Whole-brain metabolic activity on pretreatment [18 F]FDG PET/CT provides prognostic information beyond metabolic tumour burden in patients with breast cancer
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00259-026-08046-3
- Dergi Adı: EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, CINAHL, Compendex, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest), Technology Collection (ProQuest)
- İstanbul Üniversitesi Adresli: Evet
Özet
Purpose To investigate whether whole-brain (WB) metabolic activity measured on pretreatment [18 F]FDG PET/CT provides prognostic information beyond global metabolic tumour burden in patients with breast cancer. Methods This single-centre retrospective cohort included 358 patients with biopsy-confirmed breast cancer who underwent pretreatment [18 F]FDG PET/CT for staging. WB SUVmean, WB SULmean, and total metabolic tumour volume (TMTV) were measured using a semi-automated PET/CT analysis workflow. The primary endpoint was overall survival (OS). Sequential Cox models evaluated the incremental prognostic value of WB SUVmean beyond clinical variables and TMTV; WB SULmean was assessed in sensitivity analysis. Results Complete-case data were available for 354 patients. In univariable analysis, higher TMTV was associated with worse OS (HR 1.167 per 100 mL; P < 0.001), whereas higher WB SUVmean (HR 0.785; P < 0.001) and WB SULmean (HR 0.733; P < 0.001) were associated with better OS. After adjustment for age, body mass index, disease extent, fasting glucose, and TMTV, WB SUVmean remained independently associated with OS (HR 0.810, 95% CI 0.679-0.967; P = 0.019), while TMTV retained prognostic value (HR 1.104, 95% CI 1.053-1.157; P < 0.001). WB SULmean showed similar results in sensitivity analysis (HR 0.764, 95% CI 0.586-0.997; P = 0.047). Combined TMTV/WB SUVmean stratification identified three prognostic groups (global log-rank P = 2.14 & times; 10(-10)). Conclusion Pretreatment WB metabolic activity provides prognostic information beyond global metabolic tumour burden in breast cancer and may represent a complementary host-related prognostic signal, although the underlying biological mechanisms require further validation.