글로벌 연구동향
핵의학
- 2020년 07월호
[EJNMMI Res.] Comparison of Diagnostic Sensitivity of [ 18 F]fluoroestradiol and [ 18 F]fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Breast Cancer Recurrence in Patients With a History of Estrogen Receptor-Positive Primary Breast Cancer울산의대 / 채선영, 문대혁*
- 출처
- EJNMMI Res.
- 등재일
- 2020 May 24
- 저널이슈번호
- 10(1):54. doi: 10.1186/s13550-020-00643-z.
- 내용
Abstract
Background: To compare the diagnostic sensitivity of [18F]fluoroestradiol ([18F]FES) and [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer.Methods: Our database of consecutive patients enrolled in a previous prospective cohort study to assess [18F]FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent [18F]FDG PET/CT. The sensitivity of qualitative [18F]FES and [18F]FDG PET/CT interpretations was assessed, comparing them with histological diagnoses.
Results: Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of [18F]FES PET/CT was 71.1% (32/45, 95% CI, 55.7-83.6), while that of [18F]FDG PET/CT was 80.0% (36/45, 95% CI, 65.4-90.4) with a threshold of positive interpretation, and 93.3% (42/45, 95% CI, 81.7-98.6) when a threshold of equivocal was used. There was no significant difference in sensitivity between [18F]FES and [18F]FDG PET/CT (P = 0.48) with a threshold of positive [18F]FDG uptake, but the sensitivity of [18F]FDG was significantly higher than [18F]FES (P = 0.013) with a threshold of equivocal [18F]FDG uptake. One patient with a benign lesion showed negative [18F]FES but positive [18F]FDG uptake.
Conclusions: The restaging of patients who had ER-positive primary breast cancer and present with recurrent disease may include [18F]FES PET/CT as an initial test when standard imaging studies are equivocal or suspicious.
Affiliations
Sun Young Chae 1 , Hye Joo Son 1 , Dong Yun Lee 1 , Eonwoo Shin 1 , Jungsu S Oh 1 , Seung Yeon Seo 1 , Sora Baek 2 , Ji Young Kim 3 , Sae Jung Na 4 , Dae Hyuk Moon 5
1 Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
2 Department of Nuclear Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
3 Department of Nuclear Medicine, Guri Hospital of Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Republic of Korea.
4 Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
5 Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. dhmoon@amc.seoul.kr.
- 키워드
- Breast cancer; Estrogen receptor; [18F]FDG PET/CT; [18F]FES PET/CT.
- 연구소개
- [18F]FES PET/CT는 병변의 estrogen receptor (ER) 발현여부를 비침습적으로 진단해 줄 수 있는 영상검사로 [18F]FES에서 섭취증가를 보이는 경우 ER 양성의 전이성 혹은 재발성 유방암 병변임을 조직검사 없이도 진단할 수 있다는 것을 이전 연구에서 밝힌 바 있습니다 (Lancet Oncology 2019;20(4):546-555). 이번 연구는 원발성 유방암이 ER-양성이었던 환자에서 재발이 의심되는 경우 [18F]FES PET/CT와 [18F]FDG PET/CT의 진단적 민감도를 비교한 논문입니다. 조직학적 검사를 reference standard로 하여 [18F]FES PET/CT에서 양성으로 보이는 병변과 [18F]FDG PET/CT에서 양성으로 보이는 병변에 대한 진단적 민감도를 비교시 통계적으로 유의한 차이가 없음을 확인하였습니다. 향후 ER-양성의 원발성 유방암이 있었던 환자에서 재발이 의심되는 경우에, 재병기 설정의 initial test로 [18F]FES PET/CT를 사용할 수 있다는 근거를 제시한 연구라고 생각합니다.
- 덧글달기
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편집위원
유방암 가운데, 호르몬수용체가 있는 종양의 재발 평가에 F-18 fluoroestradiol의 가치를 보여준 임상연구로 여성호르몬 수용체영상용 핵의학 추적자의 임상진입에 도움이 되는 연구임. 유방암 관련 임사의사, 핵의학 의사 및 방사화학자에게 관심을 끌 논문으로 생각됨.
덧글달기닫기2020-07-02 14:32:49
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