FIGURE 3.

Sixty-seven-year-old male with stage IV non-small cell lung cancer. Top row: 3D maximum intensity projection (MIP) FDG-PET images obtained at baseline (left); after 4 months treatment with pemetrexed and bevacizumab (middle); and 9 months after the baseline scan, switched to second-line docetaxel therapy due to progression on interim scans (right). Arrowheadspoint to an FDG-avid osseous metastasis in the left ilium that initially disappears in response to treatment but then recurs. Middle row: corresponding CT (left) and PET (right) images of a single transaxial plane through the pelvis, showing the lesion of the left ilium on CT that showed no FDG-avidity after 4 months treatment with pemetrexed and bevacizumab, suggesting a treated disease (arrowheads). Bottom row: the subsequent scan, 9 months after baseline, showed no change in the CT appearance of the left iliac bone lesion, but the lesion now demonstrates intense FDG uptake, consistent with a viable/recurrent metastasis.