Visualization of Lymph Nodal and Hepatic Metastases of Medullary Thyroid Carcinoma on 18 F-Fluoride PET/CT Rômulo Hermeto Bueno do Vale, MD, José Flávio Gomes Marin, MD, Paulo Schiavom Duarte, MD, PhD, Marcelo Tatit Sapienza, MD, PhD, and Carlos Alberto Buchpiguel, MD, PhD Abstract: 18 F-fluoride uptake in soft tissue metastases has been previously described. Herein, we report a case of 18 F-fluoride uptake in lymph nodal and hepatic metastases of medullary thyroid carcinoma. Simultaneous CT showed calcified lesions in these regions. Key Words: medullary thyroid carcinoma, lymph node, liver, fluoride, 18 F, PET/CT (Clin Nucl Med 2015;40: 895–896) REFERENCES 1. Shen CT, Qiu ZL, Han TT, et al. Performance of 18 F-fluoride PET or PET/CT for the detection of bone metastases: a meta-analysis. Clin Nucl Med. 2015; 40:103–110. 2. Ali I, Johns W, Gupta SM, et al. Visualization of hepatic metastases of medullary thyroid carcinoma on Tc-99m MDP bone scintigraphy. Clin Nucl Med. 2006;31:611–613. 3. Tokuue K, Furuse M, et al. Usefulness of the 99m Tc-MDP scan in the detection of calcified liver metastases. Nuklearmedizin. 1990;29:231–233. 4. Peller PJ, Ho VB, Kransdorf MJ, et al. Extraosseous Tc-99m MDP uptake: a pathophysiologic approach. Radiographics. 1993;13:715–734. 5. Zuckier LS, Martineau P. Altered biodistribution of radiopharmaceuticals used in bone scintigraphy. Semin Nucl Med. 2015;45:81–96. 6. Agrawal K, Bhattacharya A, Harisankar CN, et al. F-18 fluoride uptake in cal- cified extraosseous metastases from ovarian papillary serous adenocarcinoma. Clin Nucl Med. 2012;37:22–23. 7. Li Y, Tafti BA, Shaba W, et al. Extraosseus uptake of F-18 fluoride in the primary malignancy and cerebral metastasis in a case of non-small-cell lung cancer. Clin Nucl Med. 2011;36:609–611. 8. Zacchi SR, Duarte PS, Coura Filho GB, et al. Incidental finding of anterior cranial fossa meningioma on 18 F-fluoride PET/CT. Clin Nucl Med. 2013;38: 913–915. 9. Cai L, Chen Y, Huang Z, et al. Incidental detection of solitary hepatic metastasis by 99m Tc-MDP and 18 F-NaF PET/CT in a patient with osteosar- coma of the tibia. Clin Nucl Med. 2015;40:759–761. Received for publication February 9, 2015; revision accepted June 13, 2015. From the Division of Nuclear Medicine, São Paulo State Cancer Institute, São Paulo, Brazil. Conflicts of interest and sources of funding: none declared. Correspondence to: Rômulo Hermeto Bueno do Vale, MD, Division of Nuclear Medicine, São Paulo Cancer Institute, (4-SS) Doutor Arnaldo Ave, Number 251, Consolação, São Paulo, Brazil 01.246-000. E-mail: romulohermeto@hotmail.com. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0363-9762/15/4011–0895 DOI: 10.1097/RLU.0000000000000939 INTERESTING IMAGE Clinical Nuclear Medicine • Volume 40, Number 11, November 2015 www.nuclearmed.com 895 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.