DIAGNOSTIC BONE SCANNING IN ONCOLOGY

Over the last several decades bone scanning has been used extensively in the evaluation of oncology patients to detect bone involvement. It can provide information about disease location, prognosis, and the eff ect of therapy. Bone scanning offers the advantages of whole body eval uation and the detection of lesions earlier than other techniques. How ever, as newer diagnostic tools become available, indications for bone scanning must be revised and the results combined with these other te sts in order to provide optimum patient care. Advances in instrumentat ion and the subsequent improvement in image quality have allowed nucle ar medicine physicians to provide more accurate bone scan interpretati ons. By optimizing image acquisition, it is often possible to determin e lesion characteristics, which are more likely to represent malignanc y. Knowledge of disease pathophysiology and other specific properties of the patient's primary tumor, along with subsequent correlation of s can abnormalities to patient history, physical examination, previous s tudies, and other radiological examinations, is essential for determin ing lesion significance. The differential diagnosis of a scan abnormal ity should also include consideration of both false normal and abnorma l causes. The final interpretation should be clearly communicated to t he clinician with appropriate recommendations for further evaluation. Only through careful attention to the patient, the clinician, and appr opriate study acquisition parameters will bone scanning maintain its p lace in the evaluation of oncology patients. Copyright (C) 1997 by W.B . Saunders Company.