Östrojen Reseptör (ER) Pozitif Meme Kanserinde ¹⁸F-FES PET/BT’nin Tedavi Yönetimine Katkısı

Amaç: ER+ Meme kanseri tanılı hastalarda ¹⁸F-FES PET/BT bulgularının tedavi yönetimine katkısı araştırıldı.

Yöntem: Meme kanseri tanısı ile ¹⁸F -FDG PET/BT çalışması yapılan ER+ (ER: >10%) hastalara tedavi öncesi prospektif olarak ¹⁸F-FES PET/BT çalışması planlandı. Hastaların histopatoloji, radyoloji, PET/BT bulguları ve takip dataları dokümente edildi. PET/BT bulguları, klinik-radyolojik/histopatolojik bulgular ile birlikte değerlendirildi.¹⁸F-FES PET/BT öncesi ve sonrası bulgulara göre planlanan tedaviler klinisyenlerce dolduran anket formları ile kayıt edildi. ¹⁸F-FES PET/BT sonrası tedavi değişiklikleri majör(intermodalite) ve minör(intramodalite) olmak üzere iki grupta toplandı. 

Bulgular: ER+ meme kanseri tanısıyla evreleme (n:12) ve yeniden evreleme (n:2) amaçlı 18F-FDG ve ¹⁸F-FES PET/BT yapılan 14 kadın hasta çalışmaya The Contribution of 18 F-FES PET/CT to Therapy Management in Estrogen Receptor Positive Breast

Cancer

Purpose

The contribution of 18 F-FES PET/CT findings to therapy management in estrogen receptor positive

breast cancer is investigated.

Methods

Pre-treatment prospective 18 F-FES PET/CT scans were planned to the patients with estrogen receptor

positive (ER +) breast cancer (ER: >10%), who had a previous 18 F -FDG PET/CT scan. The

histopathology, radiology, PET/CT findings and follow-up data of the patients were documented .The

PET/CT findings were evaluated together with the clinical- radiological/histopathological findings.

The therapy plans according to the findings of pre- and post 18 F-FES PET/CT scans were recorded with

the questionnaire forms filled by clinicians. The changes in treatment after 18 F-FES PET/CT scans were

separated into two groups as major (intermodality) and minor (intramodality).

Results

14 female patients diagnosed with ER (+) breast cancer, who underwent 18 F-FDG and 18 F-FES

PET/CT for staging (n: 12) and restaging (n: 2), were included in the study (mean age: 54).

According to radiological and 18 F -FDG PET/CT findings ,3 of the patients had early stage disease(

21,4 %) , 6 of them had locally advanced disease (35,7 %) , and 5 of them had advanced disease (35,7

%). 2 of the patients were multimetastatic, and all of the lesions could be detected by both PET/CT

modalities. In the remaining 12 patients, the number of detected metastases was 35 in 18 F -FDG

PET/CT and 33 in 18 F-FES PET/CT. The median SUVmax values of primary tumor in 18 F-FDG ve 18 F-FES

PET/CT were 4,65 (1,5 - 10,9) and 2,76 (0,98- 8,63); of axillary lymph node metastases 3,36 (2,7 -

15,7) and 2,69 (1,2 - 13,88) ; of non-axillary metastases 3,315 (1,72-13,56) and 5,01 (0,93-14,68)

,respectively. After 18 F-FES PET/CT acquisition, a regression of TNM-stage was observed in 4 patients

.A change of therapy management has been made in 5 patients (35, 7%) with the help of 18 F-FES

PET/CT findings.4 of them had a major change (2 patients went to surgery instead of receiving

adjuvant chemotherapy, 2 patients received neoadjuvant chemotherapy +surgery instead of

adjuvant chemotherapy) and 1 of them had a minor change (increased radiotherapy area) in therapy

management.

Conclusions

It is observed that 18 F-FES PET/CT findings decrease false positive results in patients with ER (+) breast

cancer, who have lesions suspicious of malignancy, therefore it has a significant influence on therapy

management. It is predicted that 18 F-FES PET/CT acquisition will contribute to therapy management

in selected cases.

Key words: 18 F-FES PET/CT, 18F -FDG PET/CT, Estrogen receptor, breast cancer