False Negative Bone Scans in Disseminated Metastatic Disease

Three patients had widespread skeletal metastases whose bone scans appeared to be normal. False negative scans were due to symmetrical increased radiopharmaceutical uptake in virtually all bones. Caution must be taken in the interpretation of bone scans in patients with malignant disease which tends to metastasize diffusely (e.g., from the breast, prostate and lung). False negative interpretations may be avoided by viewing at least one radiograph containing bone at the time the scan is interpreted, the most practical being the admission chest film.