ArticleProstate cancer and prostatic diseases2019
Quantification of bone flare on
Article in Prostate cancer and prostatic diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- Multimodal management of primary mixed neuroendocrine prostate cancer with bone flare phenomenon: a rare case report and therapeutic insights.BMC urology · 2026Article
- Full-Body Tumor Response Heterogeneity of Metastatic Neuroendocrine Tumor Patients Undergoing Peptide Receptor Radiopharmaceutical Therapy.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2025Article
- Flare phenomenon visualized byAnnals of nuclear medicine · 2024Article
- Predicting Fractures Using Vertebral 18F-NaF Uptake in Prostate Cancer Patients.Journal of bone metabolism · 2023Article
- Nuclear medicine imaging for bone metastases assessment: what else besides bone scintigraphy in the era of personalized medicine?Frontiers in medicine · 2023Review
- Pseudoprogression after advanced first-line endocrine therapy in metastatic breast cancer with bone metastasis: A case report.Frontiers in oncology · 2022Article
- Flare phenomenon in prostate cancer: recent evidence on new drugs and next generation imaging.Therapeutic advances in medical oncology · 2021Review
- Determination and clinical significance of bone pseudoprogression in hormone receptor-positive metastatic breast cancer.Therapeutic advances in medical oncology · 2021Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBone flare has been observed on
methodsTwenty-nine mCRPC patients undergoing AR-inhibiting therapy (abiraterone, orteronel, enzalutamide) received NaF PET/CT scans at baseline, week 6, and week 12 of treatment. SUV metrics were extracted globally for each patient (SUV) and for each individual lesion (iSUV). Bone flare was defined as increasing SUV metrics or lesion number at week 6 followed by subsequent week 12 decrease. Differences in metrics across timepoints were compared using Wilcoxon tests. Cox proportional hazard regression was conducted between global metrics and progression-free survival (PFS).
resultsTotal SUV was most sensitive for flare detection and was identified in 14/23 (61%) patients receiving CYP17A1-inhibitors (abiraterone, orteronel), and not identified in any of six patients receiving enzalutamide. The appearance of new lesions did not account for initial increases in SUV metrics. iSUV metrics followed patient-level trends: bone flare positive patients showed a median of 72% (range: 0-100%) of lesions with total iSUV flare. Increasing mean SUV at week 6 correlated with extended PFS (HR = 0.58, p = 0.02).
conclusionNaF PET bone flare was present on 61% of mCRPC patients in the first 6 weeks of treatment with CYP17A1-inhibitors. Characterization provided in this study suggests favorable PFS in patients showing bone flare. This characterization of NaF flare is important for guiding treatment assessment schedules to better distinguish between patients showing bone flare and those truly progressing, and should be performed for all emerging mCRPC treatments and imaging agents.
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