PMC5317078_01
(a) The initial FDG-PET/CT images after interferon-alpha therapy showed FDG-positive tumor recurrence in the left axilla, a soft tissue metastasis lateral of the left upper arm (SUV 4.1, SUVmax 6.8), and bone filiaeindens axis (A1, SUV 3.9, SUVmax 7.1). (b) The images 1 month later were made before radiotherapy (RTx) of the bone metastasis. Fused PET/CT indicated a significant osseous metastatic spread in C2 (SUVmax 11.2), C3 (b1) and os sacrum (SUV3.5). There was increased tracer uptake in a lymph node metastasis in the cervicothoracic junction (SUVmax 11.5) dextroventral and small lymph node metastasis is dextroinfracarinal (SUVmax 7.5). (c) The images 2 months after DTIC-therapy identified new bone filiae in the right acromion (SUV 5.4, SUVmax 14.1). Still malignancy typical uptake could be observed in os sacrum (SUV 3.4, SUVmax 5.8) and in the previously described lymph nodes dextrocervicolateral as well (SUV 4.9, SUVmax 11.1). There was a suspicious uptake sinistrocervical (SUV 3.2, SUVmax 4.3). (d) The last image is FDG-PET/CT after ipilimumab-therapy (IPI). There was no evidence of vital, FDG-positive tumor tissue. Thus, in comparison to the previous study, there was a significant improvement of the known osseous (d1) and lymphatic metastatic spread.
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F1