TY - JOUR T1 - Summary: Appropriate Use Criteria for Estrogen Receptor–Targeted PET Imaging with 16α-<sup>18</sup>F-Fluoro-17β-Fluoroestradiol JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 351 LP - 354 DO - 10.2967/jnumed.123.265420 VL - 64 IS - 3 AU - Gary A. Ulaner AU - David A. Mankoff AU - Amy S. Clark AU - Amy M. Fowler AU - Hannah M. Linden AU - Lanell M. Peterson AU - Farrokh Dehdashti AU - Brenda F. Kurland AU - Joanne Mortimer AU - Jason Mouabbi AU - Dae Hyuk Moon AU - Elisabeth G.E. de Vries Y1 - 2023/03/01 UR - http://jnm.snmjournals.org/content/64/3/351.abstract N2 - PET imaging with 16α-18F-fluoro-17β-fluoroestradiol (18F-FES), a radiolabeled form of estradiol, allows whole-body, noninvasive evaluation of estrogen receptor (ER). 18F-FES is approved by the U.S. Food and Drug Administration as a diagnostic agent “for the detection of ER-positive lesions as an adjunct to biopsy in patients with recurrent or metastatic breast cancer.” The Society of Nuclear Medicine and Molecular Imaging (SNMMI) convened an expert work group to comprehensively review the published literature for 18F-FES PET in patients with ER-positive breast cancer and to establish appropriate use criteria (AUC). The findings and discussions of the SNMMI 18F-FES work group, including example clinical scenarios, were published in full in 2022 and are available at https://www.snmmi.org/auc. Of the clinical scenarios evaluated, the work group concluded that the most appropriate uses of 18F-FES PET are to assess ER functionality when endocrine therapy is considered either at initial diagnosis of metastatic breast cancer or after progression of disease on endocrine therapy, the ER status of lesions that are difficult or dangerous to biopsy, and the ER status of lesions when other tests are inconclusive. These AUC are intended to enable appropriate clinical use of 18F-FES PET, more efficient approval of FES use by payers, and promotion of investigation into areas requiring further research. This summary includes the rationale, methodology, and main findings of the work group and refers the reader to the complete AUC document. ER -