PT  - JOURNAL ARTICLE
AU  - Ryu, Jeongryul
AU  - Hyung, Jaewon
AU  - Han, Sangwon
AU  - Jeong, Jae Ho
AU  - Lee, Sae Byul
AU  - Yoo, Tae-Kyung Robyn
AU  - Kim, Jisun
AU  - Kim, Hee Jeong
AU  - Chung, Il Yong
AU  - Ko, Beom Seok
AU  - Lee, Jong Won
AU  - Son, Byung Ho
AU  - Jeong, Hyehyun
AU  - Ahn, Jin-Hee
AU  - Jung, Kyung Hae
AU  - Kim, Sung-Bae
AU  - Moon, Dae Hyuk
TI  - Impact of <sup>18</sup>F-FES PET/CT on Clinical Decisions in the Management of Recurrent or Metastatic Breast Cancer
AID  - 10.2967/jnumed.124.267913
DP  - 2024 Nov 01
TA  - Journal of Nuclear Medicine
PG  - 1689--1694
VI  - 65
IP  - 11
4099  - http://jnm.snmjournals.org/content/65/11/1689.short
4100  - http://jnm.snmjournals.org/content/65/11/1689.full
SO  - J Nucl Med2024 Nov 01; 65
AB  - The clinical impact of 16α-18F-fluoro-17β-estradiol (18F-FES) PET/CT on patient management has not been well investigated. The aim of this study was to assess the clinical impact of 18F-FES PET/CT on the management of patients with recurrent or metastatic breast cancer. Methods: Study subjects were identified retrospectively from a database of a prospective trial for postmarketing surveillance of 18F-FES between 2021 and 2023. Patients who were suspected or known to have recurrent or metastatic estrogen receptor–positive breast cancer based on a routine standard workup were included. Planned management before and actual management after 18F-FES PET/CT were assessed by 2 experienced medical oncologists via medical chart review. A 5-point questionnaire was provided to evaluate the value of 18F-FES PET/CT for management planning. The rate of intention-to-treat and interdisciplinary changes, and the impact of 18F-FES PET/CT according to PET/CT result or clinical indication, were examined. Results: Of the 344 included patients, 120 (35%) experienced a change in management after 18F-FES PET/CT. In 139 (40%) patients,18F-FES PET/CT supported the existing management decision without a change in management. Intention-to-treat and interdisciplinary changes accounted for 64% (77/120) and 68% (82/120) of all changes, respectively. A higher rate of change was observed when lesions were 18F-FES–negative (44% [36/81]) than 18F-FES–positive (30% [51/172]) or mixed 18F-FES–positive/negative (36% [33/91]). Regarding clinical indications, the highest rate of change was shown when evaluating the origins of metastasis of double primary cancers (64% [9/14]). Conclusion: 18F-FES PET/CT modified the management of recurrent or metastatic breast cancer, serving as an impactful imaging modality in clinical practice.