18F-fluoroestradiol PET: Current status and potential future clinical applications

Abstract

Estrogen receptor (ER) expression in breast cancer is associated with a more favorable prognosis and is necessary for a response to endocrine therapies. Traditionally, ER expression is assessed by in vitro assays on biopsied tumor tissue. However, recent advances have allowed in vivo evaluation of ER expression with 18F-fluoroestradiol (18F-FES) PET. Clinical studies have demonstrated the use of 18F-FES PET as a method for quantifying in vivo ER expression and have explored its potential as a predictive assay and method of assessing in vivo pharmacodynamic response to endocrine therapy. This review outlines the biology and pharmacokinetics of 18F-FES, highlights the current experience with 18F-FES in patient studies on breast cancer and other diseases, and discusses potential clinical applications and the possible future clinical use of 18F-FES PET.