{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T05:45:40Z","timestamp":1749534340693,"version":"3.40.4"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p><jats:sup>18<\/jats:sup>F\u2010DCFPyL (targeted PSMA) and <jats:sup>18<\/jats:sup>F\u2010FDG dual\u2010tracer PET\/CT combination with next\u2010generation sequencing was applied in a prospective cohort of men with prostate cancer to identify the clinical and genetic characteristics with heterogeneous PET\/CT imaging features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>104 men with documented prostate cancer underwent <jats:sup>18<\/jats:sup>F\u2010DCFPyL and <jats:sup>18<\/jats:sup>F\u2010FDG PET\/CT, of which 83 underwent next\u2010generation sequencing for detecting variation of <jats:italic>AR<\/jats:italic>, <jats:italic>TP53, RB1, PTEN<\/jats:italic>, etc. Lesions were classified into DCFPyL+FDG\u00b1 lesions and DCFPyL\u2010FDG+ lesions and analyzed for heterogeneous distribution. We divided the patients with positive lesions into DCFPyL+FDG\u00b1 group and DCFPyL\u2010FDG+ group, then compared the differences in clinical features and genetic mutations between the two groups with CRPC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 92 men had positive lesions detected. By comparing lesion distribution with the DCFPyL+FDG\u2009\u00b1\u2009, DCFPyL\u2010FDG+ disease had higher proportions of visceral metastases (4.1% vs. 1.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). DCFPyL\u2010FDG+ was more frequently found in CRPC cohorts, and in the CRPC cohort, patients with DCFPyL\u2010FDG+ lesions often had worse PSA response. Exploratory analysis showed that <jats:italic>TP53<\/jats:italic> and\/or <jats:italic>RB1<\/jats:italic> mutations might be a risk factor for DCFPyL\u2010FDG+ disease (OR\u2009=\u200910.625, 95% CI 3.492\u201332.332, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with DCFPyL\u2010FDG+ lesions were more likely to have visceral metastases detected, be found in castration\u2010resistant cohorts, have <jats:italic>TP53<\/jats:italic> and\/or <jats:italic>RB1<\/jats:italic> mutations detected, and have poor therapeutic response compared to patients with DCFPyL+FDG\u00b1 lesions. Therefore, dual\u2010tracer (<jats:sup>18<\/jats:sup>F\u2010DCFPyL and <jats:sup>18<\/jats:sup>F\u2010FDG) PET\/CT is recommended for patients with low PSMA expression incompatible with the true burden of the disease and those with <jats:italic>TP53<\/jats:italic> and\/or <jats:italic>RB1<\/jats:italic> mutations to better evaluate the disease burden, tumor heterogeneity, and prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24881","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T21:16:48Z","timestamp":1741727808000},"page":"749-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the Heterogeneity of Advanced Prostate Cancer by <sup>18<\/sup>F\u2010DCFPyL and <sup>18<\/sup>F\u2010FDG PET\/CT in a Prospective Cohort"],"prefix":"10.1002","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1297-2914","authenticated-orcid":false,"given":"GuangHao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Urology Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6082-754X","authenticated-orcid":false,"given":"YueKai","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1763-1741","authenticated-orcid":false,"given":"ShangZhen","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Urology Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5301-2708","authenticated-orcid":false,"given":"LinChen","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Urology Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4905-3880","authenticated-orcid":false,"given":"Yong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7844-6374","authenticated-orcid":false,"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1076-2992","authenticated-orcid":false,"given":"ShouZhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6493-799X","authenticated-orcid":false,"given":"BenKang","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Urology Qilu Hospital of Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02757"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.119.237602"},{"issue":"5","key":"e_1_2_12_4_1","first-page":"735","article-title":"A Comparison of (18)F\u2010DCFPyL, 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