Baseline [¹⁸F]FDG PET/CT metrics and systemic inflammatory indices in relation to overall survival in a real-world breast cancer cohort
Clinical and Translational Imaging, cilt.14, sa.4, ss.339-352, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 4
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s40336-026-00767-7
- Dergi Adı: Clinical and Translational Imaging
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, EMBASE, Health Research Premium Collection (ProQuest), Technology Collection (ProQuest)
- Sayfa Sayıları: ss.339-352
- Anahtar Kelimeler: [18F]FDG PET/CT, Systemic immune-inflammation index, Pan immune-inflammation value, Breast cancer
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: The aim of this study is to explore the association between baseline [18F]fluorodeoxyglucose positron emission tomography/computed tomography ([18F]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 [¹⁸F]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.