{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T12:18:15Z","timestamp":1767183495898,"version":"3.41.2"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":332,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Institute of Cancer Research and The Royal Marsden Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To quantify the stage-shift with prostate-specific membrane antigen (PSMA) PET\/CT imaging in metastatic prostate cancer and explore treatment implications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Single-centre, retrospective analysis of patients with newly diagnosed [18F]PSMA-1007 or [68Ga]Ga-PSMA-11 PET\/CT-detected metastatic prostate cancer who had baseline bone scintigraphy between January 2015 and May 2021. Patients were subclassified into oligometastatic and polymetastatic disease utilizing the STAMPEDE2 trial (ISRCTN66357938\/NCT06320067) definition. Patient, tumour, and treatment characteristics were collected. PSMA PET\/CT concordance with conventional imaging (bone scintigraphy and low-dose CT of PET) was identified by number and site of metastases, and subgroup assigned. Spearman\u2019s rank correlation and linear regression modelling determined the association between the imaging modalities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We analysed 62 patients with a median age was 72\u2009years (range 48-86). On PSMA PET\/CT, 31\/62 (50%) patients had oligometastatic disease, and 31\/62 (50%) had polymetastatic disease. Prostate radiotherapy was delivered in 20\/31 (65%) patients with oligometastatic disease and 17\/31 (55%) with polymetastatic disease. 23\/62 (37%) patients were reclassified as M0 on conventional imaging. PSMA PET\/CT had a 2.9-fold increase in detecting bone metastases. Bone metastases concordance was found in 10\/50 (20%) by number and 30\/33 (91%) by site. PSMA PET\/CT had a 2.2-fold increase in detecting nodal metastases. Nodal metastases concordance was found in 5\/46 (11%) by number and 25\/26 (96%) by site. There was significant positive correlation between PSMA PET\/CT and conventional imaging for detecting bone [R2 = 0.25 (P\u2009&amp;lt;\u20090.001)] and nodal metastases [R2 = 0.19 (P\u2009&amp;lt;\u20090.001)]. 16\/31 (52%) had oligometastatic disease concordance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The magnitude of PSMA PET\/CT-driven stage-shift is highly variable and unpredictable with implications on treatment decisions, future trial design, and potentially clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge<\/jats:title>\n                  <jats:p>The magnitude of \u201cframe-shift\u201d with PSMA PET\/CT imaging is highly variable and unpredictable which may unreliably change treatment decisions dependent on image-defined disease extent. Prospective randomized trials are required to determine the relationship between PSMA PET\/CT-guided treatment choices and outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjro\/tzae040","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T14:22:41Z","timestamp":1731075761000},"source":"Crossref","is-referenced-by-count":3,"title":["The quantitative impact of prostate-specific membrane antigen (PSMA) PET\/CT staging in newly diagnosed metastatic prostate cancer and treatment-decision implications"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2755-4532","authenticated-orcid":false,"given":"Hoda","family":"Abdel-Aty","sequence":"first","affiliation":[{"name":"Division of Radiotherapy and Imaging, Institute of Cancer Research , London, SW3 6JB,","place":["United Kingdom"]},{"name":"Department of Radiotherapy, Royal Marsden NHS Foundation Trust , London, SW3 6JJ,","place":["United 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