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To the Editor.—
Bone scanning with use of technetium Tc 99m etidronate (formerly diphosphonate) has achieved widespread acceptance as a method for detecting metastasis in the face of negative roentgenograms. Recently, in an article entitled "Screening for Bone Metastasis: Are Only Scans Necessary?" by D. A. Pistenma et al (231:46, 1975), bone scanning of patients with proved primary carcinoma is advocated as the primary approach to the metastatic survey. A similar conclusion is drawn in an article entitled "Bone Scanning in Osseous Metastatic Diseases" by Robert O'Mara, MD (229:1915, 1974). Obviously, no test is perfect and a small percentage of patients with roentgenographically demonstrable metastases will have a normal-appearing scan.We believe the study is overused, and recently ran a prospective bone scintigraphic study in an effort to correlate bone scan findings with clinical symptoms of pain and the ability to elicit pain on physical examination by the physician in
Tiegs JR, Mishkin FS. Bone Scanning in Screening for Metastatic Disease. JAMA. 1977;237(7):644. doi:10.1001/jama.1977.03270340030013
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