Ces radiol. 2025, 79(1):15-24 | DOI: 10.55095/CesRadiol2025/002

The use of PET/CT and PET/MRI with the application of 18F-fluoroestradiol in the imaging of breast carcinomaOriginal article

Jiří Ferda1, Eva Ferdová1, Táňa Baráková1, Marika Looseová1, Martina Odvody1, Samuel Vokurka2
1 Klinika zobrazovacích metod LF UK a FN, Plzeň
2 Onkologická a radioterapeutická klinika LF UK a FN, Plzeň

Aim: 18F-fluoroestradiol is a novel radiopharmaceutical useful in the imaging of breast carcinoma, the indications in clinical scenarios are under development. The purpose of the study is to assess the clinical impact of the imaging of the breast carcinoma with estrogen-positive receptors (ER+) using 18F-fluoroestradiol (18F-FES) PET/CT or PET/MRI according to the treatment decision making. The study is concerned in the different preference of PET/CT and PET/MRI in the staging and restaging.

Methods: 40 patients with estrogen positive breast carcinoma underwent the hybrid imaging after intravenous application of 18F-FES, in 25 cases it was used PET/CT, in 15 cases PET/MRI. The radiopharmaceutical was injected with the activity of 2,5 MBq/kg. In 10 patient, PET/MRI was used as restaging method, PET/MRI was performed in the 5 cases of the staging before surgery with targeted full diagnostic MRI imaging of the breast in prone position, followed by the trunk imaging in supine position. All PET/MRI were performed after application of the gadolinium contrast material, the imaging included brain imaging in T1 STARVIBE. PET/CT was performed using the continuous PET acquisition after CT with the intravenous administration of the iodinated contrast material, in 5 cases was performed in staging, in 20 cases in restaging Results. The most important information was detection of ER+ metastases when 18F-FDG-PET was negative (12×) - including brain and liver metastases, the persistent ER+ of the metastases (7×), staging of the disease (10×), the loss of the ER (4x) and the negative finding for metastases (2), no added information was found in 5 examinations.

Conclusion: 18F-FES-PET provided the important clinical information to treatment strategy, 18F-FES-PET/MRI improves the imaging of metastases in brain and liver.

Keywords: positron emission tomography, breas carcinoma, 18F-fluorestradiol.

Accepted: January 31, 2025; Published: April 22, 2025  Show citation

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Ferda J, Ferdová E, Baráková T, Looseová M, Odvody M, Vokurka S. The use of PET/CT and PET/MRI with the application of 18F-fluoroestradiol in the imaging of breast carcinoma. Ces radiol. 2025;79(1):15-24. doi: 10.55095/CesRadiol2025/002.
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