{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:20:47Z","timestamp":1787988047418,"version":"build-2784847793"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:00:00Z","timestamp":1780704000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:00:00Z","timestamp":1780704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Innsbruck and Medical University of Innsbruck"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Little is known about predictors of response to radionuclide therapy with PSMA-ligands in patients with [\n 18<\/jats:sup>\n F]FDG-positive metastatic castration-resistant prostate cancer (mCRPC). We assessed the correlation between baseline characteristics, including dual tracer PET parameters, and response to [\n 177<\/jats:sup>\n Lu]Lu-PSMA-I&T in a cohort of patients with [\n 18<\/jats:sup>\n F]FDG-positive mCRPC. Prognostic factors related to progression-free survival (PFS) and overall survival (OS) were also investigated.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n mCRPC patients who underwent [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 and [\n 18<\/jats:sup>\n F]FDG PET\/CT prior to [\n 177<\/jats:sup>\n Lu]Lu-PSMA-I&T were retrospectively evaluated. Only [\n 18<\/jats:sup>\n F]FDG-positive patients were included in the analysis. A semi-automatic segmentation tool was applied to measure the whole-body maximum standardized uptake value (SUV\n max<\/jats:sub>\n ), mean standardized uptake value (SUV\n mean<\/jats:sub>\n ), metabolic tumor volume (MTV), and total lesion uptake (TLU) on both PET\/CTs. PSA response was defined as \u2265\u200930% and \u2265\u200950% decline. Imaging response, assessed two months after the last cycle, was defined according to RECIST 1.1 and\/or PSMA PET progression (PPP) criteria. Clinical, biochemical, and imaging-based factors were correlated to response to treatment, PFS, and OS.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Twenty-five [\n 18<\/jats:sup>\n F]FDG-positive patients who received [\n 177<\/jats:sup>\n Lu]Lu-PSMA-I&T were included. PSA30 and PSA50 responses were achieved in 11\/25 (44%) and in 9\/25 (36%) patients, respectively. In the univariate analysis [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 SUV\n mean<\/jats:sub>\n (\n p<\/jats:italic>\n \u2009=\u20090.022) and [\n 68<\/jats:sup>\n Ga]Ga-PSMA\/[\n 18<\/jats:sup>\n F]FDG SUV\n mean<\/jats:sub>\n ratio (\n p<\/jats:italic>\n \u2009=\u20090.021) were significantly associated with PSA30 response. [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 SUV\n mean<\/jats:sub>\n was also significant in the multivariate model. ROC analysis indicated an optimal [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 SUV\n mean<\/jats:sub>\n cutoff value of 10.23 (AUC\u2009=\u20090.741), and a best discriminating [\n 68<\/jats:sup>\n Ga]Ga-PSMA\/[\n 18<\/jats:sup>\n F]FDG SUV\n mean<\/jats:sub>\n cutoff ratio of 2.08 (AUC\u2009=\u20090.727). In the univariate analysis for radiological PFS (rPFS), high ALP (\n p<\/jats:italic>\n \u2009=\u20090.023), [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 MTV (\n p<\/jats:italic>\n \u2009=\u20090.011), [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 TLU (\n p<\/jats:italic>\n \u2009=\u20090.015), and [\n 18<\/jats:sup>\n F]FDG MTV (\n p<\/jats:italic>\n \u2009=\u20090.013) were significantly associated with shorter rPFS. [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 MTV showed a borderline association with rPFS in the multivariate model (\n p<\/jats:italic>\n \u2009=\u20090.061). Hemoglobin levels (\n p<\/jats:italic>\n \u2009=\u20090.008), ALP (\n p<\/jats:italic>\n \u2009=\u20090.018) and PSA (\n p<\/jats:italic>\n \u2009=\u20090.023) values before treatment were associated with OS, as well as [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 MTV (\n p<\/jats:italic>\n \u2009=\u20090.003), [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 TLU (\n p<\/jats:italic>\n \u2009=\u20090.025), and [\n 18<\/jats:sup>\n F]FDG MTV (\n p<\/jats:italic>\n \u2009=\u20090.024). However, no independent predictors of OS were identified in the multivariate analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our preliminary results suggest that a whole-body [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11 SUV\n mean<\/jats:sub>\n higher than 10 and a [\n 68<\/jats:sup>\n Ga]Ga-PSMA-11\/[\n 18<\/jats:sup>\n F]FDG SUV\n mean<\/jats:sub>\n ratio\u2009>\u20092 may serve as useful predictors for identifying patients likely to achieve at least a 30% reduction in PSA levels, even among [\n 18<\/jats:sup>\n F]FDG-positive mCRPC patients. Furthermore, our findings support the prognostic significance of tumor burden either calculated by imaging-based volumetric parameters or by known biochemical markers of disease.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00259-026-07972-6","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:14:20Z","timestamp":1780730060000},"page":"6351-6362","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world outcomes of [177Lu]Lu-PSMA-I&T in [18F]FDG-positive metastatic castration-resistant prostate cancer: factors related to response and survival"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-0686","authenticated-orcid":false,"given":"Giulia","family":"Santo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpaolo","family":"di Santo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9442-6158","authenticated-orcid":false,"given":"Ariane","family":"Kronthaler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7596-6948","authenticated-orcid":false,"given":"Mohsen","family":"Farsad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Maria","family":"Rossetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Scherbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4664-1965","authenticated-orcid":false,"given":"Francesco","family":"Cicone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-6170","authenticated-orcid":false,"given":"Irene J.","family":"Virgolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,6]]},"reference":[{"key":"7972_CR1","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1056\/NEJMoa2107322","volume":"385","author":"O Sartor","year":"2021","unstructured":"Sartor O, de Bono J, Chi KN, et al. Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med. 2021;385:1091\u2013103. https:\/\/doi.org\/10.1056\/NEJMoa2107322.","journal-title":"N Engl J Med"},{"key":"7972_CR2","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1016\/S0140-6736(21)00237-3","volume":"397","author":"MS Hofman","year":"2021","unstructured":"Hofman MS, Emmett L, Sandhu S, et al. [177Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial. Lancet. 2021;397:797\u2013804. https:\/\/doi.org\/10.1016\/S0140-6736(21)00237-3.","journal-title":"Lancet"},{"key":"7972_CR3","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/j.annonc.2023.02.015","volume":"34","author":"K Fizazi","year":"2023","unstructured":"Fizazi K, Gillessen S, ESMO Guidelines Committee. Updated treatment recommendations for prostate cancer from the ESMO Clinical Practice Guideline considering treatment intensification and use of novel systemic agents. Ann Oncol. 2023;34:557\u201363. https:\/\/doi.org\/10.1016\/j.annonc.2023.02.015.","journal-title":"Ann Oncol"},{"key":"7972_CR4","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.eururo.2024.04.010","volume":"86","author":"D Tilki","year":"2024","unstructured":"Tilki D, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer. Part II-2024 Update: treatment of relapsing and metastatic prostate cancer. Eur Urol. 2024;86:164\u201382. https:\/\/doi.org\/10.1016\/j.eururo.2024.04.010.","journal-title":"Eur Urol"},{"key":"7972_CR5","unstructured":"Pluvicto - Lutetium. (177Lu) vipivotide tetraxetan. In European Medicines Agency (EMA) - European Union. https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/pluvicto-epar-product-information_en.pdf. Accessed 6 Jan 2026."},{"key":"7972_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2024.102699","volume":"125","author":"EF Giunta","year":"2024","unstructured":"Giunta EF, Brighi N, Gurioli G, et al. 177Lu-PSMA therapy in metastatic prostate cancer: an updated review of prognostic and predictive biomarkers. Cancer Treat Rev. 2024;125:102699. https:\/\/doi.org\/10.1016\/j.ctrv.2024.102699.","journal-title":"Cancer Treat Rev"},{"key":"7972_CR7","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1583168","volume":"15","author":"H Beltran","year":"2025","unstructured":"Beltran H, Calais J, Emmett L, et al. Biomarkers to optimize PSMA-targeted radioligand therapy for metastatic castration-resistant prostate cancer. Front Oncol. 2025;15:1583168. https:\/\/doi.org\/10.3389\/fonc.2025.1583168.","journal-title":"Front Oncol"},{"key":"7972_CR8","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1007\/s00259-020-05160-8","volume":"48","author":"K Michalski","year":"2021","unstructured":"Michalski K, Ruf J, Goetz C, et al. Prognostic implications of dual tracer PET\/CT: PSMA ligand and [18F]FDG PET\/CT in patients undergoing [177Lu]PSMA radioligand therapy. Eur J Nucl Med Mol Imaging. 2021;48:2024\u201330. https:\/\/doi.org\/10.1007\/s00259-020-05160-8.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7972_CR9","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1097\/MNM.0000000000001371","volume":"42","author":"A Adnan","year":"2021","unstructured":"Adnan A, Basu S. Concept proposal for a six-tier integrated dual tracer PET-CT (68Ga-PSMA and FDG) image scoring system (\u201cPro-PET\u201d score) and examining its potential implications in metastatic castration-resistant prostate carcinoma theranostics and prognosis. Nucl Med Commun. 2021;42:566\u201374. https:\/\/doi.org\/10.1097\/MNM.0000000000001371.","journal-title":"Nucl Med Commun"},{"key":"7972_CR10","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.2967\/jnumed.112.114116","volume":"54","author":"H Jadvar","year":"2013","unstructured":"Jadvar H, Desai B, Ji L, et al. Baseline 18F-FDG PET\/CT parameters as imaging biomarkers of overall survival in castrate-resistant metastatic prostate cancer. J Nucl Med. 2013;54:1195\u2013201. https:\/\/doi.org\/10.2967\/jnumed.112.114116.","journal-title":"J Nucl Med"},{"key":"7972_CR11","doi-asserted-by":"publisher","first-page":"217441","DOI":"10.1016\/j.canlet.2025.217441","volume":"611","author":"MT Hindes","year":"2025","unstructured":"Hindes MT, McElligott AM, Best OG, et al. Metabolic reprogramming, malignant transformation and metastasis: Lessons from chronic lymphocytic leukaemia and prostate cancer. Cancer Lett. 2025;611:217441. https:\/\/doi.org\/10.1016\/j.canlet.2025.217441.","journal-title":"Cancer Lett"},{"key":"7972_CR12","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1016\/S1470-2045(22)00605-2","volume":"23","author":"JP Buteau","year":"2022","unstructured":"Buteau JP, Martin AJ, Emmett L, et al. PSMA and FDG-PET as predictive and prognostic biomarkers in patients given [177Lu]Lu-PSMA-617 versus cabazitaxel for metastatic castration-resistant prostate cancer (TheraP): a biomarker analysis from a randomised, open-label, phase 2 trial. Lancet Oncol. 2022;23:1389\u201397. https:\/\/doi.org\/10.1016\/S1470-2045(22)00605-2.","journal-title":"Lancet Oncol"},{"issue":"23","key":"7972_CR13","doi-asserted-by":"publisher","first-page":"3043","DOI":"10.1001\/jama.284.23.3043","volume":"284","author":"World Medical Association","year":"2000","unstructured":"World Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2000;284(23):3043\u20135.","journal-title":"JAMA"},{"key":"7972_CR14","unstructured":"Arzneimittelgesetz BGB. Nr. 185\/1983, last revision BGBl. II Nr. 105\/2015. https:\/\/www.ris.bka.gv.at\/GeltendeFassung.wxe?Abfrage=Bundesnormen&Gesetzesnummer=10010441"},{"key":"7972_CR15","unstructured":"\u00d6sterreichischer Verband f\u00fcr Strahlenschutz. Mitgliedsgesellschaft der International Radiation Protection Association. http:\/\/www.strahlenschutzverband.at\/index.php?id=strahlenschutzrecht0"},{"key":"7972_CR16","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1007\/s00508-025-02544-4","volume":"137","author":"S Mirzaei","year":"2025","unstructured":"Mirzaei S, Schweighofer-Zwink G, Ofner H, et al. Use of 177Lu prostate-specific membrane antigen therapy in metastatic castration-resistant prostate cancer: Joint statement of the Austrian Society of Nuclear Medicine and Theranostics and the Austrian Society of Urology and Andrology. Wien Klin Wochenschr. 2025;137:157\u201366. https:\/\/doi.org\/10.1007\/s00508-025-02544-4.","journal-title":"Wien Klin Wochenschr"},{"key":"7972_CR17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s41181-023-00191-6","volume":"8","author":"M Kraihammer","year":"2023","unstructured":"Kraihammer M, Garnuszek P, Bauman A, et al. Improved quality control of [177Lu]Lu-PSMA I&T. EJNMMI Radiopharm Chem. 2023;8:7. https:\/\/doi.org\/10.1186\/s41181-023-00191-6.","journal-title":"EJNMMI Radiopharm Chem"},{"key":"7972_CR18","unstructured":"European Pharmacopoeia. LUTETIUM (177Lu) Zadavotide guraxetan injection. 06\/2024:3170 (11th Edition)."},{"key":"7972_CR19","doi-asserted-by":"publisher","first-page":"2322","DOI":"10.1007\/s00259-020-04723-z","volume":"47","author":"J Ferdinandus","year":"2020","unstructured":"Ferdinandus J, Violet J, Sandhu S, et al. Prognostic biomarkers in men with metastatic castration-resistant prostate cancer receiving [177Lu]-PSMA-617. Eur J Nucl Med Mol Imaging. 2020;47:2322\u20137. https:\/\/doi.org\/10.1007\/s00259-020-04723-z.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"12","key":"7972_CR20","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1200\/JCO.2015.64.2702","volume":"34","author":"HI Scher","year":"2016","unstructured":"Scher HI, Morris MJ, Stadler WM, et al. Trial Design and Objectives for Castration-Resistant Prostate Cancer: Updated Recommendations From the Prostate Cancer Clinical Trials Working Group 3. J Clin Oncol. 2016;34(12):1402\u201318. https:\/\/doi.org\/10.1200\/JCO.2015.64.2702.","journal-title":"J Clin Oncol"},{"key":"7972_CR21","doi-asserted-by":"publisher","first-page":"678","DOI":"10.2967\/jnumed.119.233817","volume":"61","author":"S Fanti","year":"2020","unstructured":"Fanti S, Hadaschik B, Herrmann K. Proposal for systemic-therapy response-assessment criteria at the time of PSMA PET\/CT imaging: the PSMA PET progression criteria. J Nucl Med. 2020;61:678\u201382. https:\/\/doi.org\/10.2967\/jnumed.119.233817.","journal-title":"J Nucl Med"},{"key":"7972_CR22","doi-asserted-by":"publisher","first-page":"3917","DOI":"10.1007\/s00259-022-05787-9","volume":"49","author":"R Laudicella","year":"2022","unstructured":"Laudicella R, R\u00fcschoff JH, Ferraro DA, et al. Infiltrative growth pattern of prostate cancer is associated with lower uptake on PSMA PET and reduced diffusion restriction on mpMRI. Eur J Nucl Med Mol Imaging. 2022;49:3917\u201328. https:\/\/doi.org\/10.1007\/s00259-022-05787-9.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7972_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2024.102698","volume":"124","author":"M Bauckneht","year":"2024","unstructured":"Bauckneht M, Ciccarese C, Laudicella R, et al. Theranostics revolution in prostate cancer: basics, clinical applications, open issues and future perspectives. Cancer Treat Rev. 2024;124:102698. https:\/\/doi.org\/10.1016\/j.ctrv.2024.102698.","journal-title":"Cancer Treat Rev"},{"key":"7972_CR24","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.3348\/kjr.2024.0439","volume":"25","author":"SJ Na","year":"2024","unstructured":"Na SJ, Ha S, Kim IH, Lee JY, O JH. Description of FDG and Prostate-Specific Membrane Antigen PET\/CT findings in Korean patients with advanced metastatic castration-resistant prostate cancer. Korean J Radiol. 2024;25:1022\u20138. https:\/\/doi.org\/10.3348\/kjr.2024.0439.","journal-title":"Korean J Radiol"},{"key":"7972_CR25","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1001\/jamaoncol.2017.3588","volume":"4","author":"JJ Fox","year":"2018","unstructured":"Fox JJ, Gavane SC, Blanc-Autran E, et al. Positron emission tomography\/computed tomography-based assessments of androgen receptor expression and glycolytic activity as a prognostic biomarker for metastatic castration-resistant prostate cancer. JAMA Oncol. 2018;4:217\u201324. https:\/\/doi.org\/10.1001\/jamaoncol.2017.3588.","journal-title":"JAMA Oncol"},{"key":"7972_CR26","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12102355","volume":"12","author":"M Caracciolo","year":"2024","unstructured":"Caracciolo M, Castello A, Castellani M, et al. Prognostic role of PSMA-targeted imaging in metastatic castration-resistant prostate cancer: an overview. Biomedicines. 2024;12:2355. https:\/\/doi.org\/10.3390\/biomedicines12102355.","journal-title":"Biomedicines"},{"issue":"1","key":"7972_CR27","doi-asserted-by":"publisher","first-page":"47","DOI":"10.2967\/jnumed.124.268167","volume":"66","author":"RA Demirci","year":"2025","unstructured":"Demirci RA, Ghodsi A, Gulati R, et al. PET-Based TheraP Eligibility and Outcomes of VISION-Eligible Patients with Metastatic Castration-Resistant Prostate Cancer Who Received 177Lu-PSMA-617: Importance of 18F-FDG-Avid Discordant Findings. J Nucl Med. 2025;66(1):47\u201353. https:\/\/doi.org\/10.2967\/jnumed.124.268167.","journal-title":"J Nucl Med"},{"issue":"1","key":"7972_CR28","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-61961-z","volume":"14","author":"F Rosar","year":"2024","unstructured":"Rosar F, Burgard C, David S, et al. Dual FDG\/PSMA PET imaging to predict lesion-based progression of mCRPC during PSMA-RLT. Sci Rep. 2024;14(1):11271. https:\/\/doi.org\/10.1038\/s41598-024-61961-z.","journal-title":"Sci Rep"},{"key":"7972_CR29","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-025-07700-6","author":"S Xue","year":"2026","unstructured":"Xue S, Einspieler H, Wen S, et al. Quantitative dual-tracer PET\/CT biomarkers correlate concordant lesion uptake with PSMA-RLT outcomes in mCRPC: a dual-center study. Eur J Nucl Med Mol Imaging. 2026. https:\/\/doi.org\/10.1007\/s00259-025-07700-6.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"9","key":"7972_CR30","doi-asserted-by":"publisher","first-page":"3199","DOI":"10.1007\/s00259-025-07198-y","volume":"52","author":"T Telli","year":"2025","unstructured":"Telli T, Lopes L, Karpinski M, et al. Prognostic value of [18F]FDG- and PSMA-PET in patients evaluated for [177Lu]Lu-PSMA therapy of mCRPC. Eur J Nucl Med Mol Imaging. 2025;52(9):3199\u2013210. https:\/\/doi.org\/10.1007\/s00259-025-07198-y.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7972_CR31","doi-asserted-by":"publisher","first-page":"2451","DOI":"10.18632\/oncotarget.26789","volume":"10","author":"FE von Eyben","year":"2019","unstructured":"von Eyben FE, Singh A, Zhang J, et al. 177Lu-PSMA radioligand therapy of predominant lymph node metastatic prostate cancer. Oncotarget. 2019;10:2451\u201361. https:\/\/doi.org\/10.18632\/oncotarget.26789.","journal-title":"Oncotarget"},{"key":"7972_CR32","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1097\/MNM.0000000000001611","volume":"43","author":"L Zisser","year":"2022","unstructured":"Zisser L, Yu J, Oszwald A, et al. Response to [177Lu]Lu-PSMA radioligand therapy in metastatic castration-resistant prostate cancer patients presenting with only lymph node metastases. Nucl Med Commun. 2022;43:1113\u201320. https:\/\/doi.org\/10.1097\/MNM.0000000000001611.","journal-title":"Nucl Med Commun"},{"issue":"3","key":"7972_CR33","first-page":"28","volume":"43","author":"ME Ahmed","year":"2025","unstructured":"Ahmed ME, Reitano G, Mahmoud A, et al. Evaluation of response to 177Lu-PSMA-617 by site specific disease in metastatic castrate-resistant prostate cancer. Urol Oncol. 2025;43(3):28.","journal-title":"Urol Oncol"},{"key":"7972_CR34","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.2967\/jnumed.119.240242","volume":"61","author":"A Gafita","year":"2020","unstructured":"Gafita A, Heck MM, Rauscher I, et al. Early Prostate-Specific Antigen Changes and Clinical Outcome After 177Lu-PSMA Radionuclide Treatment in Patients with Metastatic Castration-Resistant Prostate Cancer. J Nucl Med. 2020;61:1476\u201383. https:\/\/doi.org\/10.2967\/jnumed.119.240242.","journal-title":"J Nucl Med"},{"key":"7972_CR35","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.125.270804","author":"DC Chen","year":"2025","unstructured":"Chen DC, Buteau JP, Papa N, et al. Prognostic Value of Initial Imaging and PSA Change with [177Lu]Lu-PSMA-617 Radiopharmaceutical Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer: A ProsTIC Registry Analysis. J Nucl Med. 2025. https:\/\/doi.org\/10.2967\/jnumed.125.270804.","journal-title":"J Nucl Med"},{"issue":"9","key":"7972_CR36","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1038\/s41416-018-0123-9","volume":"119","author":"N Romero-Laorden","year":"2018","unstructured":"Romero-Laorden N, Lozano R, Jayaram A, et al. Phase II pilot study of the prednisone to dexamethasone switch in metastatic castration-resistant prostate cancer (mCRPC) patients with limited progression on abiraterone plus prednisone (SWITCH study). Br J Cancer. 2018;119(9):1052\u20139. https:\/\/doi.org\/10.1038\/s41416-018-0123-9.","journal-title":"Br J Cancer"},{"issue":"5","key":"7972_CR37","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1016\/j.eururo.2016.02.055","volume":"70","author":"P Rescigno","year":"2016","unstructured":"Rescigno P, Lorente D, Bianchini D, et al. Prostate-specific Antigen decline after 4 weeks of treatment with Abiraterone Acetate and overall survival in patients with metastatic castration-resistant prostate cancer. Eur Urol. 2016;70(5):724\u201331. https:\/\/doi.org\/10.1016\/j.eururo.2016.02.055.","journal-title":"Eur Urol"},{"issue":"12","key":"7972_CR38","doi-asserted-by":"publisher","first-page":"2944","DOI":"10.1200\/JCO.1995.13.12.2944","volume":"13","author":"R Sridhara","year":"1995","unstructured":"Sridhara R, Eisenberger MA, Sinibaldi VJ, Reyno LM, Egorin MJ. Evaluation of Prostate-specific Antigen as a surrogate marker for response of hormone-refractory prostate cancer to Suramin therapy. J Clin Oncol. 1995;13(12):2944\u201353. https:\/\/doi.org\/10.1200\/JCO.1995.13.12.2944.","journal-title":"J Clin Oncol"},{"issue":"15","key":"7972_CR39","doi-asserted-by":"publisher","first-page":"2450","DOI":"10.1200\/JCO.2008.19.9810","volume":"27","author":"M Hussain","year":"2009","unstructured":"Hussain M, Goldman B, Tangen C, et al. Prostate-specific Antigen progression predicts overall survival in patients with metastatic prostate cancer: data from Southwest Oncology Group trials 9346 (Intergroup Study 0162) and 9916. J Clin Oncol. 2009;27(15):2450\u20136. https:\/\/doi.org\/10.1200\/JCO.2008.19.9810.","journal-title":"J Clin Oncol"},{"issue":"8","key":"7972_CR40","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1093\/jnci\/djj129","volume":"98","author":"DP Petrylak","year":"2006","unstructured":"Petrylak DP, Ankerst DP, Jiang CS, et al. Evaluation of Prostate-specific Antigen declines for surrogacy in patients treated on SWOG 99\u2009\u2212\u200916. J Natl Cancer Inst. 2006;98(8):516\u201321. https:\/\/doi.org\/10.1093\/jnci\/djj129.","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"7972_CR41","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.euo.2023.07.018","volume":"7","author":"M Kafka","year":"2024","unstructured":"Kafka M, Horninger A, di Santo G, et al. Real-world outcomes and predictive biomarkers for 177Lutetium Prostate-specific Membrane Antigen ligand treatment in metastatic castration-resistant prostate cancer: A European Association of Urology Young Academic Urologists Prostate Cancer Working Group multi-institutional observational study. Eur Urol Oncol. 2024;7(3):421\u20139. https:\/\/doi.org\/10.1016\/j.euo.2023.07.018.","journal-title":"Eur Urol Oncol"},{"key":"7972_CR42","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2013.158","volume":"10","author":"EA Kuczynski","year":"2013","unstructured":"Kuczynski EA, Sargent DJ, Grothey A, Kerbel RS. Drug rechallenge and treatment beyond progression\u2013implications for drug resistance. Nat Rev Clin Oncol. 2013;10:571\u2009\u2212\u200987. https:\/\/doi.org\/10.1038\/nrclinonc.2013.158.","journal-title":"Nat Rev Clin Oncol"},{"key":"7972_CR43","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1016\/S1470-2045(25)00339-0","volume":"26","author":"L Emmett","year":"2025","unstructured":"Emmett L, Papa N, Subramaniam S, et al. Prognostic and predictive value of baseline PSMA-PET total tumour volume and SUVmean in metastatic castration-resistant prostate cancer in ENZA-p (ANZUP1901): a substudy from a multicentre, open-label, randomised, phase 2 trial. Lancet Oncol. 2025;26:1168\u201377. https:\/\/doi.org\/10.1016\/S1470-2045(25)00339-0.","journal-title":"Lancet Oncol"},{"key":"7972_CR44","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16203532","volume":"16","author":"C Burgard","year":"2024","unstructured":"Burgard C, Khreish F, Dahlmanns L, et al. Analysis of molecular imaging biomarkers derived from [18F]FDG PET\/CT in mCRPC: Whole-Body Total Lesion Glycolysis (TLG) predicts overall survival in patients undergoing [225Ac]Ac-PSMA-617-augmented [177Lu]Lu-PSMA-617 radioligand therapy. Cancers (Basel). 2024;16:3532. https:\/\/doi.org\/10.3390\/cancers16203532","journal-title":"Cancers (Basel)"},{"key":"7972_CR45","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1339160","volume":"10","author":"C Burgard","year":"2024","unstructured":"Burgard C, Engler J, Blickle A, et al. Change of glucometabolic activity per PSMA expression predicts survival in mCRPC patients non-responding to PSMA radioligand therapy: introducing a novel dual imaging biomarker. Front Med. 2024;10:1339160. https:\/\/doi.org\/10.3389\/fmed.2023.1339160.","journal-title":"Front Med"},{"key":"7972_CR46","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.2967\/jnumed.122.264953","volume":"64","author":"M Hohberg","year":"2023","unstructured":"Hohberg M, Reifegerst M, Drzezga A, et al. Prediction of Response to 177Lu-PSMA Therapy Based on Tumor-to-Kidney Ratio on Pretherapeutic PSMA PET\/CT and Posttherapeutic Tumor-Dose Evaluation in mCRPC. J Nucl Med. 2023;64:1758\u201364. https:\/\/doi.org\/10.2967\/jnumed.122.264953.","journal-title":"J Nucl Med"},{"key":"7972_CR47","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.2967\/jnumed.124.269378","volume":"66","author":"J Tran-Gia","year":"2025","unstructured":"Tran-Gia J, Cicone F, Koole M, et al. Rethinking dosimetry: a European perspective. J Nucl Med. 2025;66:1323\u201330. https:\/\/doi.org\/10.2967\/jnumed.124.269378.","journal-title":"J Nucl Med"},{"key":"7972_CR48","doi-asserted-by":"publisher","first-page":"731","DOI":"10.2967\/jnumed.122.264741","volume":"64","author":"R Seifert","year":"2023","unstructured":"Seifert R, Telli T, Hadaschik B, et al. Is 18F-FDG PET Needed to Assess 177Lu-PSMA Therapy Eligibility? A VISION-like, Single-Center Analysis. J Nucl Med. 2023;64:731\u20137. https:\/\/doi.org\/10.2967\/jnumed.122.264741.","journal-title":"J Nucl Med"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-07972-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-026-07972-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-07972-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:00:50Z","timestamp":1787986850000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-026-07972-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,6]]},"references-count":48,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["7972"],"URL":"https:\/\/doi.org\/10.1007\/s00259-026-07972-6","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,6]]},"assertion":[{"value":"29 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Medical University of Innsbruck (approval no. 1296\/2024).","order":1,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from all individual participants included.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}