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We compared the performance of radiomic features to human visual interpretation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>We retrospectively analysed 102 hormone-sensitive PCa patients who underwent [<jats:sup>18<\/jats:sup>F]PSMA-1007 PET\/CT and exhibited at least one focal bone uptake with known clinical follow-up (reference standard). Using matRadiomics, we extracted features from PET and CT images of each bone uptake and identified the best predictor model for bone metastases using a machine-learning approach to generate a radiomic score. Blinded PET readers with low (<jats:italic>n<\/jats:italic>\u2009=\u20092) and high (<jats:italic>n<\/jats:italic>\u2009=\u20092) experience rated each bone uptake as either UBU or bone metastasis. The same readers performed a second read three months later, with access to the radiomic score.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of the 178 [<jats:sup>18<\/jats:sup>F]PSMA-1007 bone uptakes, 74 (41.5%) were classified as PCa metastases by the reference standard. A radiomic model combining PET and CT features achieved an accuracy of 84.69%, though it did not surpass expert PET readers in either round. Less-experienced readers had significantly lower diagnostic accuracy at baseline (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) but improved with the addition of radiomic scores (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 compared to the first round).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Radiomics might help to differentiate bone metastases from UBUs. While it did not exceed expert visual assessments, radiomics has the potential to enhance the diagnostic accuracy of less-experienced readers in evaluating [<jats:sup>18<\/jats:sup>F]PSMA-1007 PET\/CT bone uptakes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00259-025-07085-6","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T08:14:49Z","timestamp":1738052089000},"page":"2076-2086","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["[18F]PSMA-1007 PET\/CT-based radiomics may help enhance the interpretation of bone focal uptakes in hormone-sensitive prostate cancer patients"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1937-9116","authenticated-orcid":false,"given":"Matteo","family":"Bauckneht","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pasini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Di Raimondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Raffa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Isabella","family":"Donegani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Dubois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Pe\u00f1uela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Sofia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Celesti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiano","family":"Bini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Marinozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6043-9627","authenticated-orcid":false,"given":"Francesco","family":"Lanfranchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2842-0301","authenticated-orcid":false,"given":"Riccardo","family":"Laudicella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianmario","family":"Sambuceti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Stefano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"7085_CR1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.2967\/jnumed.119.229187","volume":"61","author":"I Rauscher","year":"2020","unstructured":"Rauscher I, Kr\u00f6nke M, K\u00f6nig M, et al. 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All procedures were performed in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study. All subjects gave their consent to publish their anonymized data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"M.B. reports personal fees from AAA and GE Healthcare. The other authors do not report any conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}