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May 3, 1976

Bone Scanning

Author Affiliations

Bronx, NY
Rochester, NY
San Francisco

JAMA. 1976;235(18):1965-1966. doi:10.1001/jama.1976.03260440021008

To the Editor.—  The recent article on the limitations of bone scanning in clinical oncology by Loeffler et al (234:1228, 1975) deserves comment. The authors illustrate three cases in which, they contend, the roentgenograms showed findings that were not apparent on the radionuclide studies.In case 1, a roentgenographically confirmed lytic lesion in the left ilium is described as being associated with normal scan findings in the same location. The area in question has less than the normal amount of uptake on scan—a distinct abnormality. Such "photon-deficient" lesions have been well described.1 The suggested mechanism is a compromised blood supply to the area. The asymmetry between the right and left ilium is seen clearly on the scan. No experienced observer would miss the lesion although it is true that on the basis of the scan finding, the side of the lesion could not be determined.In case 2, the