The clinical impact of 16α-¹⁸F-fluoro-17β-estradiol (¹⁸F-FES) PET/CT on patient management has not been well investigated. The aim of this study was to assess the clinical impact of ¹⁸F-FES PET/CT on the management of patients with recurrent or metastatic breast cancer. Methods: Study subjects were identified retrospectively from a database of a prospective trial for postmarketing surveillance of ¹⁸F-FES between 2021 and 2023. Patients who were suspected or known to have recurrent or metastatic estrogen receptor–positive breast cancer based on a routine standard workup were included. Planned management before and actual management after ¹⁸F-FES PET/CT were assessed by 2 experienced medical oncologists via medical chart review. A 5-point questionnaire was provided to evaluate the value of ¹⁸F-FES PET/CT for management planning. The rate of intention-to-treat and interdisciplinary changes, and the impact of ¹⁸F-FES PET/CT according to PET/CT result or clinical indication, were examined. Results: Of the 344 included patients, 120 (35%) experienced a change in management after ¹⁸F-FES PET/CT. In 139 (40%) patients,¹⁸F-FES PET/CT supported the existing management decision without a change in management. Intention-to-treat and interdisciplinary changes accounted for 64% (77/120) and 68% (82/120) of all changes, respectively. A higher rate of change was observed when lesions were ¹⁸F-FES–negative (44% [36/81]) than ¹⁸F-FES–positive (30% [51/172]) or mixed ¹⁸F-FES–positive/negative (36% [33/91]). Regarding clinical indications, the highest rate of change was shown when evaluating the origins of metastasis of double primary cancers (64% [9/14]). Conclusion: ¹⁸F-FES PET/CT modified the management of recurrent or metastatic breast cancer, serving as an impactful imaging modality in clinical practice.

16α-18 F-氟-17β-雌二醇 （¹⁸F-FES） PET/CT 对患者管理的临床影响尚未得到很好的研究。本研究的目的是评估 ¹⁸F-FES PET/CT 对复发性或转移性乳腺癌患者管理的临床影响。方法：研究对象是从 2021 年至 2023 年间对 ¹⁸例 F-FES 进行上市后监测的前瞻性试验数据库中回顾性确定的。纳入了根据常规标准病情检查疑似或已知患有复发性或转移性雌激素受体阳性乳腺癌的患者。由 2 名经验丰富的肿瘤内科医师通过病历回顾评估 ¹⁸F-FES PET/CT 前后的计划管理和实际管理。提供了一份 5 分问卷来评估 ¹⁸F-FES PET/CT 对管理计划的价值。检查了意向治疗和跨学科变化的发生率，以及根据 PET/CT 结果或临床适应症 ¹⁸F-FES PET/CT 的影响。结果：在纳入的 344 例患者中，120 例 （35%） 在 ¹⁸例 F-FES PET/CT 后经历了治疗变化。在 139 例 （40%） 患者中，¹⁸F-FES PET/CT 支持现有的管理决策，而没有改变管理。意向治疗和跨学科变化分别占所有变化的 64% （77/120） 和 68% （82/120）。当病变为 ¹⁸个 F-FES 阴性 （44% [36/81]） 比 ¹⁸个 F-FES 阳性 （30% [51/172]） 或 ¹⁸个 F-FES 阳性/阴性混合 （36% [33/91] 时，观察到更高的变化率。 在临床适应症方面，在评估双原发癌转移起源时，变化率最高 （64% [9/14]）。结论： ¹⁸F-FES PET/CT 改变了复发或转移性乳腺癌的治疗，在临床实践中是一种有影响力的影像学检查方式。