Akademik Veri Yönetim Sistemi
CLINICAL AND TRANSLATIONAL IMAGING, 2026 (SCI-Expanded, Scopus)
Purpose The aim of this study is to explore the association between baseline [F-18]fluorodeoxyglucose positron emission tomography/computed tomography ([F-18]FDG PET/CT)-derived metabolic parameters and blood-based systemic inflammatory indices in a real-world breast cancer (BC) cohort and to evaluate their associations with overall survival (OS). Methods Our single-centre retrospective cohort study included 247 BC patients who underwent pre-treatment baseline [& sup1;F-8]FDG PET/CT imaging. PET-derived metabolic parameters, including lean body mass-normalised peak uptake (SULpeak) and background-normalised bone marrow activity (bone marrow-to-liver ratio; BLRmean), were evaluated alongside systemic inflammatory indices derived from complete blood counts (CBC), namely the systemic immune-inflammation index (SII) and the pan-immune-inflammation value (PIV). OS was the sole study endpoint. To reduce clinical heterogeneity, analyses were stratified by disease stage and performed separately in Non-metastatic (Non-met) (stage I-IIIC) and metastatic (MET) (stage IV) cohorts. We fitted prespecified Cox proportional hazards models with all continuous predictors z-standardised, and hazard ratios were expressed per 1-standard deviation increase. Model performance was evaluated at clinically relevant time points of 12, 36, and 60 months. Results In prespecified Cox proportional hazards models, age and BLRmean were associated with OS. The addition of PET-derived or systemic inflammatory metrics provided limited incremental discrimination. Discriminative performance was higher at earlier follow-up intervals and declined at longer time horizons. Findings in the MET cohort showed similar directional patterns, although with reduced precision. Conclusions In this real-world BC cohort, stage-stratified analyses indicate that age and background-normalised bone marrow metabolic activity provide modest but consistent prognostic information for OS across prespecified models, particularly in Non-met disease. The incremental prognostic value of systemic inflammatory indices and tumour uptake metrics was limited.