F-18 FES Cold but F-18 FDG Hot for ER Positive Hepatic Metastasis From Breast Cancer

F-18 FES冷點但F-18 FDG熱點在雌激素受體陽性乳癌的肝轉移病灶

10.6332/ANMMI.201909_32(3).0005

黃雅瑤(Ya-Yao Huang)；陳偉武(Tom Wei-Wu Chen)；蔡佳伶(Chia-Ling Tsai)；盧彥伸(Yen-Shen Lu)；顏若芳(Ruoh-Fang Yen)

estrogen receptors ； breast cancer ； F-18 FES ； F-18 FDG ； PET/CT ； 雌激素受體 ； 乳癌 ； F-18 FES ； F-18 FDG ； 正子造影

核子醫學暨分子影像雜誌

32卷3期（2019 / 09 / 01）

153 - 156

英文

Estrogen receptors (ER) expression is known to be an important prognostic factor for breast cancer (BC). The presence of ER is also predictive for benefit of response to hormonal therapy. 16α-F-18-fluoro-17β-estradiol (F- 18 FES) positron emission tomography (PET) can provide ER status of whole-body BC lesions. However, due to high physiological F-18 FES liver uptake, the F-18 FES status in hepatic lesions is usually not taken into account. We presented a patient with metastatic BC at liver and bones. The hepatic lesion was cold in F-18 FES PET but hot in F-18 fluorodeoxyglucose PET. However, liver biopsies demonstrated that the liver lesion remained ER-positive.

雌激素受體（estrogen receptors, ER）的表現量已知為乳癌病患一重要之預後指標，且也可用以預測乳癌病患荷爾蒙治療的療效反應。已知16α-F-18-fluoro-17β-estradiol（F-18 FES）正子造影能夠即時提供乳癌病患全身病灶的活體ER表現情形。然而，F-18 FES在肝臟的高背景吸收值卻往往侷限其在乳癌病患肝轉移病灶診斷之應用。一位同時有肝臟與骨頭轉移情況之轉移性乳癌病患，其F-18 FDG影像顯示在其肝臟病灶為明顯熱點（hot spot）吸收情形，但是F-18 FES正子影像卻呈現冷點（cold spot）吸收。最後，藉由肝臟活體切片結果證實此肝臟病灶仍然為ER陽性表現。