Screening for bone metastases. Are only scans necessary?
I. R. McDougall and J. P. Kriss
The results of total skeletal scintigraphy with technetium 99m-labeled
diphosphonate in 200 patients with biopsy-proven primary cancer
demonstrated abnormalities in 114; 57 had normal roentgenograms. In 32 of
the 57 patients, the abnormalities were ascribed to malignant lesions. This
is a false-negative rate of 17% for the roentgenographic examinations. Only
three patients had abnormal roentgenograms but normal scans, a yield of
1.6% false-negative scans. In a comparison of scan and roentgenographic
findings with the skeleton divided into 12 regions, 119 of 160
abnormalities seen on scans but not on roentgenograms were attributed to
tumor. Only five of 17 regions that were abnormal on roentgenogram but not
on scans were unexplained false-negative findings. Thus, on a regional
basis, the yields of false-negative roentgenograms and scans were 9.1% and
0.4%, respectively.
