PET to image estrogen receptors

[Kayaker82]

Hello everyone and Merry Christmas! I read awhile back on here about women getting PET scans which used agents to image estrogen receptors, not the typical glucose agent. Can someone tell me what the test is called (PET imaging with FES?) and if you’ve used it, has it helped in detection of any new metastases? Thank you!!

[Half-Full]

Interesting to see this post as our onco just raised the possibility of doing this. The estrogen sensing scan is called an FES PET (Cerianna).

I had not heard of it before but from what I’ve seen it appears it can be helpful under unique circumstances. Any areas of increased uptake will theoretically be estrogen positive. The downside is that it will not show increased uptake in areas where there’s activity that are not estrogen positive. So if you’re contemplating whether estrogen therapy would be beneficial and you have limited options for safely obtaining biopsies it seems this FES PET might be a good option.

We’ve not used it yet but we may have to try it soon as we need to make a treatment change and we cannot safely do any biopsies as her cancer has spread primarily to her bones and the lining of her lungs. Taking a biopsy of the lining of her lungs is too risky as her lungs have been compromised by a prior severe case of pneumonitis. Our options are looking like it’s either Exemestane as a monotherapy or IV chemo, so we might try this FES PET to qualitatively see how much of her activity is estrogen positive.

I’m just learning of this too so others may have better feedback.

[Kayaker82 in reply to Half-Full]

Thanks for the info! Sounds like you have a good grasp on the pros and cons of this scan and I appreciate you sharing. Wishing you and yours the best in finding good treatment.

[DDIL1]

I just had my 2nd FES Pet. I’m Lobular ER/PR+ HER-. The first one I got after 3 months of treatment, to see if the meds were working. It gave a much clearer picture than the CT CHEST/Abdomen and the Bone scan I had initially. As bone scans can not detect what is from old injury. The FES showed the SUV uptake and how enhancing the Mets were. It did show in my case things were resolving so the meds were working. I then stayed on the Ibrance/Letrozole and Xcheva getting the CT and bone scans every 3 months in between which showed bone mets, a lung opacity which then I had a follow up X-ray on the lung which showed it was fine. Fast forward to 11 months.. I was having some back issues not sure if it was time for a medication change because I’m experiencing progression, so we opted to do another FES since I now had one to compare to. I just had that done 1 week ago. It showed everything resolved but one new met on T9 which might be my issue. The Bone scan showed the healed mets so you assume they are healed by how they look on the scan but you can’t see how advid enhancing they are. Since I’m Lobular it’s very hard to detect in scans. The only thing with FES it’s not spectacular for showing your liver or pancreas, so it’s not meant to be an every 3 month scan, you need the alternate scans in between. I know some with ductal or Lobular get regular PETS, and it works for them others like me need the FES combined with the CT/ Bone to get a true picture. You’ll need to see if your insurance will pay for it, I know there’s issues with that, but if you go to the Cerianna Website they do have patient advocates who work with your medical providers on coding and wording. I hope this helps.

One last thing you can’t get the FES if your on faslodex.

[ba5083 in reply to DDIL1]

Thanks so much for sharing!

[Kayaker82]

Thank you for the info! This is all good to know. Wishing you the best in getting successful treatment!