A patient demonstrating rapid progression. 59 y.o. male with thoracic vertebral metastasis. CT images at (A) pretreatment state and (B) post-treatment state, PET images at (C) pretreatment state and (D) post-treatment state, fused PET/CT images at (E) pretreatment state and (F) post-treatment state. The CT images showed that the metastatic lesion had homogeneous contrast enhancement at pretreatment status and the enhancement was attenuated apparently in post-sorafenib treatment. The SUVmax decreased only 5%. He died on day 88.