PT - JOURNAL ARTICLE AU - Hossein Jadvar AU - Bhushan Desai AU - Lingyun Ji AU - Peter S. Conti AU - Tanya B. Dorff AU - Susan G. Groshen AU - Jacek K. Pinski AU - David I. Quinn TI - Baseline <sup>18</sup>F-FDG PET/CT Parameters as Imaging Biomarkers of Overall Survival in Castrate-Resistant Metastatic Prostate Cancer AID - 10.2967/jnumed.112.114116 DP - 2013 Aug 01 TA - Journal of Nuclear Medicine PG - 1195--1201 VI - 54 IP - 8 4099 - http://jnm.snmjournals.org/content/54/8/1195.short 4100 - http://jnm.snmjournals.org/content/54/8/1195.full SO - J Nucl Med2013 Aug 01; 54 AB - The aim of this prospective investigation was to assess the association of parameters derived from baseline 18F-FDG PET/CT with overall survival (OS) in men with castrate-resistant metastatic prostate cancer. Methods: Eighty-seven men with castrate-resistant metastatic prostate cancer underwent 18F-FDG PET/CT and were followed prospectively for OS. Median follow-up in patients who were alive was 22.2 mo (range, 1.6–62.5 mo). OS was defined as the time between the PET/CT imaging or the start of chemotherapy, whichever was later, and death, with patients who were alive censored at the last follow-up date. PET parameters included maximum standardized uptake value (SUVmax) of the most active lesion, sum of SUVmax, and average SUVmax of all metabolically active lesions, after subtraction of patient-specific background-liver average SUV. Comparison of OS was based on univariate and multivariable Cox regression analyses of continuous PET parameters adjusted for standard clinical parameters (age, serum prostate-specific antigen level, alkaline phosphatase, use of pain medication, prior chemotherapy, and Gleason score at initial diagnosis). Survival curves based on Kaplan–Meier estimates are presented. Results: Among the 87 patients, 61 were dead at the time of last follow-up. Median OS was 16.5 mo (95% confidence interval [CI], 12.1–23.4 mo), and the OS probability at 24 mo was 39% ± 6%. For the univariate analysis, the hazard ratios associated with each unit increase were 1.01 (95% CI, 1.006–1.02) for sum of SUVmax (P = 0.002), 1.11 (95% CI, 1.03–1.18) for maximum SUVmax (P = 0.010), and 1.13 (95% CI, 0.99–1.30) for average SUVmax (P = 0.095). For the multivariable analysis adjusting for relevant clinical parameters, the continuous parameter sum of SUVmax remained significant (P = 0.053), with a hazard ratio of 1.01 (95% CI, 1.001–1.02). When sum of SUVmax was grouped into quartile ranges, there was poorer survival probability for the patients in the fourth-quartile range than for those in the first-quartile range, with a univariate hazard ratio of 3.8 (95% CI, 1.8–7.9). Conclusion: Sum of SUVmax derived from 18F-FDG PET/CT contributes independent prognostic information on OS in men with castrate-resistant metastatic prostate cancer, and this information may be useful in assessing the comparative effectiveness of various conventional and emerging treatment strategies.