{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:03:47Z","timestamp":1788876227949,"version":"build-2803163510"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Bonn"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617 therapy has emerged as a promising radioligand treatment for metastatic castration-resistant prostate cancer (mCRPC). Given the overall poor prognosis of mCRPC, accurately predicting the key endpoint overall survival (OS) remains an ongoing challenge, crucial for optimizing risk\/benefit assessment prior to treatment. This study investigates the prognostic utility of the simple designed Bellmunt Risk Score (BRS) in mCRPC patients treated with [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively evaluated data from 386 mCRPC patients who had received [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617 therapy at our center. BRS was constructed by attributing one point for each of the following risk factors: ECOG performance status (ECOG PS)\u2009&gt;\u20090, hemoglobin\u2009&lt;\u200910\u00a0g\/dL, and the presence of liver metastases. Additionally, an enhanced version of the score including C-reactive protein (CRP)\u2009&gt;\u200930\u00a0mg\/dL and a modified version utilizing a semi-quantitative ECOG PS were developed. Statistical analysis included Cox regression, Kaplan-Meier estimates, concordance indices and time-dependent area under the curve (tAUC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The BRS served as an independent predictor of OS in multivariable analysis. The estimated median OS was 17.6, 10.9, 6.6, and 2.7 months for patients with scores of 0, 1, 2 and 3, respectively (Log-Rank\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The tAUC values for predicting 1-year and 2-year OS were 71.6% and 74.4%, respectively. The CRP-enhanced score further improved prognostic accuracy, achieving tAUCs of 75.7% for 1-year OS and 78.1% for 2-year OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The Bellmunt Risk Score effectively stratifies mCRPC patients undergoing [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-617 therapy. Its straightforward design, based on readily accessible clinical parameters, ensures practicality and utility in real-world clinical settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07492-9","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T08:11:01Z","timestamp":1754122261000},"page":"931-939","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bellmunt risk score enables survival prediction in men with metastatic castration resistant prostate cancer (mCRPC) undergoing PSMA-targeted radioligand therapy (LUMEN)"],"prefix":"10.1007","volume":"53","author":[{"given":"Thomas","family":"B\u00fcttner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1856-5005","authenticated-orcid":false,"given":"Milka","family":"Marinova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian C.","family":"Gaertner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Kreppel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leander","family":"Fritsche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Immanuel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Geraths","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"K\u00fcrpig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"K\u00fcppers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo G.H.","family":"Schmidt-Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Essler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Ritter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Krausewitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"7492_CR1","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1056\/NEJMoa2107322","volume":"385","author":"O Sartor","year":"2021","unstructured":"Sartor O, Bono Jd, Chi KN, Fizazi K, Herrmann K, Rahbar K, et al. Lutetium-177\u2013PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med. 2021;385:1091\u2013103. https:\/\/doi.org\/10.1056\/NEJMoa2107322.","journal-title":"N Engl J Med"},{"key":"7492_CR2","doi-asserted-by":"publisher","first-page":"e5001","DOI":"10.1016\/j.urolonc.2018.08.002","volume":"36","author":"WK Oh","year":"2018","unstructured":"Oh WK, Cheng WY, Miao R, Vekeman F, Gauthier-Loiselle M, Duh MS, et al. Real-world outcomes in patients with metastatic castration-resistant prostate cancer receiving second-line chemotherapy versus an alternative androgen receptor-targeted agent (ARTA) following early progression on a first-line ARTA in a US community oncology setting. Urologic Oncology: Seminars Original Investigations. 2018;36:e5001\u20139. https:\/\/doi.org\/10.1016\/j.urolonc.2018.08.002.","journal-title":"Urologic Oncology: Seminars Original Investigations"},{"key":"7492_CR3","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1038\/s41391-023-00725-8","volume":"27","author":"SJ Freedland","year":"2024","unstructured":"Freedland SJ, Davis M, Epstein AJ, Arondekar B, Ivanova JI. Real-world treatment patterns and overall survival among men with metastatic castration-resistant prostate cancer (mCRPC) in the US medicare population. Prostate Cancer Prostatic Dis. 2024;27:327\u201333. https:\/\/doi.org\/10.1038\/s41391-023-00725-8.","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"7492_CR4","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1158\/1078-0432.Ccr-22-2875","volume":"29","author":"J Fallah","year":"2023","unstructured":"Fallah J, Agrawal S, Gittleman H, Fiero MH, Subramaniam S, John C, et al. FDA approval summary: lutetium Lu 177 vipivotide tetraxetan for patients with metastatic castration-resistant prostate cancer. Clin Cancer Res. 2023;29:1651\u20137. https:\/\/doi.org\/10.1158\/1078-0432.Ccr-22-2875.","journal-title":"Clin Cancer Res"},{"key":"7492_CR5","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.2967\/jnumed.123.266167","volume":"64","author":"O Sartor","year":"2023","unstructured":"Sartor O, Ledet E, Huang M, Schwartz J, Lieberman A, Lewis B, et al. Prediction of resistance to <\u2009sup\u2009>\u2009177\u2009Lu-PSMA therapy by assessment of baseline Circulating tumor DNA biomarkers. J Nucl Med. 2023;64:1721\u20135. https:\/\/doi.org\/10.2967\/jnumed.123.266167.","journal-title":"J Nucl Med"},{"key":"7492_CR6","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1016\/S1470-2045(22)00605-2","volume":"23","author":"JP Buteau","year":"2022","unstructured":"Buteau JP, Martin AJ, Emmett L, Iravani A, Sandhu S, Joshua AM, et al. PSMA and FDG-PET as predictive and prognostic biomarkers in patients given [<\u2009sup\u2009>\u2009177\u2009Lu]Lu-PSMA-617 versus Cabazitaxel for metastatic castration-resistant prostate cancer (TheraP): a biomarker analysis from a randomised, open-label, phase 2 trial. Lancet Oncol. 2022;23:1389\u201397. https:\/\/doi.org\/10.1016\/S1470-2045(22)00605-2.","journal-title":"Lancet Oncol"},{"key":"7492_CR7","doi-asserted-by":"publisher","first-page":"689","DOI":"10.2967\/jnumed.119.231431","volume":"61","author":"H Rathke","year":"2020","unstructured":"Rathke H, Holland-Letz T, Mier W, Flechsig P, Mavriopoulou E, R\u00f6hrich M, et al. Response prediction of <\u2009sup\u2009>\u2009177\u2009Lu-PSMA-617 radioligand therapy using Prostate-Specific antigen, chromogranin A, and lactate dehydrogenase. J Nucl Med. 2020;61:689\u201395. https:\/\/doi.org\/10.2967\/jnumed.119.231431.","journal-title":"J Nucl Med"},{"key":"7492_CR8","doi-asserted-by":"publisher","first-page":"186","DOI":"10.3390\/diagnostics11020186","volume":"11","author":"S Moazemi","year":"2021","unstructured":"Moazemi S, Erle A, L\u00fctje S, Gaertner FC, Essler M, Bundschuh RA. Estimating the potential of radiomics features and radiomics signature from pretherapeutic PSMA-PET-CT scans and clinical data for prediction of overall survival when treated with 177Lu-PSMA. Diagnostics. 2021;11:186.","journal-title":"Diagnostics"},{"key":"7492_CR9","doi-asserted-by":"publisher","first-page":"2196","DOI":"10.1007\/s00259-023-06163-x","volume":"50","author":"M Kim","year":"2023","unstructured":"Kim M, Seifert R, Fragemann J, Kersting D, Murray J, Jonske F, et al. Evaluation of thresholding methods for the quantification of [68Ga]Ga-PSMA-11 PET molecular tumor volume and their effect on survival prediction in patients with advanced prostate cancer undergoing [177Lu]Lu-PSMA-617 radioligand therapy. Eur J Nucl Med Mol Imaging. 2023;50:2196\u2013209. https:\/\/doi.org\/10.1007\/s00259-023-06163-x.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7492_CR10","doi-asserted-by":"publisher","first-page":"e007354","DOI":"10.1136\/jitc-2023-007354","volume":"11","author":"A Handke","year":"2023","unstructured":"Handke A, Kesch C, Fendler WP, Telli T, Liu Y, Hakansson A, et al. Analysing the tumor transcriptome of prostate cancer to predict efficacy of Lu-PSMA therapy. J Immunother Cancer. 2023;11:e007354. https:\/\/doi.org\/10.1136\/jitc-2023-007354.","journal-title":"J Immunother Cancer"},{"key":"7492_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2024.03.009","author":"A Gafita","year":"2024","unstructured":"Gafita A, Martin AJ, Emmett L, Eiber M, Iravani A, Fendler WP, et al. Validation of prognostic and predictive models for therapeutic response in patients treated with [177Lu]Lu-PSMA-617 versus Cabazitaxel for metastatic Castration-resistant prostate cancer (TheraP): A post hoc analysis from a randomised, Open-label, phase 2 trial. Eur Urol Oncol. 2024. https:\/\/doi.org\/10.1016\/j.euo.2024.03.009.","journal-title":"Eur Urol Oncol"},{"key":"7492_CR12","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1016\/S1470-2045(21)00274-6","volume":"22","author":"A Gafita","year":"2021","unstructured":"Gafita A, Calais J, Grogan TR, Hadaschik B, Wang H, Weber M, et al. Nomograms to predict outcomes after <\u2009sup\u2009>\u2009177\u2009Lu-PSMA therapy in men with metastatic castration-resistant prostate cancer: an international, multicentre, retrospective study. Lancet Oncol. 2021;22:1115\u201325. https:\/\/doi.org\/10.1016\/S1470-2045(21)00274-6.","journal-title":"Lancet Oncol"},{"key":"7492_CR13","doi-asserted-by":"publisher","first-page":"1850","DOI":"10.1200\/jco.2009.25.4599","volume":"28","author":"J Bellmunt","year":"2010","unstructured":"Bellmunt J, Choueiri TK, Fougeray R, Schutz FAB, Salhi Y, Winquist E, et al. Prognostic factors in patients with advanced transitional cell carcinoma of the urothelial tract experiencing treatment failure with platinum-containing regimens. J Clin Oncol. 2010;28:1850\u20135. https:\/\/doi.org\/10.1200\/jco.2009.25.4599.","journal-title":"J Clin Oncol"},{"key":"7492_CR14","doi-asserted-by":"publisher","unstructured":"Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer. Cancer. 2001;91:2214\u201321. https:\/\/doi.org\/10.1002\/1097-0142(20010615)91:12%3C;2214::AID-CNCR1251%3E;3.0.CO;2-P.","DOI":"10.1002\/1097-0142(20010615)91:12%3C;2214::AID-CNCR1251%3E;3.0.CO;2-P"},{"key":"7492_CR15","doi-asserted-by":"publisher","DOI":"10.4103\/aja.aja_53_20","author":"W-J Chen","year":"2021","unstructured":"Chen W-J, Kong D-M, Li L. Prognostic value of ECOG performance status and Gleason score in the survival of castration-resistant prostate cancer: a systematic review. Asian J Androl. 2021;23(2):163\u2013169. https:\/\/doi.org\/10.4103\/aja.aja_53_20","journal-title":"Asian J Androl"},{"key":"7492_CR16","doi-asserted-by":"publisher","first-page":"734","DOI":"10.3390\/jcm13030734","volume":"13","author":"A Shiner","year":"2024","unstructured":"Shiner A, Sperandio RC, Naimi M, Emmenegger U. Prostate cancer liver metastasis: an ominous metastatic site in need of distinct management strategies. J Clin Med. 2024;13:734.","journal-title":"J Clin Med"},{"key":"7492_CR17","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1002\/pros.24747","volume":"84","author":"T B\u00fcttner","year":"2024","unstructured":"B\u00fcttner T, Kl\u00fcmper N, Weiten R, Lossin P, Latz S, Jacobs C, et al. Bellmunt risk score as a survival predictor in patients with metastatic castration-resistant prostate cancer. Prostate. 2024;84:1119\u201327. https:\/\/doi.org\/10.1002\/pros.24747.","journal-title":"Prostate"},{"key":"7492_CR18","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.clgc.2021.11.010","volume":"20","author":"AY Abuhelwa","year":"2022","unstructured":"Abuhelwa AY, Bellmunt J, Kichenadasse G, McKinnon RA, Rowland A, Sorich MJ, et al. Enhanced bellmunt risk score for survival prediction in urothelial carcinoma treated with immunotherapy. Clin Genitourin Cancer. 2022;20:132\u20138. https:\/\/doi.org\/10.1016\/j.clgc.2021.11.010.","journal-title":"Clin Genitourin Cancer"},{"key":"7492_CR19","doi-asserted-by":"publisher","first-page":"e493","DOI":"10.1016\/S1470-2045(14)70263-3","volume":"15","author":"CI Diakos","year":"2014","unstructured":"Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-related inflammation and treatment effectiveness. Lancet Oncol. 2014;15:e493\u2013503. https:\/\/doi.org\/10.1016\/S1470-2045(14)70263-3.","journal-title":"Lancet Oncol"},{"key":"7492_CR20","doi-asserted-by":"publisher","first-page":"55567","DOI":"10.18632\/oncotarget.15698","volume":"8","author":"H Ahmadzadehfar","year":"2017","unstructured":"Ahmadzadehfar H, Zimbelmann S, Yordanova A, Fimmers R, K\u00fcrpig S, Eppard E, et al. Radioligand therapy of metastatic prostate cancer using (177)Lu-PSMA-617 after radiation exposure to (223)Ra-dichloride. Oncotarget. 2017;8:55567\u201374. https:\/\/doi.org\/10.18632\/oncotarget.15698.","journal-title":"Oncotarget"},{"key":"7492_CR21","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1136\/bmjspcare-2015-001073","volume":"7","author":"C Hern\u00e1ndez-Quiles","year":"2017","unstructured":"Hern\u00e1ndez-Quiles C, Bernabeu-Wittel M, P\u00e9rez-Belmonte LM, Mac\u00edas-Mir P, Camacho-Gonz\u00e1lez D, Massa B, et al. Concordance of Barthel index, ECOG-PS, and palliative performance scale in the assessment of functional status in patients with advanced medical diseases. BMJ Supportive Palliat Care. 2017;7:300\u20137. https:\/\/doi.org\/10.1136\/bmjspcare-2015-001073.","journal-title":"BMJ Supportive Palliat Care"},{"key":"7492_CR22","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1007\/s00520-021-06486-1","volume":"30","author":"X-W Zhang","year":"2022","unstructured":"Zhang X-W, Zhang Q, Song M-M, Zhang K-P, Zhang X, Ruan G-T, et al. The prognostic effect of hemoglobin on patients with cancer cachexia: a multicenter retrospective cohort study. Support Care Cancer. 2022;30:875\u201385. https:\/\/doi.org\/10.1007\/s00520-021-06486-1.","journal-title":"Support Care Cancer"},{"key":"7492_CR23","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1002\/sim.9717","volume":"42","author":"N Hartman","year":"2023","unstructured":"Hartman N, Kim S, He K, Kalbfleisch JD. Pitfalls of the concordance index for survival outcomes. Stat Med. 2023;42:2179\u201390. https:\/\/doi.org\/10.1002\/sim.9717.","journal-title":"Stat Med"},{"key":"7492_CR24","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1007\/s00259-021-05525-7","volume":"49","author":"F Khreish","year":"2022","unstructured":"Khreish F, Ghazal Z, Marlowe RJ, Rosar F, Sabet A, Maus S, et al. 177 Lu-PSMA-617 radioligand therapy of metastatic castration-resistant prostate cancer: initial 254-patient results from a prospective registry (REALITY Study). Eur J Nucl Med Mol Imaging. 2022;49:1075\u201385. https:\/\/doi.org\/10.1007\/s00259-021-05525-7.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7492_CR25","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1080\/14737140.2023.2213892","volume":"23","author":"K Patell","year":"2023","unstructured":"Patell K, Kurian M, Garcia JA, Mendiratta P, Barata PC, Jia AY, et al. Lutetium-177 PSMA for the treatment of metastatic castrate resistant prostate cancer: a systematic review. Expert Rev Anticancer Ther. 2023;23:731\u201344. https:\/\/doi.org\/10.1080\/14737140.2023.2213892.","journal-title":"Expert Rev Anticancer Ther"},{"key":"7492_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(24)00440-6","author":"AA Azad","year":"2024","unstructured":"Azad AA, Bressel M, Tan H, Voskoboynik M, Suder A, Weickhardt AJ, et al. Sequential [177Lu]Lu-PSMA-617 and docetaxel versus docetaxel in patients with metastatic hormone-sensitive prostate cancer (UpFrontPSMA): a multicentre, open-label, randomised, phase 2 study. Lancet Oncol. 2024. https:\/\/doi.org\/10.1016\/S1470-2045(24)00440-6.","journal-title":"Lancet Oncol"},{"key":"7492_CR27","doi-asserted-by":"publisher","first-page":"1754","DOI":"10.1007\/s00259-021-05618-3","volume":"49","author":"S Satapathy","year":"2022","unstructured":"Satapathy S, Mittal BR, Sood A, Das CK, Mavuduru RS, Goyal S, et al. 177Lu-PSMA-617 versus docetaxel in chemotherapy-na\u00efve metastatic castration-resistant prostate cancer: a randomized, controlled, phase 2 non-inferiority trial. Eur J Nucl Med Mol Imaging. 2022;49:1754\u201364. https:\/\/doi.org\/10.1007\/s00259-021-05618-3.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"7492_CR28","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/S1470-2045(24)00135-9","volume":"25","author":"L Emmett","year":"2024","unstructured":"Emmett L, Subramaniam S, Crumbaker M, Nguyen A, Joshua AM, Weickhardt A, et al. [<\u2009sup\u2009>\u2009177\u2009Lu]Lu-PSMA-617 plus enzalutamide in patients with metastatic castration-resistant prostate cancer (ENZA-p): an open-label, multicentre, randomised, phase 2 trial. Lancet Oncol. 2024;25:563\u201371. https:\/\/doi.org\/10.1016\/S1470-2045(24)00135-9.","journal-title":"Lancet Oncol"},{"key":"7492_CR29","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.euo.2023.07.018","volume":"7","author":"M Kafka","year":"2024","unstructured":"Kafka M, Horninger A, di Santo G, Virgolini I, Neuwirt H, Unterrainer LM, et al. Real-world outcomes and predictive biomarkers for (177)Lutetium prostate-specific membrane antigen ligand treatment in metastatic Castration-resistant prostate cancer: A European association of urology young academic urologists prostate cancer working group Multi-institutional observational study. Eur Urol Oncol. 2024;7:421\u20139. https:\/\/doi.org\/10.1016\/j.euo.2023.07.018.","journal-title":"Eur Urol Oncol"},{"key":"7492_CR30","doi-asserted-by":"publisher","first-page":"83","DOI":"10.21037\/apm.2016.03.02","volume":"5","author":"R Chow","year":"2016","unstructured":"Chow R, Chiu N, Bruera E, Krishnan M, Chiu L, Lam H, et al. Inter-rater reliability in performance status assessment among health care professionals: a systematic review. Annals Palliat Med. 2016;5:83\u201392.","journal-title":"Annals Palliat Med"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-025-07492-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-025-07492-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-025-07492-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T02:46:36Z","timestamp":1769222796000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-025-07492-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,2]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["7492"],"URL":"https:\/\/doi.org\/10.1007\/s00259-025-07492-9","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,2]]},"assertion":[{"value":"14 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This is an observational study. The responsible ethic committee at the Medical Faculty of University Bonn has confirmed that no ethical approval and informed consent is required (vote no. 2024-19-BO).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Thomas B\u00fcttner received speaker honorary from Astellas. Philipp Krausewitz received speaker honorary from Novartis and Johnson and Johnson. All other authors have no competing interests to declare that are relevant to the content of this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}