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Article History

Received: 21 September 2025

Accepted: 5 November 2025

First Online: 25 November 2025

Declarations

:

: KMP was supported by the Clinician Scientist Program of the University Medicine Essen Clinician Scientist Academy (UMEA; Faculty of Medicine and Deutsche Forschungsgemeinschaft [DFG]); consulting fees: Novartis, GE Healthcare; travel fees: Novartis, IPSEN; research funding: Bayer; membership of the ESHI MT (European Society for Hybrid, Molecular and Translational Imaging) Research Committee; all outside the submitted work. AH: membership of the ESHI MT  (European Society for Hybrid, Molecular and Translational Imaging) Research Committee; all outside the submitted work. TB: travel fees: PARI GmbH; all outside the submitted work KH: personal fees: Bayer, SOFIE Bioscience, SIRTEX, Adacap, Curium, Endocyte, IPSEN, Siemens Healthineers, GE Healthcare, Amgen, Novartis, ymabs, Aktis, Oncology, Pharma15; non-financial support: ABX; grants/personal fees: BTG; all outside the submitted work. DK reports speaker honoraria from Pfizer and Novartis, a research grant from Pfizer, and funding by the German Research Foundation (DFG, KE2933/1-1); all outside the submitted work. CK: Research Funding: Novartis, Amgen, Mariana Oncology; Honoraria: Novartis, Pfizer; Travel support: Pfizer, Bayer, Amgen; all outside the submitted work. BAH: Grants: DFG, Novartis, BMS, Janssen, Amgen; Royalties or licences: Uromed; consultant: Janssen, Bayer, Novartis, BMS, ABX, Merck, Onkowissen, Accord Healthcare, AstraZeneca, MSD/Pfizer, Amgen, Astellas, Lightpoint medical, Point Biopharma, Ipsen, Telix; Honoraria: Janssen, Amgen, Astellas, Monrol, Novartis; Travel fees: Janssen, AstraZeneca, Bayer, BMS, Ipsen, Amgen, Participation on a Data Safety Monitoring Board or Advisory Board: Janssen, ABX, Telix; Leadership or fiduciary role in societies: DGU; all outside the submitted work. RAW: speaker honoraria from Novartis/AAA and PentixaPharm, advisory board work for Novartis/AAA and Bayer; outside the submitted work. WPF: fees from SOFIE Bioscience (research funding), Janssen (consultant, speaker), Perceptive (consultant, image review), Bayer (consultant, speaker, research funding), Novartis (speaker, consultant), Telix (speaker), GE Healthcare (speaker, consultant), Eczacıbaşı Monrol (speaker), Abx (speaker), Amgen (speaker), Urotrials (speaker), Lilly (consultant), AstraZeneca (research funding); all outside the submitted work. LMU: funding: Bayerisches Zentrum für Krebsforschung (BZKF) and from the Munich Clinician Scientist Program (MCSP). She reports fees from Novartis (speaker), Telix (consultant) and Astellas Pharma Inc. (speaker); chair of the ESHI MT  (European Society for Hybrid, Molecular and Translational Imaging) Research Committee; all outside of the submitted work. All other authors declare no conflict of interest.

: This analysis was conducted in accordance with the Declaration of Helsinki and its subsequent amendments and approved by the respective institutional ethics committees at LMU University Hospital Munich (IRB 24–0255) and University Hospital Essen (20-9485-BO/20-9777-BO).

: Informed consent was obtained from all individual participants included in the study.

: The authors affirm that human research participants provided informed consent for publication of the images in Figs.  , , and and Suppl. Figure  .