Figure 5.

A 64-year-old female patient with a diagnosis of breast cancer, undergoing hormone therapy and with a complaint of bone pain.

Notes: Bone scintigraphy (A) shows increased uptake of technetium-99m in some vertebral bodies and in a left costal arch, which was suspicious for metastatic disease, as well as increased uptake in left femoral condyles, probably due to gonarthrosis. Whole-body MR performed at the same time shows secondary cancer diffusely distributed in the vertebral column in sagittal T1 and STIR sequences (B and C), more clearly defined than those shown on scintigraphy, as well as metastatic focus in the right ilium, which is observed in diffusion-weighted sequence (b800) in inverted grayscale in the axial plane (D) and was not detected by scintigraphy. Multiple hepatic metastases in the same diffusion-weighted sequence (E) are also observed.

Abbreviations: MR, magnetic resonance; STIR, short-tau inversion-recovery.