Frequently Asked Questions (FAQs)

Are there any benign disorders that can give multiple areas of focal radiophosphate uptake on the bone scan and thereby simulate metastases?

It is always important to consider benign explanations before labelling a patient as having metastatic disease based upon scan appearance alone. Radiophosphate uptake accurately depicts the physiology of osteoblastic hyperactivity, but does not provide a specific pathologic diagnosis. Just as benign tumors, trauma, infection and a myriad of other causes can produce focally increased uptake, multiple occurrences of these lesions can incorrectly raise the specter of metastatic disease (Table 1). For example, Paget's disease of bone is often multifocal and can result in intense scan uptake, abnormal radiographs, elevated serum alkaline phosphatase and skeletal pain

Does bone scan worsening in a patient on treatment for skeletal Metastases indicate treatment failure?

Not necessarily. An increase in the number and intensity of metastatic lesions on follow-up bone scans in patients subjected to hormonal or chemotherapy treatment

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