Molecular Imaging Agent Aims To Enable More Targeted Treatments

BY Barbara Bigelow



Barbara Bigelow, Editor

Here at Metavivor we don’t often discuss diagnostic tools or treatment plans since we are all so unique in our cancer presentation. Lately however, we are hearing from patients about a new diagnostic tool, available since Spring 2020, that they may be having difficulty accessing. Their particular cancer center may not offer it, or insurance may not approve it. So, we thought we would share some information about it here.  Afterall, education is key to advocacy.

Cerianna (fluoroestradiol F-18) is a molecular imaging agent approved by the Food and Drug Administration (FDA) indicated for use in (PET) imaging for the detection of estrogen receptor (ER) positive lesions as an adjunct to biopsy in patients with metastatic breast cancer and to help inform treatment selection for patients with recurrent or metastatic breast cancer.

Currently, when treating metastatic breast cancer patients, oncologists base clinical decisions on biopsy results which only represent the sampled area of the tumor. However, estrogen receptor (ER) expression – one of the most common breast cancer biomarkers - can vary both within the primary tumor and across different lesions. As an adjunct to biopsy, Cerianna can be used diagnostically to find ER positive lesions and give the patient a more informed diagnosis, potentially enabling more targeted and individualized treatment plans and avoiding the selection of inappropriate or less effective therapies.

Dr. Hannah M Linden, Breast Medical Oncologist, UW Medicine, University of Washington Fred Hutchison Cancer Research Center and Seattle Cancer Care Alliance in Seattle, who has conducted research and authored multiple papers on fluoroestradiol F-18, explained: “Making Cerianna more widely available is an important moment for cancer patients and a significant step forward for molecular imaging. We test ER expression in a metastatic biopsy once at the beginning of the patient's journey and we make decisions all along - when to give chemotherapy, when to use endocrine therapy, whether or not to use targeted agents - based on that one measurement. Since we know that ER expression can change with time and treatment, imaging with 18F-fluoroestradiol at critical decision points could help clinicians predict response to endocrine therapy and select optimal treatment timing and sequencing.”

For me specifically, this may have helped me greatly. Initially ER positive, I failed 3 endocrine therapies and had 3 biopsies over the course of a year before learning my cancer had mutated to Triple Negative Metastatic Breast Cancer. If I had had access to Cerianna along with my Pet Scan I might have learned this sooner and saved valuable time in my treatment.

Dr. Heather Jacene, MD, Dana Farber Cancer Institute, and The Society of Nuclear Medicine and Molecular Imaging (SNMMI) Board Member, states “Nuclear medicine uses imaging biomarkers to locate specific types of cancers within the body, providing actionable data that can change the treatment plan for patients with metastatic breast cancer. A nuclear medicine camera (PET scanner), used with a diagnostic agent such as fluoroestradiol F-18, can provide detailed information about how a patient would respond to a specific type of treatment – information that scans such as CT and MRI cannot provide. This allows your oncologist to personalize your treatment.”

“The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is working with patient groups to raise awareness of the unique value of nuclear medicine. We plan to hold a series of roundtables with breast cancer advocacy and support groups in 2022 so we can find ways to work together to provide education and to ensure access to these valuable procedures. For more information, visit”

METAvivor Research and Support, Inc. is a non-profit organization that funds research to benefit people with stage IV metastatic breast cancer (MBC). We also raise awareness, advocate for and provide information and support to people living with MBC.

To donate, visit or mail checks to

METAvivor, 1783 Forest Drive, #184, Annapolis, MD 21401

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