Appropriate-Use Guidelines for 14 Clinical Scenarios (7) in Which 18F-FES PET Might Be Used

ScenarioAppropriateness of useScore
Appropriate (scores of 7–9)
8 For assessing ER status when lesions are difficult to biopsy or biopsy is nondiagnostic8
9 For considering second line of endocrine therapy after progression of metastatic disease8
10 For considering endocrine therapy at initial diagnosis of metastatic disease8
14 For detecting ER status when findings of other imaging tests are equivocal or suggestive8
May be appropriate (scores of 4–6)
2 For diagnosing malignancy of unknown primary when biopsy is nonfeasible or nondiagnostic5
5 For routine staging of extraaxillary nodes and distant metastases5
6 For staging invasive lobular carcinoma and low-grade invasive ductal carcinoma5
7 For assessing ER status, in lieu of biopsy, in lesions that are easily accessible for biopsy5
13 For detecting lesions in suspected or known recurrent or metastatic breast cancer5
Rarely appropriate (scores of 1–3)
1 For diagnosing primary breast cancer2
3 For routine staging of primary tumor (T staging)1
4 For routine staging of axillary nodes3
11 For considering endocrine therapy at initial diagnosis of primary breast cancer1
12 For measuring response to therapy1