Skeletal Metastasis. A. A conventional radiograph shows osteoblastic deposition within the vertebral bodies of this 62 year old man with metastasis from prostate carcinoma (arrow). B. A sagittal CT image in another patient reveals extensive osteoblastic involvement throughout the lumbar and thoracic spine in addition to aortic atherosclerosis. C. A nuclear medicine planar bone scan in another patient with prostate carcinoma shows multiple areas of increased uptake within the bones of the axial skeleton. Bone scans are the most widely used primary imaging examination for detecting osseous metastasis. Because bone scans are non-specific, areas of abnormality should be followed up with radiographs, CT or MRI to specifically confirm the pathology. D. In another patient with colorectal carcinoma, a FDG-PET, fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography fused with CT shows intense uptake at the site of primary bowel carcinoma (black arrow) as well as several sites of osseous metastasis in the left acetabulum, right clavicle, and L4 vertebral body (white arrows). (Images courtesy of Lindsay J. Rowe, Newcastle, Australia).