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F-18 FES PET/CT for Breast Cancer (Estrogen Receptor Imaging)

PET imaging with 16α-[18F]fluoroestradiol that visualizes functional estrogen-receptor expression in metastatic breast cancer.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is F-18 FES PET/CT for Breast Cancer (Estrogen Receptor Imaging)?

F-18 fluoroestradiol (FES) is a positron-emitting tracer that binds estrogen receptors with high specificity. PET/CT imaging with FES (Cerianna) was FDA-approved in 2020 to assess ER status in metastatic or recurrent breast cancer.

FES PET/CT visualizes functional ER expression across all lesions simultaneously, complementing immunohistochemistry from biopsy and revealing inter- and intra-tumoral heterogeneity.

Indications include selection of endocrine therapy, evaluation of unbiopsied or inaccessible metastases, and identification of ER-negative or low-expressing disease that may explain endocrine therapy failure.

Symptoms

Confirmation of ER expression in metastases
Detection of inter-lesional ER heterogeneity
Assessment of suspected ER-negative conversion
Selection for endocrine therapy
Workup of unbiopsied lesions (bone, brain)
Pre-treatment baseline imaging
Restaging after endocrine therapy

Risk Factors

Newly diagnosed metastatic ER-positive breast cancer
Recurrent breast cancer (re-biopsy not feasible)
Endocrine therapy failure
Multiple lesions with discordant biopsy results
Bone-only metastatic disease (biopsy difficult)
Suspected ER conversion after prior treatment

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Metastatic breast cancer with treatment decision
  • Endocrine therapy failure or resistance
  • Inaccessible or unsafe biopsy site
  • Discordant ER results across lesions
  • Recurrence with unknown ER status
  • Pre-clinical-trial enrollment requiring ER status
  • Bone-only metastatic breast cancer

Treatment Methods

01
Stop tamoxifen 8 weeks and fulvestrant 24 weeks before scan
02
Stop ER agonists/antagonists per oncology team guidance
03
Hydration before and after scan
04
Outpatient procedure (1 hour after injection)
05
Multidisciplinary review with oncologist
06
Endocrine therapy selection based on FES uptake
07
Combine with FDG PET in selected dual-tracer protocols

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.