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dc.contributor.authorDonners, R
dc.contributor.authorTunariu, N
dc.contributor.authorTovey, H
dc.contributor.authorHall, E
dc.contributor.authorChua, S
dc.contributor.authorCook, G
dc.contributor.authorDu, Y
dc.contributor.authorBlackledge, MD
dc.contributor.authorParker, CC
dc.contributor.authorKoh, D-M
dc.identifier.citationEuropean Radiology, 2023,
dc.description.abstractOBJECTIVES: To investigate whether baseline 18F-sodium fluoride (NaF) and 18F-choline PET activity is associated with metastatic castration-resistant prostate cancer (mCRPC) global and individual bone metastases' DWI MR imaging response to radium-223 treatment. METHODS: Thirty-six bone-only mCRPC patients were prospectively recruited from three centers. Whole-body (WB)-MRI with DWI and 18F-NaF and 18F-choline PET/CT were performed at therapy baseline and 8-week intervals. In each patient, bone disease median global (g)ADC change between baseline and follow-up was calculated. Additionally, up to five bone target lesions per patient were delineated and individual median ADC change recorded. An ADC increase > 30% defined response per-patient and per-lesion. For the same targets, baseline 18F-NaF and 18F-choline PET SUVmax were recorded. Mean SUVmax across patient targets was correlated with gADC change and lesion SUVmax with per-lesion ADC change. RESULTS: A total of 133 lesions in 36 patients (14 responders) were analyzed. 18F-NaF PET per-patient mean SUVmax was significantly higher in responders (median = 56.0 versus 38.7 in non-responders; p = 0.008), with positive correlation between SUVmax and gADC increase (rho = 0.42; p = 0.015). A 48.7 SUVmax threshold identified responders with 77% sensitivity and 75% specificity. Baseline 18F-NaF PET per-lesion SUVmax was higher in responding metastases (median = 51.6 versus 31.8 in non-responding metastases; p = 0.001), with positive correlation between baseline lesion SUVmax and ADC increase (rho = 0.39; p < 0.001). A 36.8 SUVmax threshold yielded 72% sensitivity and 63% specificity. No significant association was found between baseline 18F-choline PET SUVmax and ADC response on a per-patient (p = 0.164) or per-lesion basis (p = 0.921). CONCLUSION: 18F-NaF PET baseline SUVmax of target mCRPC bone disease showed significant association with response to radium-223 defined by ADC change. CLINICAL RELEVANCE STATEMENT: 18F-sodium fluoride PET/CT baseline maximum SUV of castration-resistant prostate cancer bone metastases could be used as a predictive biomarker for response to radium-223 therapy. KEY POINTS: • 18F-sodium fluoride PET baseline SUVmax of castration-resistant prostate cancer bone metastases showed significant association with response to radium-223. • Baseline 18F-sodium fluoride PET can improve patient selection for radium-223 therapy. • Change in whole-body DWI parameters can be used for response correlation with baseline 18F-sodium fluoride PET SUVmax in castration-resistant prostate cancer bone metastases.
dc.relation.ispartofEuropean Radiology
dc.subjectDiffusion magnetic resonance imaging
dc.subjectPositron emission tomography computed tomography
dc.titleThe value of baseline 18F-sodium fluoride and 18F-choline PET activity for identifying responders to radium-223 treatment in castration-resistant prostate cancer bone metastases.
dc.typeJournal Article
rioxxterms.typeJournal Article/Review
pubs.organisational-groupICR/Primary Group
pubs.organisational-groupICR/Primary Group/ICR Divisions
pubs.organisational-groupICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-groupICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-groupICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished online
icr.researchteamClin Trials & Stats Unit
icr.researchteamRMH Honorary Faculty
dc.contributor.icrauthorTovey, Holly
dc.contributor.icrauthorHall, Emma
icr.provenanceDeposited by Mrs Jessica Perry (impersonating Prof Emma Hall) on 2023-11-14. Deposit type is initial. No. of files: 1. Files: The value of baseline 18F‑sodium fluoride and 18F‑choline PET.pdf

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