ArticleEuropean journal of nuclear medicine and molecular imaging2026
Whole-brain metabolic activity on pretreatment [18 F]FDG PET/CT provides prognostic information beyond metabolic tumour burden in patients with breast cancer.
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo 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.
methodsThis 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.
resultsComplete-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 × 10⁻¹⁰).
conclusionPretreatment 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.
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