Measurement of SUVmax, MTV, and TLG in reference lesions. Transaxial (A), coronal (B), and sagittal (C) hybrid FDG PET/CT images of a reference bone metastasis. A region of interest (ROI) was drawn for each reference lesion (green boxes) and checked for correct positioning in all three axial planes. The voxel with the greatest FDG avidity was marked (green dots) to confirm that this voxel was originating within the ROI. SUVmax, MTV, and TLG were then obtained using GE AW Suite software. Biopsy demonstrated an osseous metastasis in this representative case. SUVmax, maximum standardized uptake value; MTV, metabolic tumor volume; TLG, total lesion glycolysis; FDG PET/CT, fluorodeoxyglucose positron emission tomography/computed tomography.