Two cases are reviewed in whom a positive bone scan led to a diagnosis of metastatic bone disease and hospice referral. One of these was subsequently shown on magnetic resonance image (MRI) scanning to have benign metabolic bone disease; in the other, a repeat bone scan 18 months later confirmed benign pathology.
The potential impact on patient and family in these situations is considerable and the usefulness of MRI in distinguishing benign from malignant bone disease is discussed.
Citrin DL, Bessent RG, Greig WRA comparison of the sensitivity and accuracy of the 99 Tcphosphate bone scan and skeletal radiology in the diagnosis of bone metastases. Clin Radiol1977; 28: 107.
2.
Aitchison F. , Poon FW, Hadley D. et al. Vertebral metastases and an equivocal bone scan: value of magnetic resonance imaging scan - value of MRI. Nucl Med Commun1992; 13: 429-31.
3.
Daffner RH, Lupetin AR, Dash N. et al. MRI in the detection of malignant infiltration of bone marrow. Am J Rheumatol1986; 146: 353.
4.
Fujii Y., Higashi Y., Owada F. et al. Magnetic resonance imaging for the diagnosis of prostate cancer metastatic to bone. Br J Urol1995; 75: 54-58.
5.
Brown B., Laorr A., Greenspan A. et al. Negative bone scintigraphy with diffuse osteoblastic breast carcinoma metastases. Clin Nucl Med1994; 19(3): 194-96.
6.
Algra PR, Bloem JL, Tissing H. et al. Detection of vertebral metastases: comparison between MR imaging and bone scintigraphy. Radiographics1991; 11: 219-32.
7.
Turner JW, Hawes DR, Williams RDMagnetic resonance imaging for detection of prostate cancer metastatic to bone. J Urol1993; 149: 1482-84.
8.
Dodwell D., Howell A.Treating bony metastases. Br Med J1991; 303: 429-30.
