Giglio hospital, Cefalù-Italy. FDG PET-CT Before surgical resection of primitive BC, all patients underwent FDG PET-CT studies. The patients were fasted for twelve hours before performing PET-CT scan, and were injected

intravenously with FDG (37MBq/10 kg). Patients with a blood glucose level greater than 150 mg/dl were not included in the study. The weight of each patient was measured the day of the PET-CT study. Actual injected and residual radioactivity were measured by the dose measurement system. PET-CT acquisition started 50 min after radiotracer injection and images were acquired from the top of the skull to the middle of the thigh with the arms raised. Whole-body PET-CT scans were obtained using a Discovery STE scanner (General Electric Medical Systems), installed at the Nuclear Medicine Department of LATO-HSR (Cefalù, Italy). The system is

a three-dimensional BGO 47 slice PET scanner combined with an helical 8 slice CT scanner. Cediranib The PET-CT oncological protocol included a low dose CT scan and a 3D PET whole body scan (2.5 min/bed position). Patients breathed normally during the PET and CT exams. PET images were reconstructed by a 3D ordered subset expectation maximization algorithm (OSEM, 28 subsets, 2 iterations, 5.14 mm Gaussian post-smoothing) with corrections Selleck HM781-36B for random, scatter and attenuation incorporated into the iterative process. Quantitative PET measurements Quantitative analysis was performed calculating, for each breast lesion, the maximum Standardized Uptake Value (SUVmax) and the mean SUV (SUVpvc) normalized to body-weight. Partial volume effect correction (PVC) was performed to compensate spill in (signal from background region that goes inside the lesion) and spill out (signal from the lesion that goes into background region) effects in the SUVpvc [36, 37]. Since the SUVmax is the uptake index least affected by partial

volume effect no correction was applied. Briefly, the PVC method is Carbohydrate based on recovery coefficient (RC) curves obtained from NEMA 2001 IQ phantom (equipped with six buy BYL719 spheres of different sizes – from 10 mm to 37 mm- to account for size effect) as a function of PET measured metabolic volume and of PET measured sphere-to-background ratio [38]. The metabolic volume was calculated as the 60% isocontour of the maximum pixel intensity automatically drawn on the PET lesion. The radioactivity concentration in the lesion was measured as the average radioactivity concentration within the metabolic volume. The background radioactivity concentration was obtained as the average of four circular ROIs positioned over the background around the lesion. To apply the PVC correction method, PET measured metabolic volumes and lesion-to-background ratios were considered within the following ranges of RC curves: measured diameters (derived from metabolic volume) from 0 to 4 cm and lesion-to-background ratios from 2 to 30.