(A) Na18F PET images (maximum-intensity projection).

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(A) Na18F PET images (maximum-intensity projection). (A) Na18F PET images (maximum-intensity projection). Examples of extensive and rapid progression after two cycles of radium-223 dichloride are shown for two patients. On the left, patient 17 had metastatic bone tumours at baseline (upper panel) and after two cycles (lower panel), with numerous boneand lung metastases (lower panel). On the right, patient 13 had metastatic lung tumours at baseline (upper panel) and rapid progression after two cycles (lower panel). (B) Na18F PET images in patient 9 after two cycles of radium-223 dichloride (left to right: fusion PET/CT image, CT image, PET image from across section of the brain and maximum-intensity projection of the whole body). New lesions can be observed in the occipital brain on the right, indicating progression. (C) Positron emission tomography 18F-FDG PET (upper row) and Na18F PET (lower row) images for patient are shown at baseline (images on the left and PET images from cross-sections of the thorax on the right). The tracer distributions in the lungs differed remarkably. 18F-FDG, fluorine-18-fluorodeoxyglucose; Na18F, sodium fluoride-18; PET, positron emission emission tomography. Kalevi Kairemo et al. ESMO Open 2019;4:e000439 Copyright © European Society for Medical Oncology. All rights reserved.