Abstract
Interpretation of FDG PET images in oncology patients is in general a visual exercise of search for focal increased uptake (hypermetabolism). However, in some cases, hypometabolism (focal decreased uptake) can matter as much as hypermetabolism. We report three cases of FDG PET studies for oncological indications. All of them showed focal hypometabolic lesions suspicious of metastases. The diagnoses were then supported either by histological proof and/or follow-up imaging studies. The importance of being alert to both focal hypermetabolism and focal hypometabolism when interpreting FDG PET images is underscored.