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September 30, 1974

Bone Scanning in Osseous Metastatic Disease

Author Affiliations

From the Division of Nuclear Medicine, University of Arizona College of Medicine, Tucson.

JAMA. 1974;229(14):1915-1917. doi:10.1001/jama.1974.03230520057039

THE detection of metastatic disease to bone is critical in the management of patients with cancer. Bone involvement by carcinoma is a fairly common postmortem finding, exceeded in frequency only by metastases to lymph nodes, lungs, and liver.1,2 The incidence of osseous metastases has been reported to be as high as 70% in some series of autopsies. This variance in reported incidence appears to depend on the thoroughness of the examination.3 In the tumors that commonly metastasize to bone (breast, prostate, thyroid, lung, and kidney), incidence of secondary bone involvement at the time of death may range from 50% to 85%.4,5 Both isotope and roentgenographic skeletal surveys are currently being used as means of achieving this detection.

Scan vs Roentgenogram: Physiological Bases of Visualization  There is general agreement that roentgenographic evidence of secondary malignant deposits in bone frequently appears late in the clinical course. While replacement of