Bone Scanning in Osseous Metastatic Disease

THE detection of metastatic disease to bone is critical in the management of patients with cancer. Bone involvement by carcinoma is a fairly common postmortem finding, exceeded in frequency only by metastases to lymph nodes, lungs, and liver.¹,²The incidence of osseous metastases has been reported to be as high as 70% in some series of autopsies. This variance in reported incidence appears to depend on the thoroughness of the examination.³In the tumors that commonly metastasize to bone (breast, prostate, thyroid, lung, and kidney), incidence of secondary bone involvement at the time of death may range from 50% to 85%.⁴,⁵Both isotope and roentgenographic skeletal surveys are currently being used as means of achieving this detection. Scan vs Roentgenogram: Physiological Bases of Visualization There is general agreement that roentgenographic evidence of secondary malignant deposits in bone frequently appears late in the clinical course. While replacement of