© 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc. 18F-FDG PET/CT is a valuable noninvasive tool in oncologic imaging, and its application in the diagnosis of liver metastases has been very convincing. Both the sensitivity and the specificity of 18F-FDG PET/CT are high for detecting liver metastases from various tumors including colorectal, breast, and lung. Such liver metastases are typically 18F-FDG-avid. We present atypical 18F-FDG PET findings in a lung cancer patient with known liver metastases and PVT.