Figure 5c. Solitary metastatic lesion in a 52-year-old woman with lower back pain. (a, b) Sagittal (a) and transverse (b) SPECT images show involvement of the vertebral body (v) with extension into the pedicle (p). (c, d) Transverse CT scan (c) and sagittal reconstructed image (d) show a mixed lytic and sclerotic lesion extending from the vertebral body (top two arrows in c, arrowheads in d) into the pedicle (lowest arrow in c, arrows in d).