Intense FDG uptake by bone marrow following recent chemotherapy limits evaluation for osseous metastases. The impact of marrow rebound on accuracy of 18F-fluoride PET/CT is unclear. A 73-year-old woman with breast cancer presented for restaging FDG PET/CT, which showed intense activity throughout almost the entire axial skeleton and no osseous metastases. An 18F-fluoride PET/CT performed 7 days later identified multiple osseous metastases in the spine, ribs, and pelvis. This case demonstrates that 18F-fluoride PET/CT should be considered for the evaluation of osseous metastases in patients with rebound marrow uptake on FDG PET/CT.
From the Department of Medical Imaging, The University of Arizona Medical Center, Tucson, AZ.
Received for publication February 7, 2013; revision accepted April 8, 2013.
Conflicts of interest and sources of funding: none declared.
Reprints: Phillip H. Kuo, MD, PhD, Department of Medical Imaging, University of Arizona, 1501 N. Campbell Avenue, PO Box 245067, Tucson, AZ 85724-5067. E-mail: firstname.lastname@example.org.