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FIGURE 2. Precise PET/CT localization of equivocal 18F-FDG uptake and diagnosis of previously unknown bone metastasis. A 78-y-old woman with a history of bronchoalveolar NSCLC was evaluated for increasing serum carcinoembryonic antigen levels and negative whole-body, high-resolution, contrast-enhanced CT performed 2 mo earlier. (A) 18F-FDG PET coronal images show focal areas of increased 18F-FDG uptake in pelvis (arrows). PET/CT (B, center) precisely localizes area of increased 18F-FDG uptake (B, right) in right pelvis to physiologic bowel activity and lesion in left pelvis to left iliac bone (arrows). A mixed, lytic, and sclerotic lesion is demonstrated on corresponding slice of CT component evaluated with bone window (B, right, arrow). Retrospective evaluation of previous CT study demonstrated this previously missed bone lesion. Local-field radiotherapy was instituted based on PET/CT diagnosis of single bone metastasis.
