{
  "abstract": "Purpose: Triple negative breast cancer (TNBC) is an aggressive subtype, still with limited therapeutic options. [18F]FDG PET/CT is widely used in TNBC, but evidence regarding its prognostic value remains limited. The TRINE PET study, promoted by the Italian Association of Nuclear Medicine, aimed to evaluate the prognostic relevance and clinical impact of [18F]FDG PET/CT in a large real world TNBC cohort.\n\nMethods: This retrospective multicenter study included 389 TNBC patients who underwent 707 [18F]FDG PET/CT scans across 23 Italian Nuclear Medicine Units. Clinical settings were baseline staging (n = 257 patients), post neoadjuvant chemotherapy (n = 111 patients), suspected recurrence (n = 144 patients), and advanced metastatic disease (n = 195 patients). Progression free survival (PFS) and overall survival (OS) were assessed using Kaplan–Meier and Cox regression analyses. The influence of [18F]FDG PET/CT on clinical management was evaluated across all settings.\n\nResults: During a median follow up of 34 months (1–124), disease progression and death occurred in 39.3% and 28.4% of cases, respectively. Across all clinical settings, nodal and distant metastatic involvement at [18F]FDG PET/CT was strongly associated with worse PFS and OS (all p < 0.001). In multivariate analysis, distant metastases at [18F]FDG PET/CT resulted the strongest independent predictor of OS (HR 9.42, 95% CI 3.74–23.75) and PFS (HR 6.57, 95% CI 3.05–14.12), while Ki67 and [18F]FDG uptake at primary tumor did not. [18F]FDG PET/CT findings led to a change in clinical management in 20.8% of all scans, with the highest impact in the advanced metastatic setting (34.9%).\n\nConclusion: In the largest real world multicenter study dedicated to TNBC, [18F]FDG PET/CT demonstrated robust prognostic value across all disease settings. PET detected metastatic involvement emerged as the most powerful predictor of survival; moreover, [18F]FDG PET/CT influenced therapeutic decision in all settings of disease, reaching one in three scans in the advanced metastatic disease. These findings support the systematic integration of [18F]FDG PET/CT into the diagnostic pathways of TNBC.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00259-026-08056-1.",
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  "affiliations": [
    "Department of Translational Medicine, University of Ferrara, Via Aldo Moro N.8, Ferrara, Italy",
    "Nuclear Medicine Unit, Onco-Hematology Department, University Hospital of Ferrara, Ferrara, Italy",
    "Nuclear Medicine Unit, Oncology and Hematology Department, University Hospital of Modena, Modena, Italy",
    "Nuclear Medicine, University of Brescia, Brescia, Italy",
    "Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy",
    "Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy",
    "Nuclear Medicine Unit, Humanitas Gavazzeni, Bergamo, Italy",
    "Nuclear Medicine Unit, Diagnostic Imaging and Radiation Oncology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy",
    "Section of Nuclear Medicine, Department of Radiological Sciences and Haematology, Università Cattolica del Sacro Cuore, Rome, Italy",
    "Nuclear Medicine “Alessandra Bono”, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy",
    "Nuclear Medicine Department, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori “Dino Amadori” (IRST), Meldola, Italy",
    "Nuclear Medicine Service, ‘M. Bufalini’ Hospital, ‘Azienda Unità Sanitaria Locale’ Romagna, Cesena, Italy",
    "Nuclear Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy",
    "Nuclear Medicine Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy",
    "IRCCS Azienda Ospedaliera Metropolitana, Genova, Italy",
    "Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy",
    "Nuclear Medicine, AOU Maggiore Della Carità, Novara, Italy",
    "Nuclear Medicine Unit, Humanitas Istituto Clinico Catanese, Catania, Italy",
    "Nuclear Medicine Division, Department of Medical Sciences, AOU Città Della Salute E Della Scienza Di Torino, University of Turin, Turin, Italy",
    "Department of Nuclear Medicine, University Aldo Moro, Bari, Italy",
    "Department of Nuclear Medicine, Azienda Ospedaliero-Universitaria SS. Antonio E Biagio E Cesare Arrigo, Alessandria, Italy",
    "Unit of Nuclear Medicine and Molecular Imaging, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy",
    "Nuclear Medicine Unit, Giovanni Paolo II Hospital, Ragusa, Italy",
    "Nuclear Medicine Unit, Vito Fazzi Hospital, Lecce, Italy",
    "Unit of Nuclear Medicine. Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy",
    "Department of Nuclear Medicine, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Reggio Emilia, Italy",
    "Department of Nuclear Medicine, S.M. Della Misericordia Hospital, Rovigo, Italy",
    "Nuclear Medicine Unit, Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy",
    "Nuclear Medicine Unit, Department of Health Service, AORN Ospedali Dei Colli, Naples, Italy",
    "Nuclear Medicine Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy"
  ],
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      "name": "Alessio Annovazzi"
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      "name": "Alberto Miceli"
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      "name": "Pasquale Reccia"
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      "name": "Gianluca Cassarino"
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    {
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      "name": "Elisa Rizza"
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      "name": "Andrea Marongiu"
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      "name": "Annachiara Arnone"
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      "name": "Anna Margherita Maffione"
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      "name": "Salvatore Ialuna"
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      "name": "Nicola Frega"
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      "name": "Laura Evangelista"
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    {
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  "doi": "10.1007/s00259-026-08056-1",
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  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s00259-026-08056-1.pdf",
  "pmcid": "PMC13727922",
  "pmid": "42606562",
  "published": "2026-08-17",
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  "title": "Prognostic relevance of [18F]FDG PET/CT in triple-negative breast cancer: Results from the triple negative (TRINE)-PET trial",
  "title_text": "Prognostic relevance of [18F]FDG PET/CT in triple-negative breast cancer: Results from the triple negative (TRINE)-PET trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:01Z",
  "url": "https://research.draconitic.com/paper/790ysete3prqv",
  "venue": "European Journal of Nuclear Medicine and Molecular Imaging",
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