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18F-Misonidazole PET-CT scan detection of occult bone metastasis
  1. Daniel R McGowan1,2,
  2. Ruth E Macpherson3,
  3. Kevin M Bradley3,
  4. John D Fenwick1,
  5. Fergus V Gleeson1,3,
  6. Geoff S Higgins1
  1. 1Department of Oncology, University of Oxford, Oxford, UK
  2. 2Radiation Physics and Protection, Oxford University Hospitals NHS Trust, Oxford, UK
  3. 3Department of Radiology, Oxford University Hospitals NHS Trust, Oxford, UK
  1. Correspondence to Daniel R McGowan, Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; daniel.mcgowan{at}

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A 67-year-old man with locally advanced non-small cell lung cancer entered a phase I trial combining a novel phosphoinositide 3-kinase inhibitor (BKM120) with palliative radiotherapy.1 The trial uses 18F-misonidazole (FMISO) positron emission tomography (PET)-CT imaging to assess any changes in tumour hypoxia. FMISO is a tracer currently only used in the research setting.

A pretreatment FMISO PET-CT scan identified an occult, asymptomatic scapular metastasis (figure 1) undetectable on routine CT imaging (figure 2A). This was subsequently confirmed …

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