The role of nuclear medicine in monitoring treatment in skeletal malignancy

The nuclear medicine bone scan has historically bean one of the most common investigations to stage and monitor skeletal malignancy. Current guideline s for using radiographs to assess the response of skeletal metastases to sy stemic therapy are limited in their ability to give a timely result. Despit e some minor limitations caused by the flare phenomenon, skeletal scintigra phy remains widely used for this purpose, both clinically and in trials of new cancer treatments. Nuclear medicine has also played an important role i n the posttherapy evaluation of primary bone tumors, both with bone agents end nonspecific tumor agents, such as (TI)-T-201, In the future, it is poss ible that positron emission tomography radiopharmaceuticals such as 18F-flu orodeoxyglucose may prove to he superior in predicting and measuring treatm ent response in primary and metastatic bone and bone marrow disease, but fu rther work is required in this area. Copyright (C) 2001 by W.B. Saunders Co mpany.