PET CT images were obtained using a PET CT system. Enzastaurin PKC inhibitor PET CT images were acquired from the top of the head to the mid thigh at 60 min after Inhibitors,Modulators,Libraries intravenous injection of 2. 5 MBq kg of FDG. A low dose non contrasted CT scan was acquired first and used for attenuation correction. Emission images were acquired in 3 dimensional mode for 2 min per bed position. After PET acquisition, CECT was performed with a 2 mm slice thickness, 120 kV, 400 mA, 0. 5 s tube rotation, from the top of the head to the mid thigh, with breath holding. A total of 100 ml contrast medium was administered intravenously at a rate of 1. 0 ml s. The scan delay was set at 120 s after starting the injection of contrast material. Images were reconstructed by attenuation weighted ordered subset expectation maximization.

The highest SUV in all RCC tumors of each patient was defined as SUVmax. To obtain the SUVmax, the SUV values of all lesions in tumors diagnosed as RCC by CT imaging were analyzed. Statistical analysis Survival time was calculated from the date of evaluation by 18F FDG PET CT to the date of death. Cox propor tional hazards model was used to assess the Inhibitors,Modulators,Libraries effects of SUVmax on survival. The cancer specific survival curve was estimated by the Kaplan Meier methods, and the resulting curves were compared Inhibitors,Modulators,Libraries using the log rank test. All statistical analyses were carried out with SPSS soft ware. Results Patient characteristics and intervention A total of 26 patients were enrolled in this study between 2008 Jun and 2009 Inhibitors,Modulators,Libraries October. The median age was 61 years. There were 17 patients with recurrent diseases and 9 with stage IV disease.

Pathological examination showed 18 cases of clear cell carcinoma, 5 of papillary, and 2 of clear sarcomatoid. in one case, the pathological type was unknown. As for prior surgeries, 19 patients had undergone nephrectomy and 4 metastatectomy. Thirteen patients had not undergone previous Inhibitors,Modulators,Libraries systematic therapies. Of the other 13 cases with previous systematic therapies, 9 patients had undergone interferon alpha, and 6 patients underwent cytokine therapies. At the follow up end, there were 9 cases with cancer death, and we confirmed the other 17 patients alive. There were no cases with death due to other causes and no cases dropped out during follow up. The median fol low up period was 262 days.

Accumulation of FDG in the lesions diagnosed as RCC tumor by CT imaging We first, examined the FDG accumulation in all 368 tumor lesions in 26 patients who were diagnosed as stage IV or metastatic RCC by CT imaging. FDG uptake was detected in 230 of 243 lesions excluding lung or liver metastasis with diameters less than 1 cm. On the other hand, among 125 lung or liver lesions with SB1518 diameters between 5 mm and 9 mm, FDG accumu lations were detected in only 21 lesions. The SUV in RCC lesions demonstrated various values from undetectable levels to 16. 6.