Fluoroestradiol F-18 (FES PET)
A PET scan that shows which breast cancer deposits still have oestrogen receptors, helping decide whether hormone therapy will work when biopsy is impractical.
Overview
Fluoroestradiol F-18 is a PET radiotracer in which 18F-labelled oestradiol binds oestrogen receptor alpha, imaging ER expression across every lesion in the body in a single non-invasive scan. It was approved in the US in May 2020 as an adjunct to biopsy for detecting ER-positive lesions in recurrent or metastatic breast cancer, and entered NCCN guidelines in 2024. It is used when biopsy is impractical or when lesions may have lost ER, because it predicts endocrine responsiveness and reveals heterogeneous receptor loss that a single biopsy would miss. It also serves as a pharmacodynamic tool in trials of ER degraders, measuring receptor occupancy, and is under study in ER-positive ovarian and endometrial cancers. Uptake in the liver limits assessment of hepatic metastases. FES PET tells the oncologist whether hormone therapy still has a target.
18F-labelled oestradiol binds oestrogen receptor alpha, imaging ER expression across all lesions non-invasively.
1.Fluoroestradiol F-18 (FES PET) slips into a pocket on its target.
- Medicare
- Part B (clinician-administered)
Diagnostic radiopharmaceutical billed with the PET/CT scan under Part B; Cerianna is approved as an adjunct to biopsy for oestrogen receptor-positive lesions in recurrent or metastatic breast cancer.
- Commercial insurance
- variable
Newer tracer; many commercial plans still class FES PET as investigational or cover only when biopsy is not feasible.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B) · Medicare.gov: Diagnostic non-laboratory tests (imaging). Not medical or financial advice; verify with your plan.
- Notes
- No UK marketing authorisation yet, so no NICE appraisal. Access only through a clinical trial or a company early access scheme.
- NHS England
- Not routinely funded
Sources: NICE search: fluoroestradiol F-18. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2020 | Detection of ER-positive lesions as an adjunct to biopsy in patients with recurrent or metastatic breast cancer |
Trials
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Latest papers
topQuery for this drug: (TITLE:"Fluoroestradiol F-18" OR ABSTRACT:"Fluoroestradiol F-18" OR TITLE:"FES PET" OR ABSTRACT:"FES PET" OR TITLE:"Cerianna" OR ABSTRACT:"Cerianna") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Fluoroestradiol F-18 (FES PET), not a curated reading list.
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