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                                Summarizing discussion multisystem) setting. To this end, the benefit of using post-acquisition feature harmonization algorithms should be evaluated (35). Clinical application From a scientific standpoint, validation of quantitative biomarkers in terms of accuracy and precision is of the utmost importance. However, the ultimate goal of such validation is to define and/or improve the clinical benefit of quantitative PET analysis. The latter is an important aspect that is not often taken into consideration in validation studies. Simply stated: will patients benefit from our validation efforts? To arrive at an answer to this question is complex and not straightforward, as most technical validation studies do not (or cannot) make use of clinical endpoints. The clinical benefit of partial-volume correction thus far At writing of this thesis, many quantitative oncological PET studies with clinical endpoints have been performed over several decades. Therefore, in Chapter 7 we aimed to review the body of literature for PET studies with clinical endpoints that evaluated the benefit of PVC (36). To avoid narrative and potentially biased summarization of the literature, we performed a systematic review with a meta- analysis that was not restricted to cancer type. The first striking finding was that only 31 studies were eligible for inclusion, from which several studies were performed by the same groups. In almost all of the investigated studies, PVC did not change the final conclusions on the clinical value of quantitative PET. A critical note was that the PVC methodology was often confined to a recovery coefficient method, which is the most basic method for PVC (37). Indeed, it might be expected that such methods do not benefit clinical predictions or diagnoses. We elaborately discussed the reviewed studies and provided our recommendations for future use of PVC towards a clinical benefit. To summarize, we recommended that i) more sophisticated and better validated PVC methods should be used, and that ii) there should be a consensus amongst investigators regarding the preferred methodologies, and iii) in future studies partial-volume corrected data should be used in parallel to uncorrected data. Quantification does not add to visual reads in oligometastatic prostate cancer Oligometastatic prostate cancer has become a newly recognized clinical entity, both at diagnosis (synchronous) and at biochemical recurrence (metachronous) 11   213    


































































































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