Appropriate-Use Guidelines for 14 Clinical Scenarios (7) in Which 18F-FES PET Might Be Used
| Scenario | Appropriateness of use | Score |
|---|---|---|
| Appropriate (scores of 7–9) | ||
| 8 | For assessing ER status when lesions are difficult to biopsy or biopsy is nondiagnostic | 8 |
| 9 | For considering second line of endocrine therapy after progression of metastatic disease | 8 |
| 10 | For considering endocrine therapy at initial diagnosis of metastatic disease | 8 |
| 14 | For detecting ER status when findings of other imaging tests are equivocal or suggestive | 8 |
| May be appropriate (scores of 4–6) | ||
| 2 | For diagnosing malignancy of unknown primary when biopsy is nonfeasible or nondiagnostic | 5 |
| 5 | For routine staging of extraaxillary nodes and distant metastases | 5 |
| 6 | For staging invasive lobular carcinoma and low-grade invasive ductal carcinoma | 5 |
| 7 | For assessing ER status, in lieu of biopsy, in lesions that are easily accessible for biopsy | 5 |
| 13 | For detecting lesions in suspected or known recurrent or metastatic breast cancer | 5 |
| Rarely appropriate (scores of 1–3) | ||
| 1 | For diagnosing primary breast cancer | 2 |
| 3 | For routine staging of primary tumor (T staging) | 1 |
| 4 | For routine staging of axillary nodes | 3 |
| 11 | For considering endocrine therapy at initial diagnosis of primary breast cancer | 1 |
| 12 | For measuring response to therapy | 1 |