Hot Liver Sign: An Indicator of a Grave Prognosis

Abstract

A 70-year-old woman with right breast cancer underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for staging. Maximum intensity projection (Picture 1A), selected transaxial CT image (Picture 1B), corresponding PET image (Picture 1C) and the PET/CT image (Picture 1D) demonstrated an extremely "hot" liver with diffusely increased intensity throughout the parenchyma. Low physiologic activities were noticed in the brain, heart, kidneys, bowel, urinary bladder, and soft tissues. These unique metabolic findings represented an imaging pattern of "hot liver sign" which is the earliest indicator of acute liver failure with poor survival due to extensive he-