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Gasparri_2025_MDPI_cancers_The role of 18F
Journal article

The role of [18F]FES PET/CT in breast cancer management : an umbrella review

  • Cuzzocrea, Marco Division of Nuclear Medicine, Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Bellinzona and Lugano, Switzerland
  • Di Micco, Rosa Breast Surgery Unit, IRCSS Ospedale San Raffaele, Milan, Italy
  • Colombo, Giorgia Elisabeth Department of Obstetrics and Gynaecology, Chelsea and Westminster NHS Foundation Trust, London UK - Department of Gynaecology and Obstetrics, Ente Ospedaliero Cantonale (EOC), Ospedale Regionale di Lugano, Switzerland
  • Rizzo, Stefania Maria Rita ORCID Division of Radiology, Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
  • Paone, Gaetano ORCID Division of Nuclear Medicine, Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Bellinzona and Lugano, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
  • Casati, Virginia Department of Gynaecology and Obstetrics, Ente Ospedaliero Cantonale (EOC), Ospedale Regionale di Lugano, Switzerland
  • Alkhaldii, Turki Breast Surgery Unit, IRCSS Ospedale San Raffaele, Milan, Italy
  • Khajah, Fatemah Breast Surgery Unit, IRCSS Ospedale San Raffaele, Milan, Italy
  • Rauh, Claudia Department of Gynecology, University Hospital Inselspital Bern, Switzerland
  • Banys-Paluchowsky, Maggie Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Luebeck, Germany
  • Ditsch, Nina Klinik fuer Gynäkologie und Geburtshilfe, Universitätsklinikum Augsburg, Germany
  • Kuehn, Thorsten Universitaetsfrauenklinik Ulm, Germany - Faculty of Medicine, Università Vita-Salute San Raffaele, Milan, Italy
  • Gentilini, Oreste D. Breast Surgery Unit, IRCSS Ospedale San Raffaele, Milan, Italy - Faculty of Medicine, Università Vita-Salute San Raffaele, Milan, Italy
  • Treglia, Giorgio ORCID Division of Nuclear Medicine, Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Bellinzona and Lugano, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Faculty of Biology and Medicine, University of Lausanne, Switzerland
  • Gasparri, Maria Luisa ORCID Department of Gynaecology and Obstetrics, Ente Ospedaliero Cantonale (EOC), Ospedale Regionale di Lugano, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Department of Gynecology and Obstetrics, Centro di Senologia della Svizzera Italiana EOC, Ospedale Italiano di Lugano, Switzerland
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  • 2025
Published in:
  • Cancers. - 2025, vol. 17, no. 10, p. 1644
Breast cancer
[18F]FES PET/CT
Estrogen receptor
PET
Positron emission tomography
English Background/Objectives: Breast cancer (BC) is the most commonly diagnosed cancer worldwide. Estrogen receptor (ER) status is a key determinant in the diagnosis and treatment of BC. Although immunohistochemistry (IHC) is the gold standard for ER assessment, it has limitations. This umbrella review aims to evaluate the role of 16α-18F-fluoro-17β-estradiol ([18F]FES) PET/CT as a non-invasive imaging tool for assessing ER expression and its implications in BC management. Methods: A comprehensive search was conducted in PubMed/MEDLINE and Cochrane Library for systematic reviews and meta-analyses published in the last decade. Studies eligible for inclusion evaluated the diagnostic accuracy and clinical utility of [18F]FES PET/CT in BC based on a predefined research question “What is the role of fluoroestradiol ([18F]FES) PET/CT in breast cancer?”. Data extraction and quality assessment were performed independently by two reviewers using the AMSTAR-2 tool. Results: Eight systematic reviews met the inclusion criteria. [18F]FES PET/CT demonstrated high sensitivity (81–94%) and specificity (78–95%) in detecting ER-positive lesions. It provided a real-time, whole-body assessment of ER expression, outperforming IHC in detecting functional ER activity. Additionally, [18F]FES PET/CT showed promise in predicting treatment response and guiding therapy decisions, particularly in metastatic settings. Conclusions: This review highlights the clinical value of [18F]FES PET/CT in BC management, offering a non-invasive alternative for ER assessment with high diagnostic accuracy. Its integration into clinical practice may enhance personalized treatment strategies for BC patients.
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  • English
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Medicine
License
CC BY
Open access status
gold
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https://n2t.net/ark:/12658/srd1332001
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