Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 17.
doi: 10.1007/s00259-025-07409-6. Online ahead of print.

Enhanced vascular inflammation in patients with advanced prostate cancer receiving hormone therapy

Holger Einspieler #  1 , Dina Muin #  1 , Ilva Kristiana Langrate  1 , Stefan Schmitl  1 , Clemens P Spielvogel  1 , Barbara J Fueger  2 , Xiang Li  1 , Gero Kramer  3 , Shahrokh F Shariat  3   4   5   6   7 , Marcus Hacker  8 , Sazan Rasul  1
Affiliations

Enhanced vascular inflammation in patients with advanced prostate cancer receiving hormone therapy

Holger Einspieler et al. Eur J Nucl Med Mol Imaging. .

Abstract

Purpose: While blocking androgen production and action effectively slows prostate cancer (PCa) progression, it is associated with significant side effects, including an increased risk of cardiovascular disease. Inflammatory activity within atherosclerotic arteries can be assessed using [18F]FDG-PET imaging. Recently, [18F]FDG-PET has also gained relevance in PCa patients - alongside PSMA-targeted PET - for evaluating tumor aggressiveness. This study investigated the effect of hormone therapy on arterial inflammation in PCa patients using [18F]FDG-PET.

Methods: Thirty-two PCa patients receiving hormone therapy were compared to 17 age-matched PCa patients who had not undergone hormonal treatment in the 12 months prior to imaging. All participants underwent [18F]FDG-PET/CT scans. Regions of interest (ROIs) were placed across several arterial segments, as well as in the superior vena cava (SVC), spleen, and bone marrow. To account for background vascular activity, blood-pool activity in the SVC was used for correction, and target-to-background ratios (TBRs) were calculated for each arterial segment. A semi-quantitative calcified plaque (CP) score was also recorded.

Results: Patients receiving hormone therapy exhibited significantly higher TBRmax values in the abdominal aorta, ascending aorta, thoracic descending aorta, and in the combined analysis of all arteries (mean TBRmax: 1.6 vs. 1.4; all p < 0.05). Similarly, TBRmean values were significantly elevated in the abdominal and ascending aorta, as well as in the combined arterial analysis (all p < 0.05). No significant differences were observed between groups in age, BMI, total cholesterol, LDL, CRP, or CP scores (all p > 0.05).

Conclusion: Advanced PCa patients undergoing hormone therapy demonstrate increased arterial inflammation on [18F]FDG-PET imaging compared to non-hormonally treated controls. These findings support a possible mechanistic link between hormone therapy and the elevated cardiovascular risk observed in this patient population.

Keywords: Arterial inflammation; Atherosclerosis; Hormone therapy; PET/CT; Prostate cancer; [18F]FDG.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: This retrospective analysis was approved by the ethics committee of the Medical University of Vienna (1745/2021). Clinical trial number: Not applicable. Consent to participate: All patients gave their written informed consent prior to the examinations. Conflict of interest: The remaining authors have nothing to declare.

Similar articles

See all similar articles

References

    1. Yechiel Y, Chicheportiche A, Keidar Z, Ben-Haim S. Prostate Cancer radioligand therapy: Beta-labeled radiopharmaceuticals. PET Clin. 2024;19(3):389–99. - DOI - PubMed
    1. Chen H, Pang B, Zhou C, Han M, Gong J, Li Y, et al. Prostate cancer-derived small extracellular vesicle proteins: the hope in diagnosis, prognosis, and therapeutics. J Nanobiotechnol. 2023;21(1):480. - DOI
    1. Crawford ED, Heidenreich A, Lawrentschuk N, Tombal B, Pompeo ACL, Mendoza-Valdes A, et al. Androgen-targeted therapy in men with prostate cancer: evolving practice and future considerations. Prostate Cancer Prostatic Dis. 2019;22(1):24–38. - DOI - PubMed
    1. Lam T, Birzniece V, McLean M, Gurney H, Hayden A, Cheema BS. The adverse effects of androgen deprivation therapy in prostate Cancer and the benefits and potential Anti-oncogenic mechanisms of progressive resistance training. Sports Med - Open. 2020;6(1):13. - DOI - PubMed - PMC
    1. Hotta Y, Kataoka T, Kimura K. Testosterone deficiency and endothelial dysfunction: nitric oxide, asymmetric dimethylarginine, and endothelial progenitor cells. Sex Med Rev. 2019;7(4):661–8. - DOI

LinkOut - more resources