PMC3928749_01
First bone scan performed on July 2010, showing bone metastases
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F1
Routine radiological and scintigraphic bone examination confirmed multifocal bone spread with a mixed osteolytic-osteosclerotic pattern [Figure 1].
First 18F-fluorodeoxyglucose positron emission tomography performed on 1st October 2010: Maximum intensity projection projection with some pathological uptakes in the sternum, ribs, both humeri and right femur
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F2
Numerous skeletal lesions were detected, with no metastases outside bones [Figure 2a]. Evident recalcification of bone lesions was seen on computed tomography (CT), while an increase of FDG uptake was clearly observable for almost all the bone lesions [Figures 2b, 3 and 4].
Second fluorodeoxyglucose positron emission tomography from 8 February 2013: Maximum intensity projection projection showing a marked increase of metabolism in sternal, humeral and costal lesions
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F3
Evident recalcification of bone lesions was seen on computed tomography (CT), while an increase of FDG uptake was clearly observable for almost all the bone lesions [Figures 2b, 3 and 4]. However, tumor/background ratios between physiological liver uptake and pathologic FDG accumulation displayed on Figures 3b (V right rib) and 4b (sternum) confirmed the visual impression of increased radiofarmaceutical uptake [Table 1].
Mixed osteolytic-osteosclerotyc lesion on VIII right rib at firs positron emission tomography-computed tomography examination (a) showing recalcification at second examination (b)
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F4
Evident recalcification of bone lesions was seen on computed tomography (CT), while an increase of FDG uptake was clearly observable for almost all the bone lesions [Figures 2b, 3 and 4].