Fig. 8
From: Systemic treatment in breast cancer: a primer for radiologists
61-year-old woman with breast cancer and osseous metastases being treated with capecitabine. a Pretreatment bone scan shows multifocal abnormal radiotracer uptake in calvarium, multiple thoracic and lumbar vertebrae, and bilateral iliac bones. Focal uptake in left 9th rib (arrowhead) corresponds to recent traumatic fracture. b Post-treatment bone scan after 2 months of therapy shows slight increase in the intensity and extent of radiotracer uptake in the multiple known metastases, uptake in calvarium, multiple thoracic, and lumbar vertebrae and bilateral iliac bones. Given the improvement in tumour markers, this finding was regarded as response to treatment with a scintigraphic flare phenomenon. Uptake in left 9th rib is decreased (arrowhead). c Post-treatment bone scan after 4 months of therapy shows interval decrease in the intensity and extent of radiotracer uptake in the multiple known metastases. Focal uptake in right 10th rib (arrow) corresponds to a new traumatic fracture