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@ARTICLE{Hope:278614,
      author       = {T. A. Hope and M. Benz and F. Jiang and D. Thompson and F.
                      Barbato and R. Juarez and M. Hernandez Pampaloni and M.
                      Allen-Auerbach and P. Gupta and W. P. Fendler$^*$ and J.
                      Calais},
      title        = {{D}o {B}one {S}cans {O}verstage {D}isease {C}ompared with
                      {PSMA} {PET} at {I}nitial {S}taging? {A}n {I}nternational
                      {M}ulticenter {R}etrospective {S}tudy with {M}asked
                      {I}ndependent {R}eaders.},
      journal      = {Journal of nuclear medicine},
      volume       = {64},
      number       = {11},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2023-01673},
      pages        = {1744-1747},
      year         = {2023},
      note         = {2023 Nov;64(11):1744-1747},
      abstract     = {Prostate-specific membrane antigen (PSMA) PET has a higher
                      accuracy than CT and bone scans to stage patients with
                      prostate cancer. We do not understand how to apply clinical
                      trial data based on conventional imaging to patients staged
                      using PSMA PET. Therefore, we aimed to evaluate the ability
                      of bone scans to detect osseous metastases using PSMA PET as
                      a reference standard. Methods: In this multicenter
                      retrospective diagnostic study, 167 patients with prostate
                      cancer, who were imaged with bone scans and PSMA PET
                      performed within 100 d, were included for analysis. Each
                      study was interpreted by 3 masked readers, and the results
                      of the PSMA PET were used as the reference standard.
                      Endpoints were positive predictive value (PPV), negative
                      predictive value (NPV), and specificity for bone scans.
                      Additionally, interreader reproducibility, positivity rate,
                      uptake on PSMA PET, and the number of lesions were
                      evaluated. Results: In total, 167 patients were included,
                      with 77 at initial staging, 60 in the biochemical recurrence
                      and castration-sensitive prostate cancer setting, and 30 in
                      the castration-resistant prostate cancer setting. In all
                      patients, the PPV, NPV, and specificity for bone scans were
                      0.73 $(95\%$ CI, 0.61-0.82), 0.82 $(95\%$ CI, 0.74-0.88),
                      and 0.82 $(95\%$ CI, 0.74-0.88), respectively. In patients
                      at initial staging, the PPV, NPV, and specificity for bone
                      scans were 0.43 $(95\%$ CI, 0.26-0.63), 0.94 $(95\%$ CI,
                      0.85-0.98), and 0.80 $(95\%$ CI, 0.68-0.88), respectively.
                      Interreader agreement for bone disease was moderate for bone
                      scans (Fleiss κ, 0.51) and substantial for the PSMA PET
                      reference standard (Fleiss κ, 0.80). Conclusion: In this
                      multicenter retrospective study, the PPV of bone scans was
                      low in patients at initial staging, with $57\%$ of positive
                      bone scans being false positives. This suggests that a large
                      proportion of patients considered low-volume metastatic by
                      the bone scan actually had localized disease, which is
                      critical when applying clinical data from trials such as the
                      STAMPEDE M1 radiation therapy trial to patients being staged
                      with PSMA PET.},
      keywords     = {PSMA PET (Other) / bone scans (Other) / initial staging
                      (Other) / oncology (Other) / prostate cancer (Other) /
                      radiopharmaceuticals (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37591547},
      doi          = {10.2967/jnumed.123.265916},
      url          = {https://inrepo02.dkfz.de/record/278614},
}