated with stage, histology, lymphovascular space involvement (LVSI), and lymph node metastasis, and 18F-FDG SUV was significantly associated with stage, myometrial invasion, tumor size, and lymph node metastasis. Receiver-operating characteristic curve analysis revealed that 18F-FES SUV could significantly detect tumor progression and survival, with areas under the curve of 0.813 and 0.790, respectively, whereas 18F-FDG SUV could detect them with areas under the curve of 0.557 and 0.635, respectively. The Kaplan–Meier survival curve showed that patients with a low 18F-FES SUV had significantly poor PFS (P &lt; 0.001) and overall survival (P = 0.001) compared with patients with a high SUV, whereas 18F-FDG showed no significant differences. In a subanalysis of 27 patients with a low risk of recurrence (FIGO stage IA endometrioid carcinoma [grade 1 or 2] without LVSI), those with a low 18F-FES SUV also had poorer PFS than those with a high SUV (P = 0.002). In multivariate analysis, an 18F-FES SUV of less than 2.63 (P = 0.037; hazard ratio, 10.727; 95% CI, 1.16–99.35) and FIGO stages III and IV (P = 0.042; hazard ratio, 8.838; 95% CI, 1.09–71.84) were significantly associated with PFS. Conclusion: A low 18F-FES for the primary tumor was strongly associated with prognostic factors of EC such as LVSI and lymph node metastasis, and a low 18F-FES SUV was an independent prognostic factor for PFS in patients with EC. These data suggest that pretreatment 18F-FES PET might be useful in determining the appropriate treatment for patients with EC. ER -