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ORIGINAL ARTICLES  BREAST CANCER II 

The Quarterly Journal of Nuclear Medicine 1998 March;42(1):26-32

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Estrogen receptor scintigraphy

Scheidhauer K., Scharl A.*, Schicha H.

From the Department of Nuclear Medicine and *Gynecology University of Cologne, Cologne, Germany


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Radio-­labeled ­estrogen ­receptor ­ligands are ­tracers ­that can be ­used for func­tional ­receptor diag­nosis. ­Their spec­i­ficity ­towards recep­tors, ­together ­with the ­fact ­that ­only 50-70% of mam­mary car­ci­nomas are ­receptor pos­i­tive, ren­ders ­them unsuit­able for detec­tion of pri­mary ­tumors or metas­tases, and ­this ­means ­that ­estrogen ­receptor scin­tig­raphy can be ­used nei­ther for ­tumor ­screening nor for ­staging. How­ever, ­both 18F-­labeled and 123I-­labeled ­estradiol deriv­a­tives are suit­able for in ­vivo ­imaging of ­estrogen recep­tors. ­Their ­high spec­i­ficity, estab­lished in ­animal experi­ments and in ­vitro ­studies has ­been repro­duced in in ­vivo appli­ca­tions in ­humans. ­Tracers ­with posi­tron radi­a­tion emit­ters are, how­ever, ­hardly suit­able for ­broad appli­ca­tion ­owing to the ­short ­half-­life of 18F, ­which ­would ­mean ­that ­users ­would ­need to be sit­u­ated ­close to a cyclo­tron and a cor­re­spond­ingly ­equipped radio­chem­ical labor­a­tory. The ­number of avail­able PET scan­ners, on the ­other ­hand, has ­increased ­over the ­last few ­years, espe­cially in Ger­many, so ­that ­this, at ­least, ­does not ­present a lim­iting ­factor. All the ­same, 123I-­labeled ­estradiol deriv­a­tives ­will ­find ­more wide­spread appli­ca­tion, ­since the ­number of ­gamma-cam­eras incor­po­rating ­modern ­multi-­head ­systems is sev­eral ­times ­greater. The ­results of ­studies ­with 123I-E2-scin­tig­raphy pub­lished to ­date are ­very prom­ising, ­even ­given the ­initial tech­nical prob­lems men­tioned ­above. As a ­method of exam­ina­tion, it ­could be optim­ised by ­using ­improved ­tracers ­with a ­higher ­tumor con­trast and ­less dis­tur­bance ­from over­lap­ping in diag­nos­ti­cally rel­e­vant loca­tions, for ­instance, by ­selecting ­tracers ­with ­higher activ­ities ­whose excre­tion is ­more ­renal ­than hepat­o­bil­iary. The use of ­modern ­multi-­head ­camera ­systems can ­also be ­expected to ­improve the ­photon ­yield.

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