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FIGURE 4. 18F-FDG PET and companion 18F bone scan of metastatic disease of lumbar vertebrae. 18F bone scan, 18F-FDG PET scan, and CT study are from same patient taken separately in same week. (A) Coronal slice from 18F bone scan showing 2 distinct lesions in left portion of L2 vertebral body (arrow). (B) Identical slice from 18F-FDG PET scan faintly positive for more inferior area of L2 (arrow). (C and D) Transaxial and sagittal fused CT and 18F bone scans showing inferior lesion on transaxial slice and 2 lesions on reformatted sagittal slice through same area. (E and F) 18F-FDG PET fusion with same CT scan shows only inferior lesion in L2. Physiologic osteoblastic uptake in tumor may be severalfold greater with 18F than with 18F-FDG or 99mTc-MDP.
