European Journal of Nuclear Medicine and Molecular Imaging最新文献

{"title":"Detecting early cardiomyopathy in transthyretin variant carriers: reappraising the diagnostic value of Perugini grade 1 radiotracer uptake on bone scintigraphy.","authors":"H S A Tingen,M Berends,A Tubben,P van der Meer,R H J A Slart,J Bijzet,P A van der Zwaag,C Kimmich,C Knackstedt,F L H Muntinghe,E J Houwerzijl,B P C Hazenberg,H L A Nienhuis","doi":"10.1007/s00259-025-07328-6","DOIUrl":"https://doi.org/10.1007/s00259-025-07328-6","url":null,"abstract":"PURPOSETo determine whether TTRv carriers with Perugini grade 1 cardiac radiotracer uptake on [99mTc]Tc- hydroxydiphosphonate bone scintigraphy have or develop ATTR-CM.METHODSThis retrospective observational study was conducted at the Groningen Amyloidosis Centre of Expertise between April 2012 and June 2023. TTRv carriers with Perugini grade 1 uptake on bone scintigraphy were followed until to June 2024. Data on symptoms, biomarkers, imaging, and biopsies were collected. A descriptive analysis was performed to evaluate whether carriers met the diagnostic criteria for ATTR-CM or 'probable ATTR-CM' at baseline and follow-up.RESULTSOut of 178 TTRv carriers in screening, 12 carriers had Perugini grade 1 cardiac radiotracer uptake on bone scintigraphy. At baseline, 2 carriers met the diagnostic criteria for ATTR-CM and 3 carriers met the criteria for probable ATTR-CM. Of the 7 carriers without (probable) ATTR-CM at baseline, 3 carriers were diagnosed with ATTR-CM during follow-up and 1 carrier developed probable ATTR-CM during follow-up. Three carriers showed signs of cardiomyopathy during follow-up, but did not meet the criteria for (probable) ATTR-CM. One of these cases may have been false-positive due to hydroxychloroquine use.CONCLUSIONOur findings suggest that Perugini grade 1 cardiac radiotracer uptake is an early marker of ATTR-CM in TTRv carriers, potentially enabling earlier diagnosis and intervention.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"137 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144122045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between yttrium-90 glass microspheres specific activity, particle density and treatment outcomes in HCC and mCRC","authors":"Marnix G. E. H. Lam, Etienne Garin, Kirk D. Fowers, Armeen Mahvash, Siddharth A. Padia, Riad Salem","doi":"10.1007/s00259-025-07334-8","DOIUrl":"https://doi.org/10.1007/s00259-025-07334-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To investigate relationships between treatment week, relative to Ytrrium-90 (⁹⁰Y) glass microsphere calibration (i.e., specific activity and particle density), and outcomes for hepatocellular carcinoma (HCC) or colorectal cancer liver metastasis (mCRC).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Multinational, multicenter study TARGET (retrospective; <i>n</i> = 209 HCC patients) was combined with EPOCH (phase III trial; <i>n</i> = 428 mCRC patients). Efficacy included overall response rate (ORR), overall survival (OS), progression-free survival (PFS), hepatic PFS, and tumour marker response rates. Safety included clinical and laboratory toxicity. Retrospective multicompartment dosimetry, tumour and normal tissue absorbed dose were available for TARGET; single compartment dosimetry was available for EPOCH.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>No efficacy relationship was found relative to treatment week for TARGET or EPOCH. mRECIST ORR in TARGET for weeks 1 and 2 were 74/125 (59.2%) and 55/84 (65.5%), and by RECIST 1.1 in EPOCH were 54/142 (38.0%) and 15/43 (34.9%), respectively (<i>p</i> &gt; 0.05). Median OS for TARGET weeks 1 and 2 were 21.4 and 20.3 months (<i>p</i> = 0.07), and in EPOCH were 14.9 and 16.4 months, respectively (<i>p</i> = 0.37). No difference in the TARGET primary endpoint of hyperbilirubinemia was noted for weeks 1 and 2, odds ratio 0.64, <i>p</i> = 0.59. TARGET ≥ grade 3 device-related adverse events (AEs) for weeks 1 (16.8%) and 2 (26.2%) were not significantly different (<i>p</i> = 0.11). EPOCH rates of ≥ grade 3 asthenia for weeks 1 (9.2%) and 2 (23.3%) were statistically different (<i>p</i> = 0.01).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>No efficacy treatment benefit for week 2 versus week 1 was observed in TARGET or EPOCH, but week 2 treatment trended towards a higher rate and severity of specific AEs.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"133 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radioembolization of hepatocellular carcinoma with 90Y glass microspheres: an earlier administration day unexpectedly improves tumour control probability.","authors":"Matteo Bagnalasta,Stefania Mazzaglia,Maria Chiara De Nile,Chiara Romanò,Giovanna Pitoni,Alice Phillips,Gaetano Amato,Carlo Spreafico,Carlo Morosi,Tommaso Cascella,Alfonso Marchianò,Marianna Maspero,Valentina Bellia,Gianluca Aliberti,Alessandra Alessi,Vincenzo Mazzaferro,Marco Maccauro,Carlo Chiesa","doi":"10.1007/s00259-025-07295-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07295-y","url":null,"abstract":"PURPOSE90Y glass microspheres have a shelf life of 12 days from the calibration date, allowing flexible administration after a variable decay interval. For a fixed intended activity, a longer interval results in a higher number of administered microspheres per GBq and in a lower activity per sphere as. This study aimed to demonstrate that, for a fixed Tumour Absorbed Dose (TAD), Tumour Control Probability (TCP) is higher when the decay interval is shorter (4 days vs. 8 days). In the second part of the study, we focused on fully perfused lesions, i.e. those showing matching perfused and radiological volumes, where calculating mean microsphere spatial density (ρ) is meaningful. We investigated which variable was associated with radiological response.METHODSWe retrospectively analysed lesion-by-lesion response at the best response time using the mRECIST criterion. Two chronologically sequential cohorts of patients were compared. Both cohorts were planned and treated with lobar administration, with exactly the same methodology, except for the post-calibration decay interval (Administration day: day 4 vs day 8). Infiltrative lesions and those with additional treatments post-radioembolization were excluded. To compare efficacy at the same TAD, we plotted TCP curves as a function of TAD and stratified TCP by lesion mass (M), using an arbitrary 50 g cut-off (equivalent to a 4.6 cm diameter). On fully perfused lesions, TCP was analyzed also as function of ρ and mass. We then conducted univariate ROC and multivariate analysed to assess response impact based on TAD, ρ, as, and M, grouping CR + PR (Objective Response, OR) versus SD + PD, as well as CR versus PR + SD + PD.RESULTSA total of 94 patients with 150 lesions were analyzed. TCP (for TAD up to 600 Gy) was significantly higher for the 59 lesions treated on Day 4 compared to the 91 lesions treated on Day 8, though the difference diminished at higher TAD values. In fully perfused lesions, TCP plateaued at 344 Gy and 160 Gy for lesions treated on Day 8 and Day 4 respectively. ROC analysis for fully perfused lesions showed poor AUC values for CR + PR versus SD + PD: 0.62, p = 0.01 for as, 0.63, p = 0.01 for TAD, and 0.60 p = 0.01 for M, with AUC for ρ being non-significant. When comparing CR versus PR + SD + PD classes, only M was significant, with a fair AUC value of 0.71, p = 0.01. Multivariate analysis showed that CR + PR was significantly associated only to as, with 79% higher response probability for administration on Day 4. When considering CR alone, significance was confirmed only for M, with an odd ratio of 0.19.DISCUSSIONOur findings on TCP confirmed our preliminary unpublished studies from a different lesion cohort assessed by two independent radiologists. Additionally, our results align with recent experimental histological studies on complete pathological necrosis (CPN) in explanted liver samples after neoadjuvant segmentectomy prior to liver transplantation. However, our data and the CPN findi","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"127 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic evaluation of [212Pb]Pb-AB001 and [177Lu]Lu-PSMA-617 in a mouse model of disseminated prostate cancer.","authors":"Anna Julie Kjøl Høyvik,Monika Kvassheim,Li-Wei Ma,Elisabeth Wiig,Tiril Hillestad,Mona-Elisabeth Revheim,Rugile Liukaityte,Øyvind Bruland,Asta Juzeniene","doi":"10.1007/s00259-025-07330-y","DOIUrl":"https://doi.org/10.1007/s00259-025-07330-y","url":null,"abstract":"BACKGROUNDMetastatic castration-resistant prostate cancer (mCRPC) frequently leads to bone and soft tissue metastases, leading to poor prognosis. The beta-emitting radioligand [177Lu]Lu-PSMA-617 targets the prostate-specific membrane antigen (PSMA) and may be less efficient against micrometastatic disease. The alpha-emitting radioligand [212Pb]Pb-AB001 could offer enhanced treatment by delivering high energy over a short range. This study compared the efficacy of [212Pb]Pb-AB001 and [177Lu]Lu-PSMA-617 in a mouse model of disseminated prostate cancer.METHODSBinding and internalisation of radioligands were evaluated in PC-3 PIP-luc cells. A mouse model was established by intracardiac injection of these cells. Treatments with 0.24‒1.0 MBq [212Pb]Pb-AB001 or 22‒66 MBq [177Lu]Lu-PSMA-617 were initiated 7 d post-cell inoculation. Metastatic burden was measured using bioluminescence imaging, and PSMA-targeted uptake was determined with [18F]F-PSMA-1007 µPET/µCT. Gamma-autoradiography evaluated [212Pb]Pb-AB001 distribution, and bone metastases were identified by radiography.RESULTSBoth radioligands displayed comparable in vitro binding. In vivo studies revealed metastatic formation in clinically relevant organs. µPET/µCT demonstrated increased [18F]F-PSMA-1007 uptake in metastases, matching the bioluminescence imaging results. Focal [212Pb]Pb-AB001 distribution in the metastatic xenograft indicated heterogeneously distributed micrometastases in the organs. A median survival up to 47 d was achieved with [212Pb]Pb-AB001, compared to 25 d for controls and 27 d for [177Lu]Lu-PSMA-617. An activity-dependent reduction in bone metastases was observed for [177Lu]Lu-PSMA-617, while no bone lesions were detected in [212Pb]Pb-AB001-treated mice.CONCLUSION[212Pb]Pb-AB001 showed significant efficacy against micrometastases and advantages over [177Lu]Lu-PSMA-617 in preventing or treating early bone metastases for the investigated injected activities. This implies clinical potential for treating mCRPC, including patients at risk of early metastatic disease, but further studies including dosimetry and toxicity analyses are required with regards to activity levels.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"31 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The brain-white adipose tissue axis may play a crucial role in diabetes mellitus: a metabolic network analysis using total-body PET/CT imaging","authors":"Lubing Sun, Yaping Wu, Junpeng Yang, Junting Liang, Panlong Li, Xuan Yu, Nan Meng, Tao Sun, Meiyun Wang, Chuanliang Chen","doi":"10.1007/s00259-025-07337-5","DOIUrl":"https://doi.org/10.1007/s00259-025-07337-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This study aims to construct an individualized glucose metabolism network using total-body ¹⁸F-FDG PET imaging, which provides a comprehensive view of glucose metabolism across various organs, to explore the role of inter-organ interactions in Diabetes Mellitus (DM).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this study, we constructed covariance metabolic networks using static total-body PET images, normalized by lean body mass, from 36 patients with DM (DM group) and 36 age- and sex-matched healthy controls (HC group). Differences in network properties between the DM and HC groups were evaluated at both group and individual levels. In addition, correlation analysis was performed to explore the relationship between network properties and baseline clinical data in the DM subjects.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We observed that the same edges in the first three edges with the largest values were brain-subcutaneous adipose tissue (SAT) and brain-visceral adipose tissue (VAT) at both group and individual levels. There was a positive correlation between the brain-VAT and BMI and there was a negative correlation between the brain-SAT and age. The most perturbed organ was the brain at both group and individual levels, and there was a positive correlation between the strength of abnormality of brain and age.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study successfully used static total-body PET imaging to construct individualized glucose metabolism networks for patients with DM, identifying the brain-VAT and brain-SAT as the most significantly altered edge and the brain as the most affected organ. These findings provide novel insights into the role of the brain-white adipose tissue axis in glucose metabolism in DM.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"150 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical evaluation of [211At]At-AuNP-ABDMPL16 for targeted alpha therapy in Melanoma.","authors":"Jiajia Zhang,Shanshan Qin,Xuhao Huang,Erina Hilmayanti,Fan Hu,Xiaohui Luan,Tianzhen Ye,Feize Li,Yuanyou Yang,Ning Liu,Kazuya Kabayama,Koichi Fukase,Fei Yu","doi":"10.1007/s00259-025-07238-7","DOIUrl":"https://doi.org/10.1007/s00259-025-07238-7","url":null,"abstract":"PURPOSEThe aim of this study is to overcome the challenges of poor tumor penetration and systemic toxicity in targeted alpha therapy (TAT) while also evaluating its immunomodulatory effects to enhance antitumor immune responses in melanoma treatment.METHODSThis study developed a 211At-labeled single-domain antibody agent ([211At]At-AuNP-ABDMPL16) targeting PD-L1, a protein overexpressed in melanoma cells. The binding affinity and internalization of [211At]At-AuNP-ABDMPL16 were evaluated in vitro using melanoma cell lines. In vivo studies in melanoma-bearing mice were conducted to assess biodistribution, pharmacokinetics, therapeutic efficacy, and the immune response induced by the treatment.RESULTS[211At]At-AuNP-ABDMPL16 demonstrated high binding affinity and efficient internalization in melanoma cells, resulting in significant tumor cell death through α-particle radiation. In vivo, [211At]At-AuNP-ABDMPL16 preferentially accumulated in tumors, inhibited tumor growth, and prolonged survival in melanoma-bearing mice. The treatment also triggered a robust anti-tumor immune response, marked by increased cytotoxic T lymphocytes and reduced regulatory T cells within the tumor microenvironment, with minimal systemic toxicity.CONCLUSION[211At]At-AuNP-ABDMPL16 shows promise as a novel therapeutic for melanoma, combining effective tumor targeting with potent cytotoxic and immune-activating effects. These findings support further investigation of this 211At-labeled single-domain antibodies in clinical applications.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"18 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First clinical investigation to predict lymphovascular and/or perineural invasion in gastric cancer using 18F-FAPI-42 PET/CT parameters.","authors":"Lilan Fu,Fei Xie,Penghui Sun,Ye Dong,Kemin Zhou,Li Jiang,Ruihe Wu,Yanjiang Han,Hubing Wu,Ganghua Tang,Wenlan Zhou","doi":"10.1007/s00259-025-07325-9","DOIUrl":"https://doi.org/10.1007/s00259-025-07325-9","url":null,"abstract":"OBJECTIVEThis study was conducted to explore the predictive value of PET parameters derived from 18F-FAPI-42 PET/CT in assessing lymphovascular and/or perineural invasion (LVI/PNI) in gastric cancer (GC) patients.METHODS72 GC patients who underwent 18F-FAPI-42 PET/CT prior to surgical resection were included. Clinicopathological factors and PET parameters were collected and analyzed in LVI/PNI-negative and LVI/PNI-positive groups. The predictive value of PET parameters for LVI/PNI status was evaluated using the receiver operating characteristic (ROC) curve. A nomogram was developed using significant predictors from multivariate stepwise regression analysis and its performance was assessed by decision curve analysis (DCA).RESULTSUnivariate analysis indicated a significant association between LVI/PNI status and PET parameters (SUVmax, SUVmean, and TBR) (all p < 0.001). The area under the ROC curve (AUC) values for predicting LVI/PNI were 0.932 [95% CI (0.877-0.987)] for SUVmax, 0.923 [95% CI (0.861-0.984)] for SUVmean, and 0.925 [95% CI (0.865-0.985)] for TBR. The optimal cutoff values for prediction, along with their corresponding sensitivity and specificity, were 3.86 (93.3% and 81.5%) for SUVmax, 2.04 (93.3% and 81.5%) for SUVmean, and 9.75 (91.1% and 81.5%) for TBR. Multivariate analysis identified histological grade and SUVmax as independent risk factors for LVI/PNI prediction. Our nomogram had good discriminatory ability (AUC = 0.934) and offered net benefits in predicting LVI/PNI status by DCA.CONCLUSIONThis study demonstrates that FAPI uptake parameters exhibit an exceptionally high capacity and serve as a noninvasive preoperative tool for predicting LVI/PNI status in GC, with SUVmax emerging as the most suitable predictive indicator.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"30 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional intra thoracic kidney due to Bochdalek hernia detected in [18F]FDG PET/CT performed for lung cancer staging.","authors":"Soler Claude,Datry Vincent,Pegard Clothilde,Mathieu Gauthé","doi":"10.1007/s00259-025-07343-7","DOIUrl":"https://doi.org/10.1007/s00259-025-07343-7","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"32 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Separation of simultaneously acquired [89Zr]atezolizumab and [18F]FDG PET scans.","authors":"Zekai Li,Janneke W de Boer,Tom van Meerten,Anne G H Niezink,Walter Noordzij,Adriaan A Lammertsma,Charalampos Tsoumpas,Adrienne H Brouwers","doi":"10.1007/s00259-025-07340-w","DOIUrl":"https://doi.org/10.1007/s00259-025-07340-w","url":null,"abstract":"","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"54 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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.","authors":"Amir Karimzadeh,Kimberley Hansen,Stefan Hein,Bernhard Haller,Matthias M Heck,Robert Tauber,Calogero D Alessandria,Matthias Eiber,Isabel Rauscher","doi":"10.1007/s00259-025-07200-7","DOIUrl":"https://doi.org/10.1007/s00259-025-07200-7","url":null,"abstract":"PURPOSEThis retrospective analysis evaluated the prognostic value of baseline 18F-flotufolastat-PET bone tumor metrics for severe hematologic toxicity in metastatic castration-resistant prostate cancer (mCRPC) patients treated with [177Lu]Lu-PSMA-I&T.METHODSData from 182 mCRPC patients with baseline 18F-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 3-4 considered severe. Cox regression was used to identify prognostic factors for AEs.RESULTSBaseline bone tumor volume prognosticated leukocytopenia (HR 1.03 per 100 ml, p = 0.036), while the number of bone lesions was prognostic for anemia (HR 1.04 per 10 lesions, p < 0.001) and severe anemia (HR per 10 lesions 1.05, p = 0.009). Higher baseline hemoglobin correlated with reduced leukocytopenia (HR 0.74, p = 0.002), thrombocytopenia (HR 0.80, p = 0.033), and severe anemia (HR 0.52, p < 0.001). Baseline kidney dysfunction was linked to anemia (HR 2.46, p = 0.002) and severe anemia (HR 3.81, p = 0.023). Prior [223Ra]Radiumdichloride treatment prognosticated severe thrombocytopenia (HR 6.43, p = 0.021).CONCLUSIONBaseline 18F-flotufolastat-PET metrics and pretherapeutic clinical parameters are key prognostic factors for severe hematologic toxicity in mCRPC patients treated with [177Lu]Lu-PSMA-I&T.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"10 1","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}