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Functional oestrogen receptor α imaging in endometrial carcinoma using 16α-[18F]fluoro-17β-oestradiol PET

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Abstract

Purpose

To investigate the correlation between uptake of 16α-[18F]fluoro-17β-oestradiol (FES) and expression of oestrogen receptors as well as other related immunohistochemistry markers, positron emission tomography (PET) was performed in patients with endometrial carcinoma before surgery.

Methods

Nineteen patients with endometrioid adenocarcinoma underwent preoperative PET studies with FES and 2-[18F]fluoro-2-deoxy-D-glucose (FDG). Standardized uptake values (SUVs) for each tracer and the regional FDG to FES SUV ratio were calculated using images after coregistration. PET values were compared with postoperative stage, differentiation grade and immunohistochemical scores including oestrogen receptor subtypes (ERα, ERβ), progesterone receptor B (PR-B), Ki-67 and glucose transporter 1 (GLUT1).

Results

FES uptake showed a significantly positive correlation with expression of ERα. The FDG to FES ratio showed a significantly negative correlation with expression of ERα and PR-B. The FES uptake and FDG to FES ratio did not correlate with expression of ERβ, Ki-67 or GLUT1. FDG uptake was not correlated with any of the immunohistochemical scores. The PR-B score was strongly correlated with the ERα score. Well-differentiated carcinoma (grade 1) showed a significantly higher FES uptake and significantly lower FDG to FES ratio than moderately or poorly differentiated carcinoma (grade 2–3). None of the PET parameters were significantly different between advanced-stage carcinoma (≥ stage IB) and early-stage carcinoma (IA) based on the Féderation International de Gynécologie et d’Obstétrique (FIGO) staging classification. Differentiation grade was the most closely correlated parameter to FES uptake and FDG to FES ratio by multivariate analyses.

Conclusion

FES PET combined with FDG would be useful for non-invasive evaluation of ERα distribution, as well as ERα function, which reflects differentiation grade in endometrial carcinoma.

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Acknowledgments

The authors thank Ms. Yuko Horiuchi, doctors Akiko Shinagawa, M.D. and Yoko Sawamura, M.D. in the Department of Gynecology, Faculty of Medical Sciences, as well as the staff of the Biological Imaging Research Center, University of Fukui, for clinical and technical support. This study was partly funded by the Research and Development Project Aimed at Economic Revitalization (Leading Project) from MEXT Japan, the 21st Century COE Program (Medical Science), and Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (20790887, 21390342) and a Grant-in-Aid for Scientific Research from the Japan Radiological Society.

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Authors and Affiliations

  1. Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Fukui, 910-1193, Japan

    Tetsuya Tsujikawa, Yasushi Kiyono, Takashi Kudo, Yasuhisa Fujibayashi & Hidehiko Okazawa

  2. Department of Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan

    Yoshio Yoshida, Tetsuji Kurokawa & Fumikazu Kotsuji

  3. Research and Education Program for Life Science, University of Fukui, Fukui, Japan

    Hidehiko Okazawa

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  1. Tetsuya Tsujikawa
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  2. Yoshio Yoshida
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Correspondence to Hidehiko Okazawa.

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Tsujikawa, T., Yoshida, Y., Kiyono, Y. et al. Functional oestrogen receptor α imaging in endometrial carcinoma using 16α-[18F]fluoro-17β-oestradiol PET. Eur J Nucl Med Mol Imaging 38, 37–45 (2011). https://doi.org/10.1007/s00259-010-1589-8

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  • DOI: https://doi.org/10.1007/s00259-010-1589-8

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