Background/Objectives:Breast cancer (BC) is the most commonly diagnosed cancer worldwide. Estrogen receptor (ER) status is a key determinant in the diagnosis and treatment of BC. Although immunohistochemistry (IHC) is the gold standard for ER assessment, it has limitations. This umbrella review aims to evaluate the role of 16α-18F-fluoro-17β-estradiol ([18F]FES) PET/CT as a non-invasive imaging tool for assessing ER expression and its implications in BC management.Methods:A comprehensive search was conducted in PubMed/MEDLINE and Cochrane Library for systematic reviews and meta-analyses published in the last decade. Studies eligible for inclusion evaluated the diagnostic accuracy and clinical utility of [18F]FES PET/CT in BC based on a predefined research question “What is the role of fluoroestradiol ([18F]FES) PET/CT in breast cancer?”. Data extraction and quality assessment were performed independently by two reviewers using the AMSTAR-2 tool.Results:Eight systematic reviews met the inclusion criteria. [18F]FES PET/CT demonstrated high sensitivity (81–94%) and specificity (78–95%) in detecting ER-positive lesions. It provided a real-time, whole-body assessment of ER expression, outperforming IHC in detecting functional ER activity. Additionally, [18F]FES PET/CT showed promise in predicting treatment response and guiding therapy decisions, particularly in metastatic settings.Conclusions:This review highlights the clinical value of [18F]FES PET/CT in BC management, offering a non-invasive alternative for ER assessment with high diagnostic accuracy. Its integration into clinical practice may enhance personalized treatment strategies for BC patients.
**背景/目的：** 乳腺癌是全球最常见的恶性肿瘤。雌激素受体状态是乳腺癌诊断与治疗的关键决定因素。尽管免疫组织化学法是评估ER的金标准，但其存在局限性。本伞状综述旨在评估16α-18F-氟-17β-雌二醇正电子发射断层扫描/计算机断层扫描作为一种非侵入性成像工具在评估ER表达及其在乳腺癌管理中的意义方面的作用。 **方法：** 在PubMed/MEDLINE和Cochrane图书馆中对过去十年发表的系统综述和荟萃分析进行了全面检索。符合纳入标准的研究基于预设的研究问题“氟代雌二醇PET/CT在乳腺癌中的作用是什么？”，评估了[18F]FES PET/CT在乳腺癌中的诊断准确性和临床效用。数据提取和质量评估由两名评审员使用AMSTAR-2工具独立完成。 **结果：** 八篇系统综述符合纳入标准。[18F]FES PET/CT在检测ER阳性病灶方面表现出高敏感性（81–94%）和高特异性（78–95%）。它提供了ER表达的实时、全身评估，在检测功能性ER活性方面优于IHC。此外，[18F]FES PET/CT在预测治疗反应和指导治疗决策方面显示出潜力，尤其是在转移性环境中。 **结论：** 本综述强调了[18F]FES PET/CT在乳腺癌管理中的临床价值，为ER评估提供了一种具有高诊断准确性的非侵入性替代方案。将其整合到临床实践中，可能有助于优化乳腺癌患者的个体化治疗策略。
The Role of [18F]FES PET/CT in Breast Cancer Management: An Umbrella Review
肿瘤(癌症)患者之家