Bone metastases in castration-resistant prostate cancer: Associations between morphologic CT patterns, glycolytic activity, and androgen receptor expression on PET and overall survival Journal Article


Authors: Vargas, H. A.; Wassberg, C.; Fox, J. J.; Wibmer, A.; Goldman, D. A.; Kuk, D.; Gonen, M.; Larson, S. M.; Morris, M. J.; Scher, H. I.; Hricak, H.
Article Title: Bone metastases in castration-resistant prostate cancer: Associations between morphologic CT patterns, glycolytic activity, and androgen receptor expression on PET and overall survival
Abstract: Purpose: To compare the features of bone metastases at computed tomography (CT) to tracer uptake at fluorine 18 fluorode-oxyglucose (FDG) positron emission tomography (PET) and fluorine 18 16β-fluoro-5-dihydrotestosterone (FDHT) PET and to determine associations between these imaging features and overall survival in men with castrationresistant prostate cancer. Materials and Methods: This is a retrospective study of 38 patients with castra-tion- resistant prostate cancer. Two readers independently evaluated CT, FDG PET, and FDHT PET features of bone metastases. Associations between imaging findings and overall survival were determined by using univariate Cox proportional hazards regression. Results: In 38 patients, reader 1 detected 881 lesions and reader 2 detected 867 lesions. Attenuation coefficients at CT correlated inversely with FDG (reader 1: r = -0.3007; P < .001; reader 2: r = -0.3147; P < .001) and FDHT (reader 1: r = -0.2680; P = .001; reader 2: r = -0.3656; P < .001) uptake. The number of lesions on CT scans was significantly associated with overall survival (reader 1: hazard ratio [HR], 1.025; P = .05; reader 2: HR, 1.021; P = .04). The numbers of lesions on FDG and FDHT PET scans were significantly associated with overall survival for reader 1 (HR, 1.051-1.109; P < .001) and reader 2 (HR, 1.026-1.082; P ≤ .009). Patients with higher FDHT uptake (lesion with the highest maximum standardized uptake value) had significantly shorter overall survival (reader 1: HR, 1.078; P = .02; reader 2: HR, 1.092; P = .02). FDG uptake intensity was not associated with overall survival (reader 1, P = .65; reader 2, P = .38). Conclusion: In patients with castration-resistant prostate cancer, numbers of bone lesions on CT, FDG PET, and FDHT PET scans and the intensity of FDHT uptake are significantly associated with overall survival. © RSNA, 2013.
Keywords: adult; cancer survival; clinical article; controlled study; protein expression; aged; unclassified drug; overall survival; bone metastasis; positron emission tomography; disease association; computer assisted tomography; image analysis; diagnostic imaging; retrospective study; drug uptake; fluorodeoxyglucose f 18; intermethod comparison; androgen receptor; tracer; glycolysis; image display; castration resistant prostate cancer; 16beta fluoro 5 dihydrotestosterone f 18; cancer prognosis; human; male; priority journal; article
Journal Title: Radiology
Volume: 271
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2014-04-01
Start Page: 220
End Page: 229
Language: English
DOI: 10.1148/radiol.13130625
PROVIDER: scopus
PUBMED: 24475817
PMCID: PMC4263648
DOI/URL:
Notes: Export Date: 1 May 2014 -- CODEN: RADLA -- Source: Scopus
Altmetric Score
MSK Authors
  1. Josef J Fox
    45 Fox
  2. Michael Morris
    277 Morris
  3. Mithat Gonen
    713 Gonen
  4. Hedvig Hricak
    330 Hricak
  5. Steven M Larson
    770 Larson
  6. Deborah Kuk
    81 Kuk
  7. Howard Scher
    832 Scher
  8. Debra Alyssa Goldman
    94 Goldman
  9. Andreas Georg Wibmer
    18 Wibmer