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Bone Case 3 Answers

1) Are there any abnormal areas of uptake?
2) If so, where?

There are multiple areas of raised uptake throughout the axial skeleton and proximal long bones in keeping with widespread osseous metastatic disease. The bone metastases were very subtle and hence overlooked on the original staging CT some 1 month prior to this. Outcome for this patient is probably unchanged due to the widespread nature of the metastatic disease

3) What are the advantages of this technique over CT?

Osseous metastases can be difficult to appreciate on CT unless fine section cuts with bone windows are inspected closely. Bone scintigraphy is probably more sensitive for the detection of bone metastases as it covers the whole skeleton. Bone scintigraphy is not routinely indicated in staging lung cancer but the presence of bony metastases is a poor prognostic sign.

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The text is entirely the opinion of the author and does not necessarily reflect that of RUH NHS Trust or the Bristol Radiology Training Scheme. Website content devised by Paul McCoubrie.