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5 important advantages of bone scan in early detection of cancer metastasis
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5 important advantages of bone scan in early detection of cancer metastasis

3 weeks ago
385 بازدید
Dr. Shabnam Rafizadeh

Dr. Shabnam Rafizadeh

Tehran

Neurologist and spine specialist

90 / 100 SEO score

In many cases, cancer may spread secretly to the bones — a process known as bone metastasis. Early diagnosis of these metastases is very important, because it can change the treatment process, reduce complications and improve the patient's quality of life. One of the common and effective methods for examining bones in this field is Bone Scan (Bone Scan or Bone Scintigraphy).

In this article, we first briefly explain the concept and method of bone scan, then we discuss its five key advantages in early metastasis detection and We conclude with limitations, practical tips, and conclusions.

The concept and method of bone scanning

Bone scan (Bone Scintigraphy) is a nuclear medicine imaging method. In this method, a radioactive substance (usually technetium-99m — ^99mTc with bisphosphonate) is injected into the patient's vein. After circulating in the blood, this substance accumulates in bone areas with higher metabolism (such as bones that are involved in repair or changes). Then, with the gamma camera device, the gamma rays emitted from the body are recorded. By analyzing the distribution of these radiations, bone images are obtained that show points with excessive absorption ("hot spots").

This method is usually performed as a whole-body (Whole-body), so it provides the possibility of extensive skeletal examination.
In some cases, to improve accuracy, SPECT (single-photon emission tomography) method or combination with CT (SPECT/CT) is used to determine the exact location of the lesion in transverse bone structures.

of course scan 5 Advantages The importance of bone scan in early detection of cancer metastasis

What is a bone scan?

Why is early diagnosis of metastasis important?

Before getting into the benefits of bone scanning, it is necessary to understand why early detection of bone metastasis is important:

  1. More effective and targeted treatment: The earlier the bone metastasis is detected, the better the possibility of therapeutic intervention (such as local radiation therapy, anti-osteoporotic drugs such as bisulfonates or targeted therapy).
  2. Reduce severe skeletal complications: Bone metastases can cause severe pain, pathologic fractures (breaks in weakened bones), or pressure on the spinal cord. Before these complications appear, diagnosis can prevent them.
  3. More accurate decision-making in cancer staging: If the doctor knows that cancer cells have reached the bone, he can determine the stage of the cancer more accurately and the treatment plan may change (for example, using enhanced systemic therapy).
  4. Monitoring the course of the disease and response to treatment: When metastasis is diagnosed, a bone scan can help evaluate the response to treatment and detect the progression of the disease.

Given this importance, the advantages of bone scanning in the early diagnosis of metastasis are necessary to be thoroughly investigated.

5 important advantages of bone scanning in early detection of cancer metastasis

In the following, we discuss the five main advantages of bone scanning as a diagnostic method for the early detection of bone metastasis:

1. High sensitivity to identify metabolic bone lesions

One of the most prominent advantages of bone scanning is its high sensitivity in detecting metabolic changes in bone, before structural destruction becomes visible.

  • Primary metastases may cause changes in bone metabolism (increased oxygen consumption, increased blood circulation, changes in bone remodeling) that increase radiopharmaceutical absorption in that area. This means that the bone scan can see the lesion before obvious structural changes in traditional radiology images (such as plain radiography).
  • Some studies have reported that bone scans can show lesions up to 6 months earlier than plain radiography.
  • Compared to plain CT and radiography, bone scanning provides extensive skeletal coverage with better sensitivity (especially in target areas such as the pelvis or pelvis).
  • For example, in prostate cancer, which is one of the most common cancers that metastasizes to bone, bone scintigraphy is recognized as the standard screening method for bone metastasis due to its good sensitivity and reasonable cost.

Therefore, high sensitivity as the first advantage allows the detection of bone metastasis in the early stages.

2. Whole-body coverage

Another very important advantage of bone scan is that it allows for the examination of the whole skeleton of the body.

  • By performing a whole-body bone scan, all skeletal bones from head to toe can be examined and suspicious points can be identified in one session. This feature is very important, because metastasis may appear in bones that the doctor did not pay attention to.
  • In contrast, some other methods such as local CT (e.g. spine, pelvis or ribs) show only a limited area and may miss distant lesions.
  • Also, coverage of the entire skeleton in one scan saves time and money, as the need for multiple local or repeated imaging is reduced.

Therefore, the second advantage is access to a general and comprehensive overview of the patient's bone status.

3. Affordable and relatively high availability

One of the key factors in choosing a diagnostic method is its cost and availability. Bone scanning is applicable in many diagnostic centers and its cost is usually lower than more advanced methods such as PET-CT or whole body MRI.

  • It has been mentioned in numerous studies that bone scanning is widely used due to its lower cost and less required infrastructure than some newer methods.
  • In some countries or medical centers where advanced equipment such as PET with special radiopharmaceuticals is not available, bone scan is a practical and effective option.
  • For metastases screening (i.e. initial investigation), this method is often more cost-effective than using expensive methods from the beginning.

The third advantage, i.e. affordability and acceptable access, makes bone scanning a cost-effective option for patients and medical centers.

4. The possibility of monitoring the course of the disease and response to treatment

After the diagnosis of bone metastasis, one of the important needs is to follow up the patient's condition and check the treatment effect. In this context, bone scan plays an important role.

  • By performing bone scans at regular intervals, it is possible to observe changes in radiopharmaceutical absorption (decrease or increase in "hot spots") and evaluate the treatment outcome (such as reduction of metastasis activity or its progression).
  • This monitoring can help the doctor decide to continue the current treatment, change the drug dose or add a new treatment method.
  • In some studies, bone scans have been used as a measure of response to treatment, although it should be noted that sometimes there is a "flare phenomenon"—that is, after treatment begins, bone activity temporarily increases, which may be mistaken for disease progression.
  • Combining bone scan with comparing time series and examining quantitative changes can play a strategic role in treatment management.

So the fourth advantage is the ability to monitor the process and evaluate the response to treatment.

5. The ability to combine with complementary imaging methods and increase the accuracy of diagnosis

A fifth advantage relates to the association and combination of bone scanning with other imaging methods — that is, additional use for confirming or pinpointing the precise location of lesions.

  • When the bone scan shows suspicious points, local imaging methods such as CT, MRI, or PET can be used to confirm the presence of metastasis and to accurately determine its shape and size.
  • Especially if the bone scan has inconclusive or "false-positive" results, additional methods help to improve the interpretation of the results.
  • Combining a bone scan with SPECT/CT allows a lesion showing radiopharmaceutical uptake to be localized to more precise bony structures (eg, whether the lesion is cortical or intraosseous).
  • In more advanced molecular imaging (eg, bone PET with special tracers), a bone scan can also be used as an initial screening method, revealing larger or more solid lesions.
  • In fact, the combination of methods increases the sensitivity and specificity of the diagnosis of the whole collection.

Then the fifth advantage is the ability to combine with other methods to increase accuracy and resolution.

In this way, the five important advantages of bone scanning in the early detection of metastasis are:

AdvantageShort description
High sensitivityDetection of metabolic lesions before structural changes
Total coverage SkeletalPossibility of examining all bones in one scan
Effordable and accessibleLower cost compared to more advanced methods
Monitoring the disease processEvaluating the effect of treatment and disease progress
Combining with methods ComplementaryConfirmation and accurate localization of lesions with the help of other imaging methods
scan Bone
Bone scan at Vistan Clinic

Where is the best bone scan clinic in Tehran?

If I want to introduce an outstanding option among the best bone scan (bone density) clinics in Tehran, Vistan Clinic in Saadat Abad, Tehran is one of the reliable and distinguished choices. In this clinic specialist and subspecialist doctors are ready to provide services.

Address: Saadat Abad Center: Saadat Abad, northwest side of Saro Road (intersection of Paknejad and Saro) - next to Dasht Behesht Complex

Contact number: 09939198680whatsapp

Why Vistan is a strong choice for bone scanning?

Up-to-date and standard equipment
Vistan has offered "Bone Densitometry (DEXA)" services as part of its specialized services.
Precise and calibrated devices, experienced technicians and standard protocol, make the results reliable.

Comprehensive Specialty Medical Coverage
Wistan is not just a bone densitology clinic - it also includes several specialty areas such as radiology, nuclear imaging, gastroenterology, neurology, and physical medicine.
This means that if you need a side examination such as treating osteoporosis, consulting an internist or examining bone nutrition, everything is available in one place.

Expert and multidisciplinary team
In Vistan, internal doctors, radiologists, imaging technicians and support team, each of them work in their field of expertise so that the bone scan process from the beginning to the final interpretation is done in the best way.

Ease of access and modern environment
The location in Saadat Abad, close to the northwest areas of Tehran, provides the possibility of easy access by private or public vehicles.
Clinic space, reception equipment, waiting room and benefiting from health and relaxing standards are other features of Vistan (according to its website images).

Post-scan support and advice
Getting your BMD number is only part of the job — more important is expert advice based on the results, including advice on nutrition, exercise, medication or follow-up care. As a multispecialty clinic, Vistan provides this support

Points you should know before visiting

  • Before performing bone densification, be sure to call the clinic and ask about the preparation conditions (for example, avoiding calcium supplements a few hours before or fasting if needed).
  • Make sure the device used is DEXA or equivalent (the gold standard for bone density).
  • Ask your insurance or medical coverage whether Vistan Clinic is under contract or not.
  • Request a detailed interpretation of the results in writing or with an explanation by the doctor that you can use in your treatment plan.

Comparison table of bone scan against other methods

AspectBone scanMRIPET/CT
Sensitivity to primary metabolic lesionsHighModerate to high (especially MRI) whole body)very high (depending on tracer)
total skeletal coverageyes (whole body)possible on whole body MRI, but usually cross-sectionalyes (if full scan)
costusually LowerHigher (especially whole-body MRI)Higher (tracer, PET device, maintenance cost)
Imaging timeUsually 2-4 hours (with drug absorption period)Depending on region and protocol – may be longerShorter than MRI, but tracer preparation Time consuming
Possibility of structural combination / accurate localizationLimited (overview)Great for soft tissue and structureGreat for metabolism + structure (in combined PET/CT)
Suitable for periodic monitoringYesUsually yes, but cost and time HigherYes, but the higher cost may have limitations

Overview. A bone scan is a test that uses nuclear imaging to help diagnose and track several types of bone disease. Nuclear imaging involves using small amounts of radioactive substances, called radioactive tracers, a special camera that can detect the radioactivity and a computer.


A bone scan is a test that uses nuclear imaging to help diagnose and track different types of bone diseases. Nuclear imaging involves the use of small amounts of radioactive material, called radioactive tracers, a special camera that can detect the radioactivity, and a computer.

Quoted from the site: mayoclinic.org

Practical tips and challenges

Although bone scanning has many advantages, practical points and limitations should also be considered:

Limitations and Precautions

  1. Lower specificity and pseudo-positive results
    Bone scan has good sensitivity, but its specificity is lower; This means that other bone processes (such as infection, inflammation, fracture, repair, or non-tumor bone diseases) can also show increased uptake and cause false positives.
    Therefore, if suspicious areas are observed, additional imaging is often required.
  2. Flare phenomenon
    After starting effective treatment (for example, anti-osteoporosis treatment), a temporary increase in absorption may be seen in bone lesions, which apparently indicates disease progression, but actually indicates a therapeutic response. This can complicate the interpretation of results.
  3. Points of very small lesions or within the bone marrow
    Very small lesions or lesions that have not yet caused a detectable metabolic change may not be visible on a bone scan. In contrast, MRI, with its high sensitivity to changes within the bone marrow, can show lesions that a bone scan misses.
  4. Radiation and Radioactivity Issues
    Although the radiation dose received in a bone scan is usually within the range considered safe, repeated use or in sensitive patients should be done with caution.
  5. need to coordinate with other methods for complete interpretation
    Sometimes bone scan only provides a preliminary indication and for the final decision, methods such as CT, MRI or PET are needed to determine the exact location, nature and severity of the lesion.

Suggested tips for the effective use of bone scanning

  • Choosing the right time: It is better to perform a bone scan when the patient is in a stable condition, for example, before starting heavy treatments or a period that may cause temporary metabolic changes.
  • Interpretation by an experienced nuclear radiologist: interpretation of bone scans requires expertise, especially in differentiating metastatic lesions from non-tumorous lesions.
  • Comparison with previous images: Using previous scans to match locations and time changes is very helpful.
  • Combined use: if the results are doubtful, combination with other methods (eg SPECT/CT or MRI) is recommended.
  • Attention to the patient's clinic: the bone scan finding should be interpreted in the context of the patient's clinical condition (symptoms, tests, other imaging).

Practical example (hypothetical case study)

To clarify the use of bone scan and its benefits, we will examine a hypothetical example of a patient:

Patient: a 55-year-old woman with a history of breast cancer under treatment
New symptoms: Mild pain in the pelvic bone at night
Doctor's decision: Check for bone metastasis with a bone scan

Diagnosis process and revealed benefits

  1. Performance of whole-body bone scan
    After technetium-99M injection and proper waiting, whole-body images were prepared with a gamma camera.
    Result: several small areas with excessive uptake were seen in the hip bone and ribs.
  2. Early lesion detection
    These lesions were relatively small and not yet visible on plain radiographic images—an advantage of the high sensitivity of bone scans.
  3. Coverage of whole bones
    In this same scan, damage was also seen to several ribs that would likely have been missed if only the pelvic region had been examined—the advantage of complete coverage.
  4. Affordability
    The cost of bone scan is affordable for the patient and it is possible to perform it in many centers, while whole body MRI or PET may require more cost, time and facilities.
  5. Confirmation with complementary methods
    To confirm the findings, the patient underwent pelvic MRI and SPECT/CT and the lesions were confirmed; This combination of methods increased the confidence of the diagnosis — an advantage of combining methods.
  6. Monitoring During Treatment
    After initiation of anti-bone therapy and targeted drugs, bone scans were repeated at regular intervals (eg, every 6 months) to check for decreased or increased resorption in lesion areas (advantage of trend monitoring). In one of the courses, we saw a small "flare effect", which was seen as a positive answer according to the patient's condition and the results before and after.

Such an example shows how the five advantages of bone scanning can be applied in a real case.

Detection Process and revealed benefits
Bone scan

FAQ

What is a bone scan?

It is an imaging method with radioactive material to check bone health and metastasis.

Does a bone scan hurt?

No, only the initial injection may have a slight burning sensation.

Is it dangerous?

No, the dose of radiation is very low and harmless.

How long does it take?

About 2 to 4 hours (with drug absorption and imaging time).

Does it need to be fasted?

No, you just need to drink plenty of fluids and wear metal-free clothing.

Who needs it?

Patients suspected of metastasis, infection, hidden fracture or bone disease.

Can pregnant women do?

No, except in special circumstances and with the doctor's opinion.

What is a bone scan?

Summary

In this article, we reviewed 5 important advantages of bone scan in early detection of cancer metastasis:

  1. High sensitivity to identify metabolic lesions before structural changes
  2. Full skeletal coverage in one scan
  3. Cost-effectiveness and better accessibility than more advanced methods
  4. Ability to monitor disease process and evaluate response to treatment
  5. Possibility of combining with other imaging methods to confirm and accurately determine lesions

Also, we examined the limitations, practical tips, practical examples and ethical challenges. In general, bone scan is a powerful and useful method in the diagnosis of bone metastasis, especially in the early stages, but it should always be used with careful interpretation, combining with other methods and following clinical considerations.

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