Best investigation for the detection of bone metastases

Best investigation for the detection of bone metastases is?

A. X-ray
B. CT Scan
C. MRI
D. Bone scan

Correct answer : D. Bone scan

Best investigation for the detection of bone metastases

  • Radioisotope bone scan is the preferred method for the detection of bone metastases
  • It is more sensitive than radiography for the detection of most metastases
  • Technetium-99m is the commonly used radioisotope
  • It accumulates in reactive new bone that is formed in the metastases resulting in a ‘hot spot‘ in the scan
  • The amount of accumulation depends on the level of blood flow
  • In some cases, ‘cold spots‘ are also noted due to the absence of bone formation within the lesion
  • The results from a bone scan are not specific as the tracer can accumulate in other areas with increased bone formation such as sites of fracture healing / infection
  • So a bone scan should be followed by other radiological modalities such as CT scan to confirm the lesion

Ref: Radiological imaging for the diagnosis of bone metastases, L. D. Rybak, D. I. Rosenthal, The Quarterly Journal of Nuclear Medicine and Molecular Imaging, 2001;45:53-64

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