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The primary intent of our article was to inform the clinician that false-negative scans do occur, possibly with an incidence greater than the often quoted figure of 3% to 5%. Explanation for this higher incidence of false-negativity was stated in our article; however, the most likely reason may relate to the use of the postmortem examination to identify metastases compared with using roentgenographic or needle biopsy determinations. Metastatic location may also be of considerable importance, since seven of our ten patients had abnormal bone scans in nonvertebral areas with 28 of 29 lesions being detected by scanning.Two of our patients did receive chemotherapy, although, as noted by Dr Gorten's references, the short-term effect of chemotherapy on the bone scan is at best poorly documented. However, unlike Dr Gorten, we think that systemic chemotherapy need not be "frequently included in the routine management of bronchogenic carcinoma," with small
Henry D. Covelli. False-Negative Bone Scans-Reply. JAMA. 1981;246(24):2808. doi:10.1001/jama.1981.03320240017012