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Of these, 104 patients (68.4%) underwent LuPSMA therapy, while 48 (31.6%) received other standard of care (SOC). PET\/CT analyses included visual assessment and semiquantitative measurements. Clinical and laboratory parameters were recorded. Overall survival (OS) and PSA response (decline\u2009&gt;\u200950%) were primary and secondary endpoints, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG-derived total tumor volume was the only independent predictor of overall survival both in patients subsequently treated with LuPSMA (HR 1.28 [95%CI 1.02\u20141.61]; p\u2009=\u20090.03) or in those under other SOC (HR 1.61 [95%CI 1.02\u20142.56]; p\u2009=\u20090.04), respectively. In other SOC patients, additional independent predictors of OS were total lesion PSMA uptake (PSMA-TL; HR 1.14 [95%CI 1.03\u20131.26]; p\u2009=\u20090.01), [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG mean SUV (HR 20.88 [95%CI 1.2\u2013364.74]; p\u2009=\u20090.04), and [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG total lesion glycolysis (HR 1.61 [95%CI 1.02\u20132.56]; p\u2009=\u20090.04). In LuPSMA patients, PSMA-PET SUVmean was a significant independent predictor of PSA decline\u2009\u2265\u200950% (OR 2.97 [95%CI 1.27\u20138.16]; p\u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      PSMA-PET and [\n                      <jats:sup>18<\/jats:sup>\n                      F]FDG-PET provide imaging biomarkers of outcome in candidates for LuPSMA. FDG-PET total tumor volume was an independent predictor of overall survival in candidates for LuPSMA therapy, irrespective of subsequent treatment decision. PSMA-PET SUVmean was associated with biochemical response to LuPSMA. Dual tracer imaging should further be assessed in prospective trials for mCRPC treatment guidance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07198-y","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T21:14:23Z","timestamp":1742591663000},"page":"3199-3210","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Prognostic value of [18F]FDG- and PSMA-PET in patients evaluated for [177Lu]Lu-PSMA therapy of mCRPC"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9939-282X","authenticated-orcid":false,"given":"Tugce","family":"Telli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonor","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Karpinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M.","family":"Pabst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Gr\u00fcnwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuangyu","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Hadaschik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Kesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lale","family":"Umutlu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Herrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Seifert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang P.","family":"Fendler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"issue":"2","key":"7198_CR1","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/j.eururo.2017.06.002","volume":"73","author":"S Gillessen","year":"2018","unstructured":"Gillessen S, Attard G, Beer TM, et al. 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The local ethics committee (University Hospital Clinical Ethic Committee) approved this retrospective study (Permission Numbers: 22\u201310822-BO\/23\u201311654) and waived the need for study-specific consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participate declarations"}},{"value":"The authors received support not related to the manuscript as follows: TT reports fees from Abx (speaker). RS received research\/travel support from Boehringer Ingelheim Funds and Else Kr\u00f6ner-Fresenius-Stiftung. MK: Stock Ownership: Bayer. KMP has received a Clinician Scientist Stipend from the University Medicine Essen Clinician Scientist Academy (UMEA) sponsored by the faculty of medicine and Deutsche Forschungsgemeinschaft (DFG), travel fees from IPSEN, research funding from Bayer and honoraria from Novartis.VG: Employment: University Hospital Essen. Stock Ownership: AstraZeneca, Bicycle Therapeutics, Bristol-Myers Squibb, Genmab, MSD. Honoraria: Advanced Accelerator Applications\/Novartis, Amgen, Apogepha, Astellas Pharma, AstraZeneca, Bristol-Myers Squibb, Eisai, Ipsen, Janssen-Cilag, Merck Serono, MSD Oncology, Ono Pharmaceutical, Pfizer. Consulting or Advisory Role: Bristol-Myers Squibb, Cureteq, Debiopharm Group, Eisai, Gilead Sciences, Ipsen, Janssen-Cilag, MSD Oncology, Novartis, Oncorena, PCI Biotech, Pfizer, Synthekine. Research Funding: Amgen (Inst), Bicycle Therapeutics (Inst), Bristol-Myers Squibb (Inst), Gilead Sciences (Inst), Ipsen (Inst), MSD Oncology (Inst), Seagen (Inst). Travel Expenses: AstraZeneca, Ipsen, Janssen, Merck Serono, Pfizer. BH reports Consulting or Advisory role for Lightpoint medical, Janssen, Bayer, Abx, Astellas, Merck, Amgen, MSD, Novartis, BMS, Onkowissen, POINT Biopharma, Pfizer, Ipsen, Accord Healthcare, Telix; Travel support from AstraZeneca, Bristol-Myers Squibb, Janssen, Bayer, and Ipsen; Research Funding from Janssen, Novartis and BMS, all outside of the submitted work. CK reports consulting fees from Apogepha, speaker fees from Novartis and Pfizer, travel support from Janssen, Amgen and Bayer and research funding from Novartis, Amgen and Mariana Oncology. WPF\u00a0reports fees from SOFIE Bioscience (research funding), Janssen (consultant, speaker), Calyx (consultant, image review), Bayer (consultant, speaker, research funding), Novartis (speaker, consultant), Telix (speaker), GE Healthcare (speaker, consultant), Eczac\u0131ba\u015f\u0131 Monrol (speaker), Abx (speaker), Amgen (speaker), Urotrials (speaker) outside of the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Competing interest"}}]}}