{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T10:00:18Z","timestamp":1780999218647,"version":"3.54.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006416","name":"Universidade Estadual De Campinas","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006416","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>[\u00b9\u2078F]FDG PET\/CT has been widely used in oncology for diagnosis and treatment monitoring. Reduced cerebral [\u00b9\u2078F]FDG uptake has been observed in patients with disseminated malignancies, potentially associated with the Warburg effect and elevated lactate levels. This study investigated the prognostic relevance of the brain-to-liver [\u00b9\u2078F]FDG uptake ratio (BLR) in MM patients who underwent PET\/CT at diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>BLR was calculated as the ratio between the mean standardized uptake value (SUV) of the whole brain and that of the liver. A total of 72 patients were retrospectively included in the study (58% male; median age 65 years (IQR55;70); 67% were classified as ISS stage III).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      BLR, as a continuous variable, showed a statistically significant difference between groups according to sex (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), overweight status (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), and ISS stage (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), and was negatively correlated with \u03b2\u2082-microglobulin (\n                      <jats:italic>r<\/jats:italic>\n                      = \u2212\u20090.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). With a median follow-up of 23 months (IQR 8; 65), 74% patients had died from MM-related causes. Patients with BLR\u2009&gt;\u20092.7 demonstrated superior 60-month overall survival (52%vs.10%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and progression-free survival (19%vs.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), respectively. Multivariate Cox regression confirmed BLR (HR 1.86 95%CI: 1.03\u20133.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038 (OS); HR 1.93 95%CI: 1.13\u20133.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016 (PFS))as an independent factor and the use of autologous hematopoietic cell transplantation (HCT) as consolidation for both OS and PFS. In addition, ISS stage III was also a prognostic factor for OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher brain-to-liver [\u00b9\u2078F]FDG uptake ratio (&gt;\u20092.7) at diagnosis predicts better clinical outcomes in multiple myeloma. BLR is significantly associated with established clinical markers of tumor burden in multiple myeloma. These findings suggest that BLR is a feasible and reproducible metric with potential prognostic value in multiple myeloma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07844-z","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:21:46Z","timestamp":1774052506000},"page":"5033-5041","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic brain-to-liver [18f]fdg uptake ratio predicts survival in multiple myeloma: A retrospective study"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3680-6642","authenticated-orcid":false,"given":"Maria Emilia S.","family":"Takahashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9755-5506","authenticated-orcid":false,"given":"Tiago P.","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0266-610X","authenticated-orcid":false,"given":"Christopher","family":"Cralcev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7177-7664","authenticated-orcid":false,"given":"Eliana","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6956-3701","authenticated-orcid":false,"given":"Marcos Paulo D. 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Approval was granted by the Ethics Committee of Universidade Estadual de Campinas (CAAE 97966618.5.0000.5404).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}