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Bone scan

Standard test for evaluating bone metastases.

Known as skeletal scinitigraphy utilizing various radionucleotides, including technetium-99m bound to methylene diphosponate.

The radionuclide bone scan uses a technetium-99 (99Tc)-labelled bone-seeking bisphosphonate with preferential uptake at sites of active bone formation that reflects the metabolic reaction of bone to any underlying disease process. 

 

When bone metastases develop there is usually sufficient reactive new bone formation to produce a focal increase in tracer uptake.

 

This tracer uptake occurs, often before bone destruction can be seen on radiographs. 

 

With the exception of patients with MM, the bone scan is more sensitive than plain radiographs for the detection of skeletal pathology.

More readily detects osteoblastic lesions than osteolytic lesions.

SPECT scanning uses the same radionucleotides as in bone scans but it uses specific tomography images and allows for improved anatomic localization.

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