Pinhole scanning in tumors and tumorous conditions of bone: A new imaging approach to skeletal oncology

Abstract

Tumors and tumorous conditions of bone are one of the most important and diagnostically challenging diseases, and their primary imaging diagnostic means is radiography. As the clinical situation dictates radiography may be supplemented with conventional X-ray tomography, computed tomography (CT) scan, and magnetic resonance (MR) imaging. Bone scan is another important adjunct whose usefulness and exquisite sensitivity are well established. Recently, the use of pinhole bone scan (PBS) has been extended in the imaging of virtually the entire spectrum of bone diseases, including tumors and tumorous conditions, proving its tremendous value. Thus, the extended application of PBS now permits: (1)Anatomical andchemical profile study of bone tumors; (2) evaluation of involutional changes in benign bone tumors and some tumorous conditions; (3) delineation of individual lesions in polyostotic diseases, such as fibrous dysplasia, enchondromatosis, multiple exostosis, osteopetrosis, and others; (4) detection of occult metastasis and osteoid osteoma nidus; (5) portrayal of intramedullary skip metastasis in osteosarcoma and conventional giant cell tumor; (6) assessment of tumor extent and watershed phenomenon; (7) and clarification of unexplained bone pain and altered serum phosphates. It appears that PBS is an economical, practicable, potent solution to the dilemma of not only the low specificity but also the relatively low sensitivity of the conventional planar scan and even single photon emission computed tomography (SPECT) is the diagnosis of bone tumors and tumorous conditions.