Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Jun;52(7):2710-2722.
doi: 10.1007/s00259-025-07186-2. Epub 2025 Mar 11.

Head-to-Head comparison of [18F]FES and [18F]FDG PET/CT in breast cancer patients: has a new era come?

Priscilla Guglielmo  1   2 , Rosario Mazzola  3   4 , Shadya Sara Darwish  5 , Francesco Valenti  5 , Tommaso Martino De Pas  6 , Lucia Setti  1 , Manuela Bonacina  1 , Massimo Maria Grassi  5 , Laura Evangelista  2   7
Affiliations
Comparative Study

Head-to-Head comparison of [18F]FES and [18F]FDG PET/CT in breast cancer patients: has a new era come?

Priscilla Guglielmo et al. Eur J Nucl Med Mol Imaging. 2025 Jun.

Abstract

Purpose: This review systematically compared, in a head-to-head manner, the diagnostic and prognostic performance of [18F]FDG and [18F]FES PET/CT in breast cancer (BC) patients.

Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases up to January 2025, without temporal limitations or restrictions on the number of patients in the included studies, to identify relevant articles comparing the diagnostic value of [18F]FDG and [18F]FES PET in BC patients. Selected imaging studies were analyzed using a modified version of the Critical Appraisal Skills Programme checklist dedicated to systematic reviews.

Results: A total of 20 papers were evaluated. Based on the CASP analysis, the quality of the study was variable. Totally, 806 patients affected by BC underwent both [18F]FDG and [18F]FES PET. Different setting of disease were considered, such as staging/diagnostic and prognostic value. In the initial staging of disease, [18F]FES PET/CT seemed to be more accurate than [18F]FDG. In the prognostic field, [18F]FES expression was a positive factor for the better prognosis, in particular when the amount of [18F]FDG uptake was low. [18F]FES seemed to be promising as a molecular agent in patients affected by invasive lobular BC.

Conclusion: These findings underscore the potential of [18F]FES as a complementary imaging biomarker to [18F]FDG, advocating for further studies to standardize PET metrics and refine their combined clinical utility.

Keywords: Breast cancer; FDG; FES; PET/CT; Prognosis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval: This is a literature review and therefore no ethical approval is required. Competing interests: The authors have no relevant financial or non-financial interests to disclose. Clinical trial number: Not applicable. Human ethics and consent to participate: Not applicable.

References

    1. World Health Organization. Breast Cancer.
    1. Groheux D. Breast cancer systemic staging (Comparison of computed tomography, bone scan, and 18F-Fluorodeoxyglucose PET/Computed Tomography). PET Clin. 2023;18:503–15. https://doi.org/10.1016/j.cpet.2023.04.006 . - DOI - PubMed
    1. Croshaw R, Shapiro-Wright H, Svensson E, Erb K, Julian T. Accuracy of clinical examination, digital mammogram, ultrasound, and MRI in determining postneoadjuvant pathologic tumor response in operable breast cancer patients. Ann Surg Oncol. 2011;18:3160–3. https://doi.org/10.1245/s10434-011-1919-5 . - DOI - PubMed
    1. Ulaner GA, Vaz SC. Women’s health update: growing role of PET for patients with breast cancer. Semin Nucl Med. 2024;54:247–55. https://doi.org/10.1053/j.semnuclmed.2024.01.007 . - DOI - PubMed
    1. Groheux D. FDG-PET/CT for primary staging and detection of recurrence of breast cancer. Semin Nucl Med. 2022;52:508–19. https://doi.org/10.1053/j.semnuclmed.2022.05.001 . - DOI - PubMed

Substances

LinkOut - more resources