{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:02:36Z","timestamp":1781650956041,"version":"3.54.5"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","award":["#23YOUN25"],"award-info":[{"award-number":["#23YOUN25"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000892","name":"Prostate Cancer Foundation","doi-asserted-by":"publisher","award":["#23YOUN25"],"award-info":[{"award-number":["#23YOUN25"]}],"id":[{"id":"10.13039\/100000892","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cancer Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Potential rural-urban differences in prostate cancer care are understudied, particularly regarding the utilization of advanced diagnostic tests. Herein we examined variations in Positron Emission Tomography (PET) utilization for prostate cancer care, including diagnosis, staging and treatment planning, across residential regions in the United States.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients newly diagnosed with prostate cancer between 2019 and 2021 and post-diagnostic PETs were identified using full Medicare claims data. PET use was assessed in all newly diagnosed patients, though indications vary by risk. Patients\u2019 counties were categorized as metro, urban, or rural, from most to least urbanized. Regional PET utilization was further examined at the level of hospital referral regions. A multivariable logistic regression model was performed to assess the impact of rurality on PET imaging. A secondary analysis included an interaction term for race to explore the effect of residence on PET imaging by racial group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Overall, 495 865 patients were included in the analysis: 393 861 (79.4%) lived in metro, 56 698 (11.4%) in urban and 39 707 (8.0%) in rural counties. Patients in metro counties underwent PET imaging more often (8.4%) than patients in urban (7.3%) or rural counties (7.2%), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001. At a level of hospital referral region, PET utilization rates ranged from 2.2 to 20.8%. PET imaging was more commonly performed in White compared to Black or Hispanic patients. Rural patients were less likely to undergo PET imaging compared to metro patients (odds ratio [OR] 0.87, 95% Confidence interval [CI]: 0.82\u20130.92 <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Rural Black (OR 0.69, 95%CI 0.57\u20130.83, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and rural White patients (OR 0.89, 95%CI 0.83\u20130.94 <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) were less likely to obtain PET imaging compared to their metro counterparts, p-interaction\u2009&lt;\u20090.0001.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Rural patients were less likely to undergo PET imaging than metro patients. The effect of rurality was most pronounced among Black patients. Our findings underscore the need for strategies to support equitable use of PET imaging.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s40644-025-00898-6","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T09:29:48Z","timestamp":1751621388000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Geographic variability in contemporary utilization of PET imaging for prostate cancer: a medicare claims cohort study"],"prefix":"10.1186","volume":"25","author":[{"given":"Stephan M.","family":"Korn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyu","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Zurl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara K.","family":"Pohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Stelzl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Dagnino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Lipsitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Kibel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry L.","family":"Kilbridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy","family":"Loeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hebert Alberto","family":"Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quoc-Dien","family":"Trinh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander P.","family":"Cole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"issue":"1","key":"898_CR1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1038\/s41391-018-0083-4","volume":"22","author":"MJ Krimphove","year":"2019","unstructured":"Krimphove MJ, Cole AP, Fletcher SA, Harmouch SS, Berg S, Lipsitz SR, et al. Evaluation of the contribution of demographics, access to health care, treatment, and tumor characteristics to Racial differences in survival of advanced prostate cancer. Prostate Cancer Prostatic Dis. 2019;22(1):125\u201336.","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"898_CR2","doi-asserted-by":"crossref","unstructured":"Shen X, Kane K, Katz AJ, Usinger D, Cao Y, Chen RC. Differences in rural versus urban patients with prostate Cancer in diagnosis and treatment: an analysis of a Population-Based cohort. JCO Oncol Pract. 2024;OP2300547.","DOI":"10.1200\/OP.23.00547"},{"key":"898_CR3","doi-asserted-by":"crossref","unstructured":"Fletcher SA, Marchese M, Cole AP, Mahal BA, Friedlander DF, Krimphove M et al. Geographic Distribution of Racial Differences in Prostate Cancer Mortality. JAMA Netw Open. 2020 [cited 2025 May 31];3(3):E201839. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/32232449\/","DOI":"10.1001\/jamanetworkopen.2020.1839"},{"key":"898_CR4","doi-asserted-by":"crossref","unstructured":"Lewis-Thames MW, Langston ME, Khan S, Han Y, Fuzzell L, Xu S et al. Racial and Ethnic Differences in Rural-Urban Trends in 5-Year Survival of Patients with Lung, Prostate, Breast, and Colorectal Cancers: 1975\u20132011 Surveillance, Epidemiology, and End Results (SEER). JAMA Netw Open. 2022 [cited 2025 May 31];5(5):E2212246. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35587350\/","DOI":"10.1001\/jamanetworkopen.2022.12246"},{"key":"898_CR5","doi-asserted-by":"crossref","unstructured":"Qian Z, Chen YJ, Feldman J, Beatrici E, Filipas DK, Moore CM et al. Prostate magnetic resonance imaging utilization and its relationship with advanced prostate cancer detection. Urol Oncol. 2024 [cited 2024 Oct 15];42(11):370.e1-370.e7. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/39013714\/","DOI":"10.1016\/j.urolonc.2024.05.009"},{"issue":"4","key":"898_CR6","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1016\/j.euf.2021.08.013","volume":"8","author":"C Manfredi","year":"2022","unstructured":"Manfredi C, Fern\u00e1ndez-Pascual E, Arcaniolo D, Emberton M, Sanchez-Salas R, Artigas Guix C, et al. The role of prostate-specific membrane antigen positron emission tomography\/magnetic resonance imaging in primary and recurrent prostate cancer: A systematic review of the literature. Eur Urol Focus. 2022;8(4):942\u201357.","journal-title":"Eur Urol Focus"},{"key":"898_CR7","doi-asserted-by":"publisher","unstructured":"Mattana F, Muraglia L, Rajwa P, Zattoni F, Marra G, Chiu PKF et al. Metastatic Sites\u2019 Location and Impact on Patient Management After the Introduction of Prostate-specific Membrane Antigen Positron Emission Tomography in Newly Diagnosed and Biochemically Recurrent Prostate Cancer: A Critical Review. Eur Urol Oncol. 2023;6(2):128\u201336. Available from: https:\/\/doi.org\/10.1016\/j.euo.2023.01.014","DOI":"10.1016\/j.euo.2023.01.014"},{"issue":"1","key":"898_CR8","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/j.eururo.2023.03.001","volume":"84","author":"KM Chow","year":"2023","unstructured":"Chow KM, So WZ, Lee HJ, Lee A, Yap DWT, Takwoingi Y, et al. Head-to-head comparison of the diagnostic accuracy of prostate-specific membrane antigen positron emission tomography and conventional imaging modalities for initial staging of Intermediate- to High-risk prostate cancer: A systematic review and Meta-anal. Eur Urol. 2023;84(1):36\u201348.","journal-title":"Eur Urol"},{"issue":"4","key":"898_CR9","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1097\/MOU.0000000000001103","volume":"33","author":"F Quhal","year":"2023","unstructured":"Quhal F, Bryniarski P, Rivas JG, Gandaglia G, Shariat SF, Rajwa P. Salvage lymphadenectomy after primary therapy with curative intent for prostate cancer. Curr Opin Urol. 2023;33(4):269\u201373.","journal-title":"Curr Opin Urol"},{"issue":"12","key":"898_CR10","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1056\/NEJMoa2107322","volume":"385","author":"O Sartor","year":"2021","unstructured":"Sartor O, de Bono J, Chi KN, Fizazi K, Herrmann K, Rahbar K, et al. Lutetium-177-PSMA-617 for metastatic Castration-Resistant prostate Cancer. N Engl J Med. 2021;385(12):1091\u2013103.","journal-title":"N Engl J Med"},{"key":"898_CR11","doi-asserted-by":"crossref","unstructured":"Weiner AB, Agrawal R, Valle LF, Sonni I, Kishan AU, Rettig MB et al. Impact of PSMA PET on Prostate Cancer Management. Curr Treat Options Oncol. 2024 [cited 2024 Nov 12];25(2):191\u2013205. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/38270802\/","DOI":"10.1007\/s11864-024-01181-9"},{"key":"898_CR12","doi-asserted-by":"publisher","unstructured":"Subramanian K, Martinez J, Castellanos SH, Ivanidze J, Nagar H, Nicholson S et al. Complex implementation factors demonstrated when evaluating cost-effectiveness and monitoring racial disparities associated with [18F]DCFPyL PET\/CT in prostate cancer men. Sci Rep. 2023;13(1):1\u201310. Available from: https:\/\/doi.org\/10.1038\/s41598-023-35567-w","DOI":"10.1038\/s41598-023-35567-w"},{"issue":"5","key":"898_CR13","doi-asserted-by":"publisher","first-page":"695","DOI":"10.2967\/jnumed.120.251751","volume":"62","author":"MD Bucknor","year":"2021","unstructured":"Bucknor MD, Lichtensztajn DY, Lin TK, Borno HT, Gomez SL, Hope TA. Disparities in PET imaging for prostate Cancer at a tertiary academic medical center. J Nucl Med. 2021;62(5):695\u20139.","journal-title":"J Nucl Med"},{"key":"898_CR14","unstructured":"Dartmouth Atlas Data. [cited 2024 Jul 31]. Available from: https:\/\/data.dartmouthatlas.org\/supplemental\/#crosswalks"},{"key":"898_CR15","doi-asserted-by":"crossref","unstructured":"Bronner KK, Goodman DC. The Dartmouth Atlas of Health Care - bringing health care analyses to health systems, policymakers, and the public. Research in health services & regions. 2022 [cited 2024 Nov 24];1(1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/39177806\/","DOI":"10.1007\/s43999-022-00006-2"},{"key":"898_CR16","unstructured":"U.S. Department of Agriculture, Economic Research Service. Rural-Urban Continuum Codes. January 2024. Available from: https:\/\/www.ers.usda.gov\/data-products\/rural-urban-continuum-codes\/documentation\/#referencedate"},{"key":"898_CR17","doi-asserted-by":"crossref","unstructured":"Rahman M, White EM, Thomas KS, Jutkowitz E. Assessment of Rural-Urban Differences in Health Care Use and Survival Among Medicare Beneficiaries With Alzheimer Disease and Related Dementia. JAMA Netw Open. 2020 [cited 2024 Sep 23];3(10). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33090226\/","DOI":"10.1001\/jamanetworkopen.2020.22111"},{"issue":"22","key":"898_CR18","doi-asserted-by":"publisher","first-page":"4020","DOI":"10.1002\/cncr.28313","volume":"119","author":"Z Wang","year":"2013","unstructured":"Wang Z, Goodman M, Saba N, El-Rayes BF. Incidence and prognosis of gastroesophageal cancer in rural, urban, and metropolitan areas of the united States. Cancer. 2013;119(22):4020\u20137.","journal-title":"Cancer"},{"key":"898_CR19","doi-asserted-by":"crossref","unstructured":"Feyereisen SL, Puro N, McConnell W. Addressing Provider Shortages in Rural America: The Role of State Opt-Out Policy Adoptions in Promoting Hospital Anesthesia Provision. Journal of Rural Health. 2021 [cited 2025 Jun 1];37(4):684\u201391. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/32613667\/","DOI":"10.1111\/jrh.12487"},{"key":"898_CR20","doi-asserted-by":"crossref","unstructured":"Petermann V, Zahnd WE, Vanderpool RC, Eberth JM, Rohweder C, Teal R et al. How cancer programs identify and address the financial burdens of rural cancer patients. Supportive Care in Cancer. 2022 [cited 2025 Jun 1];30(3):2047\u201358. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34655327\/","DOI":"10.1007\/s00520-021-06577-z"},{"key":"898_CR21","doi-asserted-by":"crossref","unstructured":"Zuniga SA, Lango MN. Effect of rural and urban geography on larynx cancer incidence and survival. Laryngoscope. 2018 [cited 2025 Jun 4];128(8):1874\u201380. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29238975\/","DOI":"10.1002\/lary.27042"},{"key":"898_CR22","doi-asserted-by":"crossref","unstructured":"Joseph LJ, Goodman M, Higgins K, Pilai R, Ramalingam SS, Magliocca K et al. Racial disparities in squamous cell carcinoma of the oral tongue among women: A SEER data analysis. Oral Oncol. 2015 [cited 2025 Jun 4];51(6):586\u201392. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/25865553\/","DOI":"10.1016\/j.oraloncology.2015.03.010"},{"issue":"1","key":"898_CR23","doi-asserted-by":"publisher","first-page":"270","DOI":"10.2307\/2533218","volume":"50","author":"SR Lipsitz","year":"1994","unstructured":"Lipsitz SR, Fitzmaurice GM, Orav EJ, Laird NM. Performance of generalized estimating equations in practical situations. Biometrics. 1994;50(1):270\u20138.","journal-title":"Biometrics"},{"issue":"8","key":"898_CR24","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.2105\/AJPH.2016.303212","volume":"106","author":"JT Caldwell","year":"2016","unstructured":"Caldwell JT, Ford CL, Wallace SP, Wang MC, Takahashi LM. Intersection of living in a rural versus urban area and race\/ethnicity in explaining access to health care in the united States. Am J Public Health. 2016;106(8):1463\u20139.","journal-title":"Am J Public Health"},{"issue":"9","key":"898_CR25","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.2105\/AJPH.2020.305703","volume":"110","author":"JC Probst","year":"2020","unstructured":"Probst JC, Zahnd WE, Hung P, Eberth JM, Crouch EL, Merrell MA. Rural-Urban mortality disparities: variations across causes of death and race\/ethnicity, 2013\u20132017. Am J Public Health. 2020;110(9):1325\u20137.","journal-title":"Am J Public Health"},{"key":"898_CR26","doi-asserted-by":"crossref","unstructured":"Dasgupta P, Baade PD, Aitken JF, Ralph N, Chambers SK, Dunn J. Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence. Vol. 9, Frontiers in oncology. Switzerland; 2019;238.","DOI":"10.3389\/fonc.2019.00238"},{"issue":"3","key":"898_CR27","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1097\/JU.0000000000002736","volume":"208","author":"AP Cole","year":"2022","unstructured":"Cole AP, Chen X, Langbein BJ, Giganti F, Kasivisvanathan V, Emberton M, et al. Geographic variability, time trends and association of preoperative magnetic resonance imaging with surgical outcomes for elderly united States men with prostate cancer: A surveillance, epidemiology, and end Results-Medicare analysis. J Urol. 2022;208(3):609\u201317.","journal-title":"J Urol"},{"key":"898_CR28","doi-asserted-by":"crossref","unstructured":"El Khoury CJ, Freedland SJ, Gandhi K, Keith SW, Nikita N, Shaver A et al. Disparities in the utilization of magnetic resonance imaging for prostate cancer detection: a population-based study. J Natl Cancer Inst. 2025 [cited 2025 Jun 4];117(2):270\u20138. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/39312683\/","DOI":"10.1093\/jnci\/djae234"},{"key":"898_CR29","doi-asserted-by":"publisher","unstructured":"Hanna TN, Steenburg SD, Rosenkrantz AB, Pyatt RS, Duszak R, Friedberg EB. Emerging Challenges and Opportunities in the Evolution of Teleradiology. American Journal of Roentgenology. 2020 [cited 2025 Jun 4];215(6):1411\u20136. Available from: https:\/\/www.ajronline.org\/doi\/pdf\/https:\/\/doi.org\/10.2214\/AJR.20.23007?download=true","DOI":"10.2214\/AJR.20.23007?download=true"},{"key":"898_CR30","doi-asserted-by":"crossref","unstructured":"Nass SJ, Cogle CR, Brink JA, Langlotz CP, Balogh EP, Muellner A et al. Improving cancer diagnosis and care: Patient access to oncologic imaging expertise. Journal of Clinical Oncology. 2019 [cited 2025 Jun 4];37(20):1690\u20134. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/31050908\/","DOI":"10.1200\/JCO.18.01970"},{"key":"898_CR31","doi-asserted-by":"crossref","unstructured":"Pham R, Constantinou N, Plecha D. Utilizing the hub-and-spoke model to deliver quality breast imaging in a large health system. J Breast Imaging. 2019 [cited 2025 Jun 4];1(1):51\u20135. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/38424877\/","DOI":"10.1093\/jbi\/wby010"},{"key":"898_CR32","doi-asserted-by":"crossref","unstructured":"Elrod JK, Fortenberry JL. The hub-and-spoke organization design: An avenue for serving patients well. BMC Health Serv Res. 2017 [cited 2025 Jun 4];17(Suppl 1). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/28722550\/","DOI":"10.1186\/s12913-017-2341-x"},{"key":"898_CR33","doi-asserted-by":"crossref","unstructured":"Moreno A, Schwamm LH, Siddiqui KA, Viswanathan A, Whitney C, Rost N et al. Frequent Hub-Spoke Contact Is Associated with Improved Spoke Hospital Performance: Results from the Massachusetts General Hospital Telestroke Network. Telemedicine and e-Health. 2018 [cited 2025 Jun 4];24(9):678\u201383. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29271703\/","DOI":"10.1089\/tmj.2017.0252"},{"key":"898_CR34","doi-asserted-by":"crossref","unstructured":"Hansen NL, Koo BC, Gallagher FA, Warren AY, Doble A, Gnanapragasam V et al. Comparison of initial and tertiary centre second opinion reads of multiparametric magnetic resonance imaging of the prostate prior to repeat biopsy. Eur Radiol. 2017 [cited 2025 Jun 4];27(6):2259\u201366. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27778089\/","DOI":"10.1007\/s00330-016-4635-5"},{"key":"898_CR35","doi-asserted-by":"crossref","unstructured":"Okon NJ, Fogle CC, McNamara MJ, Oser CS, Dietrich DW, Gohdes D et al. Statewide efforts to narrow the rural-urban gap in acute stroke care. Am J Prev Med. 2010 [cited 2025 Jun 4];39(4):329\u201333. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/20837283\/","DOI":"10.1016\/j.amepre.2010.05.019"},{"key":"898_CR36","doi-asserted-by":"crossref","unstructured":"Hunter TB, Krupinski EA. University-based teleradiology in the united states. Healthcare (Switzerland). 2014 [cited 2025 Jun 4];2(2):192\u2013206. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/27429270\/","DOI":"10.3390\/healthcare2020192"},{"key":"898_CR37","doi-asserted-by":"crossref","unstructured":"Rosenkrantz AB, Hanna TN, Steenburg SD, Tarrant MJ, Pyatt RS, Friedberg EB. The Current State of Teleradiology Across the United States: A National Survey of Radiologists\u2019 Habits, Attitudes, and Perceptions on Teleradiology Practice. Journal of the American College of Radiology. 2019 [cited 2025 Jun 4];16(12):1677\u201387. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/31271736\/","DOI":"10.1016\/j.jacr.2019.05.053"},{"key":"898_CR38","doi-asserted-by":"crossref","unstructured":"Illemann NM, Illemann TM. Mobile imaging trailers: A scoping review of CT and MRI modalities. Radiography. 2024 [cited 2025 Jun 4];30(2):431\u20139. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/38199159\/","DOI":"10.1016\/j.radi.2023.12.008"},{"key":"898_CR39","doi-asserted-by":"crossref","unstructured":"Al-Naser Y, Alshadeedi F. Bringing imaging to the people: Enhancing access and equity in healthcare through mobile imaging. J Med Imaging Radiat Sci. 2024 [cited 2025 Jun 4];55(4). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/39047372\/","DOI":"10.1016\/j.jmir.2024.101715"},{"key":"898_CR40","doi-asserted-by":"crossref","unstructured":"Fontenoy AM, Langlois A, Chang SL, Daigle JM, Pelletier \u00c9, Guertin MH et al. Contribution and performance of mobile units in an organized mammography screening program. Canadian Journal of Public Health. 2013 [cited 2025 Jun 4];104(3). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/23823881\/","DOI":"10.17269\/cjph.104.3810"},{"key":"898_CR41","doi-asserted-by":"crossref","unstructured":"Swami N, Baez YA, Franco I, Nguyen T, Meiyappan K, Ton M et al. Localized prostate cancer disparities in risk group at presentation and access to treatment for Hispanic men. Prostate Cancer Prostatic Dis. 2023 [cited 2024 Oct 6];26(2):309\u201316. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35306541\/","DOI":"10.1038\/s41391-022-00526-5"},{"key":"898_CR42","doi-asserted-by":"crossref","unstructured":"Hougen HY, Swami N, Dee EC, Alshalalfa M, Meiyappan K, Florez N et al. Disparities in Diagnosis, Treatment Access, and Time to Treatment Among Hispanic Men With Metastatic Prostate Cancer. JCO Oncol Pract. 2023 [cited 2024 Nov 15];19(8):645\u201353. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/37262399\/","DOI":"10.1200\/OP.23.00040"},{"key":"898_CR43","doi-asserted-by":"crossref","unstructured":"Mahal BA, Chen YW, Muralidhar V, Mahal AR, Choueiri TK, Hoffman KE et al. Racial disparities in prostate cancer outcome among prostate-specific antigen screening eligible populations in the United States. Ann Oncol. 2017 [cited 2024 Nov 15];28(5):1098\u2013104. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/28453693\/","DOI":"10.1093\/annonc\/mdx041"},{"issue":"11","key":"898_CR44","doi-asserted-by":"publisher","first-page":"e2132388","DOI":"10.1001\/jamanetworkopen.2021.32388","volume":"4","author":"N Abashidze","year":"2021","unstructured":"Abashidze N, Stecher C, Rosenkrantz AB, Duszak RJ, Hughes DR. Racial and ethnic disparities in the use of prostate magnetic resonance imaging following an elevated prostate-Specific antigen test. JAMA Netw Open. 2021;4(11):e2132388.","journal-title":"JAMA Netw Open"},{"key":"898_CR45","doi-asserted-by":"crossref","unstructured":"Leapman MS, Dinan M, Pasha S, Long J, Washington SL, Ma X et al. Mediators of Racial Disparity in the Use of Prostate Magnetic Resonance Imaging among Patients with Prostate Cancer. JAMA Oncol. 2022 [cited 2025 Jun 4];8(5):687\u201396. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35238879\/","DOI":"10.1001\/jamaoncol.2021.8116"},{"key":"898_CR46","doi-asserted-by":"crossref","unstructured":"Bhatia S, Landier W, Paskett ED, Peters KB, Merrill JK, Phillips J et al. Rural-Urban Disparities in Cancer Outcomes: Opportunities for Future Research. J Natl Cancer Inst. 2022 [cited 2024 Oct 6];114(7):940\u201352. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/35148389\/","DOI":"10.1093\/jnci\/djac030"},{"issue":"3","key":"898_CR47","doi-asserted-by":"publisher","first-page":"140","DOI":"10.6004\/jnccn.2024.0019","volume":"22","author":"EM Schaeffer","year":"2024","unstructured":"Schaeffer EM, Srinivas S, Adra N, An Y, Bitting R, Chapin B, et al. NCCN Guidelines\u00ae insights: prostate cancer, version 3.2024. J Natl Compr Canc Netw. 2024;22(3):140\u201350.","journal-title":"J Natl Compr Canc Netw"},{"key":"898_CR48","doi-asserted-by":"publisher","unstructured":"Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate Cancer-2024 update. Part I: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2024;86(2):148\u201363. https:\/\/doi.org\/10.1016\/j.eururo.2024.03.027","DOI":"10.1016\/j.eururo.2024.03.027"},{"issue":"1","key":"898_CR49","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1038\/s41391-019-0157-y","volume":"23","author":"SA Fletcher","year":"2020","unstructured":"Fletcher SA, von Landenberg N, Cole AP, Gild P, Choueiri TK, Lipsitz SR, et al. Contemporary National trends in prostate cancer risk profile at diagnosis. Prostate Cancer Prostatic Dis. 2020;23(1):81\u20137.","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"898_CR50","doi-asserted-by":"crossref","unstructured":"Surasi DSS, Wang X, Bathala TK, Hwang H, Arora S, Westphalen AC et al. The impact and collateral damage of COVID-19 on prostate MRI and guided biopsy operations: Society of Abdominal Radiology Prostate Cancer Disease-Focused Panel survey analysis. Abdominal Radiology. 2021 [cited 2025 Jun 1];46(9):4362\u20139. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33904992\/","DOI":"10.1007\/s00261-021-03087-8"},{"key":"898_CR51","doi-asserted-by":"crossref","unstructured":"Zattra O, Fraga A, Lu N, Gee MS, Liu RW, Lev MH et al. Trends in cancer imaging by indication, care setting, and hospital type during the COVID-19 pandemic and recovery at four hospitals in Massachusetts. Cancer Med. 2021 [cited 2025 Jun 2];10(18):6327\u201335. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34355873\/","DOI":"10.1002\/cam4.4183"},{"key":"898_CR52","doi-asserted-by":"crossref","unstructured":"Lacson R, Shi J, Kapoor N, Eappen S, Boland GW, Khorasani R. Exacerbation of Inequities in Use of Diagnostic Radiology During the Early Stages of Reopening After COVID-19. Journal of the American College of Radiology. 2021 [cited 2025 Jun 2];18(5):696\u2013703. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33482115\/","DOI":"10.1016\/j.jacr.2020.12.009"},{"key":"898_CR53","doi-asserted-by":"crossref","unstructured":"Adin ME, Uezono H, Isufi E, Pang Y, Zucconi W, Saperstein L et al. Clinical PET\/CT utilization during the COVID-19 pandemic: Initial experience at Yale University. Nucl Med Commun. 2021 [cited 2025 Jun 2];42(11):1277\u201384. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/34049340\/","DOI":"10.1097\/MNM.0000000000001445"},{"key":"898_CR54","doi-asserted-by":"crossref","unstructured":"Angelini M, Teglia F, Astolfi L, Casolari G, Boffetta P. Decrease of cancer diagnosis during COVID-19 pandemic: a systematic review and meta-analysis. Eur J Epidemiol. 2023 [cited 2025 Jun 1];38(1):31\u20138. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/36593334\/","DOI":"10.1007\/s10654-022-00946-6"},{"key":"898_CR55","doi-asserted-by":"crossref","unstructured":"Herb J, Wolff R, McDaniel P, Holmes M, Lund J, Stitzenberg K. Rural representation of the surveillance, epidemiology, and end results database. Cancer Causes Control. 2021 [cited 2024 Nov 19];32(3):211\u201320. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/33392903\/","DOI":"10.1007\/s10552-020-01375-0"},{"key":"898_CR56","doi-asserted-by":"crossref","unstructured":"Nadpara PA, Madhavan SS. Linking Medicare, Medicaid, and cancer registry data to study the burden of cancers in West Virginia. Medicare Medicaid Res Rev. 2012 [cited 2024 Nov 19];2(4). Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/24800152\/","DOI":"10.5600\/mmrr.002.04.A01"},{"key":"898_CR57","doi-asserted-by":"crossref","unstructured":"Zurl H, Qian Z, Stelzl DR, Dagnino F, Korn SM, Labban M et al. Carbon Emissions From Patient Travel for Health Care. JAMA Netw Open. 2025 [cited 2025 Apr 20];8(3):e252513. Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/40163116\/","DOI":"10.1001\/jamanetworkopen.2025.2513"}],"container-title":["Cancer Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40644-025-00898-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40644-025-00898-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40644-025-00898-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T09:29:59Z","timestamp":1751621399000},"score":1,"resource":{"primary":{"URL":"https:\/\/cancerimagingjournal.biomedcentral.com\/articles\/10.1186\/s40644-025-00898-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,4]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["898"],"URL":"https:\/\/doi.org\/10.1186\/s40644-025-00898-6","relation":{},"ISSN":["1470-7330"],"issn-type":[{"value":"1470-7330","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,4]]},"assertion":[{"value":"24 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 July 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":"The study was approved by the Mass General Brigham Institutional Review Board under protocol number 019P000756, adhered to HIPAA compliance requirements, and was performed in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Q-DT reports consulting fees from Astellas, Bayer, Intuitive Surgical, Janssen, Novartis, Pfizer, and research funding from the American Cancer Society, Pfizer Global Medical Grants (Prostate Cancer Disparities #63354905) and funding from Health Disparity Research Award from the Department of Defense Congressionally Directed Medical Research Program (#PC220551). APC reports research funding from the Bruce A Beal and Robert L Beal surgical fellowship of the BWH Department of Surgery, from the Prostate Cancer Foundation and American Cancer Society (#23YOUN25) and from a Physician Research Award from the Department of Defense Congressionally Directed Medical Research Program (#PC220342). SMK reports speaker fees from Janssen, Astellas and research fund from the Max Kade foundation\/Austrian Academy of Science. ASK reports consulting fees from Janssen, Profound, Pfizer, Bristol Myers Squibb, Merck. KLK reports research funding from American Cancer Society, Pfizer Global Medical Grants (Prostate Cancer Disparities #63475209) and funding from Health Disparity Research Award from the Department of Defense Congressionally Directed Medical Research Program (#PC200248). SFS reports receiving honoraria from Astellas, AstraZeneca, BMS, Ferring, Ipsen, Janssen, MSD, Olympus, Pfizer, Roche, and Takeda; having a consulting or advisory role in Astellas, AstraZeneca, BMS, Ferring, Ipsen, Janssen, MSD, Olympus, Pfizer, Pierre Fabre, Roche, and Takeda; and being in the speakers\u2019 bureau of Astellas, Astra Zeneca, Bayer, BMS, Ferring, Ipsen, Janssen, MSD, Olympus, Pfizer, Richard Wolf, Roche, and Takeda. SL reports consulting with Astellas, Savor Health, Blue Earth, Endo Pharmaceuticals, and Doceree, unrelated to the current manuscript, and research funding from the Prostate Cancer Foundation, National Cancer Institute, Centers for Disease Control, Department of Defense, and Endo Phamaceuticals.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"During the preparation of this work the authors used DeepL and GPT 4.0 Open AI for language editing of the manuscript. However, the content and analysis presented were independently generated and did not involve the use of any AI model.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration of generative AI"}}],"article-number":"86"}}