PSMA-RADS v2.0 beats BUMP score for focal bone lesions on PSMA-1007 PET/CT in prostate cancer, a multicenter evaluation

Prostate-specific membrane antigen (PSMA) PET/CT: PSMA Reporting and Data System v2.0 outperformed bone uptake metastatic probability (BUMP) for focal bone uptake (sensitivity 98% vs 74%; specificity 96% vs 80%). BUMP AUROC 0.812 (95% CI 0.636-0.931) in 130 patients/412 lesions.

• In 44 equivocal PSMA-RADS Score 3 lesions, BUMP discrimination fell to AUROC 0.61 (95% CI 0.457-0.781), indicating limited added value.
• BUMP optimal threshold was 0.134 with an F1 score of 0.800.

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