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Absolute BSI changes and dichotomized BSI correlated to prostate-specific antigen responses (both P0.001) but not to clinical responses. Absolute changes in BSI and BSI response classification correlated significantly with standardized clinical response criteria for the assessment of treatment responses of skeletal metastases in prostate cancer. Absolute changes in BSI and BSI response classification correlated significantly with standardized clinical response criteria for the assessment of treatment responses of skeletal metastase