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Bone uptake metastatic probability (BUMP) score - a composite imaging-clinical model, was compared with PSMA Reporting and Data System (PSMA-RADS, Version 2) for predicting skeletal metastases in UBU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A real-world cohort of [18F]PSMA-1007 PET\/CT scans performed at three tertiary cancer centres was retrospectively analysed. Bone lesions with focal PSMA uptake were evaluated. SUV\n                      <jats:sub>max<\/jats:sub>\n                      , CT-derived mean Hounsfield unit and androgen deprivation therapy status were recorded to calculate BUMP score for each lesion. Lesional PSMA-RADS scores were assigned by experienced radiologists. Ground truth was established using follow-up imaging, prostate-specific antigen (PSA) kinetics and multidisciplinary consensus. Receiver operating characteristic (ROC) analyses assessed diagnostic performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      130 patients (median age 70\u00a0years) with 412 bone lesions were analysed; 60.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009251) of lesions were metastatic. Median SUV\n                      <jats:sub>max<\/jats:sub>\n                      was higher in malignant than benign lesions: 7.54 (Interquartile range (IQR) 10.3) versus 3.53 (IQR 1.51). BUMP achieved an AUROC of 0.812 (95% CI: 0.636\u20140.931), the optimal threshold was 0.134 yielding an F1 score of 0.800. PSMA-RADS v2.0 outperformed BUMP with higher sensitivity and specificity (98% and 96%, versus 74% and 80%). In equivocal PSMA-RADS Score 3 lesions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944), BUMP showed reduced discrimination (AUROC 0.61, 95% CI 0.457\u20130.781).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BUMP had good predictive ability for classifying bone metastases but underperformed compared with human-led PSMA-RADS assessment. For equivocal lesions BUMP offered limited added value, highlighting the importance of expert interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-08154-0","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T07:07:36Z","timestamp":1788246456000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative analysis of PSMA-RADS Version 2.0 versus bone uptake metastatic probability (BUMP) score for characterising focal bone uptake on [18F]PSMA-1007 PET\/CT in prostate cancer \u2013 a multicentre evaluation"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5942-3396","authenticated-orcid":false,"given":"James","family":"Cairns","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8551-8786","authenticated-orcid":false,"given":"Salman","family":"Arain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3683-9583","authenticated-orcid":false,"given":"Amarnath","family":"Challapalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Stavropoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamir","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Ward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3254-462X","authenticated-orcid":false,"given":"John","family":"Sage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-2080","authenticated-orcid":false,"given":"Georgia","family":"Ionescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8424-8024","authenticated-orcid":false,"given":"Julien M. 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No direct patient identifiers were entered, privacy-preserving configurations were used, and all outputs were independently verified against the source data by the authors.","order":1,"name":"Ethics","label":"Declarations","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"John Sage, Georgia Ionescu and Julien Willaime were employees of Mirada Medical Ltd at the time this work was carried out. No further conflicts of interest to disclose.","order":2,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Ethics"}}]}}