{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:12:36Z","timestamp":1785211956226,"version":"3.55.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T00:00:00Z","timestamp":1737590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>This retrospective analysis evaluates baseline <jats:sup>18<\/jats:sup>F-flotufolastat positron emission tomography (PET) parameters as prognostic parameters for treatment response and outcome in patients with metastatic castration-resistant prostate cancer (mCRPC) undergoing treatment with [<jats:sup>177<\/jats:sup>Lu]Lu-PSMA-I&amp;T.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A total of 188 mCRPC patients with baseline <jats:sup>18<\/jats:sup>F-flotufolastat PET scans were included. Tumor lesions were semiautomatically delineated, with imaging parameters including volume-based and standardized uptake value (SUV)-based metrics. Outcome measures included prostate-specific antigen (PSA) response, PSA-progression-free survival (PSA-PFS), and overall survival (OS). Univariate and multivariate regression analyses assessed the impact of baseline imaging and pretherapeutic clinical parameters on outcome. Event time distributions were estimated with the Kaplan-Meier method, and groups were compared with log-rank tests.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Significant prognostic parameters for PSA response and PSA-PFS included log-transformed whole-body SUVmax (odds ratio (OR), 3.26, 95% confidence interval (CI), 2.01\u20135.55 and hazard ratio (HR), 0.51, 95% CI, 0.4\u20130.66; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and prior chemotherapy (OR 0.3, 95% CI, 0.12\u20130.72 and HR 1.64, 95% CI, 1.07\u20132.58; <jats:italic>p<\/jats:italic>\u2009=\u20090.008 and <jats:italic>p<\/jats:italic>\u2009=\u20090.028, respectively). For OS, significant prognosticators were the following log-transformed parameters: number of lesions (HR 1.38, 95% CI, 1.24\u20131.53; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), TTV (HR 1.27, 95% CI, 1.18\u20131.37; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and ITLV (HR 1.24, 95% CI, 1.16\u20131.33; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with log-transformed TTV (HR 1.15, 95% CI, 1.04\u20131.27; <jats:italic>p<\/jats:italic>\u2009=\u20090.008) remaining significant in multivariate analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>At baseline, SUV-based <jats:sup>18<\/jats:sup>F-flotufolastat PET metrics (e.g., whole-body SUVmax) serve as significant positive prognosticators for short-term outcomes (PSA response and PSA-PFS). In contrast, volume-based metrics (e.g., TTV) are significant negative prognosticators for long-term outcome (OS), in mCRPC patients treated with [<jats:sup>177<\/jats:sup>Lu]Lu-PSMA-I&amp;T.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00259-024-07003-2","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T05:40:31Z","timestamp":1737610831000},"page":"2041-2050","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic 18F-flotufolastat PET parameters for outcome assessment of 177Lu-labeled PSMA-targeted radioligand therapy in metastatic castration-resistant prostate cancer"],"prefix":"10.1007","volume":"52","author":[{"given":"Amir","family":"Karimzadeh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ergela","family":"Hasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Haller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias M.","family":"Heck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Tauber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calogero","family":"D`Alessandria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang A.","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Eiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Rauscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"7003_CR1","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.2967\/jnumed.116.173757","volume":"57","author":"K Rahbar","year":"2016","unstructured":"Rahbar K, Schmidt M, Heinzel A, et al. 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We certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Written informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"ME&IR report fees from Blue Earth Diagnostics Ltd. (consultant, research funding). ME reports fees from Novartis\/AAA (consultant, speaker), Telix (consultant), Bayer (consultant, research funding), RayzeBio (consultant), Point Biopharma (consultant), Eckert-Ziegler (speaker), ABX GmbH (speaker) and Janssen Pharmaceuticals (consultant, speakers bureau), Parexel (image review) and Bioclinica (image review) outside the submitted work and a patent application for rhPSMA. He and other inventors are entitled to royalties on sales of 18F-flotufolastat. WW reports research support from BlueEarth Diagnostics, ITM, Novartis, and Pentixapharm. He has also acted as consultant for these companies. WW is an Associate Editor of EJNMMI. RT: Advisory boards, speaking fees; travel support, conference access; author fees; shares: Astellas, AstraZeneca, Bayer, BMS, Eisai, EUSA, Ipsen, Janssen, Merck, MSD, Novartis, Orion, Philogen, Roche, Sanofi, Thieme. No other potential conflicts of interest relevant to this article exist.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}