Evaluation of bone pain in carcinoma of the lung. Role of the localized false-negative scan

H. D. Covelli, A. J. Zaloznik and K. M. Shekitka

False-negative bone scans localized to the vertebral column were detected in ten patients with primary carcinoma of the lung. All patients had macroscopic vertebral metastases at autopsy despite recent normal technetium Tc 99m bone scans and skeletal roentgenograms. Bone scans were 96% accurate in detecting nonvertebral metastases that were grossly visible at postmortem, with seven patients demonstrating multiple skeletal defects. False-negative studies of the vertebral column apparently prevented both the clinician and radiotherapist from treating symptomatic metastases in eight patients despite the administration of radiotherapy to other scan-positive symptomatic areas or to the primary tumor site.