Intrapatient heterogeneity of [89Zr]trastuzumab uptake in a 64-year-old woman with metastatic estrogen-receptor-positive/HER2-positive breast cancer. She had received 10 prior regimens for metastatic disease. Axial CT (left top, soft tissue window), axial fused [89Zr]trastuzumab-CT (left lower), axial CT (middle top, lung window), axial fused [89Zr]trastuzumab-CT (middle lower), and anterior reprojection MIP image (right) demonstrate increased [89Zr]trastuzumab uptake (white arrow) within the hepatic lesions without increased uptake (black arrow) within the pulmonary metastases. These images were obtained 7 days after injection of [89Zr]trastuzumab.