Skip to main content

Main menu

  • Home
  • Content
    • Current
    • Ahead of print
    • Past Issues
    • JNM Supplement
    • SNMMI Annual Meeting Abstracts
  • Subscriptions
    • Subscribers
    • Institutional and Non-member
    • Rates
    • Corporate & Special Sales
    • Journal Claims
  • Authors
    • Submit to JNM
    • Information for Authors
    • Assignment of Copyright
    • AQARA requirements
  • Info
    • Permissions
    • Advertisers
    • Continuing Education
  • About
    • About Us
    • Editorial Board
    • Contact Information
  • More
    • Alerts
    • Feedback
    • Help
    • SNMMI Journals
  • SNMMI
    • JNM
    • JNMT
    • SNMMI Journals
    • SNMMI

User menu

  • Subscribe
  • My alerts
  • Log in
  • My Cart

Search

  • Advanced search
Journal of Nuclear Medicine
  • SNMMI
    • JNM
    • JNMT
    • SNMMI Journals
    • SNMMI
  • Subscribe
  • My alerts
  • Log in
  • My Cart
Journal of Nuclear Medicine

Advanced Search

  • Home
  • Content
    • Current
    • Ahead of print
    • Past Issues
    • JNM Supplement
    • SNMMI Annual Meeting Abstracts
  • Subscriptions
    • Subscribers
    • Institutional and Non-member
    • Rates
    • Corporate & Special Sales
    • Journal Claims
  • Authors
    • Submit to JNM
    • Information for Authors
    • Assignment of Copyright
    • AQARA requirements
  • Info
    • Permissions
    • Advertisers
    • Continuing Education
  • About
    • About Us
    • Editorial Board
    • Contact Information
  • More
    • Alerts
    • Feedback
    • Help
    • SNMMI Journals
  • Follow JNM on Twitter
  • Visit JNM on Facebook
  • Join JNM on LinkedIn
  • Subscribe to our RSS feeds
Research ArticleClinical Investigation

Quantification of Metastatic Prostate Cancer Whole-Body Tumor Burden with 18F-FDG PET Parameters and Associations with Overall Survival After First-Line Abiraterone or Enzalutamide: A Single-Center Retrospective Cohort Study

Andreas G. Wibmer, Michael J. Morris, Mithat Gonen, Junting Zheng, Hedvig Hricak, Steven Larson, Howard I. Scher and Hebert Alberto Vargas
Journal of Nuclear Medicine August 2021, 62 (8) 1050-1056; DOI: https://doi.org/10.2967/jnumed.120.256602
Andreas G. Wibmer
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michael J. Morris
2Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mithat Gonen
3Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Junting Zheng
3Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hedvig Hricak
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Steven Larson
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Howard I. Scher
2Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hebert Alberto Vargas
1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Figure
    • Download figure
    • Open in new tab
    • Download powerpoint
  • FIGURE 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 1.

    Flowchart of study cohort selection.

  • FIGURE 2.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 2.

    18F-FDG PET/CT of patient with mPC illustrating image analysis methodology of this study. Maximum-intensity projection (A) shows 18F-FDG–avid metastases in aortocaval lymph node (B, top), common iliac lymph node (B, middle), and ischial bone (B, bottom). For every 18F-FDG–avid metastasis, PET-derived metrics (i.e., MTV and TLG) were extracted and then summarized on whole-body scale for statistical analyses.

  • FIGURE 3.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIGURE 3.

    OS probabilities of patients with mCRPC after first-line treatment with abiraterone or enzalutamide, stratified by median whole-body TLG measured on 18F-FDG PET/CT. Sample size was too small for deriving reliable optimal cutoff TLG, and no statistical test was applied. Median OS times with 95% CI are provided.

Tables

  • Figures
    • View popup
    TABLE 1

    Descriptive Statistics for Entire Study Cohort and Separately for mCRPC and mCSPC Patients

    ParameterOverall (n = 96)mCRPC (n = 71)mCSPC (n = 25)P*
    Age at initial prostate cancer diagnosis (y)66.2 (59.7, 71.6)67.4 (59.7, 72.9)64.2 (59.7, 65.9)0.012
    Gleason grade group at initial diagnosis0.439
     15 (5.2)4 (5.6)1 (4.0)
     27 (7.3)7 (9.9)0
     319 (19.8)12 (16.9)7 (28.0)
     422 (22.9)16 (22.5)6 (24.0)
     536 (37.5)27 (38.0)9 (36.0)
     Not available7 (7.3)5 (7.0)2 (8.0)
    Initial prostate cancer treatment0.022
    Prostatectomy ± hormonal therapy40 (41.7)24 (33.8)16 (64.0)
    Radiation ± hormonal therapy27 (28.1)24 (33.8)3 (12.0)
    Hormonal therapy29 (30.2)23 (32.4)6 (24.0)
    Initial cancer diagnosis to castration resistance (mo)—50.5 (13.9, 125.3)——
    Initial cancer diagnosis to treatment† start (mo)42.5 (11.9, 116.0)57.9 (15.4–127.1)8.4 (6.2–74.5)0.002
    Castration resistance to treatment† start (mo)—1.2 (0.3, 5.5)——
    Age at start of treatment† (y)71.0 (65.8, 79.6)73.8 (67.1, 82.1)67.9 (63.7, 70.7)0.002
    Treatment type0.161
     Abiraterone plus prednisone57 (59.4)39 (54.9)18 (72.0)
     Enzalutamide39 (40.6)32 (45.1)7 (28.0)
    Laboratory parameters at treatment† start
     Prostate-specific antigen (ng/mL)13.3 (3.1, 32.4)15.1 (4.4, 37.7)3.5 (1.0, 23.4)0.016
     Albumin (g/dL)4.2 (4.1, 4.4)4.2 (4.0, 4.4)4.4 (4.1, 4.7)0.019
     Alkaline phosphatase (U/L)88 (70, 141)94 (70, 150)75.5 (62, 96.5)0.079
     Hemoglobin (g/dL)12.7 (11.8, 13.6)12.3 (11.3, 13.1)13.8 (12.6, 14.8)<0.001
     Lactate dehydrogenase (U/L)201 (173, 251)218 (182, 260)187 (155, 204)0.003
    18F-FDG PET/CT data
     Time from PET/CT to treatment† start (d)22.5 (11.5, 40)22 (12, 36)23 (8, 43)0.708
     Injected 18F-FDG activity (MBq)459 (437, 459)463 (433, 488)451 (440, 463)0.269
     Time from tracer injection to scan start (min)67 (61, 79.5)70 (63, 80)62 (60, 73)0.052
     SUVmax (g/mL)7.1 (5.3, 10.9)7.2 (5.5, 11.7)5.9 (4.8, 9.0)0.188
     Number of 18F-FDG–avid metastases4 (2, 14)5 (3, 15)2 (0, 8)0.018
     Whole-body metabolic tumor volume (mL)45.7 (13.0, 120.8)57.0 (20.9, 145.3)15.5 (0, 62.9)0.005
     Whole-body TLG (g)123.3 (38.5, 568.1)167.0 (48.7, 583.7)59.5 (0, 194.1)0.004
    Follow-up after treatment† start in survivors (mo)56.3 (37.7, 66.8)45.3 (32.9, 65.7)60.1 (29.7, 67.8)0.334
    Median survival after treatment† start (mo) [95% CI]39.7 [28.6, 53.5]27.8 [22.1, 39.7]76.1 [50.3, -]<0.001
    • * For comparison of mCRPC and mCSPC patients.

    • † Treatment with abiraterone plus prednisone, or enzalutamide.

    • Qualitative data are absolute counts and percentage; continuous data are median and interquartile range.

    • View popup
    TABLE 2

    Results of Cox Proportional Hazards Regression Analyses of OS Probability After Initiation of Abiraterone or Enzalutamide Therapy

    UnivariateMultivariate
    ParameterHRPHRP
    mCRPC patients (n = 71)
     Age at start of treatment1.03 [0.99, 1.06]0.11
     Treatment agent0.48
      Enzalutamide (n = 32)Reference
      Abiraterone (n = 39)1.21 [0.71, 2.08]
     Laboratory parameters at treatment start
      Prostate-specific antigen (log)1.13 [0.95, 1.35]0.17
      Albumin0.55 [0.23, 1.31]0.18
      Alkaline phosphatase (log)1.90 [1.34, 2.70]<0.001Not selected
      Hemoglobin0.80 [0.67, 0.95]0.0130.81 [0.69, 0.96]0.013
      Lactate dehydrogenase1.005 [1.003, 1.008]<0.001Not selected
     18F-FDG PET/CT metrics
      SUVmax (g/mL)1.14 [1.08, 1.21]<0.001Not selected
      Number of 18F-FDG–avid metastases1.08 [1.05, 1.11]<0.001Not selected
      Whole-body MTV (log)1.86 [1.49, 2.33]<0.001Not selected
      Whole-body TLG (log)1.84 [1.51, 2.26]<0.0011.88 [1.53, 2.32]<0.001
    mCSPC patients (n = 25)
     Age at start of treatment1.02 [0.9, 1.15]0.76
     Treatment agent0.72
      Enzalutamide (n = 7)Reference
      Abiraterone (n = 18)0.73 [0.13, 3.98]
     Laboratory parameters at treatment start
      Prostate-specific antigen (log)1.07 [0.72, 1.58]0.74
      Albumin1.29 [0.9, 17.2]0.85
      Alkaline phosphatase (log)1.55 [0.59, 4.05]0.37
      Hemoglobin0.66 [0.43, 1.03]0.065
      Lactate dehydrogenase1.00 [0.98, 1.02]0.89
     18F-FDG PET/CT metrics
      SUVmax (g/mL)0.99 [0.90, 1.09]0.80
      Number of 18F-FDG–avid metastases1.03 [0.96, 1.11]0.43
      Whole-body MTV (log)1.21 [0.83, 1.76]0.33
      Whole-body TLG (log)1.18 [0.86, 1.61]0.31
    • “Treatment” indicates treatment with abiraterone plus prednisone, or enzalutamide. “Not selected” indicates not selected during stepwise selection. Data in brackets are 95% CIs.

PreviousNext
Back to top

In this issue

Journal of Nuclear Medicine: 62 (8)
Journal of Nuclear Medicine
Vol. 62, Issue 8
August 1, 2021
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Journal of Nuclear Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Quantification of Metastatic Prostate Cancer Whole-Body Tumor Burden with 18F-FDG PET Parameters and Associations with Overall Survival After First-Line Abiraterone or Enzalutamide: A Single-Center Retrospective Cohort Study
(Your Name) has sent you a message from Journal of Nuclear Medicine
(Your Name) thought you would like to see the Journal of Nuclear Medicine web site.
Citation Tools
Quantification of Metastatic Prostate Cancer Whole-Body Tumor Burden with 18F-FDG PET Parameters and Associations with Overall Survival After First-Line Abiraterone or Enzalutamide: A Single-Center Retrospective Cohort Study
Andreas G. Wibmer, Michael J. Morris, Mithat Gonen, Junting Zheng, Hedvig Hricak, Steven Larson, Howard I. Scher, Hebert Alberto Vargas
Journal of Nuclear Medicine Aug 2021, 62 (8) 1050-1056; DOI: 10.2967/jnumed.120.256602

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Quantification of Metastatic Prostate Cancer Whole-Body Tumor Burden with 18F-FDG PET Parameters and Associations with Overall Survival After First-Line Abiraterone or Enzalutamide: A Single-Center Retrospective Cohort Study
Andreas G. Wibmer, Michael J. Morris, Mithat Gonen, Junting Zheng, Hedvig Hricak, Steven Larson, Howard I. Scher, Hebert Alberto Vargas
Journal of Nuclear Medicine Aug 2021, 62 (8) 1050-1056; DOI: 10.2967/jnumed.120.256602
Twitter logo Facebook logo LinkedIn logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Bookmark this article

Jump to section

  • Article
    • Visual Abstract
    • Abstract
    • MATERIALS AND METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSION
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

  • This Month in JNM
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Eligibility for 177Lu-PSMA Therapy Depends on the Choice of Companion Diagnostic Tracer: A Comparison of 68Ga-PSMA-11 and 99mTc-MIP-1404 in Metastatic Castration-Resistant Prostate Cancer
  • Application of the Lugano Classification for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The PRoLoG Consensus Initiative (Part 2—Technical)
  • Fetal Dose from PET and CT in Pregnant Patients
Show more Clinical Investigation

Similar Articles

Keywords

  • metastatic prostate cancer
  • 18F-FDG PET/CT
  • whole-body tumor burden
  • Overall survival
  • abiraterone
SNMMI

© 2023 Journal of Nuclear Medicine

Powered by HighWire