Figure 4.

Clinical case of a patient with a previous history of treated left breast cancer and melanoma of the right leg with melanoma pulmonary metastasis recently operated. The images of the upper line show the PET/CT examination before the start of immune checkpoint inhibitor (pembrolizumab), and the images in the lower line show the PET/CT examination performed 9 months after the start of the treatment with (in A) a maximum intensity projection (MIP) PET image; in B, an axial CT slice; in C, an axial PET slice; in D, an axial PET/CT fused slice; in E, a frontal PET/CT fused slice. The green arrow on the pre-therapeutic PET MIP indicates the post-operative inflammation of melanoma pulmonary metastasis. The blue arrows on the follow-up PET/CT examination indicate that an intense left axillary lymph node uptake (SUVmax 4.7) appeared, which was considered suspicious of disease progression when it was found to be an inflammatory reactive lymph node in histological analysis.