Bone Scan

The bone scan (Table 10.4) has had a long-standing role for evaluating the entire skeleton for metastatic NB (Shulkin et al. 1992). In addition, many primary NBs also accumulate Tc-99m MDP because of their calcifications. The depiction of osseous lesions depends on the reaction of bone to the presence of tumor within bone. The bone scan provides a major diagnostic advantage over skeletal surveys in the assessment of bony NB lesions. Considerable attention to scan technique and positioning is critical to distinguish normal metaphyseal uptake from NB involvement, particularly when these lesions are symmetrical. Since NB frequently localizes in the metaphyseal region adjacent to the epiphyseal plates, sites of normally increased uptake of bone seeking tracers, metastatic involvement may be difficult to appreciate in these areas of normal high physiological accumulation.

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