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. 2021 Dec 27;49(6):1857–1869. doi: 10.1007/s00259-021-05650-3

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 7 — A 54-year-old patient with metastatic BRAF wild-type melanoma who developed immune-related thyroiditis during treatment with immunotherapy with pembrolizumab. Serial ¹⁸F-FDG PET maximum intensity projections before starting and during ICI therapy are shown in (a). The baseline scan from the day 26 shows metastases in soft tissues and lung (both histologically proven). First follow-up scan (day 120) is indicating partial metabolic response in all metastatic lesions and increase in ¹⁸F-FDG uptake in the thyroid gland (SUV_75%=2.5 g/mL). On day 154, patient was diagnosed with irThyroiditis according to thyroid hormone laboratory results and endocrinologist’s examination. Next ¹⁸F-FDG PET/CT (day 246) shows a marked progression disease with new metastatic lesions in bones, liver, lung, right adrenal gland, and soft tissues with decreased ¹⁸F-FDG uptake in the thyroid gland (SUV_75%=1.7 g/mL). Coronal slices from day 120 are shown for CT (b), PET (c), and fused PET/CT (d). Increase in ¹⁸F-FDG uptake in the thyroid gland was seen on PET 34 days before clinical detection (e)