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Dynamic Brain [F18]-Fluoroestradiol (FES) PET Protocol Optimization for Improved Detection of Breast Cancer Brain Metastases.

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AJNR. American journal of neuroradiology 2026
Retraction 확인
출처

PICO 자동 추출 (휴리스틱, conf 3/4)

유사 논문
P · Population 대상 환자/모집단
환자: ER primary disease and BC-BM were enrolled prospectively and underwent dynamic [F]FES PET/CT and contemporaneous standard-of-care contrast-enhanced brain MRI
I · Intervention 중재 / 시술
dynamic [F]FES PET/CT and contemporaneous standard-of-care contrast-enhanced brain MRI
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
Our findings suggest that 60-75 minutes post-injection may represent the optimal acquisition time window and highlight the importance of timing standardization for neuro-oncologic applications of brain [F]FES PET.

Elmoujarkach E, Sharbatdaran A, Pontolillo L, Jean J, Agee M, Digregorio N, Cristofanilli M, Andreopoulou E, Beal K, Knisely JPS, Pannullo S, Magge R, Ramakrishna R, Dyke J, Nehmeh S, Ivanidze J

📝 환자 설명용 한 줄

[BACKGROUND AND PURPOSE] Brain [F]Fluoroestradiol (FES) PET enables noninvasive assessment of estrogen receptor (ER) expression and may improve detection of ER-positive (ER) breast cancer brain metast

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↓ .bib ↓ .ris
APA Elmoujarkach E, Sharbatdaran A, et al. (2026). Dynamic Brain [F18]-Fluoroestradiol (FES) PET Protocol Optimization for Improved Detection of Breast Cancer Brain Metastases.. AJNR. American journal of neuroradiology. https://doi.org/10.3174/ajnr.A9316
MLA Elmoujarkach E, et al.. "Dynamic Brain [F18]-Fluoroestradiol (FES) PET Protocol Optimization for Improved Detection of Breast Cancer Brain Metastases.." AJNR. American journal of neuroradiology, 2026.
PMID 41887747 ↗
DOI 10.3174/ajnr.A9316

Abstract

[BACKGROUND AND PURPOSE] Brain [F]Fluoroestradiol (FES) PET enables noninvasive assessment of estrogen receptor (ER) expression and may improve detection of ER-positive (ER) breast cancer brain metastases (BC-BM), with pilot studies demonstrating clinical utility. Our aim was to leverage our dynamic brain [F]FES PET acquisition protocol to characterize BC-BM uptake kinetics across different post-injection intervals, with the goal of improving lesion detectability.

[MATERIALS AND METHODS] Patients with ER primary disease and BC-BM were enrolled prospectively and underwent dynamic [F]FES PET/CT and contemporaneous standard-of-care contrast-enhanced brain MRI. PET was acquired over 90 minutes using a dynamic protocol (34 frames). Four 15-minute static time windows were reconstructed including 30-45, 45-60, 60-75, and 75-90 minutes post-injection, respectively. MRI was used as gold standard for clinical lesion characterization and segmentation, with subsequent [F]FES PET co-registration. Time-window-specific PET-MRI lesion matching rate (LMR) and mean standardized uptake value ratio (SUVR, normalized to cerebellar cortex) were calculated.

[RESULTS] Eleven patients with a total of 92 MRI-confirmed lesions were included (73 parenchymal, 8 leptomeningeal, 6 calvarial, 4 dural-based, and 1 pituitary stalk). Time window-3 yielded the highest LMR at 68% (63/92 lesions), followed by time window-2 (62%), time window-4 (60%), and time window-1 (57%). Mean SUVR increased across time, with means of 1.83 ± 1.46, 2.08 ± 1.88, 2.29 ± 2.37, and 2.38 ± 2.50 for time window-1, -2, -3, and -4, respectively. Despite higher SUVR at later time points, 8 lesions (6 parenchymal, 1 leptomeningeal, and 1 calvarial) that were visible at 60-75 min were undetectable at 75-90 min.

[CONCLUSION] Time window-3 at 60-75 minutes post-injection provided optimal LMR for brain [F]FES PET in ER BC and suspected BM. Imaging beyond this interval may not further improve diagnostic yield and may reduce visibility. Limitations of this study include small cohort size, population heterogeneity with regard to prior treatment, and lack of pathologic confirmation. Our findings suggest that 60-75 minutes post-injection may represent the optimal acquisition time window and highlight the importance of timing standardization for neuro-oncologic applications of brain [F]FES PET.