ПЭТ/КТ с 18F-фторэстрадиолом: современный взгляд на применение в ядерной медицине

Рак молочной железы – одно из наиболее часто диагностируемых онкологических заболеваний и ведущая причина смерти от рака у женщин. Примерно 70–80 % случаев рака молочной железы являются положительными по рецепторам эстрогена (РЭ) и/или прогестерона, что делает эндокринную терапию важным этапом лечения. Экспрессия РЭ при раке молочной железы обычно оценивается путем иммуногистохимического исследования ткани. Метод позитронно-эмиссионной томографии, совмещенной с компьютерной томографией (ПЭТ/КТ), позволяет оценить не только анатомические и структурные, но и метаболические изменения в опухолевой ткани. ¹⁸F-фторэстрадиол (¹⁸F-ФЭС) – радиофармацевтический лекарственный препарат, аналог эстрадиола, который используется в диагностике опухолей, экспрессирующих РЭ. Применение ¹⁸F-ФЭС является неинвазивным методом молекулярной визуализации для определения и количественной оценки экспрессии РЭ in vivo. Различные исследования показывают, что накопление ¹⁸F-ФЭС указывает на РЭ-положительную опухолевую ткань, что в большинстве случаев подтверждается при иммуногистохимическом исследовании биоптата. Хотя современные руководства рекомендуют выполнять ПЭТ/КТ с ¹⁸F-фтордезоксиглюкозой, когда рутинные методы обследования не дают однозначного ответа, ПЭТ/КТ с ¹⁸F-ФЭС у пациентов с РЭположительным раком молочной железы может быть методом выбора. Следует отметить, что ПЭТ/КТ с ¹⁸F-ФЭС может помочь в диагностике опухолей с высоким уровнем экспрессии РЭ, в частности рака яичников.

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