THE YIELD OF BONE-SCINTIGRAPHY IN CANCER AND NONCANCER PATIENTS - ITSASSOCIATION WITH INDICATION AND CLARITY OP THE REFERRAL QUESTION

The yield of bone scintigraphy was assessed in a general hospital. A r andom 1:2 sample of the bone studies performed within a year was evalu ated. The referral forms were judged to show absent, ambiguous or clea r diagnostic questions. The indications for which the study was ordere d were matched with the scintigraphic diagnosis, and yield was defined as the proportion of studies with relevant findings on scintigraphy. The overall yield was 23.5%. In cancer patients the yield was 27.2% an d in repeat studies 40.2%. In non-cancer patients the yield was 19.8% and when scintigraphy was perfomed for the evaluation of specific dise ase entities it was 35.7%. Relatively low-yield indications in non-can cer patients were suspected metastases 11.1%, and evaluation of X-ray abnormalities 11.5%. An association between the clarity of the diagnos tic question and the scintigraphic yield was detected in non-cancer pa tients. When a diagnostic question was absent the yield was 12%, ambig uous 19%, and when it was clear 26%. This correlation is probably attr ibuted to better understanding of this common procedure, and better de finition of the diagnostic question in patients with diverse clinical conditions as compared to cancer patients in whom the question always relates to the presence of bone metastases.