{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:52:06Z","timestamp":1793407926264,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>This retrospective analysis evaluated the prognostic value of baseline <jats:sup>18<\/jats:sup>F-flotufolastat-PET bone tumor metrics for severe hematologic toxicity in metastatic castration-resistant prostate cancer (mCRPC) patients treated 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>Data from 182 mCRPC patients with baseline <jats:sup>18<\/jats:sup>F-flotufolastat-PET scans and complete hematologic profiles were analyzed. Bone lesions were semiautomatically delineated, and clinical parameters (e.g., pretreatments, lab results) were assessed. Hematologic adverse events (AEs) were defined per Common Terminology Criteria for Adverse Events version 5.0, with grades 3\u20134 considered severe. Cox regression was used to identify prognostic factors for AEs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Baseline bone tumor volume prognosticated leukocytopenia (HR 1.03 per 100\u00a0ml, <jats:italic>p<\/jats:italic>\u2009=\u20090.036), while the number of bone lesions was prognostic for anemia (HR 1.04 per 10 lesions, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and severe anemia (HR per 10 lesions 1.05, <jats:italic>p<\/jats:italic>\u2009=\u20090.009). Higher baseline hemoglobin correlated with reduced leukocytopenia (HR 0.74, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), thrombocytopenia (HR 0.80, <jats:italic>p<\/jats:italic>\u2009=\u20090.033), and severe anemia (HR 0.52, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Baseline kidney dysfunction was linked to anemia (HR 2.46, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and severe anemia (HR 3.81, <jats:italic>p<\/jats:italic>\u2009=\u20090.023). Prior [<jats:sup>223<\/jats:sup>Ra]Radiumdichloride treatment prognosticated severe thrombocytopenia (HR 6.43, <jats:italic>p<\/jats:italic>\u2009=\u20090.021).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Baseline <jats:sup>18<\/jats:sup>F-flotufolastat-PET metrics and pretherapeutic clinical parameters are key prognostic factors for severe hematologic toxicity in mCRPC patients treated with [<jats:sup>177<\/jats:sup>Lu]Lu-PSMA-I&amp;T.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00259-025-07200-7","type":"journal-article","created":{"date-parts":[[2025,5,18]],"date-time":"2025-05-18T22:55:47Z","timestamp":1747608947000},"page":"4434-4445","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of baseline 18F-flotufolastat PET bone tumor volume for prognosticating severe hematologic toxicity in patients with metastatic castration-resistant prostate Cancer receiving 177Lu-PSMA-targeted radioligand therapy"],"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":"Stefan","family":"Hein","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":"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":[[2025,5,19]]},"reference":[{"key":"7200_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, Eppard E, Bode A, Yordanova 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. 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"}}]}}